Abdul Rahim Komal, Padhani Zahra A, Ali Anna, Das Jai K, Salam Rehana A, Bhutta Zulfiqar A, Lassi Zohra S
Centre of Excellence in Trauma and Emergencies (CETE), Aga Khan University Hospital, Karachi 74800, Pakistan.
Dean's Office, Medical College, Aga Khan University Hospital, Karachi 74800, Pakistan.
Nutr Rev. 2025 Aug 25. doi: 10.1093/nutrit/nuaf158.
Wasting is a key indicator of child survival and well-being. Enhancing practices related to infant and young child feeding (IYCF) is a suggested strategy to mitigate mortality risks and enhance nutritional conditions associated with wasting. Interventions centered on behavioral modifications through IYCF counseling hold promise in increasing the effectiveness of IYCF practices.
In this review we sought to study the impact of intensive IYCF counseling interventions for preventing wasting and nutritional edema among infants and children up to 5 years of age.
We searched 9 electronic databases for articles published up to July 2021, and conducted an updated search on Ovid MEDLINE and MEDLINE for articles published until April 13, 2023. Randomized controlled trials (RCTs) were included in the review.
Two review authors independently assessed the search results, extracted data, and evaluated the risk of bias.
Our outcomes included prevalence of wasting and underweight, deterioration to severe wasting, anthropometric outcomes (weight-for-height z-score, weight-for-age z-score) and child morbidity and mortality. We summarized the findings of this review for primary outcomes according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. A total of 10 studies from 17 records were found to be eligible for inclusion, and all of these studies were meta-analyzed. Evidence suggests that compared to controls, IYCF counseling is likely to have little to no impact on the prevalence of wasting (relative risk [RR], 0.93; 95% CI, 0.83-1.04; 10 studies; GRADE: moderate). Intensive IYCF counseling had little to no impact on WHZ, MUAC, or WAZ and had an uncertain impact on the prevalence of diarrhea, fever, cough, and underweight (RR, 0.83; 95% CI, 0.70-0.97; 8 studies; GRADE: very low).
Nutrition education and counseling showed uncertain GRADE evidence on reducing prevalence of underweight but had no association with wasting. The findings of this review warrant further studies to investigate the impact of IYCF counseling on child morbidity.
PROSPERO registration No. CRD42021277429.
消瘦是儿童生存和福祉的关键指标。加强与婴幼儿喂养（IYCF）相关的做法是一项建议策略，以降低死亡风险并改善与消瘦相关的营养状况。通过IYCF咨询以行为改变为中心的干预措施有望提高IYCF做法的有效性。
在本综述中，我们试图研究强化IYCF咨询干预措施对预防5岁及以下婴幼儿消瘦和营养性水肿的影响。
我们检索了9个电子数据库，查找截至2021年7月发表的文章，并在Ovid MEDLINE和MEDLINE上进行了更新检索，查找截至2023年4月13日发表的文章。纳入综述的为随机对照试验（RCT）。
两位综述作者独立评估检索结果、提取数据并评估偏倚风险。
我们的结局包括消瘦和体重不足的患病率、恶化为重度消瘦、人体测量学结局（身高别体重z评分、年龄别体重z评分）以及儿童发病率和死亡率。我们根据推荐分级、评估、制定和评价（GRADE）标准总结了本综述关于主要结局的研究结果。从17条记录中发现共有10项研究符合纳入标准，所有这些研究均进行了荟萃分析。证据表明，与对照组相比，IYCF咨询可能对消瘦患病率几乎没有影响（相对风险[RR]，0.93；95%置信区间，0.83 - 1.04；10项研究；GRADE：中等）。强化IYCF咨询对身高别体重、上臂围或年龄别体重几乎没有影响，对腹泻、发热、咳嗽和体重不足的患病率影响不确定（RR，0.83；95%置信区间，0.70 - 0.97；8项研究；GRADE：极低）。
营养教育和咨询在降低体重不足患病率方面显示出证据等级不确定的结果，但与消瘦无关。本综述的结果值得进一步研究，以调查IYCF咨询对儿童发病率的影响。
PROSPERO注册号CRD42021277429。
