Improved Child Nutrition and Development Through Social Transfers

• Social Transfer (Other): A social transfer will be given conditioned upon breastfeeding at 24-months postpartum.

Primary outcomes

• Prevalence of Complementary Breastfeeding [from 12 to 24 months postpartum]: Prevalence of complementary breastfeeding at 24 months postpartum.
• Complementary Breastfeeding Duration [from 12 to 24 months postpartum]: Duration of complementary breastfeeding in weeks.

Secondary outcomes

• Weight-for-Age z-score [12 months; 24 months]: Infants will be weighed in kilograms by a mobile weighing scale. Measurements will be analyzed as age standardized z-scores.
• Child Health Outcomes [12 months; 24 months]: We will assess the child's health outcomes by using a questionnaire administered to the caregiver. The questionnaire will ask a range of yes or no questions about child diarrhea, respiratory illness, fever, and child antibiotic use.
• Percent weight loss [12 months; 24 months;]: Percent weight loss will use body weight (kg) and pregnancy weight of the mother controlling for time of measurement. Percent weight loss will be calculated as ((current weight - pregnancy weight) / pregnancy weight) × 100.
• Mother and Child Hemoglobin Levels [12 months; 24 months]: We will assess the mother and child anemia levels. The HemoCue Hb 301 will be used to give an instant measurement of the Haemoglobin (Hb) level of the patient. Capillary blood will be collected through a finger prick. Blood samples drawn for the haemoglobin assessment will be discarded after the test. Iron levels will be analyzed as a continuous outcome.
• Maternal Depression [12 months; 24 months]: Maternal postpartum depression will be assessed using the Patient Health Questionnaire-9 (PHQ-9); categorized as a binary: no depression (score <10) or depression present (score ≥10).
• Height-for-age z-score [12 months; 24 months]: Height will be measured in centimeters by using a Height Measuring Device, stadiometer, 20-205cm. All measurements will be analyzed as age standardized z-scores
• Mid-upper arm circumference (MUAC) [12 months; 24 months]: Infants will be measured for mid-upper arm circumference (MUAC) using non-stretchable measuring tape. All measurements will be analyzed as age standardized z-scores.
• Mother and Child Anemia [12 months; 24 months]: The HemoCue Hb 301 will be used to give an instant measurement of the Haemoglobin (Hb) level of the patient. Capillary blood will be collected through a finger prick. Blood samples drawn for the haemoglobin assessment will be discarded after the test. Hemoglobin levels (gm/dL) will be used to categorize mothers and children into a binary variable: anemic or not anemic.
• Maternal weight change [12 months; 24 months;]: Weight weight change will use body weight (kg) and pregnancy weight of the mother controlling for time of measurement. Maternal weight change will be calculated as the difference between postpartum weight and pregnancy weight. Because pregnancy weight varies by gestational age, analyses will control for gestational age at pregnancy weight measurement and time postpartum at outcome measurement. Categorized as: no weight loss (0 kg); moderate weight loss (<0 to >-5 kg); high weight loss (≥-5 kg); moderate weight gain (>0 to <5 kg); high weight gain (≥5 kg).
• Change in systolic and diastolic blood pressure (mmHg) [12 months; 24 months;]: Change in systolic and diastolic blood pressure (mmHg) from baseline of the mothers will be categorized as low, normal, or high according to standard clinical thresholds.
• Change in systolic and diastolic blood pressure (mmHg) [12 months; 24 months;]: Change in systolic and diastolic blood pressure (mmHg) from baseline of the mothers will be analyzed as a continuous measure.
• Caregiver Reported Early Development Instruments (CREDI) cognitive z-score [12 months; 24 months]: The CREDI long-form will be administered. Raw item data will be converted to norm-referenced z-scores using the CREDI scoring procedure.
• CREDI language z-score [12 months; 24 months]: The CREDI long-form will be administered. Raw item data will be converted to norm-referenced z-scores using the CREDI scoring procedure.
• CREDI motor z-score [12 months; 24 months]: The CREDI long-form will be administered. Raw item data will be converted to norm-referenced z-scores using the CREDI scoring procedure.
• CREDI social-emotional z-score [12 months; 24 months]: The CREDI long-form will be administered. Raw item data will be converted to norm-referenced z-scores using the CREDI scoring procedure.
• Maternal Anxiety [12 months; 24 months]: Maternal postpartum anziety will be assessed using the the GAD-7 (Generalized Anxiety Disorder-7); a seven-item self-report questionnaire designed to measure the severity of anxiety; categorized as: Minimal Anxiety: score 0-4; Mild Anxiety: score 5-9; Moderate Anxiety: score 10-14; Severe Anxiety: score 15-21

Sex: Female, ages: 12 Years to any

Inclusion Criteria:

1. Are enrolled in the Taabo multigenerational birth cohort (MGC)
2. Completed the postpartum interview of the Taabo MGC
3. Have a child who is within two weeks of their 12-month birthday,
4. are breastfeeding at time of recruitment,
5. live in the Taabo HDSS, Côte d'Ivoire
6. have no illnesses that contraindicates breastfeeding,
7. had a healthy singleton infant with a birth weight of at least 2500 grams, and
8. agree to participate and sign an informed consent; if underage (12-17 years), a legal representative will also have to agree to sign the informed consent

Exclusion Criteria:

1. Plans to move permanently outside study area
2. Has a medical, intellectual or psychological disability
3. Contraindication for breastfeeding
4. Children born with < 2500 grams