The Effects of Structured Lactation Nutrition Education and Dali ni Horbo Supplementation on Maternal Nutritional Intake, Breastfeeding Practices, Infant Growth, and Gut Microbiota: A Randomized Controlled Trial

Inclusion Criteria:

• Lactating mothers aged 18-40 years.
• Having a healthy, singleton infant aged 0-1 month at enrollment.
• Residing within the service areas of the participating primary healthcare centers in Medan, Indonesia.
• Currently breastfeeding and intending to continue breastfeeding throughout the study period.
• Able to consume Dali ni Horbo and willing to follow the assigned intervention.
• Willing to participate in all study assessments, including dietary assessment, anthropometric measurements, and infant stool collection.
• Able to communicate effectively and complete the study questionnaires.
• Willing to provide written informed consent.

Exclusion Criteria:

• Mothers or infants with medical conditions that may significantly affect breastfeeding, maternal nutritional status, nutrient metabolism, or infant growth.
• Mothers with severe postpartum complications or conditions requiring hospitalization.
• Infants with congenital abnormalities, gastrointestinal disorders, metabolic diseases, severe infections, or other conditions affecting feeding or growth.
• Infants born preterm or with low birth weight, according to the study protocol.
• Mothers with a known allergy or intolerance to buffalo milk, cow's milk, or dairy products.
• Mothers following a medically prescribed restrictive diet that could affect the study outcomes.
• Current participation in another nutritional or clinical intervention study.
• Use of nutritional supplements, probiotics, antibiotics, or other treatments that may substantially affect maternal nutrient intake or infant gut microbiota, unless permitted by the study protocol.
• Inability or unwillingness to comply with the intervention and follow-up procedures.