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,Lam T Nguyen,Tu S Nguyen,Yatin Berde,Yen Ling Low,Nga T Tran,Siew Ling Tey,Dieu T T Huynh,Jacobus P Van Wouwe

doi:10.1371/journal.pone.0200519

Zhiying Zhang, Lam T Nguyen + Show 7 more

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https://doi.org/10.1371/journal.pone.0200519

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Abstract

BackgroundMaternal nutrition during pregnancy and breastfeeding is important for the healthy growth and development of the fetus and infant.PurposeThis 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.MethodsWe 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).ResultsThere 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.ConclusionsMMS 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.

Highlights

There was no significant difference in the duration of any breastfeeding (ABF) from birth between the groups
The intervention was associated with improvements in neurodevelopment in children at 30 months old
Optimal maternal nutrition during pregnancy and breastfeeding is critical for the healthy growth and development of the fetus and infant, which lays the foundation for their long-term health in later life

Summary

Introduction

Optimal maternal nutrition during pregnancy and breastfeeding is critical for the healthy growth and development of the fetus and infant, which lays the foundation for their long-term health in later life. Yang and Huffman reviewed nutrition intervention trials for pregnant and lactating women and categorized the studies according to different types of fortified foods and products, including protein/fat free fortified beverages, products containing cow’s milk, fortified high-fat products, and formulated non-milk drinks [3]. When both maternal nutritional status improvements and birth outcome improvements are the focus of interest, fortified food supplements such as those containing milk and/or essential fatty acids, are preferred over fortified beverages containing only micronutrient[3]. 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

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