TABLE 3.
Effect of infant supplementation with milk–cereal mix on growth, breastfeeding, and biochemical outcomes at 12 mo of age1
| Adjusted risk ratio or adjusted MD (95% CI)2 | ||||||
|---|---|---|---|---|---|---|
| Modest- protein group (n = 512) | High-protein group (n = 519) | No supplement group (n = 517) | Modest-protein group vs. no supplement group (ref.) | High-protein group vs. no supplement group (ref.) | High-protein group vs. modest-protein group (ref.) | |
| Attained anthropometric measures at 12 mo of age3 | ||||||
| Primary outcome | ||||||
| LAZ (n = 498, 496, 496) | −1.45 ± 1.04 | −1.38 ± 1.02 | −1.49 ± 1.09 | 0.04 (−0.03, 0.11) | 0.08 (0.01, 0.15)4 | 0.04 (−0.03, 0.11) |
| Secondary outcomes | ||||||
| WAZ (n = 498, 496, 496) | −1.28 ± 1.00 | −1.20 ± 0.97 | −1.39 ± 1.02 | 0.06 (−0.01, 0.13) | 0.12 (0.06, 0.19)4 | 0.06 (−0.01, 0.13) |
| WLZ (n = 498, 496, 496) | −0.78 ± 0.98 | −0.72 ± 0.94 | −0.89 ± 0.97 | 0.05 (−0.03, 0.14) | 0.11 (0.02, 0.19)4 | 0.05 (−0.04, 0.14) |
| MUAC-Z (n = 498, 496, 496) | −0.71 ± 0.92 | −0.65 ± 0.92 | −0.80 ± 0.93 | 0.04 (−0.04, 0.12) | 0.10 (0.02, 0.18)4 | 0.06 (−0.02, 0.14) |
| HC z score (n = 498, 496, 496) | −1.50 ± 0.96 | −1.56 ± 0.99 | −1.60 ± 0.90 | 0.07 (−0.03, 0.17) | 0.02 (−0.09, 0.12) | −0.06 (−0.16, 0.05) |
| Stunted (n = 498, 496, 496) | 139 (27.9) | 135 (27.2) | 147 (29.6) | 0.96 (0.76, 1.21) | 0.90 (0.71, 1.14) | 0.94 (0.74, 1.20) |
| Wasted (n = 498, 496, 496) | 58 (11.7) | 48 (9.7) | 63 (12.7) | 1.04 (0.72, 1.48) | 0.75 (0.51, 1.09) | 0.72 (0.49, 1.06) |
| Underweight (n = 498, 496, 496) | 118 (23.7) | 93 (18.8) | 145 (29.2) | 0.90 (0.70, 1.15) | 0.64 (0.49, 0.83)4 | 0.69 (0.53, 0.91)4 |
| MUAC <12.5 cm (n = 498, 496, 496) | 54 (10.8) | 43 (8.7) | 63 (12.7) | 0.98 (0.68, 1.41) | 0.67 (0.45, 0.98)4 | 0.69 (0.46, 1.03) |
| MUAC-Z < −2 (n = 498, 496, 496) | 39 (7.8) | 28 (5.7) | 51 (10.3) | 0.89 (0.59, 1.37) | 0.52 (0.33, 0.83)4 | 0.58 (0.35, 0.95)4 |
| HC z score < −2 (n = 498, 496, 496) | 151 (30.3) | 152 (30.7) | 162 (32.7) | 0.97 (0.78, 1.21) | 0.96 (0.77, 1.20) | 0.99 (0.79, 1.24) |
| Change in anthropometric measures2,3 | ||||||
| Change in LAZ (6–9 mo) (n = 488, 484, 483) | −0.05 ± 0.52 | −0.01 ± 0.56 | −0.09 ± 0.53 | 0.03 (−0.04, 0.09) | 0.08 (0.01, 0.14)3,4 | 0.05 (−0.01, 0.11) |
| Change in LAZ (9–12 mo) (n = 488, 485, 484) | −0.19 ± 0.53 | −0.20 ± 0.50 | −0.20 ± 0.50 | 0.00 (−0.06, 0.07) | 0.00 (−0.07, 0.06) | 0.00 (−0.07, 0.06) |
| Change in WLZ (6–9 mo) (n = 488, 484, 483) | −0.25 ± 0.69 | −0.25 ± 0.74 | −0.27 ± 0.65 | 0.04 (−0.04, 0.12) | 0.04 (−0.04, 0.11) | −0.01 (−0.09, 0.07) |
| Change in WLZ (9–12 mo) (n = 488, 485, 484) | −0.10 ± 0.65 | −0.04 ± 0.68 | −0.11 ± 0.68 | 0.02 (−0.06, 0.10) | 0.07 (−0.01, 0.15) | 0.05 (−0.04, 0.13) |
| Change in MUAC, cm (6–9 mo) (n = 483, 482, 480) | 0.16 ± 0.65 | 0.21 ± 0.62 | 0.09 ± 0.64 | 0.07 (−0.01, 0.16) | 0.12 (0.04, 0.20)4 | 0.05 (−0.03, 0.13) |
| Change in MUAC, cm (9–12 mo) (n = 488, 485, 484) | 0.05 ± 0.61 | 0.05 ± 0.63 | 0.09 ± 0.63 | −0.04 (−0.11, 0.04) | −0.03 (−0.11, 0.04) | 0.00 (−0.07, 0.08) |
| Hb concentration and proportion with anemia | ||||||
| Hb, g/dL (n = 485, 484, 490) | 10.4 (1.19) | 10.4 (1.18) | 10.3 (1.29) | 0.15 (−0.01, 0.30) | 0.15 (−0.01, 0.30) | 0.00 (−0.16, 0.15) |
| Proportion anemic (n = 485, 484, 490) | 318 (65.6) | 304 (62.8) | 342 (69.8) | 0.94 (0.81, 1.09) | 0.90 (0.77, 1.05) | 0.96 (0.82, 1.12) |
| Breastfeeding | ||||||
| Proportion with continued breastfeeding (n = 504, 501, 500) | 469 (93.1) | 468 (93.4) | 472 (94.4) | 0.98 (0.86, 1.12) | 0.99 (0.87, 1.12) | 1.01 (0.89, 1.14) |
Values are n (%) and means ± SDs, with outcome measures of adjusted risk ratio for proportion with stunting, wasting, underweight, MUAC < 12.5 cm, MUAC-Z < −2, HC z score < −2, anemia, and continued breastfeeding; and with adjusted MD for other parameters. We used a GLM of the Gaussian family with an identity-link function for continuous outcomes; GLM of the binomial family with a log-link function for binary outcomes; and a GLM of the Gaussian family with an identity-link function for changes in anthropometric indexes from enrollment to 9 mo and from 9 to 12 mo. GLM, generalized linear model; Hb, hemoglobin; HC, head circumference; LAZ, length-for-age z score; MD, mean difference; MUAC, midupper arm circumference; MUAC-Z, midupper arm circumference z score; WAZ, weight-for-age z score; WLZ, weight-for-length z score.
Adjusted for LAZ, WAZ score at enrolment, and mother's years of education for anthropometric outcomes; no adjustments were made for Hb concentration (g/dL), proportion with anemia, and proportion with continued breastfeeding.
Infants with any of the following at 9 and/or 12 mo of age (denoting extreme values or implausible data points based on familiarity with the study population) were excluded from the growth-based analysis: LAZ < −6 or LAZ >2; WAZ < −6 or WAZ >2; or WLZ < −5 or WLZ >2. A total of 17 infants were therefore excluded.
Statistically significant at P < 0.05.