Interventions to improve infant and young child feeding practices in Ethiopia: a systematic review

ObjectiveIn Ethiopia, despite the implementation of several interventions to improve infant and young child feeding (IYCF) practices, no published studies have highlighted the most effective IYCF interventions in the country. This systematic review investigated the impacts of various interventions on IYCF in Ethiopia.Source of informationA systematic search was conducted on seven computerised bibliographic databases (Embase, ProQuest Central, Scopus, PsycINFO, Web of Science, MEDLINE/PubMed and CINAHL) to locate experimental or quasi-experimental studies published between the year 2000 and May 2021.Study eligibility criteriaInterventional studies that measured IYCF indicators (early initiation of breast feeding (EIBF), exclusive breast feeding (EBF), the introduction of complementary foods, minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet) as outcome variables were included.Study appraisal and synthesisAll included studies were examined for biases related to interventional studies (ie, selection bias, performance bias, attrition bias, detection bias and reporting bias). Author reports of effect size measures were used to narratively report the findings of each study.ResultsOf the 23 eligible studies, 14 studies were quasi-experimental and 9 studies were cluster randomised trials (CRTs). Eight quasi-experimental studies had a serious risk of bias, while two CRTs had a high risk of bias. Four studies for EBF and six studies for EIBF showed significant impacts of policy advocacy, health service strengthening, interpersonal communication, community mobilisation and mass media campaigns. Six studies for MDD and three studies for MMF indicated significant effects of community-level and health facility complementary feeding promotions on infants and young children. Interventions that delivered in combination increased the impacts in improving EIBF, MDD and MMF compared with a single intervention.ConclusionOur review showed that 12 out of 21 eligible studies that implemented in the form of community-level and health facility interventions improved EIBF, EBF, and/or MDD in Ethiopia.Protocol registration numberPROSPERO, CRD42020155519.

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Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates

BMJ Open ◽

10.1136/bmjopen-2020-036757 ◽

2020 ◽

Vol 10 (9) ◽

pp. e036757

Author(s):

Amna Rabbani ◽

Zahra A Padhani ◽

Faareha A Siddiqui ◽

Jai K Das ◽

Zulfiqar Bhutta

Keyword(s):

Systematic Review ◽

Young Child ◽

Breast Feeding ◽

Grey Literature ◽

Bottle Feeding ◽

Child Feeding ◽

Young Child Feeding ◽

Conflict Settings ◽

Infant And Young Child ◽

Increased Risk

BackgroundBreast feeding in conflict settings is known to be the safest way to protect infant and young children from malnourishment and increased risk of infections. This systematic review assesses the evidence on infant and young child feeding (IYCF) practices in conflict settings.MethodologyWe conducted a search in PubMed and CENTRAL and also searched for grey literature from the year 1980 to August 2019. We included studies conducted in settings inflicted with armed conflict; which comprised settings undergoing conflict, as well as, those within 5 years of its cessation. Studies were included if they discussed IYCF practices, barriers, programmes and guidelines to promote and improve IYCF practices. Two review authors independently evaluated and screened studies for eligibility and extracted data; followed by a descriptive and thematic analysis.ResultsWe included 56 studies in our review including 11 published articles and 45 reports from grey literature and broadly classified into four predetermined sections: epidemiology (n=24), barriers/enablers (n=18), programmes/interventions (n=15) and implementation guidelines (n=30). Epidemiological evidence shows that IYCF practices were generally poor in conflict settings with median prevalence of exclusive breast feeding at 25%, continued breast feeding at 29%, bottle feeding at 58.3%, introduction to solid, semisolid or soft foods at 71.1% and minimum dietary diversity at 60.3%.IYCF practices were affected by displacement, stress, maternal malnutrition and mental health, family casualties and free distribution of breast milk substitutes. To improve IYCF, several interventions were implemented; including, training of health workers, educating mothers, community networking and mobilisation, lactation-support service, baby friendly hospital initiative, mother–baby friendly spaces and support groups.ConclusionThe evidence suggests that IYCF practices are generally poor in conflict inflicted settings. However, there is potential for improvement by designing effective interventions, responsibly disseminating, monitoring and implementing IYCF guidelines as prescribed by WHO development partners, government and non-government organisations with dedicated funds and investing in capacity development.

