Abstract
Most children in South Asia are breastfed at some point in their lives; however, many are not breastfed optimally, including the early initiation of breastfeeding (EIBF) within 1 hr of birth, avoidance of prelacteal feeds (APF), exclusive breastfeeding (EBF) for 6 months, and continued breastfeeding (CBF) up to 2 years of age or beyond. This review identifies and collates evidence on the effectiveness of interventions to support optimal breastfeeding in five countries in South Asia: Afghanistan, Bangladesh, India, Nepal, and Pakistan. A scoping review was conducted of peer‐reviewed and grey literature. The 31 eligible studies included randomized trials and quasi‐experimental designs that were conducted between 1990 and 2015. Data were collated regarding intervention design, characteristics, and effectiveness to support EIBF, APF, EBF, and CBF. Most studies reported a positive impact on breastfeeding outcomes, including 21/25 studies that examined EIBF, 15/19 studies that examined EBF, and 10/10 studies that examined APF. The only study that examined CBF reported no effect. Education, counselling, and maternal, newborn, and child health initiatives were common intervention types with positive effects on breastfeeding outcomes. Interventions were delivered in health facility, community, and home/family environments. Programmes and interventions that reached women and their families with repeated exposure and beginning during pregnancy were more likely to improve EIBF and EBF outcomes. Interventions with no impact on breastfeeding were characterized by short duration, irregular frequency, inappropriate timing, poor coverage, and targeting.
Highlights
Breastfeeding has numerous benefits for survival and lifelong health by protecting against childhood infections and breast cancer, increasing intelligence, and probable reductions in overweight, diabetes, and ovarian cancer (UNICEF, 2014; Victora et al, 2016)
We explore and summarize evidence from peer‐reviewed and programme evaluation literature on interventions to improve breastfeeding practices in Afghanistan, Bangladesh, India, Nepal, and Pakistan between 1990 and 2015 to inform research, programming and policy efforts in the region
Evidence gaps on the impact of interventions on breastfeeding outcomes were identified for specific countries (Afghanistan, Nepal, and Pakistan), breastfeeding outcomes, and implementation environments
Summary
Breastfeeding has numerous benefits for survival and lifelong health by protecting against childhood infections and breast cancer, increasing intelligence, and probable reductions in overweight, diabetes, and ovarian cancer (UNICEF, 2014; Victora et al, 2016). Trends in breastfeeding practices in the five largest South Asian countries found that over half of children do not benefit from early initiation of breastfeeding (EIBF), despite recent improvements in Bangladesh, India, and Nepal (UNICEF, 2016). The WHO Global Strategy for Infant and Young Child Feeding recommends a set of interventions to improve breastfeeding (WHO, 2003). There is substantial heterogeneity in breastfeeding practices within and across countries in South Asia (Benedict, Craig, Torlesse, & Stoltzfus, 2018; UNICEF, 2016), reflecting the varying impact of policy and programme action to protect, promote and support breastfeeding in the region. We explore and summarize evidence from peer‐reviewed and programme evaluation literature on interventions to improve breastfeeding practices in Afghanistan, Bangladesh, India, Nepal, and Pakistan between 1990 and 2015 to inform research, programming and policy efforts in the region.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
