Nutritional management of growth faltering in infants aged under six months in Asia and Africa. Study protocol for an individually randomised trial
(BRANCH, BReAstfeediNg Counselling and management of growtH)
The BReAstfeediNg Counselling and management of growtH (BRANCH) study is a multicenter, randomized controlled trial aimed at improving the nutritional management of growth faltering in infants under six months in South Asia and Sub-Saharan Africa. The study is coordinated by the World Health Organization (WHO) and funded by the Bill and Melinda Gates Foundation. It focuses on seven countries: Bangladesh, India, Pakistan, Ethiopia, Nigeria, Tanzania, and Uganda.
Growth faltering in early infancy is a critical concern, especially among preterm and low birth weight (LBW) infants. Failure to catch up on growth increases risks of mortality, morbidity, and poor neurodevelopmental outcomes. Exclusive breastfeeding is the primary recommended intervention, but evidence-based guidelines for managing growth faltering in the first six months are lacking. The BRANCH study aims to fill this gap by evaluating nutritional supplementation alongside intensive breastfeeding support.
The overall aim of this study is to determine the effect of nutritional supplementation plus intensive breastfeeding support compared with intensive breastfeeding support alone on mortality, morbidity and growth in infants aged 0-6 months with growth faltering in low resource settings in South Asia and Sub-Saharan Africa.
The findings from this trial will contribute to WHO guidelines on managing growth faltering in early infancy, guiding policy and intervention strategies in low-resource settings. Results will be widely disseminated to stakeholders, including ministries of health, healthcare providers, and the global research community.