A 2026 randomized controlled trial of 1,568 infants in Nepal found that fortified balanced energy-protein supplements given to mothers during pregnancy or lactation did not improve infant growth at 6 or 12 months. Babies whose mothers received supplements grew just as much as babies whose mothers did not, with essentially zero difference in length-for-age, weight-for-age, and other growth measures. According to Gram Research analysis, this challenges current World Health Organization recommendations and suggests that alternative strategies beyond supplements are needed to address infant growth problems in developing regions.
Researchers in Nepal tested whether giving pregnant and nursing mothers special fortified supplements would help babies grow better. The study followed over 1,500 mothers and their infants for up to a year. Surprisingly, the supplements did not improve how much babies grew, how long they were, or how much they weighed at 6 or 12 months old. According to Gram Research analysis, this finding challenges current recommendations and suggests doctors need to find different ways to help babies in developing countries grow stronger and healthier.
Key Statistics
A 2026 randomized controlled trial involving 1,568 infants in rural Nepal found that fortified balanced energy-protein supplements during pregnancy produced no measurable improvement in infant length-for-age at 6 months, with a mean difference of only 0.01 on the measurement scale.
Among 1,554 mothers and 1,568 infants in the MINT trial, lactation supplementation showed no effect on infant growth outcomes, with a mean difference of negative 0.02 for length-for-age z-score at 6 months, indicating supplements did not prevent growth faltering.
The 2026 Nepal study found no significant differences in stunting, wasting, or underweight prevalence at 6 months between infants whose mothers received supplements and those who did not, suggesting nutritional supplementation alone cannot address infant malnutrition in this population.
A 2026 efficacy trial in Nepal demonstrated that null effects of balanced energy-protein supplementation persisted at 12 months of age and remained unchanged even after adjusting for birth size, indicating supplements had no impact on infant growth trajectories.
The Quick Take
- What they studied: Whether giving pregnant women and nursing mothers special high-protein, high-calorie supplements would help their babies grow taller and healthier during the first year of life.
- Who participated: 1,568 babies and their mothers in rural Nepal, a region where many babies are born smaller than normal and don’t grow as quickly as they should.
- Key finding: Babies whose mothers received the fortified supplements grew just as much as babies whose mothers did not receive supplements. The difference in growth was essentially zero at both 6 and 12 months of age.
- What it means for you: If you live in a similar region with limited food access, this research suggests that supplements alone may not be enough to solve baby growth problems. Healthcare providers should look for other solutions, such as improving overall food availability, water quality, and healthcare access in communities.
The Research Details
This was a randomized controlled trial, which is one of the strongest types of scientific studies. Researchers randomly assigned mothers in rural Nepal to receive either fortified supplements or no supplements during pregnancy and early breastfeeding. The study used a 2x2 factorial design, meaning some mothers got supplements during pregnancy only, some during lactation only, some during both periods, and some got no supplements at all. This allowed researchers to test whether timing mattered.
The supplements were specially formulated with balanced amounts of protein and calories, plus added vitamins and minerals. Researchers measured babies at birth, 6 months, and 12 months to track their growth using standard measurements like length-for-age, weight-for-age, and head circumference. They used statistical methods to compare growth between groups and determine if differences were meaningful or just due to chance.
The study was conducted in Sarlahi, Nepal, an area where malnutrition is common and many babies are born smaller than ideal. This location was chosen specifically because it represents a population that could potentially benefit most from nutritional interventions.
This research design is important because it removes bias and allows researchers to determine cause and effect. By randomly assigning mothers to groups, researchers ensured that differences between groups were due to the supplements themselves, not other factors like how wealthy families were or how much food they had access to. Testing both pregnancy and lactation supplementation separately helped identify which period, if any, might be most important for infant growth.
This study has several strengths: it included over 1,500 participants, used random assignment, measured multiple growth outcomes, and followed infants for a full year. The researchers also checked whether results changed when they adjusted for how big babies were at birth, which is important because birth size affects later growth. However, the study was unblinded, meaning mothers and healthcare workers knew who was receiving supplements, which could have influenced behavior. The study was designed to detect meaningful differences in growth, so the null results are reliable rather than due to insufficient sample size.
What the Results Show
The main finding was that fortified balanced energy-protein supplements had no effect on how long babies were at 6 months of age, which was the primary measure of growth. For babies whose mothers received supplements during pregnancy, the average length-for-age score was essentially identical to babies whose mothers did not receive supplements (a difference of only 0.01 on the measurement scale). Similarly, supplements given during lactation showed no benefit, with a difference of negative 0.02, which is so small it could easily be due to chance.
These null results held true even when researchers adjusted their analysis to account for how big babies were when born. This is important because birth size strongly influences how babies grow afterward. The fact that supplementation didn’t help even when accounting for birth size suggests the supplements truly had no effect on infant growth trajectories.
The researchers also examined many secondary growth measures including weight-for-length, weight-for-age, head circumference, and mid-upper arm circumference. None of these measurements showed meaningful differences between supplemented and non-supplemented groups at either 6 or 12 months. Additionally, the rates of stunting (being too short for age), wasting (being too thin), and being underweight were similar across all groups.