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SystEmatic review and meta-aNAlysis of infanT and young child feeding Practices (ENAT-P) in Ethiopia: protocol

BMJ Open ◽

10.1136/bmjopen-2017-017437 ◽

2017 ◽

Vol 7 (8) ◽

pp. e017437 ◽

Cited By ~ 12

Author(s):

Tesfa Dejenie Habtewold ◽

Md. Atiqul Islam ◽

Nigussie Tadesse Sharew ◽

Shimels Hussien Mohammed ◽

Mulugeta Molla Birhanu ◽

...

Keyword(s):

Systematic Review ◽

Young Child ◽

Breast Feeding ◽

Meta Analysis ◽

National Development ◽

Child Feeding ◽

Timely Initiation ◽

Young Child Feeding ◽

Infant And Young Child ◽

Substantial Heterogeneity

IntroductionInfant and young child feeding (IYCF) is the cornerstone of infant and child survival, healthy growth and development, healthy future generations and national development. In spite of the importance of optimal nutrition in low- and middle-income countries, there has been no review conducted in Ethiopia. Thus, the aim of this systematic review and meta-analysis is to estimate the national coverage and identify the associated factors of IYCF practices in Ethiopia.MethodsPubMed, Scopus, EMBASE, CINHAL, EBSCO, Web of Science and WHO Global Health Library databases will be searched for all available publications from 1 January 2000 to 30 September 2017. All published studies on the timely initiation of breast feeding, exclusive breast feeding and timely initiation of complementary feeding practice in Ethiopia will be screened, selected and reviewed. Bibliographies of identified articles and grey literature will be hand-searched as well. Heterogeneity of studies will be quantified using Higgins's method where I2statistic >80% indicates substantial heterogeneity. Funnel plots and Egger's regression test will be used to assess potential publication bias. The Newcastle–Ottawa Scale (NOS) will be used to assess the quality of evidence and risk of bias. Meta-analysis and meta-regression will be carried out to estimate the pooled national prevalence rate and an OR of each associated factor of IYCF practices. Narrative synthesis will be performed if meta-analysis is not feasible due to the substantial heterogeneity of studies.Ethics and disseminationEthical clearance is not required for this study because primary data will not be collected. The results of this systematic review and meta-analysis will be published in a peer-reviewed journal and presented at an (inter)national research symposium.Systematic review registrationThis systematic review and meta-analysis has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017056768.

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Interventions to Improve Infant and Young Child Feeding Practices in Ethiopia: A Systematic Review

10.21203/rs.3.rs-56786/v1 ◽

2020 ◽

Author(s):

Kedir Yimam Ahmed ◽

Kingsley E. Agho ◽

Andrew Page ◽

Amit Arora ◽

Felix Ogbo

Keyword(s):

