Breastfeeding assessment tools for at-risk and malnourished infants aged under 6 months old: a systematic review

Brugaletta, Concetta; Roch, Karine Le; Saxton, Jennifer; Bizouerne, Cécile; McGrath, Marie; Kerac, Marko

doi:10.12688/f1000research.24516.2

Cited by 5 publications

(7 citation statements)

References 76 publications

(16 reference statements)

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“…These studies should focus on the potential role of maternal malnutrition, both under and overweight and micronutrient deficiencies, on DOL and SRIM, and use objective measures of breast milk volume and quality. It is particularly important to prioritise SRIM and DOL prevention among infants less than 6 months old to prevent wasting taking into account available BF assessment tools for at‐risk and malnourished infants aged under 6 months old (Brugaletta et al, 2020; UNICEF, 2021).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for self‐reported insufficient milk during the first 6 months of life: A systematic review

Segura‐Pérez

Richter

Rhodes

et al. 2022

Maternal & Child Nutrition

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The objective of this systematic review was to identify multifactorial risk factors for self-reported insufficient milk (SRIM) and delayed onset of lactation (DOL). The review protocol was registered a priori in PROSPERO (ID# CDR42021240413). Of the 120 studies included (98 on SRIM, 18 on DOL, and 4 both), 37 (31%) studies were conducted in North America, followed by 26 (21.6%) in Europe, 25 (21%) in East Asia, and Pacific, 15 (12.5%) in Latin America and the Caribbean, 7 (6%) in the Middle East and North Africa, 5 (4%) in South Asia, 3 (2.5%) in Sub-Saharan Africa, and 2 (1.7%) included multiple countries. A total of 79 studies were from highincome countries, 30 from upper-middle-income, 10 from low-middle-income countries, and one study was conducted in a high-income and an upper-middleincome country. Findings indicated that DOL increased the risk of SRIM. Protective factors identified for DOL and SRIM were hospital practices, such as timely breastfeeding (BF) initiation, avoiding in-hospital commercial milk formula supplementation, and BF counselling/support. By contrast, maternal overweight/obesity, caesarean section, and poor maternal physical and mental health were risk factors for DOL and SRIM. SRIM was associated with primiparity, the mother's interpretation of the baby's fussiness or crying, and low maternal BF self-efficacy. Biomedical factors including epidural anaesthesia and prolonged stage II labour were associated with DOL. Thus, to protect against SRIM and DOL it is key to prevent unnecessary caesarean sections, implement the Baby-Friendly Ten Steps at maternity facilities, and provide BF counselling that includes baby behaviours.

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Section: Discussionmentioning

confidence: 99%

Risk factors for self‐reported insufficient milk during the first 6 months of life: A systematic review

Segura‐Pérez

Richter

Rhodes

et al. 2022

Maternal & Child Nutrition

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“…The HHFA-MAMI general scores with interquartile range (n=15) were: general service availability 51% (35-63), general service readiness 69% (64-76), management & finance 50% (44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59) and clinical quality of care 48%. Within general service availability, infrastructure (50%, 41-53) and health workforce (21%, 0-33) scored lowest with only four facilities meeting the primary health facility density indicator and one meeting the nurse/ midwife density indicator (Table 2).…”

Section: General Service Readiness In Primary Health Facilities (Obje...mentioning

confidence: 99%

“…Within general service availability, infrastructure (50%,[41][42][43][44][45][46][47][48][49][50][51][52][53] and health workforce (21%, 0-33) scored lowest with only four facilities meeting the primary health facility density indicator and one meeting the nurse/ midwife density indicator (Table2). HHFA-MAMI results: primary health care dimensions and MAMI availability & readiness…”

mentioning

confidence: 99%

Primary health facility readiness to care for infants under six months at risk of poor growth and development: A HHFA-based survey

