A comprehensive intervention package including an egg- and milk-based snack improves the linear growth and dietary diversity of children under two years children in rural Bangladesh: A community-based cluster randomized controlled trial

Abstract Approximately one-third of children under-five in developing countries are stunted and many are micronutrient-deficient. We aimed to compare the effect of an intervention package including egg and milk-based snacks on linear growth and dietary diversity of children of 6‒12 months in rural Bangladesh. It was a community-based cluster randomized controlled longitudinal trial where 412 mother-infant dyads were allocated to receive either regular government health communication only (control; n = 206) or food vouchers (including eggs, semolina, milk, sugar, and oil) monthly to prepare egg and milk-based snacks, along with multiple micronutrient powder (MNP), child feeding and handwashing counseling for one year (treatment; n = 206). The difference in length gain and dietary diversity of the children was respectively the primary and secondary outcomes of the study. The intervention was tested using a generalized linear regression model. At baseline, the mean weight and length of the children did not significantly differ between groups. Around ninety percent of the children in both groups were breastfed. At endpoint, the mean length of children was (83.52 and 80.89 cm; difference: 2.62, p<0.001); LAZ score (Cof: 0.38, CI: 0.24, 0.51, p<0.001); rate of stunting (IRR: 0.39, CI: 0.22, 0.67, p<0.001); and dietary diversity were significantly better in the treatment group. This comprehensive intervention package improved the growth and dietary diversity of children in ultra-poor Bangladeshi households; scaling up this intervention within resource-poor settings should be considered. Trial registration: It was registered retrospectively at ClinicalTrials.gov as NCT03641001, 21/8/2018