Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition
Location: Hall D
Poster Board Number: 283
Objective: Though many children in South Asia are breastfed at some point in their lives, most children are not breastfed optimally, including early initiation of breastfeeding within one hour of birth (EIBF), avoidance of prelacteal feeds during the first three days (APF), exclusive breastfeeding for 6 months (EBF) and continued breastfeeding through 2 years (CBF). This review identifies and collates evidence on the effectiveness of interventions to support and promote optimal breastfeeding in five countries in South Asia from 1990-2015.
Methods: A scoping review was conducted in which PubMed, Web of Science, GenderWatch, POPLINE and Sociological Abstracts were searched to identify and screen peer-reviewed and program evaluation literature in Afghanistan, Bangladesh, India, Nepal and Pakistan. Eligible studies included randomized trials and quasi-experimental designs that were conducted between 1990-2015 and reported breastfeeding outcomes. Data was charted on intervention design, characteristics, and effectiveness to support EIBF, APF, EBF and CBF. Analysis was guided by a socio-ecological framework on breastfeeding.
Results: Thirty-one studies were included. Most studies reported positive impact on EIBF (n=25) or EBF (n=19) outcomes. Fewer studies reported evidence on CBF or APF. Interventions were delivered at the home, community, or health facility. Common intervention types with positive effectiveness were education and counseling and maternal, newborn and child health initiatives. Mass media and community mobilization efforts were also identified, though less often. Programs that reached women and their families through repeated exposure, beginning during pregnancy, increased EIBF and EBF outcomes. Interventions with no impact on breastfeeding were characterized by short duration, irregular frequency, poor gestational timing and poor intervention coverage and targeting.
Conclusions: Effectiveness of interventions to support optimal breastfeeding practices is influenced by program design, implementation and delivery. Research is especially lacking on CBF and APF. Future research must evaluate program implementation pathways to improve and scale-up strategies that support optimal breastfeeding practices from birth through 2 years in South Asia.
Ithaca, New York