(OR05-02-23) Maternal Thiamine Supplementation During the Exclusive Breastfeeding Period Promotes Infants’ Cognitive Encoding and Discrimination at 24 and 52 Weeks Relative to Placebo

Objectives: Although accumulating evidence indicates that a diet deficient in thiamine undercuts infants’ neuro-cognitive development, questions remain about the specific neuro-cognitive abilities affected. We investigated the extent to which maternal thiamine supplementation impacted breastfed Cambodian infants’ ability to encode novel patterns and discriminate them from similar novel stimuli.

Methods: In this double-blind randomized controlled trial, 335 rural Cambodian lactating mothers were randomly assigned to receive capsules containing either 0, 1.2, 2.4, or 10mg of thiamine daily. Supplementation extended from 2 to 24 weeks postpartum. We examined infants’ encoding and discrimination ability via the Visual Paired Comparison (VPC) task at both 24 weeks (endline) and a 52-week follow-up. Infants’ looking times were measured during six blocks of trials; for each block, infants viewed a novel pattern (a face or a geometric design) during a 15-second familiarization period, followed by viewing the now-familiar pattern paired with a new novel pattern in two counterbalanced 10-second test periods. We predicted that infants of mothers receiving higher levels of thiamine supplementation would display enhanced novelty preference scores. 313 infants provided analyzable data for the VPC task for at least one timepoint (24 or 52 weeks).

Results: A 4 (thiamine supplementation group) X 2 (timepoint) mixed-design ANOVA revealed a significant main effect of thiamine supplementation group, F(3,226) = 4.49, p = .004, but no significant main effect of timepoint or supplementation group X timepoint interaction. Planned comparisons revealed significantly greater novelty preference in all supplementation groups relative to placebo (all p’s < .04), but no significant differences between the three supplementation groups (all p’s > .27).

Conclusions: Maternal thiamine supplementation of 1.2mg or more daily during the exclusive breastfeeding period benefitted breastfed Cambodian infants’ encoding and discrimination of novel patterns at 24 and 52 weeks. These abilities are known to contribute to a cascade predicting downstream cognitive function. Findings from the present study thus underscore the importance of adequate thiamine for ensuring infants’ optimal cognitive development.

Funding Sources: Bill & Melinda Gates Foundation and New York Academy of Sciences