IMPACT OF FOOD SUPPLEMENTATION DURING LACTATION ON INFANT BREAST-MILKINTAKE AND ON THE PROPORTION OF INFANTS EXCLUSIVELY BREAST-FED

To evaluate whether milk production can be improved by increasing food intake, a randomized, double-blind, supplementation trial was complet ed among 102 lactating Guatemalan women. The subjects were undernouris hed, as indicated by their low values for calf circumference (CC) and the small size of their infants at birth. A high-energy (2.14 MJ/d, HE S) and a low-energy (0.50 MJ/d, LES) supplement were distributed 6 d/w k from wk 5 to 25 of lactation. Data were evaluated using repeated-mea sures analysis of variance on the increments from initial values for e ach outcome variable with one-tailed tests of statistical significance . The maternal energy intake increased 1.18 MJ/d (P < 0.01) more among the HES than the LES women. Benefit from supplementation was more evi dent among the more undernourished (CC less than or equal to median va lue, 29.5 cm) women. Among these 53 lower-CC women, infant milk and mi lk energy intakes were 10% higher (64 g/d and 14 MJ/d, respectively, a t wk 25) in the HES than the LES group. After controlling for other de terminants of infant milk and energy intakes in regression analyses, t he significance of these differences increased to P < 0.04. However, t here was no detectable effect on infant growth. Logistic regression an alysis was used to show that HES women were significantly (P < 0.05) m ore likely than LES women to be exclusively breast-feeding their infan ts at wk 20, the time when the effect of supplementation was most evid ent. These findings establish that milk production and the duration of exclusive breast-feeding of undernourished women can be improved with the provision of supplemental food.