Effectiveness of nutrition-specific interventions in pregnancy and early childhood

The 2013 Lancet series on Maternal and Child Nutrition included a comprehensive review of interventions that affect the nutritional status of women and young children in low- and middle-income countries (LMICs). The series’s authors estimated that if 10 known effective interventions were scaled up to 90% coverage, we could eliminate 15% of under-5 deaths and reduce stunting by 21% globally [1]. The objective of this chapter is to review and update this work with the latest research evidence on the effectiveness of these 10 and other nutrition-specific interventions to prevent poor growth and improve child survival during the crucial first 1,000 days of life. We will focus primarily on interventions delivered at scale through the health system. Outcomes of interest include birth outcomes (preterm, small for gestational age, low birth weight), risk of subsequent growth faltering (stunting, wasting), and mortality during the first 5 years of life. We will not consider effects on anemia, developmental outcomes, or overweight/obesity risk, nor will we address the broader range of nutrition-sensitive interventions that affect more distal determinants of nutritional status (including food production systems, water and sanitation, and household socioeconomic status). Others have provided comprehensive reviews of these important strategies [2].