Nutrition and maternal, neonatal, and child health.
Study Goal
The researchers aimed to evaluate the impact of Vitamin A supplementation on infant mortality and child health in low- and middle-income countries.
Results Summary
Vitamin A supplementation in the first few days of life reduced infant mortality in Asia but not in Africa. Biannual large-dose Vitamin A supplements for children aged 6-59 months were found to be an important strategy for improving child health and survival.
Population
Infants and children (6-59 months) in low- and middle-income countries, with specific focus on Asia and Africa.
Effective Dosage
Biannual large-dose (exact amount not specified)
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
prenatal calcium supplementation | decrease | pre-eclampsia and eclampsia morbidity and mortality | populations with low intakes | - | can reduce the risk | #1 |
antenatal iron-folic acid use | decrease | anemia | many countries | - | may reduce | #2 |
multiple micronutrient supplementation during pregnancy | decrease | fetal growth restriction and low birth weight | - | - | to reduce | #3 |
Early initiation of breastfeeding (within an hour) | decrease | infant mortality | - | - | reduce | #4 |
exclusive breastfeeding in the first 6 months of life | decrease | infant mortality | - | - | reduce | #5 |
vitamin A supplementation in the first few days of life | decrease | infant mortality | Asia | - | reduce | #6 |
Biannual large-dose vitamin A supplements | increase | child health and survival | children 6-59 months of age | - | important strategies for improving | #7 |
zinc for treatment of diarrhea | increase | child health and survival | - | - | important strategies for improving | #8 |
This article reviews the central role of nutrition in advancing the maternal, newborn, and child health agenda with a focus on evidence for effective interventions generated using randomized controlled trials in low- and middle-income countries (LMIC). The 1000 days spanning from conception to 2 years of life are a critical period of time when nutritional needs must be ensured; failure to do so can lead to adverse impacts on short-term survival as well as long-term health and development [corrected]. The burden of maternal mortality continues to be high in many under-resourced settings; prenatal calcium supplementation in populations with low intakes can reduce the risk of pre-eclampsia and eclampsia morbidity and mortality and is recommended, and antenatal iron-folic acid use in many countries may reduce anemia, a condition that may be an underlying factor in postpartum hemorrhage. Sufficient evidence exists to promote multiple micronutrient supplementation during pregnancy to reduce fetal growth restriction and low birth weight. Early initiation of breastfeeding (within an hour), exclusive breastfeeding in the first 6 months of life, and vitamin A supplementation in the first few days of life in Asia (but not in Africa) reduce infant mortality. Biannual large-dose vitamin A supplements to children 6-59 months of age and zinc for treatment of diarrhea continue to be important strategies for improving child health and survival. Early nutrition and micronutrient status can influence child development but should be integrated with early responsive learning interventions. Future research is needed that goes beyond the 1000 days to ensure adequate preconceptional nutrition and health, with special emphasis on adolescents who contribute to a large proportion of first births in many LMIC. Thus, we make the case for integrating proven nutrition interventions with those for health in pregnant women, and with those for health and child development in neonates, infants, and young children to help advance the global MNCH agenda.