Effectiveness of interventions on early initiation of breastfeeding in South Asia: a systematic review and meta-analysis of randomized controlled trials.

IF 2.9 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
M A Rifat, Mahashweta Chakrabarty, Syeda Saima Alam, Masum Ali, Syeda Sumaiya Nasrin, Plabon Sarkar, Aditya Singh, Sanjib Saha
{"title":"Effectiveness of interventions on early initiation of breastfeeding in South Asia: a systematic review and meta-analysis of randomized controlled trials.","authors":"M A Rifat, Mahashweta Chakrabarty, Syeda Saima Alam, Masum Ali, Syeda Sumaiya Nasrin, Plabon Sarkar, Aditya Singh, Sanjib Saha","doi":"10.1186/s13006-025-00736-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Early initiation of breastfeeding, defined as breastfeeding within one hour of birth, halves the risk of neonatal mortality, establishing it as a crucial outcome component in various interventions implemented across South Asian countries. However, the overall effect of these interventions remain unexamined. Therefore, this study seeks to address this knowledge gap by evaluating the overall effect of these interventions on maternal early initiation of breastfeeding practice.</p><p><strong>Methods: </strong>A systematic literature search was performed to identify randomised controlled trials conducted in South Asia focusing on early initiation of breastfeeding as an outcome variable. The interventions identified were categorized into behavioral, mobile health (mHealth), health system strengthening, and nutritional interventions. Random effects meta-analysis was conducted to estimate the pooled effect of interventions and effectiveness by intervention categories. Heterogeneity was explored by sub-group and meta-regression analyses. The risk of bias and strength of evidence were assessed by Cochrane's RoB2 assessment tool and GRADE criteria, respectively.</p><p><strong>Results: </strong>We included 22 articles published, representing 19 unique interventions, from a pool of 2,524 screened records for review and narrative synthesis. Among these, 19 articles were eligible for meta-analysis. The pooled relative risk (RR) of early initiation of breastfeeding among mothers in the intervention groups, as compared to their counterparts, was 1.55 (95% CI: 1.24, 1.95; I<sup>2</sup> = 99.56; p < 0.001). Interventions targeted health system strengthening represented stronger effect than other types of interventions. The overall strength of evidence was moderate.</p><p><strong>Conclusion: </strong>The overall intervention effect appeared efficacious in improving maternal early initiation of breastfeeding practice in South Asia, providing valuable insights for policymakers to develop contextually feasible strategies.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"43"},"PeriodicalIF":2.9000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117840/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Breastfeeding Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13006-025-00736-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Early initiation of breastfeeding, defined as breastfeeding within one hour of birth, halves the risk of neonatal mortality, establishing it as a crucial outcome component in various interventions implemented across South Asian countries. However, the overall effect of these interventions remain unexamined. Therefore, this study seeks to address this knowledge gap by evaluating the overall effect of these interventions on maternal early initiation of breastfeeding practice.

Methods: A systematic literature search was performed to identify randomised controlled trials conducted in South Asia focusing on early initiation of breastfeeding as an outcome variable. The interventions identified were categorized into behavioral, mobile health (mHealth), health system strengthening, and nutritional interventions. Random effects meta-analysis was conducted to estimate the pooled effect of interventions and effectiveness by intervention categories. Heterogeneity was explored by sub-group and meta-regression analyses. The risk of bias and strength of evidence were assessed by Cochrane's RoB2 assessment tool and GRADE criteria, respectively.

Results: We included 22 articles published, representing 19 unique interventions, from a pool of 2,524 screened records for review and narrative synthesis. Among these, 19 articles were eligible for meta-analysis. The pooled relative risk (RR) of early initiation of breastfeeding among mothers in the intervention groups, as compared to their counterparts, was 1.55 (95% CI: 1.24, 1.95; I2 = 99.56; p < 0.001). Interventions targeted health system strengthening represented stronger effect than other types of interventions. The overall strength of evidence was moderate.

Conclusion: The overall intervention effect appeared efficacious in improving maternal early initiation of breastfeeding practice in South Asia, providing valuable insights for policymakers to develop contextually feasible strategies.

南亚早期开始母乳喂养干预措施的有效性:随机对照试验的系统回顾和荟萃分析。
背景:早期开始母乳喂养(定义为出生后一小时内母乳喂养)可将新生儿死亡风险减半,使其成为南亚国家实施的各种干预措施的关键结果组成部分。然而,这些干预措施的总体效果仍未得到检验。因此,本研究旨在通过评估这些干预措施对母亲早期开始母乳喂养实践的总体影响来解决这一知识差距。方法:进行了系统的文献检索,以确定在南亚进行的以早期开始母乳喂养为结果变量的随机对照试验。已确定的干预措施分为行为干预、移动健康(mHealth)、加强卫生系统和营养干预。随机效应荟萃分析按干预类别估计干预的综合效应和有效性。通过亚组分析和元回归分析探讨异质性。偏倚风险和证据强度分别采用Cochrane的RoB2评估工具和GRADE标准进行评估。结果:我们从2,524份经过筛选的记录中纳入了22篇已发表的文章,代表了19种独特的干预措施,用于综述和叙事综合。其中,有19篇文章符合meta分析。干预组中母亲早期开始母乳喂养的总相对危险度(RR)为1.55 (95% CI: 1.24, 1.95;i2 = 99.56;结论:在改善南亚地区母亲早期开始母乳喂养实践方面,总体干预效果似乎是有效的,为政策制定者制定情境可行的策略提供了有价值的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
International Breastfeeding Journal
International Breastfeeding Journal Medicine-Obstetrics and Gynecology
CiteScore
6.30
自引率
11.40%
发文量
76
审稿时长
32 weeks
期刊介绍: Breastfeeding is recognized as an important public health issue with enormous social and economic implications. Infants who do not receive breast milk are likely to experience poorer health outcomes than breastfed infants; mothers who do not breastfeed increase their own health risks. Publications on the topic of breastfeeding are wide ranging. Articles about breastfeeding are currently published journals focused on nursing, midwifery, paediatric, obstetric, family medicine, public health, immunology, physiology, sociology and many other topics. In addition, electronic publishing allows fast publication time for authors and Open Access ensures the journal is easily accessible to readers.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信