Early short-term infant food supplementation, maternal weight loss and duration of breast-feeding: a randomised controlled trial in rural Senegal

• Published in: European journal of clinical nutrition Vol. 60; no. 2; pp. 265 - 271
• Main Authors: Ly, C.T, Diallo, A, Simondon, F, Simondon, K.B
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.02.2006; Nature Publishing; Nature Publishing Group
• Subjects: Adult; Baby foods; Biological and medical sciences; Birth; birth interval; body weight; Body weight gain; Body weight loss; Bottle Feeding; Breast; Breast feeding; Breast Feeding - statistics & numerical data; Breastfeeding & lactation; Clinical Nutrition; Clinical trials; complementary foods; Confidence intervals; Dietary supplements; duration; Epidemiology; Female; Food; Humans; Infant; Infant Food; infant foods; infant growth; infant nutrition; Infant Nutritional Physiological Phenomena; Infants; intent to supplement; Internal Medicine; Lactation; Lactation - physiology; length; maternal nutrition; Maternal Nutritional Physiological Phenomena; Maternal Welfare; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Mothers; Nutrient solutions; Nutrients; original-article; physiology; Postpartum; Pregnancy; Pregnancy Rate; Proportional Hazards Models; Public Health; Randomization; Regression analysis; Regression models; rural population; Senegal; Short term; Statistical analysis; statistics & numerical data; Time Factors; villages; Weaning; Weight; weight gain; Weight Loss; Weight Loss - physiology; Senegal; Africa; controlled trials; complementary feeding; birth intervals; maternal nutrition; lactation; Africa; Short term; Rural environment; Lactation; Nutrition; Weight loss; Duration; Breast feeding; Birth; Feeding; Mother; Infant food; Clinical trial; Early; Time interval; Supplementation
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/sj.ejcn.1602311

Objective: Early supplementation of breastfed infants may have consequences both for the mother and the child. We hypothesised that it would result in decreased maternal weight loss and in shorter durations of breastfeeding and birth intervals. Design: Controlled randomised population-based trial. Setting: Six villages in the Sine area of Senegal, West Africa. Subjects: Healthy breastfed infants and their mothers, 68 controls and 66 supplemented infants at randomization. Intervention: Supplementation with high-energy, nutrient dense food from 4 to 7 months of age, twice daily under supervision of field workers. Both controls and supplemented infants were free to eat other complementary foods. Maternal weight was measured monthly. Dates of breastfeeding cessation and of subsequent births were collected prospectively through weekly demographic surveillance, and were analysed using Cox's regression models and 'intent-to-supplement' approach. Results: Mean maternal weight gain from 4 to 7 months postpartum tended to be greater in the supplemented group (+0.25 kg/months, 95% confidence interval (CI): -0.07, +0.57). Supplemented infants were breastfed for significantly longer durations than controls (medians: 24.9 and 23.7 months, respectively, P: 0.034). Their adjusted hazard ratio (HR) for breastfeeding cessation was 0.59 (95% CI: 0.40, 0.89). Their mothers had a lower risk of a new birth than mothers of controls (adjusted HR: 0.57, 95% CI: 0.36, 0.92). Conclusions: Early short-term infant supplementation tended to decrease maternal postpartum weight loss, but it increased, rather than shortened, the duration of breastfeeding and birth interval. Sponsorship: This study was supported by a grant from the French Ministry of Research (Grant 92L0623).