Nutrition education to support weaning of term‐born infants | Figure 1

%27%3e%3cg%20id=%27Group-14%27%20transform=%27translate(13.000000,%20103.176124)%27%3e%3cg%20id=%27Group-Copy-5%27%20transform=%27translate(0.000000,%20182.676124)%27%3e%3crect%20id=%27Rectangle-8%27%20fill=%27%23E2E0DE%27%20x=%270%27%20y=%270%27%20width=%2736%27%20height=%2736%27%20rx=%2718%27%3e%3c/rect%3e%3cpath%20d=%27M28,27.6503435%20C28,22.127496%2023.5228474,17.6503435%2018,17.6503435%20C12.4771525,17.6503435%208,22.127496%208,27.6503435%20M18,16.3472505%20C20.8165136,16.3472505%2023.099749,14.0640151%2023.099749,11.2475015%20C23.099749,8.43098783%2020.8165136,6.1477524%2018,6.1477524%20C15.1834863,6.1477524%2012.9002509,8.43098783%2012.9002509,11.2475015%20C12.9002509,14.0640151%2015.1834863,16.3472505%2018,16.3472505%20Z%27%20id=%27Combined-Shape%27%20fill=%27%23FFFFFF%27%20fill-rule=%27nonzero%27%3e%3c/path%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/svg%3e)

Deleted account

Some actions are only available when you log in.

Report case

Report this to our moderators

Nutrition education to support weaning of term‐born infants

You can view up to 4 cases without signing up Sign up for unlimited access

Review question

We reviewed the evidence for effects of nutrition education about appropriate feeding practices during weaning on growth and development in children born at term gestation.

Background

Around the world, over 150 million children are undernourished and over 42 million are overweight and obese. Providing families with appropriate education about feeding practices during weaning may help to optimise nutrition while helping to protect children who are at risk of undernutrition, as well as those susceptible to being overweight and obese.

Study characteristics

We examined research published up to December 2019 and found 21 clinical trials recruiting 14,241 babies. The nutrition education provided in all included studies, whereby analysis could be pooled together, was aimed at reducing the risk of undernutrition in childhood. Five studies were undertaken in high‐income countries, but the findings reported could not be included and pooled together in this review.

Key results

We found that giving nutrition education about appropriate feeding practices during weaning to families in low‐ to moderate‐income settings may improve weight and height at 12 months of age. We are very uncertain about the effects of nutrition education on children's development and risk of anaemia at one year of age, as only two studies reported each of these outcomes. Therefore, these results are described only in the text. We did not find any studies that assessed the effects of nutrition education on children's risk of overweight and obesity and reported outcomes that could be pooled together in this review.

Certainty of evidence

The certainty of evidence for the reduction in risk of childhood undernutrition with nutrition education is low to moderate at best due to limitations in study design and differences among the studies included in our review. The amount of improvement in growth noted is small and of unclear clinical significance. More long‐term studies are needed to see if this improvement continues into later life, leading to bigger improvements. We rated the certainty of evidence for other outcomes included in this study as low due to the limited number of included studies.

Further research is needed to determine whether nutrition education can reduce risks of overnutrition and obesity in children.

Read the full Cochrane Review here

Comment

Sign up to add a comment

More about this case

ResolvedVerified literature

Why you should join Figure 1

Sign up to explore now

Similar cases

\ \ There is continuing uncertainty about the effectiveness of interventions to increase fruit and vegetable consumption in children aged 5 years and under.\ EVIDENCE GAP\ Cochrane Review; 55 studies with 11,108 children aged 5 years and under, looking at the effectiveness of child-feeding practices, parent nutrition education, or multicomponent interventions for increasing fruit and vegetable consumption.](https://app.figure1.com/case-detail/17334174-2e6a-4324-a9c0-806e6bacdcaf)

