Abstract
The World Health Organization recommends deworming to reduce soil‐transmitted helminth (STH)‐attributable morbidity in women of reproductive age, including pregnant and lactating women, to reduce blood loss, iron deficiency anaemia and nutrient malabsorption. This study assessed the impact of maternal postpartum deworming with albendazole approximately 1 day after delivery on infant milk intake among a subset of 216 randomly selected mother–infant pairs recruited into a large trial in Peru. Infant milk intake was measured using the deuterium‐oxide method at 1‐ and 6‐month postpartum. Maternal STH infection was measured at 6‐month postpartum. At 1‐month postpartum, mean intake was 756 ± 16 and 774 ± 18 mL day−1 in the albendazole and placebo groups, respectively (mean difference: −18 mL day−1; 95% CI: −65, 30). At 6‐month postpartum, mean intake was 903 ± 16 and 908 ± 18 mL day−1 in the albendazole and placebo groups, respectively (mean difference: −5 mL day−1; 95% CI: −52, 43). There was no statistically significant difference in milk intake between groups at either time point. At 6‐month postpartum, mothers infected with Trichuris trichiura had infants with higher milk intakes (adjusted mean difference: 70 mL day−1; 95% CI: 20, 120) compared with uninfected mothers. However, there was no statistically significant difference in infant milk intake between mothers who had moderate‐and‐heavy intensity infection compared with the comparison group (mothers with no and light intensity infection). A lower prevalence and intensity of infection, and inclusion of uninfected mothers in both arms of the trial, resulting in effect dilution, may explain the null findings.
Highlights
Adequate nutrition during early infancy, during the first 1,000 days from conception to 2 years of age, is imperative for improving infant health and development outcomes (Bhutta et al, 2008, 2013)
It is well established that exclusive breastfeeding is the ideal source of infant nutrition during the first 6 months of life (World Health Organization, 2014) and that it is associated with lower infant infection, morbidity and even mortality (Black et al, 2013; Kramer & Kakuma, 2012)
The present study aimed to assess the associations between maternal postpartum deworming and maternal soil-transmitted helminth (STH) infection, and the quantity of infant milk intake, using the state-of-the-art dose-to-mother deuterium-oxide turnover technique (Lopez-Teros et al, 2017)
Summary
Adequate nutrition during early infancy, during the first 1,000 days from conception to 2 years of age, is imperative for improving infant health and development outcomes (Bhutta et al, 2008, 2013). It is well established that exclusive breastfeeding is the ideal source of infant nutrition during the first 6 months of life (World Health Organization, 2014) and that it is associated with lower infant infection, morbidity and even mortality (Black et al, 2013; Kramer & Kakuma, 2012). Maternal undernutrition during pregnancy and lactation is a global health concern, especially in low- and middle-income countries where low-nutrient density diets and concurrent risk of infection are common (Ahmed et al, 2012). To date, neither the effect of deworming nor of STH infection on lactation performance (i.e., milk composition or quantity of intake) has been studied. The present study aimed to assess the associations between maternal postpartum deworming and maternal STH infection, and the quantity of infant milk intake, using the state-of-the-art dose-to-mother deuterium-oxide turnover technique (Lopez-Teros et al, 2017)
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