Systematic Review ◽

Young Child ◽

Interpersonal Communication ◽

Policy Advocacy ◽

Community Mobilisation ◽

Child Feeding ◽

Media Campaigns ◽

Young Child Feeding ◽

Infant And Young Child ◽

Quasi Experimental

Abstract Background: Detailed understanding of the specific types of interventions that can be implemented to increase infant and young child feeding (IYCF) is essential to improve child health and development. In Ethiopia, despite the implementation of several interventions to improve IYCF practices, no published studies have highlighted the most effective IYCF interventions in the country. This systematic review investigated the impacts of various interventions on IYCF in Ethiopia.Methods: A systematic search was conducted on seven computerized bibliographic databases (Embase, ProQuest Central, Scopus, PsycINFO, Web of Science, MEDLINE/PubMed and CINAHL) to locate experimental or quasi-experimental studies. Interventional studies that measured IYCF indicators (early initiation of breastfeeding [EIBF], exclusive breastfeeding [EBF], the introduction of complementary foods, minimum dietary diversity [MDD], minimum meal frequency [MMF] and minimum acceptable diet [MAD]) as outcome variables were included.Results: Of the thirteen eligible studies, ten studies were quasi-experimental and three studies were cluster randomised trials. Five studies showed that interventions in the form of policy advocacy, health service strengthening, interpersonal communication, community mobilisation, and mass media campaigns improved EBF. Four studies indicated that community-level and health facility breastfeeding promotions increased EIBF. Three studies for MDD and two studies for MMF indicated significant effects of policy advocacy, interpersonal communication, community mobilisation, and mass media campaigns on infants and young children. Interventions that were delivered in combination increased the impacts in improving EIBF, MDD and MMF compared to single intervention.Conclusion: Our review showed that a combination of community-level interventions improved EIBF, EBF, MDD, and MMF in Ethiopia. The improvement in IYCF in Ethiopia would require multi-prong approaches at the household and community levels along the continuum of care from conception until a child’s second birthday.

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Infant and young child feeding guidelines: awareness amongst mothers and practices followed

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180568 ◽

2018 ◽

Vol 5 (2) ◽

pp. 629

Author(s):

Shraddha Dubewar ◽

Sarfaraz Ahmed ◽

Saleem H. Tambe ◽

Arvind Chavan

Keyword(s):

Young Child ◽

Breast Feeding ◽

Statistical Significance ◽

Feeding Practices ◽

Educational Status ◽

Child Feeding ◽

Lower Segment Caesarean Section ◽

Young Child Feeding ◽

Infant And Young Child ◽

Education Status

Background: Globally if the exclusive breast feeding is adopted there is up to 15% reduction in the mortality of under five children. At the same time proper “complementary feeding practices” leads to up to 10% more decrease in the mortality rates. The objective of this study was to study the infant and young child feeding practices among mothersMethods: This was an observational study, conducted at Aditya Hospital, Hyderabad in the period duration of 2012-2013. All children upto 24 months of life and their mothers were included in the study.Results: Most common reasons given by the mothers were pain in the stitches and discomfort and anesthesia effect due to lower segment caesarean section (LSCS) (70%). it was found that there was no significant correlation between education status of mother and time of initiation of breast feeding (P=0.6). it was found that there was no statistical significance between giving of pre-lacteals according to educational status of mothers. Almost 60% (n=64) of the mothers were appropriate in starting complementary foods at the age of 6 months. Conclusions: Women need to be educated separately with knowledge regarding of appropriate feeding practices so that both mothers and babies benefit from it; leading further to a healthy nation.

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Infant and Young Child Feeding by Mothers in a Selected Rural Area of Mymensingh

Community Based Medical Journal ◽

10.3329/cbmj.v5i2.53926 ◽

2016 ◽

Vol 5 (2) ◽

pp. 21-25

Author(s):

Sultana Sobnam Dipu ◽

Md Tufael Hossain ◽

Maksuda Begum ◽

AHM Hasan ◽

Fakir Sameul Alam ◽

...

Keyword(s):

