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Effect of breastfeeding promotion interventions on child growth: a systematic review and meta-analysis
Elsa R J Giugliani1, Bernardo L Horta2, Christian Loret de Mola2
1Post-Graduate Programme in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Insights
Breastfeeding promotion interventions did not significantly alter child weight or length. However, they showed a modest, significant reduction in body mass index (BMI) z scores, particularly in low- and high-income settings.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Science
Background:
- Child growth and development are critical public health indicators.
- Breastfeeding is widely promoted for its benefits to child health and development.
- Previous reviews have examined the impact of breastfeeding promotion interventions on child growth.
Purpose of the Study:
- To systematically review and meta-analyze the effects of breastfeeding promotion interventions on child growth.
- To update existing evidence on the impact of these interventions on weight, length, and BMI.
Main Methods:
- Searched multiple databases (PubMed/MEDLINE, Embase, Cochrane, Lilacs, SciELO) for studies published between 2006 and 2014.
- Included studies evaluating any breastfeeding promotion intervention's effect on child weight, length, or BMI.
- Conducted meta-analyses on pooled data from 35 relevant studies.
Main Results:
- Breastfeeding promotion interventions showed no significant impact on weight or length/height z scores.
- A modest but significant reduction in body mass index/weight-for-height z scores was observed.
- This BMI reduction was primarily noted in studies from low- and high-income settings.
- Significant heterogeneity was present across studies for all outcomes.
Conclusions:
- Breastfeeding promotion interventions are not associated with significant changes in infant weight or length.
- These interventions demonstrate a modest, significant effect in reducing body mass index/weight-for-height z scores.
- The findings highlight a nuanced impact of breastfeeding promotion on child growth metrics.
Aim:
To update a previous systematic review and meta-analyses about the effect of breastfeeding promotion interventions on child growth.
Methods:
Studies evaluating the effect of any type of breastfeeding promotion intervention on child weight, length (or height) and weight/height (or BMI) were screened. Papers published between 2006 and 2014 were checked using the following databases: PubMed/MEDLINE, Embase, Cochrane Database of Systematic Reviews, Lilacs and SciELO.
Results:
Sixteen studies were added to 19 other studies identified in the previous review, resulting in 35 studies. Meta-analyses of studies reporting on mean weight, length, weight/length or BMI showed that the interventions had no impact on weight or length/height z scores [pooled effect: 0.03 (95% confidence interval: -0.06;0.12) and 0.03 (95% confidence interval: -0.02;0.08), respectively] and had a modest, but significant, reduction in body mass index/weight-for-height z scores [z score mean difference: -0.06 (95% confidence interval: -0.12;0.00)], which was limited to studies from low- and high-incomes settings. For all three outcomes, there was important heterogeneity among studies, which should be taken into account when interpreting the results.
Conclusion:
Breastfeeding promotion interventions were not associated with significant changes in weight or length, but led to a modest, albeit significant, reduction in body mass index/weight-for-height z scores.
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