Small-quantity Lipid-based Nutrient Supplements, Together with Malaria and Diarrhea Treatment, Improve Growth and Development in Young Burkinabe Children.

Objectives: Small-quantity lipid-based nutrient supplement (SQ-LNS) is a promising home fortification product to supplement young children's diets, but the optimal zinc level to include is uncertain. We assessed growth and development in young Burkinabe children who received SQLNS without or with varied amounts of zinc. Methods: In a partially masked, placebo-controlled, randomized trial, 34 communities were assigned to immediate (II) or non-intervention (NI). 2469 eligible II children were randomly assigned to 1 of 4 groups to receive 20 g LNS/d containing 0, 5 or 10 mg of zinc (and placebo tablet) or LNS without zinc and 5 mg zinc tablet from 9-18 mo of age, along with treatment of malaria and diarrhea. Children in NI (n=797) received neither SQ-LNS, tablets nor morbidity treatment. At 9 and 18 mo, length, weight, and mid-upper arm circumference (MUAC) were measured in all children. In a randomly selected subgroup, motor, language, and personal-social development was assessed at 18 mo (n=747 II; n=376 DI). Results: Reported adherence was 97±5% for SQ-LNS and tablets. Length, weight, MUAC and developmental scores were significantly greater at 18 mo in children who received SQ-LNS and morbidity treatment (p<0.001) compared to NI, but did not differ by II group. Stunting prevalence at 18 mo was 39% in children in NI and significantly reduced to 24-33% in children in the II groups (p<0.0001). Conclusions: Providing daily 20 g LNS with or without zinc along with malaria and diarrhea treatment significantly improved growth and motor, language, and personal-social development in young children.