Effectiveness of Breastfeeding Support Packages in Low- and Middle-Income Countries for Infants under Six Months: A Systematic Review

Small and nutritionally at-risk infants under six months, defined as those with wasting, underweight, or other forms of growth failure, are at high-risk mortality morbidity. The World Health Organisation 2013 guidelines on severe acute malnutrition highlight the need to effectively manage this vulnerable group, but programmatic challenges widely reported. This review aims inform future management strategies for small months in low- middle-income countries (LMICs) by synthesising evidence existing breastfeeding support packages all months. We searched PubMed, CINAHL, Cochrane Library, EMBASE, Global databases from inception 18 July 2018. Intervention interest were packages. Studies reporting practices and/or caregivers’/healthcare staffs’ knowledge/skills/practices LMICs included. Study quality was assessed using NICE appraisal checklist intervention studies. A narrative data synthesis Synthesis Without Meta-analysis (SWiM) guideline conducted key features successful programmes identified. Of 15,256 studies initially identified, 41 eligible inclusion. They geographically diverse, representing 22 LMICs. Interventions mainly targeted mother–infant pairs only 7% (n = 3) included infants. rated be good adequate quality. Twenty focused hospital-based interventions, another 20 community-based one study compared both. Among counselling 6) education showed most positive effect followed training 4), promotion 4) peer 3). Breastfeeding also improved caregivers’ knowledge/skills/practices. Identified can serve "primary prevention" interventions For infants, these adapted formally tested Future work should examine impacts anthropometry morbidity outcomes. protocol registered International Prospective Register Systematic Reviews (PROSPERO 2018 CRD42018102795).