Abstract
Undernutrition is associated with 45% of total infant deaths, totalling 2.7 million globally per year. The vast majority of the burden is felt in low- and middle-income countries (LMICs). This review aims to assess the effectiveness of infant and young child feeding (IYCF) interventions. We searched multiple databases including Cochrane Controlled Trials Register (CENTRAL), MEDLINE, EMBASE. Title/abstract screening and full-text screening and data extraction filtered 77 studies for inclusion. Breastfeeding education interventions (n = 38) showed 20% increase in rates of early initiation of breastfeeding, 102% increase in exclusive breastfeeding (EBF) at 3 months and 53% increase in EBF at 6 months and 24% decreases in diarrheal diseases. Complementary feeding education intervention (n=12) showed a 0.41 standard deviation (SD) increase in WAZ, and 0.25 SD in HAZ in food secure setting. Complementary food provision with or without education (n=17) showed a 0.14 SD increase in HAZ and 36% decrease in stunting. Supplementary food interventions (n=12) showed a significant 0.15 SD increase in WHZ. Subgroup analyses showed healthcare professional led interventions were largely more effective, especially on breastfeeding outcomes. We believe this is a comprehensive review of the existing literature on IYCF studies in LMICs. Though breastfeeding education is well supported in its effectiveness on breastfeeding practices, limited evidence exists for growth outcomes. Supplementation interventions seem to have better effects at improving growth. However, more research is required to reach more substantial conclusions.
Highlights
Undernutrition is associated with 2.7 million child deaths worldwide which makes up 45% of all infant mortality, according to the World Health Organization [1]
This review includes 66 studies of which 38 studies contributed to breastfeeding education comparisons, 17 studies contributed to complementary feed provision regardless of, studies contributed to complementary feeding education only and studies contributed to supplementary feeding comparisons
The present review offers such utility in breastfeeding education and practice as well as for the provision of complementary nutrition allowing for maximized growth and minimized states of malnutrition and disease
Summary
Undernutrition is associated with 2.7 million child deaths worldwide which makes up 45% of all infant mortality, according to the World Health Organization [1]. Nutrients 2020, 12, 722 associated with increased severity and frequency of infections, raising energy requirements, while reducing appetite and nutrition absorption [2]. This is increasing the risk of death [3]. Another effect of malnutrition is cognitive development which can affect school performance and has negative effects on long term careers [3]. Stunting has been linked to cognitive delays and increased mortality [4], while wasting contributes to stunting itself [5]
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