Effect of complementary food supplementation on breastfeeding and home diet in rural Bangladeshi children12

• Published in: The American journal of clinical nutrition 2016-11, Vol.104 (5), p.1450-1458
• Main Authors: Campbell, Rebecca K, Hurley, Kristen M, Shamim, Abu Ahmed, Shaikh, Saijuddin, Chowdhury, Zaynah T, Mehra, Sucheta, de Pee, Saskia, Ahmed, Tahmeed, West, Keith P, Christian, Parul
• Format: Article
• Language: English
• Subjects: Bangladesh; breastfeeding; complementary food; dietary diversity; growth; International Nutrition; stunting; supplementation
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.116.135509

Background: Complementary food supplements (CFSs) can enhance growth where stunting is common, but substitution for the usual diet may reduce observed benefits. Objective: We aimed to characterize dietary diversity from home foods in a CFS efficacy trial and determine whether supplementation reduced breastfeeding frequency or displaced home foods. Design: In a cluster-randomized controlled trial in rural Bangladesh, children (n = 5499) received, for 1 y starting at age 6 mo, periodic child feeding counseling for mothers (control) or counseling plus 1 of 4 CFSs fed as a daily snack. Breastfeeding status and past 24-h diet were assessed at enrollment and every 3 mo thereafter until 18 mo of age. A 7–food group dietary diversity score (DDS) was calculated from home foods only, and a DDS ≥4 constituted minimum dietary diversity (MDD). Results: Most children (97%) were breastfed through 18 mo of age, and 24-h breastfeeding frequency did not differ by supplementation group. Child dietary diversity was low; only 51% of children met the MDD by 18 mo. Rice, potatoes, and biscuits (cookies) were the most frequently consumed foods, whereas the legumes, dairy, eggs, and vitamin A–rich fruit and vegetable food groups were each consumed by