Global evidence

In terms of breast feeding, WHO recommends early (i.e. within one hour of giving birth) initiation of breastfeeding. A recent trial has shown that early initiation of breastfeeding could reduce neonatal mortality by 22% (Edmond et al, 2006). Black et al, 2008, assessed the effect of promotion strategies on exclusive breastfeeding rates for infants younger than 6 months and on continued breastfeeding up to 12 months of age. A Cochrane review (Britton et al, 2007) that analyzed 34 trials (with 29,385 mother–infant pairs from 14 countries) showed that all forms of extra support increased the duration of “any breastfeeding” (including partial and exclusive breastfeeding); the relative risk (RR) for stopping any breastfeeding before 6 months was 0•91 (95% CI 0•86–0•96) .

In terms of complementary feeding, the global evidence on appropriate Infant and Young Child Feeding (IYCF) practices include timely initiation of feeding solid/semi-solid foods from age 6 months, feeding small amounts and increasing the amount of foods and the frequency of feeding as the child gets older, while maintaining breastfeeding . A review of complementary-feeding strategies concluded that appropriately designed interventions can have a positive effect on feeding practices (Caulfield et al, 1999). Bhutta et al 2008, reviewed the effect of complementary-feeding strategies on growth and micronutrient status and did additional meta-analyses on linear growth at various ages. With ten studies that had measured similar outcomes, data were pooled according to whether or not the target population had an average income of more than US$1 per day per person (as a measure of food security) . The studies showed that education strategies were of most benefit in populations that had sufficient means to procure appropriate food (Gulden et al, 2000; Penny et al, 2005; Santos et al, 2001).

In populations without this security, educational interventions were of benefit when combined with food supplements (Bhutta, 2008). In food-secure populations, the strongest evidence of effect was seen from the interventions in China (Gulden et al, 2000) and Peru (Penny et al, 2005). The benefits on growth from food supplementation in food-insecure populations were consistent with those seen with large-scale conditional cash transfer (CCTs) programmes in similar populations in Mexico (Behrman et al, 2001) and Nicaragua (Maluccio et al, 2005). These programmes combined cash transfers and nutritional education, and one also included a supplementary food fortified with multiple micronutrients (Behrman et al, 2001). The effect of complementary feeding strategies was therefore estimated in various contexts and age-groups by combining the information from the pooled analysis of experimental studies and the assessment of the Progresa programme in Mexico (Behrman et al, 2001). 


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Global evidence
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