Small-quantity, lipid-based nutrient supplements provided to women during pregnancy and 6 mo postpartum and to their infants from 6 mo of age increase the mean attained length of 18-mo-old children in semi-urban Ghana: a randomized controlled trial

Randomized controlled trial in semi-urban Ghana among pregnant women enrolled at about 16 weeks' gestation and followed with their children through 18 months of age. In the SQ-LNS arm, 440 women were randomized in a three-arm trial conducted at antenatal clinics in the Yilo Krobo and Lower Manya Krobo districts near Accra.

The active regimen provided mothers 20-g daily small-quantity lipid-based nutrient supplement (SQ-LNS) sachets during pregnancy and the first 6 months postpartum. Their infants then received SQ-LNS from 6 to 18 months as 10-g sachets twice daily mixed with complementary foods; the products supplied energy and micronutrients orally.

SQ-LNS improved child linear growth by 18 months. Mean length in the SQ-LNS group was 79.7 cm versus 79.1 cm in the iron-folic acid and multiple micronutrient groups, and the combined two-group analysis showed a 0.61 cm benefit for length (P = 0.001), a 0.20 higher LAZ (P = 0.002), a 210 g higher weight (P = 0.010), and a 16 higher WAZ (P = 0.018). Stunting was lower in the SQ-LNS group: 8.9% versus 13.7% and 12.9% in the comparison groups, with a received-enrollment analysis RR of 0.67 (95% CI: 0.46, 0.99) and P = 0.045 for prevalence across groups. Change in WLZ from birth to 18 months did not differ across groups.

The study was conducted in a single semi-urban region of Ghana, which may limit generalizability. Some key findings depended on analytic definitions of enrollment, and not all growth outcomes improved, as WLZ change from birth to 18 months was not different across groups. Follow-up was limited to 18 months, so longer-term effects were not assessed.