Dietary Supplementation of Gambian Nursing Mothers and Lactational Performance

Roberts, SusanB.; Watkinson, Michael; Whitehead, R. G.; Paul, Alison; Prentice, Ann; Watkinson, AnneA.

doi:10.1016/s0140-6736(80)92048-6

Cited by 63 publications

(25 citation statements)

References 9 publications

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“…Rates of infection (especially malaria) [38], exposure to aflatoxins [61,62] and pesticide exposure [63] are other external environmental stressors that could have long-term effects whose seasonal patterns may have changed over time, and which could plausibly influence maternal early development. One intriguing possibility is dietary changes owing to supplementation during pregnancy and lactation designed to improve maternal and neonatal outcomes [64–67]. For example, between 1980 and 1984, pregnant women in Keneba were given a daily balanced dietary supplement, which was increased during the hungry season [66,68].…”

Section: Discussionmentioning

confidence: 99%

Intergenerational effects of maternal birth season on offspring size in rural Gambia

et al. 2012

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Environmental conditions experienced in early life can influence an individual's growth and long-term health, and potentially also that of their offspring. However, such developmental effects on intergenerational outcomes have rarely been studied. Here we investigate intergenerational effects of early environment in humans using survey- and clinic-based data from rural Gambia, a population experiencing substantial seasonal stress that influences foetal growth and has long-term effects on first-generation survival. Using Fourier regression to model seasonality, we test whether (i) parental birth season has intergenerational consequences for offspring in utero growth (1982 neonates, born 1976–2009) and (ii) whether such effects have been reduced by improvements to population health in recent decades. Contrary to our predictions, we show effects of maternal birth season on offspring birth weight and head circumference only in recent maternal cohorts born after 1975. Offspring birth weight varied according to maternal birth season from 2.85 to 3.03 kg among women born during 1975–1984 and from 2.84 to 3.41 kg among those born after 1984, but the seasonality effect reversed between these cohorts. These results were not mediated by differences in maternal age or parity. Equivalent patterns were observed for offspring head circumference (statistically significant) and length (not significant), but not for ponderal index. No relationships were found between paternal birth season and offspring neonatal anthropometrics. Our results indicate that even in rural populations living under conditions of relative affluence, brief variation in environmental conditions during maternal early life may exert long-term intergenerational effects on offspring.

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Section: Discussionmentioning

confidence: 99%

Intergenerational effects of maternal birth season on offspring size in rural Gambia

et al. 2012

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“…This has been the first published study assessing the impact of nutritional supplementation on changes in LBM of HIV positive breastfeeding mothers. Prentice et al observed increased subcutaneous fat and increased weights in their study of nutritional supplementation of non-HIV infected breastfeeding mothers; however no body composition measurements were done [46]. …”

Section: Discussionmentioning

confidence: 99%

Effect of nutritional supplementation of breastfeeding HIV positive mothers on maternal and child health: findings from a randomized controlled clinical trial

2011

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BackgroundIt has been well established that breastfeeding is beneficial for child health, however there has been debate regarding the effect of lactation on maternal health in the presence of HIV infection and the need for nutritional supplementation in HIV positive lactating mothers.AimsTo assess the effect of nutritional supplementation to HIV infected lactating mothers on nutritional and health status of mothers and their infants.MethodsA randomized controlled clinical trial to study the impact of nutritional supplementation on breastfeeding mothers. Measurements included anthropometry; body composition indicators; CD4 count, haemoglobin and albumin; as well as incidence rates of opportunistic infections; depression and quality of life scores. Infant measurements included anthropometry, development and rates of infections.ResultsThe supplement made no significant impact on any maternal or infant outcomes. However in the small group of mothers with low BMI, the intake of supplement was significantly associated with preventing loss of lean body mass (1.32 kg vs. 3.17 kg; p = 0.026). There was no significant impact of supplementation on the infants.ConclusionsA 50 g daily nutritional supplement to breastfeeding mothers had no or limited effect on mother and child health outcomes.Clinical trial registrationISRCTN68128332 (http://www.controlled-trials.com/ISRCTN68128332)

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“…The association between the time maternal diet is improved and the amount of milk produced needs further clarification; it is an important issue for proper planning of food supplementation programs for pregnant or lactating women (87). The possibly critical time factor could account for the minimal influence on the output volume that resulted from postnatal food supplementation of Gambian mothers (84) and the improved output volume reported in Nigerian and Mexican mothers supplemented during pregnancy as well as lactation (78,80).…”

Section: Maternal Factorsmentioning

confidence: 99%