Biological Pathways Linking Integrated Interventions to Infant Growth in the first 6 months of life: Findings from a Mediator Analysis of the WINGS Randomized Controlled Trial

Background Growth faltering during infancy remains a major public health concern in low- and middle-income countries. We examined whether birth size, infant gut microbiome, growth and inflammatory biomarkers, and breast milk macro and micronutrients mediated the effects of an integrated intervention package on infant growth at 6 months of life. Methods This mediation analysis was nested within the Women and Infants Integrated Interventions for Growth Study (WINGS), a factorial randomized controlled trial conducted in urban low- and middle-income communities in Delhi, India. The intervention package included nutrition, health, water, sanitation and hygiene (WASH), and psychosocial support del