SQ‑LNS (Small‑Quantity Lipid‑Based Supplements): Targeted approaches for vulnerable groups

In this episode of Milestones in Pediatric Nutrition, Professor Andrew Prentice interviews Professor Kathryn Dewey from UC Davis about small quantity lipid-based nutrient supplements (SQ-LNS). Professor Dewey traces her research journey from documenting breastfeeding practices in Mexico and conducting the landmark DARLING study, which demonstrated differences between breastfed and formula-fed infants, to her randomized trials in Honduras that established the evidence base for WHO's exclusive breastfeeding recommendation through six months. Her work on complementary feeding identified universal nutrient gaps for iron and zinc between 6-24 months, leading to development of SQ-LNS—120-calorie supplements containing legume paste, omega-3-rich oils, milk powder, and 22 micronutrients. The ambitious iLiNS Project, involving eight institutions across four African countries, demonstrated that SQ-LNS uniquely improved both micronutrient status and growth. Meta-analyses encompassing 14 trials across nine countries with 37,000 children revealed remarkable outcomes: 27% reduction in mortality, 31% decrease in severe wasting, 17% reduction in severe stunting, 64% decrease in iron deficiency anemia, and 16-19% improvement in developmental outcomes. These findings led to inclusion in WHO guidelines (2023), global investment frameworks (2024), and establishment of the SQ-LNS Task Force to facilitate global implementation.