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Impact of Infant and Young Child Feeding (IYCF) Nutrition Interventions on Breastfeeding Practices Growth and Mortality in Low- and Middle-Income Countries: Systematic Review

机译:婴幼儿喂养(IYCF)营养干预对中低收入国家母乳喂养习惯生长和死亡率的影响:系统评价

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摘要

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 ( = 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.
机译:营养不良与婴儿死亡总数的45%相关,每年全球总计270万。在中低收入国家(LMIC)中感觉到了最大的负担。这篇综述旨在评估婴幼儿喂养(IYCF)干预措施的有效性。我们搜索了多个数据库,包括Cochrane对照试验注册中心(CENTRAL),MEDLINE,EMBASE。标题/摘要筛选,全文筛选以及数据提取过滤了77项纳入研究。母乳喂养教育干预措施(= 38)显示,在3个月时早期开始母乳喂养的比率增加了20%,在3个月时纯母乳喂养(EBF)的比率增加了102%,在6个月时EBF的比率增加了53%,腹泻疾病的比率下降了24%。补充喂养教育干预措施(n = 12)显示,在食品安全环境中,WAZ增加0.41标准差(SD),HAZ增加0.25 SD。接受或不接受教育的补充食物(n = 17)显示,热影响区的SD增加0.14,发育迟缓的SD减少36%。补充食品干预措施(n = 12)显示,WHZ显着增加0.15 SD。亚组分析显示,由医疗保健专业人士领导的干预措施尤其在母乳喂养结果方面更为有效。我们认为,这是对LMIC中有关IYCF研究的现有文献的全面综述。尽管母乳喂养教育在母乳喂养实践方面的有效性得到了很好的支持,但是关于生长结果的证据有限。补充干预措施似乎在改善增长方面具有更好的效果。但是,需要更多的研究来得出更实质的结论。

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