Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates
Background Breast 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.Methodology We...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020-09-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e036757.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841555000641191936 |
|---|---|
| author | Jai K Das Zulfiqar Bhutta Amna Rabbani Zahra A Padhani Faareha A Siddiqui |
| author_facet | Jai K Das Zulfiqar Bhutta Amna Rabbani Zahra A Padhani Faareha A Siddiqui |
| author_sort | Jai K Das |
| collection | DOAJ |
| description | Background Breast 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.Methodology We 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.Results We 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.Conclusion The 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. |
| format | Article |
| id | doaj-art-3d8e632cec484d85bd1dea154cac0405 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-3d8e632cec484d85bd1dea154cac04052025-01-08T07:05:09ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-036757Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocatesJai K Das0Zulfiqar Bhutta1Amna Rabbani2Zahra A Padhani3Faareha A Siddiqui49 Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan7 Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, CanadaDivision of Women and Child Health, Aga Khan University, Karachi, Sindh, PakistanSchool of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaDivision of Women and Child Health, Aga Khan University, Karachi, Sindh, PakistanBackground Breast 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.Methodology We 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.Results We 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.Conclusion The 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.https://bmjopen.bmj.com/content/10/9/e036757.full |
| spellingShingle | Jai K Das Zulfiqar Bhutta Amna Rabbani Zahra A Padhani Faareha A Siddiqui Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates BMJ Open |
| title | Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates |
| title_full | Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates |
| title_fullStr | Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates |
| title_full_unstemmed | Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates |
| title_short | Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates |
| title_sort | systematic review of infant and young child feeding practices in conflict areas what the evidence advocates |
| url | https://bmjopen.bmj.com/content/10/9/e036757.full |
| work_keys_str_mv | AT jaikdas systematicreviewofinfantandyoungchildfeedingpracticesinconflictareaswhattheevidenceadvocates AT zulfiqarbhutta systematicreviewofinfantandyoungchildfeedingpracticesinconflictareaswhattheevidenceadvocates AT amnarabbani systematicreviewofinfantandyoungchildfeedingpracticesinconflictareaswhattheevidenceadvocates AT zahraapadhani systematicreviewofinfantandyoungchildfeedingpracticesinconflictareaswhattheevidenceadvocates AT faarehaasiddiqui systematicreviewofinfantandyoungchildfeedingpracticesinconflictareaswhattheevidenceadvocates |