Beyond the primary growth measurements, researchers looked at whether supplements prevented malnutrition-related conditions. The prevalence of stunting, wasting, and underweight status at 6 months showed no significant differences between groups. When researchers followed a subset of infants to 12 months, these patterns persisted. The lack of effect across multiple different growth measures strengthens the conclusion that the supplements simply did not improve infant growth in this population.
This finding contradicts the World Health Organization’s recommendation for balanced energy-protein supplementation during pregnancy in undernourished populations. However, most previous evidence supporting this recommendation came from studies in different regions or with different populations. This is one of the first large-scale trials specifically examining whether extending supplementation through lactation improves infant growth. The null result suggests that either the supplement formulation, dosage, or duration may need adjustment, or that other factors beyond maternal nutrition are limiting infant growth in this setting.
The study was unblinded, meaning mothers and health workers knew who was receiving supplements, which could have influenced their behavior or reporting. The study measured growth at specific time points (6 and 12 months) rather than continuously, so some growth changes might have been missed. The research was conducted in one specific region of Nepal, so results may not apply to other areas with different food availability, healthcare systems, or populations. Additionally, the study could not determine why supplements didn’t work, whether due to poor absorption, inadequate dosage, or other underlying causes of growth faltering in the region.
The Bottom Line
Based on this research, fortified balanced energy-protein supplements alone are not an effective strategy for improving infant growth in rural Nepal. Healthcare providers should consider alternative or complementary approaches such as improving overall household food security, ensuring access to clean water and sanitation, treating infections promptly, and providing comprehensive healthcare. This does not mean nutrition is unimportant, but rather that supplements alone are insufficient. Confidence in this recommendation is high because the study was large, well-designed, and showed consistent null results across multiple measures.
Healthcare workers, public health officials, and policymakers in South Asia and other developing regions should pay attention to this research. Mothers and families in areas with limited food access should understand that while supplements may help, they are not a complete solution. Nutrition researchers should use these findings to design better interventions. This research does not apply to pregnant women in well-nourished populations, where different nutritional challenges exist.
If supplements were going to help infant growth, researchers would have expected to see measurable differences by 6 months of age. The fact that no differences appeared at 6 months and persisted at 12 months suggests that if supplements do have any benefit, it would take longer than a year to become apparent, which is unlikely for infant growth outcomes.
Frequently Asked Questions
Do pregnancy supplements help babies grow bigger and healthier?
A 2026 Nepal trial of 1,568 infants found that fortified supplements during pregnancy and lactation did not improve infant growth at 6 or 12 months. Babies whose mothers received supplements grew identically to those who did not, suggesting supplements alone are insufficient for addressing growth problems in developing regions.
Should pregnant women in Nepal take fortified protein supplements?
This 2026 study found no growth benefits from fortified supplements in rural Nepal. While nutrition remains important, supplements alone did not prevent stunting or improve infant measurements. Healthcare providers should focus on broader strategies including food security, clean water access, and comprehensive healthcare rather than relying on supplements.
What causes babies to be born small and not grow well in developing countries?
Multiple factors contribute to poor infant growth including maternal malnutrition, infections, inadequate healthcare, unsafe water, and poor sanitation. This 2026 Nepal trial suggests that addressing only maternal nutrition through supplements is insufficient. Comprehensive approaches targeting all these factors are needed.
Can breastfeeding supplements improve how fast babies grow?
The 2026 MINT trial tested whether giving nursing mothers fortified supplements would improve infant growth and found no benefit. Lactation supplements showed no effect on infant length, weight, head circumference, or rates of stunting at 6 or 12 months of age.
What should be done instead of supplements to help babies grow better?
This research suggests alternative strategies are needed, such as improving household food security, ensuring access to clean water and sanitation, treating infections promptly, and providing comprehensive healthcare. These broader approaches may be more effective than nutritional supplements alone for addressing infant growth faltering.
Want to Apply This Research?
- Track infant length and weight measurements monthly using a growth chart app, comparing actual growth to age-appropriate standards. Record the specific dates and measurements to identify growth patterns over time rather than relying on single measurements.
- Instead of relying solely on supplements, use the app to monitor and log multiple factors affecting infant growth: daily food intake, water quality and access, illness episodes, breastfeeding frequency, and healthcare visits. This comprehensive tracking helps identify which factors most strongly correlate with growth in your specific situation.
- Set up monthly reminders to measure and record infant length, weight, and head circumference. Compare these measurements to growth standards for your region. If growth is slower than expected, use the app to review logged factors (nutrition, illness, healthcare access) to identify modifiable issues beyond just supplementation.
This research describes a specific trial in rural Nepal and may not apply to all populations or regions. Pregnant women and nursing mothers should consult with their healthcare provider before making decisions about supplementation. This article summarizes research findings and does not constitute medical advice. Individual nutritional needs vary based on health status, food access, and other factors. Healthcare providers should consider this research alongside other evidence and local conditions when making recommendations for pregnant women and infants.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.