Standard Deviation ◽

Young Child ◽

Sample Size ◽

Rural Area ◽

Breast Feeding ◽

Child Nutrition ◽

Child Feeding ◽

Cross Sectional ◽

Young Child Feeding ◽

Infant And Young Child

This study was done to know about infant and young child feeding by mothers in a selected rural area of Mymensingh and to assess nutritional status of infant and young child. This was a descriptive cross-sectional study. The sample size was 625. Sample size and study area was purposively selected. The study was conducted from December 2016 to January 2017 in Churkhai and Winnerpar villages of Bhavokhali union of Sadar upazila Mymensingh. Data were collected on a predesigned questionnaire by direct interviewing the respondents. Data analysis was done by SPSS version 16. A total of 625 mothers who had one child aged between newborn to 24 months participated in the study. Age of mothers ranged from 15 years to 50 years. Mean age of mothers was 24.56 years and standard deviation 5.36 years. Most of the mothers belonged to 15 to 24 years of age. The age of children ranged from newborn to 24 months. Mean age of children was 15.16 months, standard deviation 7.51 months. Majority of children belonged to 19 to 24 months. Majority (54.72%) had normal nutrition. Breast feeding continued up to the age when interviewed, offering colostrums and breast feeding given within half an hour after delivery were excellent among 63.36% of mothers. Weaning in due time, appropriate servings and weaning food appropriate were excellent among 74.80% of mothers of weaning age child. Exclusive breast feeding 74.02% and breast feeding continued up to the age of 24 months were 79.33% were good. Infant and Young Child Feeding practices observed in this study though better than other studies, needs more attention for improved child nutrition and survival. CBMJ 2016 July: Vol. 05 No. 02 P: 21-25

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Knowledge and Practices Regarding Infant and Young Child Feeding among Mothers Working in Readymade Garments Sector in Bangladesh: A Cross-Sectional Survey

Current Research in Nutrition and Food Science Journal ◽

10.12944/crnfsj.9.1.19 ◽

2021 ◽

Vol 9 (1) ◽

pp. 190-201

Author(s):

Afrin Iqbal

Keyword(s):

Young Child ◽

Breast Feeding ◽

Reproductive Age ◽

Feeding Practice ◽

Child Feeding ◽

Cross Sectional ◽

Exclusive Breast Feeding ◽

Young Child Feeding ◽

Infant And Young Child ◽

Maternity Benefits

Optimum is. Adequate Infant and young child feeding (IYCF), critical for child’s growth and development, requires a significant amount of time andcan be challenging for working mothers. In Bangladesh, about four million women work long-hours in Readymade Garment (RMG) factories without proper maternity benefits which raises concern regarding optimum IYCF practice. We conducted a descriptive cross-sectional study in Dhaka, Bangladesh to identify the knowledge and common practices of IYCF among mothers working in Readymade Garment sector. Ninety-three women of reproductive age (15-49 years), working in Readymade Garment sector, with children aged 6-23 months, were interviewed. Our study revealed- majority knew about exclusive breast feeding (EBF) (76%), duration to continue breast feeding (73%) and early initiation of breast feeding (53%). The exclusive breast-feeding practice in mothers employed in RMG sector was 44%. Three-fourths of the mothers knew and initiated complementary feeding timely. Both knowledge regarding age-adjusted minimum meal frequency (MMF) (19.4%) and minimum quantity (8.6%) were low; compared to actual practices. Nearly two-fifth of the mothers (40%) had to start working before their child reached six months of age enabling them to provide their baby with breastmilk substitutes. Mothers employed in Readymade Garment sector had better IYCF practice than general population. Proper workplace environment with mandatory breast-feeding corners, daycare facilities and ensuring maternity benefits in these mothers could help achieve an even better IYCF practices for their children.

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Infant and Young Child Feeding Pattern in Children Attending in the Outpatient Department of an Urban Hospital

Bangladesh Journal of Child Health ◽

10.3329/bjch.v40i2.31564 ◽

2017 ◽

Vol 40 (2) ◽

pp. 92-97

Author(s):

Banani Chakraborty ◽

Jubaida Rumana ◽

Hosne Ara Begum ◽

Afsana Afroz

Keyword(s):

