Project Details

Fortified Balanced Energy Protein Supplementation in Pregnancy & Infant Growth and Neurodevelopment

Daniel Erchick, PhD, MPH

Summary

BACKGROUND: Undernourished women in low-and-middle income countries are more likely to deliver infants that are preterm, small, and at higher risk of inadequate early infant growth and development, with lasting effects through adulthood. In Nepal, rates of stunting (i.e., short for his/her age) and wasting (i.e., thin for his/her height) in childhood are 36% and 10%, respectively. GAP: Although an antenatal care recommendation for a balanced energy and protein (BEP) supplement in pregnancy in undernourished areas exists, the variation in formats, ingredients, and nutrient composition of supplements has made programmatic progress difficult. Recently, an expert consensus developed specifications for a BEP “ready-to-use” food supplement fortified with 15 micronutrients and 500 mg calcium for pregnant and lactating women in LMICs. HYPOTHESIS: This study will estimate the impact of a “complete” nutritional intervention for pregnant women – specifically, a BEP “ready-to-use” food supplement with 15 micronutrients and 500 mg calcium (called BEP++) – on infant growth and development outcomes in the first 6 months of life. We hypothesize that the nutritional supplementation for mothers during pregnancy will improve the growth and development of their infants in the first 6 months of life. METHODS: We propose a postnatal follow-up of mother-infant dyads in a community-based randomized controlled trial, wherein half of the women received a nutritious food supplement and the other half no supplement during pregnancy, to determine if the supplement can benefit infant growth and development in the first 6 months of life. RESULTS: Pending. IMPACT: If BEP++ in pregnancy is found to be efficacious for improvement of infant growth and development outcomes, this food supplement could be locally manufactured and distributed to pregnant women in settings where maternal undernutrition is high, access to care is limited, and few other effective interventions exist. Website Link: https://publichealth.jhu.edu/departments/international-health