Effect of fortified balanced energy-protein supplementation during pregnancy and lactation on infant neurodevelopment: a community-based randomized controlled trial in rural Nepal

Summary

This 2×2 factorial randomised controlled trial evaluated fortified balanced energy–protein supplementation during pregnancy and/or lactation on infant neurodevelopment in rural Nepal. Whilst there was a significant interaction in the language domain for infants whose mothers received supplementation in both periods, pregnancy or lactation supplementation alone did not significantly improve cognitive, motor, or socioemotional development at 6 months. The findings suggest that maternal nutritional supplementation timing may differentially affect infant neurodevelopmental outcomes, with potential benefits concentrated in language development when supplementation spans both pregnancy and lactation.

Regional applicability

This study was conducted in rural Nepal and provides evidence on maternal nutritional supplementation relevant to lower-income settings with high rates of maternal undernutrition. The findings may have limited direct applicability to United Kingdom practice, where maternal nutrition is generally adequate; however, the mechanistic insights on supplementation timing and neurodevelopment could inform global public health nutrition policy and future maternal nutrition interventions in resource-constrained settings.

Key measures

Bayley Scales of Infant and Toddler Development (fourth edition) standard scores in cognitive, motor, language, and socioemotional domains; mean differences with 95% confidence intervals

Outcomes reported

The study measured infant neurodevelopment at 6 months using the Bayley Scales of Infant and Toddler Development (fourth edition), assessing cognitive, motor, language, and socioemotional domains. Primary findings indicated a significant interaction between pregnancy and lactation supplementation in the language domain only, with no significant differences in cognitive, motor, or socioemotional scores when mothers received supplementation during pregnancy or lactation alone.

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