Interventions to improve growth during exclusive breastfeeding of children aged 0-6 months in low- and middle-income countries
Citation: Park JJH, Siden E, Harari O, et al. Interventions to improve linear growth during exclusive breastfeeding life-stage for children aged 0-6 months living in low- and middle-income countries: a systematic review with network and pairwise meta-analyses. Gates Open Research. 2020;3:1720.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: Bill and Melinda Gates Foundation.
What is this? Despite significant progress in maternal, newborn and child health, many children fail to reach their linear growth potential, particularly in low- and middle-income countries (LMICs).
The authors of this systematic review and network meta-analysis searched for randomized trials of interventions related to micronutrient supplements, food supplements, deworming for mothers, maternal and breastfeeding education and promotion, WASH and kangaroo care for infants aged 0-6 months and/or their breastfeeding mothers in LMICs. They restricted their searches to studies published in English and did the search in September 2019. They included 29 randomised trials (35,119 mother and infant pairs).
What works? Kangaroo care improved the growth velocity of head circumference and length compared to standard care.
Multiple micronutrients given to infants improved their length-for-age z-score (LAZ) compared to standard care.
What doesn’t work: The review found no improvements in LAZ or stunting with deworming and WASH interventions.
The review found no improvement in LAZ when supplementing breastfeeding mothers with multiple micronutrients.
No interventions were found to reduce the risk of stunting compared to standard care.
Implications: The authors concluded that they had identified important improvements with kangaroo care, but that they did not find sufficient evidence for other interventions. They highlighted a need for more efficient clinical trial design to continue to elucidate the most effective interventions.
Other considerations: The authors of the review discussed their findings in the context of socioeconomic status and place of residence (LMICs).
This summary was prepared by Tuba Yavuz, checked by Sydney Johnson, and finalized by Mike Clarke.