Young Child ◽

Breast Feeding ◽

Dietary Diversity ◽

Early Initiation ◽

Outpatient Department ◽

Feeding Pattern ◽

Urban Hospital ◽

Child Feeding ◽

Young Child Feeding ◽

Infant And Young Child

Background: Proper feeding practices during the first two years of life is essential for growth nutrition and development of young children. Optimum infant and young child feeding can reduce childhood mortality and morbidity significantly. Present study was done to know the infant and young child feeding pattern in the children of 0-23 months of age attending out patient department of an urban hospital.Methods: This cross sectional study was conducted among 314 mother/child pair attending the outpatient department of an urban hospital during the period of September 2014 to December 2014.Result: 68.5% children had early initiation of breast feeding and exclusive breast feeding among children below 6 months was 66.8%.Continued breast feeding among the children of 12 to 15 months was 80.4% and 84.2 % children were given solid food at 6 months of age. Adequate minimum dietary diversity, minimum meal frequency and minimal acceptable diet among children 6-23 months were 61.4%,57.3% and 39.4% respectively.64.5%% children were taking iron rich food or supplementation.Conclusion: Early initiation of breast feeding(0-23mo) and Exclusive breastfeeding(0- 6mo) were satisfactory in the study children but IYCF practice in children of 6-23 months was not optimum and far away from the HPNSDP 2011-2016 target of 52% of children to be fed with minimum acceptable diet.Bangladesh J Child Health 2016; VOL 40 (2) :92-97

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Child nutrition in countries of the Commonwealth of Independent States: time to redirect strategies?

Public Health Nutrition ◽

10.1017/s1368980008003261 ◽

2008 ◽

Vol 11 (12) ◽

pp. 1209-1219 ◽

Cited By ~ 12

Author(s):

Adriano Cattaneo ◽

Arnold Timmer ◽

Tamara Bomestar ◽

Jenny Bua ◽

Sanjiv Kumar ◽

...

Keyword(s):

Young Child ◽

Breast Feeding ◽

Child Nutrition ◽

Current Control ◽

Micronutrient Deficiencies ◽

Child Feeding ◽

Commonwealth Of Independent States ◽

Young Child Feeding ◽

Infant And Young Child ◽

Independent States

AbstractBackgroundCountries in the Commonwealth of Independent States made little progress in child nutrition and mortality between 1990 and 2005. The present paper assesses the nutritional status of children <5 years of age and discusses possible strategies for improvement.MethodsData on low birth weight, infant and young child feeding, underweight, overweight and micronutrient deficiencies were compiled from available reports and databases, complemented through questionnaires to UNICEF Country Offices, and analysed by country, age, gender, urban/rural residence, maternal education and wealth quintiles.ResultsExclusive breast-feeding in the first 6 months and continuing breast-feeding up to 2 years fall short of WHO and UNICEF recommendations. Complementary foods are introduced too early and may be poor in protein and micronutrients. Stunting and underweight are prevalent, especially in children aged 12 to 35 months; overweight is even more prevalent. Vitamin A and I deficiencies are still present in some countries, despite current control efforts. Anaemia ranges between 20 % and 40 %. Higher rates of malnutrition are found in rural areas, children of less educated mothers and lower-income families.DiscussionCurrent public health strategies should be redirected to address: (i) overall protection, promotion and support of infant and young child feeding, in addition to breast-feeding; (ii) overweight, in addition to underweight and stunting; and (iii) malnutrition as a whole, in addition to micronutrient deficiencies. An equity lens should be used in developing policies and plans and implementing and monitoring programmes. Capacity building, cross-sectoral action, improved data collection within adequate legal frameworks and community engagement should be the pillars of redirected strategies.