van Immerzeel,

Ba,

Diagne

et al. 2024

Preprint

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Malnutrition in infants under six months of age (u6m) is poorly identified and managed in many countries, increasing these children’s risk of poor growth and development and preventable mortality and morbidity. New 2023 WHO malnutrition guidelines recommend assessment, classification and treatment at primary health care level. This study aimed to assess primary health facility availability and readiness for WHO-recommended nutritional care in infants u6m. We adapted the WHO Harmonized Health Facility Assessment (HHFA) with additional items for Management of small and nutritionally At-risk Infants u6m and their Mothers (MAMI): the HHFA-MAMI tool. Methods included survey of health care providers, direct observation and data extraction from routine registers to calculate mean percentages of a set of items for different readiness areas. We assessed 15 primary health facilities in Senegal, focusing on the five contact points for infants u6m: delivery and postnatal care, immunization programmes, sick child clinics and community health care. The HHFA-MAMI scores with interquartile range (n=15) were: general service availability 51% (35-63), general service readiness 69% (64-76), management & finance 50% (44-59), clinical quality of care 48%. MAMI availability scored 50% and readiness 36%, MAMI infrastructure scored 72%, health workforce 61%, assess MAMI 53%, classify MAMI 17% and treat MAMI 38%, equipment 32% and guidelines & training 23%. Service utilization was highest in postnatal care and immunization contact points, MAMI availability & readiness was highest in delivery and postnatal care. We conclude that primary health facilities in Senegal have potential to care for infants u6m at risk of poor growth and development with high general PHC readiness and frequent use of care contact points for infants u6m. MAMI availability and readiness require improvements to provide WHO-recommended care.

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“…The coronavirus (COVID‐19) was initially recognized by the World Health Organization (WHO) as a dangerous respiratory infectious disease and a global public health emergency on 11th March 2020 (Brugaletta et al., 2020; WHO, 2020). The Ministry of Health in Tanzania reported the first COVID‐19 case on 16th March 2020.…”

Section: Introductionmentioning

confidence: 99%

“We always felt psychologically unstable”: A qualitative study of midwives' experiences in providing maternity care during the COVID‐19 pandemic in Tanzania

Joho,

Abdallah

2024

Nursing Open

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AimWe explored midwives' experiences and challenges in providing maternity care during the period of the first surge of the COVID‐19 pandemic in Dodoma.DesignPhenomenological study design was used to explore midwives' experiences and challenges in providing maternity care during the COVID‐19 pandemic in Tanzania.MethodsWe conducted interviews with a total of 23 midwives, using semi‐structured interviews and an audio recorder. Five focus group discussions (FGDs) were conducted. To analyse the data, we used interpretive phenomenological thematic data analysis with NVivo software. To analyse templates, we followed a step‐by‐step process, starting with familiarizing ourselves with the data, followed by preliminary coding, organizing themes, developing an initial coding template, using the initial template, refining the template and finally applying it to the entire dataset.ResultsIt was found that three themes and eight subthemes merged in the current study. The main themes were ① mental health distress, ② work environment challenges and ③ isolation of midwives by different groups.Public ContributionReducing risk and protecting midwives from infectious diseases will improve the workforce, reduce the number of hospital stays, reduce the cost of hospital services, improve birth outcomes and indirectly improve family, community and national economies.ConclusionDue to the system's failure to provide psychological support, protective environment and isolation rooms for confirmed or suspected cases put midwives at a higher risk of contracting the virus and had to work in a stressful environment. In addition to having the right tools, midwives must also receive emotional and psychological support in order to be at their best. The system must ensure that midwives are ready for uncertain times, such as pandemic infectious disease outbreaks, by providing protective work place environment such as personal protective equipment, psychological support and isolation room for confirmed COVID‐19 cases.

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Breastfeeding assessment tools for at-risk and malnourished infants aged under 6 months old: a systematic review

Cited by 5 publications

References 76 publications

Risk factors for self‐reported insufficient milk during the first 6 months of life: A systematic review

Risk factors for self‐reported insufficient milk during the first 6 months of life: A systematic review

Primary health facility readiness to care for infants under six months at risk of poor growth and development: A HHFA-based survey

“We always felt psychologically unstable”: A qualitative study of midwives' experiences in providing maternity care during the COVID‐19 pandemic in Tanzania

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