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Randomized Controlled Trial
. 2018 Jul 16;13(7):e0200519.
doi: 10.1371/journal.pone.0200519. eCollection 2018.

Impact of maternal nutritional supplementation in conjunction with a breastfeeding support program during the last trimester to 12 weeks postpartum on breastfeeding practices and child development at 30 months old

Zhiying Zhang  1 , Nga T Tran  2 , Tu S Nguyen  2 , Lam T Nguyen  2 , Yatin Berde  3 , Siew Ling Tey  1 , Yen Ling Low  1 , Dieu T T Huynh  1
Affiliations
Randomized Controlled Trial

Impact of maternal nutritional supplementation in conjunction with a breastfeeding support program during the last trimester to 12 weeks postpartum on breastfeeding practices and child development at 30 months old

Zhiying Zhang et al. PLoS One. .

Abstract

Background: Maternal nutrition during pregnancy and breastfeeding is important for the healthy growth and development of the fetus and infant.

Purpose: This study aimed to evaluate the long-term effects of a maternal milk supplementation (MMS) in conjunction with a breastfeeding support program on breastfeeding practices including duration of any breastfeeding and exclusive breastfeeding and child neurodevelopment outcomes at 30 months old.

Methods: We followed up the offspring of 204 Vietnamese women who completed a randomized controlled trial where the intervention group received MMS with a breastfeeding support program from the last trimester to 12 weeks postpartum while the control group received standard care. At 30 months postpartum, information on child feeding practices was collected and child neurodevelopment was assessed by the Bayley Scales of Infant and Toddler Development (Bayley-III).

Results: There was no significant difference in the duration of any breastfeeding (ABF) from birth between the groups. However, the intervention group had longer exclusive breastfeeding (EBF) duration (p = 0.0172), higher EBF rate at 6 months (p = 0.0093) and lower risk of discontinuing EBF (p = 0.0071) than the control. Children in the intervention group had significantly higher Bayley-III composite scores in the domains of cognitive (p = 0.0498) and motor (p = 0.0422) functions, as well as a tendency toward better social-emotional behavior (p = 0.0513) than children in the control group. The association between maternal intervention and child development was attenuated after further adjustment for birth weight but not EBF duration, suggesting that improvements in child development may be partially attributed to the benefits of prenatal nutrition supplementation on birth outcomes.

Conclusions: MMS with breastfeeding support during late pregnancy and early postpartum significantly improved EBF practices. The intervention was also associated with improvements in neurodevelopment in children at 30 months old.

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Conflict of interest statement

The study was funded by Abbott Nutrition. ZZ, SLT, YLL, and DTTH, are employees of Abbott Nutrition. Abbott Nutrition was responsible for the study design, data analysis and manuscript preparation and submission. YB is an employee of Cognizant Technologies Solution Pvt. Ltd, a Contract Research Organization which provides statistical services to Abbott Nutrition. The specific roles of the authors are articulated in the ‘author contributions’ section. We confirm that this does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Study flow chart.
RCT, randomized controlled trial; BF, breastfed.
Fig 2
Fig 2
Kaplan-Meier survival curves for duration of (a) any breastfeeding duration and (b) exclusive breastfeeding by treatment. - - - - - Control, _________ Intervention, + Censored.
See this image and copyright information in PMC

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