Effectiveness of programmes and interventions to support optimal breastfeeding among children 0-23 months, South...

Area of Science:

• Maternal and Child Health
• Public Health Interventions
• Nutrition Science

Background:

• Optimal breastfeeding practices, including early initiation (EIBF), avoidance of prelacteal feeds (APF), exclusive breastfeeding (EBF), and continued breastfeeding (CBF), are crucial for child survival and development in South Asia.
• Despite high breastfeeding rates, suboptimal practices remain prevalent, necessitating effective interventions.

Purpose of the Study:

• To review and synthesize evidence on the effectiveness of interventions supporting optimal breastfeeding practices in Afghanistan, Bangladesh, India, Nepal, and Pakistan.
• To identify characteristics of successful interventions for EIBF, APF, EBF, and CBF.

Main Methods:

• A scoping review of peer-reviewed and grey literature published between 1990 and 2015.
• Inclusion of 31 studies with randomized trials and quasi-experimental designs.
• Data extraction on intervention design, characteristics, and impact on breastfeeding outcomes.

Main Results:

• Most studies reported positive impacts: 21/25 for EIBF, 15/19 for EBF, and 10/10 for APF.
• Education, counseling, and integrated maternal, newborn, and child health initiatives were common effective intervention types.
• Interventions with repeated exposure, starting during pregnancy, and delivered in multiple environments (health facility, community, home) showed greater success.

Conclusions:

• Interventions are effective in improving early initiation, exclusivity, and avoidance of prelacteal feeds in South Asia.
• Continued breastfeeding (CBF) effectiveness requires further investigation.
• Successful interventions are characterized by comprehensive delivery, repeated exposure, and early initiation during pregnancy.