Preventive lipid-based nutrient supplements given with complementary foods to infants and young children 6 to 23 months of age for health, nutrition, and developmental outcomes

Lipid-based nutrient supplements (LNS) are foods that contain energy, minerals and vitamins that can improve growth in children. 

This review assessed the effects and safety of preventive LNS given with complementary foods on health, nutrition and developmental outcomes of non-hospitalised infants and children aged six to 23 months, and whether or not they are more effective than other foods (including fortified blended foods (FBF)) or micronutrient powders (MNP; a mixture of vitamins and minerals that is sprinkled onto food)). 

The reviewers included 17 studies (54 papers) with 23,200 children. Four included studies were conducted in Malawi, three in Bangladesh, two in Ghana and one each in Burkina Faso, Haiti, Honduras, Chad, Congo, Kenya, Niger, Peru, Guatemala, and Indonesia. Four included studies enrolled pregnant women and provided LNS plus complementary feeding during pregnancy and post-partum, followed by infant supplementation starting at six months of age. The other studies provided LNS plus complementary feeding to children after six months of age. None of the included studies were conducted in emergeny settings. 

The reviewers found evidence to suggest that:

  • compared with no intervention, LNS+complementary feeding probably improves growth outcomes and reduces the occurrence of children who are of short stature for their age (stunting), have low weight for their age (moderate underweight), have low weight for their height (moderate wasting) and anaemia, without adverse effects; and seems to be more effective if provided for a duration longer than 12 months; 
  • compared with FBF, LNS+complementary feeding probably reduces moderate stunting, moderate wasting and moderate underweight; and
  • compared with MNP, LNS+complementary feeding is probably more effective at reducing moderate underweight and improving height and weight.

The reviewers considered the evidence to be at high risk of bias for blinding of participants and personnel due to the nature of the intervention, and of low or moderate quality for most outcomes. They concluded that, compared to no intervention, LNS plus complementary feeding is effective at improving growth outcomes and anaemia without adverse effects among children aged six to 23 months in low- and middle income countries in Asia and Africa, and more effective if provided over a longer duration of time (over 12 months). Also, there is limited evidence that LNS plus completementary feeding is more effective than FBF and MNP at improving growth outcomes.

The evidence is current to October 2018. 

Read the full Review on The Cochrane Library.