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Protection, promotion and support of breast-feeding in Europe: current situation

Public Health Nutrition ◽

10.1079/phn2004660 ◽

2005 ◽

Vol 8 (1) ◽

pp. 39-46 ◽

Cited By ~ 8

Author(s):

Adriano Cattaneo ◽

Agneta Yngve ◽

Berthold Koletzko ◽

Luis Ruiz Guzman

Keyword(s):

Young Child ◽

Breast Feeding ◽

Current Situation ◽

Global Strategy ◽

World Health ◽

Child Feeding ◽

Eu Countries ◽

Young Child Feeding ◽

Infant And Young Child ◽

Service Training

AbstractObjective:To describe the current situation regarding protection, promotion and support of breast-feeding in Europe, as a first step towards the development of a blueprint for action.Design and setting:A questionnaire was completed by 29 key informants and 128 other informants in the EU, including member states, accession and candidate countries.Results:EU countries do not fully comply with the policies and recommendations of the Global Strategy on Infant and Young Child Feeding that they endorsed during the 55th World Health Assembly in 2002. Some countries do not even comply with the targets of the Innocenti Declaration (1990). Pre-service training on breast-feeding practice is inadequate and in-service training achieves only low to medium coverage. The Baby Friendly Hospital Initiative is well developed only in three countries; in 19 countries, less than 15% of births occur in baby-friendly hospitals. The International Code of Marketing of Breastmilk Substitutes, endorsed in 1981 by all countries, is not fully applied and submitted to independent monitoring. The legislation for working mothers meets on average the International Labour Organization standards, but covers only women with full formal employment. Voluntary mother-to-mother support groups and trained peer counsellors are present in 27 and 13 countries, respectively. Breast-feeding rates span over a wide range; comparisons are difficult due to use of non-standard methods. The rate of exclusive breast-feeding at 6 months is low everywhere, even in countries with high initiation rates.Conclusions:EU countries need to revise their policies and practices to meet the principles inscribed in the Global Strategy on Infant and Young Child Feeding in order to better protect, promote and support breast-feeding.

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Infant and young child feeding practices and child undernutrition in Bangladesh: insights from nationally representative data

Public Health Nutrition ◽

10.1017/s1368980012001073 ◽

2012 ◽

Vol 15 (9) ◽

pp. 1697-1704 ◽

Cited By ~ 49

Author(s):

Amanda Zongrone ◽

Kate Winskell ◽

Purnima Menon

Keyword(s):

Logistic Regression ◽

Young Child ◽

Breast Feeding ◽

Complementary Feeding ◽

Child Feeding ◽

Diet Diversity ◽

Exclusive Breast Feeding ◽

Young Child Feeding ◽

Infant And Young Child ◽

Nationally Representative

AbstractObjectiveTo determine the association between indicators of infant and young child feeding (IYCF) and anthropometric measures of nutritional status among children aged 0–23 months in a nationally representative data set.DesignData from the 2007 Bangladesh Demographic and Health Survey were used. Analyses were conducted using multiple linear regression and logistic regression analyses adjusted for the complex survey design of the survey, controlling for child, maternal and household characteristics, and including regional dummy variables.SettingBangladesh.SubjectsPairs (n 2096) of last born infants and their mothers.ResultsExclusive breast-feeding under 6 months of age was associated with higher weight-for-height Z-score (effect size (ES) = 0·29; P < 0·05). Appropriate complementary feeding in children aged 6–8 months was associated with higher height-for-age Z-score (HAZ; ES = 0·63; P < 0·01) and higher weight-for-age Z-score (WAZ; ES = 0·30; P < 0·05). Higher dietary diversity index (DDI) was associated with higher HAZ (ES = 0·08; P < 0·01 for every 1 point higher DDI) and higher WAZ (ES = 0·04; P < 0·05). Children who achieved minimum diet diversity had higher HAZ (ES = 0·20; P < 0·05). Logistic regression models confirmed that exclusive breast-feeding was protective against wasting and DDI was protective against stunting and underweight.ConclusionsOur results highlight the importance of IYCF practices as determinants of child growth outcomes in this context, and reinforce the need for interventions that address the spectrum of IYCF practices, from exclusive breast-feeding to age-appropriate complementary feeding, especially diet diversity, in efforts to improve nutrition of infants and young children.

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