A systematic review of hot weather impacts on infant feeding practices in low-and middle-income countries

Abstract

BackgroundIncreased rates of exclusive breastfeeding could significantly improve infant survival in low- and middle-income countries. There is a concern that increased hot weather due to climate change may increase rates of supplemental feeding due to infants requiring fluids, or the perception that infants are dehydrated.ObjectiveTo understand how hot weather conditions may impact infant feeding practices by identifying and appraising evidence that exclusively breastfed infants can maintain hydration levels under hot weather conditions, and by examining available literature on infant feeding practices in hot weather.MethodsSystematic review of published studies that met inclusion criteria in MEDLINE, EMBASE, Global Health and Web of Science databases. The quality of included studies was appraised against predetermined criteria and relevant data extracted to produce a narrative synthesis of results.ResultsEighteen studies were identified. There is no evidence among studies of infant hydration that infants under the age of 6months require supplementary food or fluids in hot weather conditions. In some settings, healthcare providers and relatives continue to advise water supplementation in hot weather or during the warm seasons. Cultural practices, socio-economic status, and other locally specific factors also affect infant feeding practices and may be affected by weather and seasonal changes themselves.ConclusionInterventions to discourage water/other fluid supplementation in breastfeeding infants below 6 months are needed, especially in low-middle income countries. Families and healthcare providers should be advised that exclusive breastfeeding (EBF) is recommended even in hot conditions.

The epidemiology and associated factors of non-exclusive breastfeeding: a comparative cross-sectional study of livelihood-secure and insecure areas

“…Because this study focused on reporting only the epidemiology of NEBF and identifying associated factors in two areas with different climatic zones and vulnerability status, it does not definitively establish causal links between the effect of hot climatic zones and the provision of water and other fluids to u6m infants, as established elsewhere (111)(112)(113). As a result, we emphasize the careful interpretation of our findings and highlight the importance of further investigation to quantify the impact of climate change and seasonal variation on the population attributable risk (PAR) of NEBF practice in various climatic zones, particularly in resource-limited settings such as Ethiopia.…”

Breastfeeding practices and social norms in Kinshasa, Democratic Republic of the Congo: A qualitative study

“…This misconception has been previously reported in Kinshasa [ 25 ], and Ghana [ 43 ]. However, during the first six months of life, even in warm climates, healthy infants who are exclusively breastfed do not need water [ 44 ]. Moreover, in Kinshasa, access to safe drinking water is limited.…”

Role of Governance in Developing Disaster Resiliency and Its Impact on Economic Sustainability

“…The different studies reviewed in the literature show that most countries across Europe are believed to suffer from heat, storms, and flooding as well as long-term dangers such as sea-level rise and drought (Sheehan et al 2022;Edney et al 2022). The studies also show that most government leaders and place-specific decision-makers (the local government) are more aware of local adaptation strategies that can be used to enhance disaster resilience.…”