School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
Sekolah Tinggi Ilmu Kesehatan Yarsi Mataram, Mataram, Indonesia.
J Nurs Scholarsh. 2022 Nov;54(6):692-703. doi: 10.1111/jnu.12799. Epub 2022 Jul 18.
This meta-analysis was conducted to examine the association between breastfeeding and undernutrition among children under 5 years of age in developing countries.
Systematic review and meta-analysis.
A comprehensive literature search was conducted of datasets from Embase, CINHAL, PubMed, Cochrane Library, and Indonesian databases to include eligible studies. Comprehensive Meta-Analysis 3.0 statistical software was used to perform data entry and data analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were extracted from each study or were calculated based on the reported number of cases and controls in each study. Random-effects models or fixed-effects models were used to demonstrate overall risk estimates. A moderator analysis was conducted to examine possible moderators explaining the heterogeneity across studies.
In total, 33 studies were included which examined the association of breastfeeding with undernutrition. A random-effects model showed that breastfeeding had inverse correlations with overall undernutrition (OR = 0.82, 95% CI = 0.68, 0.99) and the stunting type of undernutrition (OR = 0.73, 95% CI = 0.55, 0.95). A moderator analysis showed that studies which included exclusive breastfeeding and unclear birth weights had low risks of overall undernutrition (p < 0.05). Moreover, studies which included exclusive breastfeeding and adopted a case-control study design exhibited a low risk of the stunting type of undernutrition (p < 0.05).
Providing breastfeeding or exclusive breastfeeding can benefit children under 5 years of age in developing countries reduce overall undernutrition and the stunting type of undernutrition.
Healthcare professionals should develop and implement suitable strategies to increase awareness regarding the importance of breastfeeding and enhance breastfeeding and exclusive breastfeeding adherence.
本荟萃分析旨在研究发展中国家 5 岁以下儿童母乳喂养与营养不足之间的关联。
系统评价和荟萃分析。
对 Embase、CINHAL、PubMed、Cochrane 图书馆和印度尼西亚数据库中的数据集进行全面文献检索，纳入符合条件的研究。使用 Comprehensive Meta-Analysis 3.0 统计软件进行数据输入和数据分析。从每项研究中提取优势比（OR）及其 95%置信区间（CI），或者根据每项研究中报告的病例和对照数量计算。使用随机效应模型或固定效应模型来展示总体风险估计。进行了一项调节分析，以检查可能的调节因素，解释研究之间的异质性。
共纳入 33 项研究，考察了母乳喂养与营养不足之间的关联。随机效应模型显示，母乳喂养与总体营养不足（OR=0.82，95%CI=0.68，0.99）和发育迟缓型营养不足（OR=0.73，95%CI=0.55，0.95）呈负相关。调节分析显示，纳入纯母乳喂养和未明确出生体重的研究总体营养不足风险较低（p<0.05）。此外，纳入纯母乳喂养且采用病例对照研究设计的研究发育迟缓型营养不足风险较低（p<0.05）。
为 5 岁以下儿童提供母乳喂养或纯母乳喂养可使发展中国家的儿童受益，降低总体营养不足和发育迟缓型营养不足的风险。
医疗保健专业人员应制定并实施适当的策略，提高人们对母乳喂养重要性的认识，并加强母乳喂养和纯母乳喂养的依从性。
