Maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews.

<h4>Background</h4>Small and nutritionally at-risk infants under 6 months (<6m) are a vulnerable group at increased risk of mortality, morbidity, poor growth and sub-optimal development. Current national and international (World Health Organization) management guidelines focus mainly...

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Autores principales:	Victoria von Salmuth, Eilise Brennan, Marko Kerac, Marie McGrath, Severine Frison, Natasha Lelijveld
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/79ae7362945a49d2a287b72e64912ff0
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spelling	oai:doaj.org-article:79ae7362945a49d2a287b72e64912ff02021-12-02T20:17:50ZMaternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews.1932-620310.1371/journal.pone.0256188https://doaj.org/article/79ae7362945a49d2a287b72e64912ff02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256188https://doaj.org/toc/1932-6203<h4>Background</h4>Small and nutritionally at-risk infants under 6 months (<6m) are a vulnerable group at increased risk of mortality, morbidity, poor growth and sub-optimal development. Current national and international (World Health Organization) management guidelines focus mainly on infants' needs, yet growing evidence suggests that maternal factors also influence infant outcomes. We aimed to inform future guidelines by exploring the impacts of maternal-focused interventions on infant feeding and growth.<h4>Methods</h4>We conducted a systematic review of reviews published since 2008 (PROSPERO, register number CRD 42019141724). We explored five databases and a wide variety of maternal-focused interventions based in low- and middle-income countries. Infant outcomes of interest included anthropometric status, birthweight, infant mortality, breastfeeding and complementary feeding practices. Given heterogenous interventions, we present a narrative synthesis of the extracted data.<h4>Results</h4>We included a total of 55 systematic reviews. Numerous maternal interventions were effective in improving infant growth or feeding outcomes. These included breastfeeding promotion, education, support and counselling interventions. Maternal mental health, while under-researched, showed potential to positively impact infant growth. There was also some evidence for a positive impact of: women's empowerment, m-health technologies, conditional cash transfers, water, sanitation and hygiene and agricultural interventions. Effectiveness was increased when implemented as part of a multi-sectoral program. Antenatal supplementation with macronutrient, multiple micronutrients, Vitamin D, zinc, iron folic acid and possibly calcium, iodine and B12 in deficient women, improved birth outcomes. In contrast, evidence for postnatal supplementation was limited as was evidence directly focusing on small and nutritionally at-risk infants; most reviews focused on the prevention of growth faltering.<h4>Conclusion</h4>Our findings suggest sufficient evidence to justify greater inclusion of mothers in more holistic packages of care for small and nutritionally at-risk infants aged <6m. Context specific approaches are likely needed to support mother-infant dyads and ensure infants survive and thrive.Victoria von SalmuthEilise BrennanMarko KeracMarie McGrathSeverine FrisonNatasha LelijveldPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0256188 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Victoria von Salmuth Eilise Brennan Marko Kerac Marie McGrath Severine Frison Natasha Lelijveld Maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews.
description	<h4>Background</h4>Small and nutritionally at-risk infants under 6 months (<6m) are a vulnerable group at increased risk of mortality, morbidity, poor growth and sub-optimal development. Current national and international (World Health Organization) management guidelines focus mainly on infants' needs, yet growing evidence suggests that maternal factors also influence infant outcomes. We aimed to inform future guidelines by exploring the impacts of maternal-focused interventions on infant feeding and growth.<h4>Methods</h4>We conducted a systematic review of reviews published since 2008 (PROSPERO, register number CRD 42019141724). We explored five databases and a wide variety of maternal-focused interventions based in low- and middle-income countries. Infant outcomes of interest included anthropometric status, birthweight, infant mortality, breastfeeding and complementary feeding practices. Given heterogenous interventions, we present a narrative synthesis of the extracted data.<h4>Results</h4>We included a total of 55 systematic reviews. Numerous maternal interventions were effective in improving infant growth or feeding outcomes. These included breastfeeding promotion, education, support and counselling interventions. Maternal mental health, while under-researched, showed potential to positively impact infant growth. There was also some evidence for a positive impact of: women's empowerment, m-health technologies, conditional cash transfers, water, sanitation and hygiene and agricultural interventions. Effectiveness was increased when implemented as part of a multi-sectoral program. Antenatal supplementation with macronutrient, multiple micronutrients, Vitamin D, zinc, iron folic acid and possibly calcium, iodine and B12 in deficient women, improved birth outcomes. In contrast, evidence for postnatal supplementation was limited as was evidence directly focusing on small and nutritionally at-risk infants; most reviews focused on the prevention of growth faltering.<h4>Conclusion</h4>Our findings suggest sufficient evidence to justify greater inclusion of mothers in more holistic packages of care for small and nutritionally at-risk infants aged <6m. Context specific approaches are likely needed to support mother-infant dyads and ensure infants survive and thrive.
format	article
author	Victoria von Salmuth Eilise Brennan Marko Kerac Marie McGrath Severine Frison Natasha Lelijveld
author_facet	Victoria von Salmuth Eilise Brennan Marko Kerac Marie McGrath Severine Frison Natasha Lelijveld
author_sort	Victoria von Salmuth
title	Maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews.
title_short	Maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews.
title_full	Maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews.
title_fullStr	Maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews.
title_full_unstemmed	Maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews.
title_sort	maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: a systematic review of reviews.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/79ae7362945a49d2a287b72e64912ff0
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Maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews.

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