\ \ What is the aim of this review?\ The aim of this Cochrane Review was to find out if rotavirus vaccines are effective in preventing diarrhoea and deaths in infants and young children. We also aimed to find out if the rotavirus vaccines are safe. We collected and analyzed all relevant studies to answer these questions, and found 55 studies.\ Key messages\ RV1, RV5, and Rotavac prevent episodes of rotavirus diarrhoea (moderate‐ to high‐certainty evidence). We found no increased risk of serious adverse events (moderate‐ to high‐certainty evidence) including intussusception (where the bowel telescopes on itself, and can cause obstruction) (very low to low‐certainty evidence).\ What was studied in the review?\ Rotavirus infection is a common cause of diarrhoea in infants and young children, and can cause mild illness, hospitalization, and death. Since 2009, the World Health Organization (WHO) has recommended that a rotavirus vaccine be included in all national infant and child immunization programmes, and 95 countries have so far followed this recommendation. In the years before infants and children started receiving rotavirus vaccine, rotavirus infection resulted in about half a million deaths a year in children aged under five years, mainly in low‐ and middle‐income countries.\ In this review we included randomized controlled trials in infants and young children that evaluated a monovalent rotavirus vaccine (RV1; Rotarix, GlaxoSmithKline) or a pentavalent rotavirus vaccine (RV5; RotaTeq, Merck). These vaccines have been evaluated in several large trials and are approved for use in many countries. We also included trials that evaluated another monovalent rotavirus vaccine (Rotavac; Bharat Biotech), which is used in India only. The rotavirus vaccines were compared with placebo or with no vaccine. The included studies did not allow comparisons between the vaccines.\ What are the main results of the review?\ We found 55 relevant studies with 216,480 participants. The trials took place in several locations worldwide. These studies compared a rotavirus vaccine versus placebo or versus no vaccine for infants and young children. The vaccines tested were RV1 (36 trials with 119,114 participants), RV5 (15 trials with 88,934 participants), and Rotavac (four trials with 8432 participants). Fifty‐one studies were funded or co‐funded by vaccine manufacturers, while four were independent of manufacturer funding.\ In the first two years of life, RV1:\ ●prevents more than 80% of severe cases of rotavirus diarrhoea in countries with low death rates (high‐certainty evidence)\ ●prevents 35% to 63% of severe rotavirus diarrhoea in countries with high death rates (high‐certainty evidence)\ ●probably prevents 37% to 41% of severe cases of diarrhoea from all causes (such as any viral infection, bacterial infection, or parasitic infection) in countries with low death rates (moderate‐certainty evidence)\ ●probably prevents 18% to 27% of severe cases of diarrhoea from all causes in countries with high death rates (moderate‐ to high‐certainty evidence).\ In the first two years of life, RV5:\ ●probably prevents 82% to 92% of severe cases of rotavirus diarrhoea in countries with low death rates (moderate‐certainty evidence)\ ●prevents 41% to 57% of severe cases of rotavirus diarrhoea in countries with high death rates (high‐certainty evidence)\ ●probably prevents 15% of severe cases of diarrhoea from all causes in countries with high death rates (moderate‐ to high‐certainty evidence); we did not identify any studies that reported on diarrhoea from all causes in countries with low death rates.\ In the first two years of life, Rotavac:\ ●probably prevents more than 50% of severe cases of rotavirus diarrhoea in India, a country with high death rates (moderate‐certainty evidence)\ ●probably prevents 18% of severe cases of diarrhoea from all causes in India (moderate‐certainty evidence). Rotavac has not been evaluated in a randomized controlled trial in a country with low death rates.\ We found little or no difference in the number of serious adverse events (moderate‐ to high‐certainty evidence), or intussusception cases (low‐ to very low‐certainty evidence), between those receiving RV1, RV5, or Rotavac compared with placebo or no intervention.\ How up‐to‐date is this review?\ We searched for studies that had been published up to 4 April 2018.](https://app.figure1.com/case-detail/2169afe9-8fd0-4d28-9fd2-01d5a37c6bd4)

\ \ Review question\ In preterm or low birth weight infants receiving gavage tube feedings, does push tube feeding compared with gravity tube feeding result in increased adverse events (low oxygen saturation, low heart rate, time to full suck feeding).\ Background\ Infants born prematurely (before 37 weeks) may be unable to co‐ordinate sucking, swallowing, and breathing, and require gavage feeding. In gavage feeding, milk is delivered intermittently through a tube passed via the nose or the mouth into the stomach. Intermittent bolus milk feeds may be administered by using a syringe to gently push milk into the infant's stomach (push feed). Alternatively, milk can be poured into a syringe attached to the tube and allowed to drip in by gravity (gravity feed).\ Study characteristics\ The search is up‐to‐date as of July 2020. We included one study (31 infants) in this updated review.\ Key results\ Evidence is insufficient to show whether use of push compared with gravity gavage feeding results in more rapid establishment of full gavage feeds without increasing adverse events in preterm or low birth weight infants, or both, who require intermittent bolus gavage feeding.\ Certainty of evidence\ Evidence from randomised trials comparing push versus gravity intermittent gavage tube feeding in preterm or low birth weight infants (less than 2500 grams) is insufficient to inform practice.](https://app.figure1.com/case-detail/40a89a04-f6a0-4c75-af62-b80b979fd054)

\ \ What are the effects of supplementary feeding on populations that are food insecure, vulnerable and malnourished?\ Cochrane Overview; eight systematic reviews including 95 studies (up to 7940 adults, and more than 12,595 children).\ Key messages\ Across a range of vulnerable populations, supplementary feeding programmes sometimes show modest benefit in nutritional outcomes. In a few studies examining mortality (death), effects were either small or absent, and research mostly looked at short‐term effects.\ There was little or no evidence available regarding people's quality of life, adherence to treatment, attendance at clinic or the costs of supplementary feeding programmes.](https://app.figure1.com/case-detail/5a6fbb68-7d34-423a-b9e4-0e32a25ca339)

Trending now

\ \ A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.\ He had a history of hypertension, long-term smoking, and a sedentary lifestyle.\ On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)

\ \ A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.\ Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)

\ \ A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)

\ \ patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)

Privacy Preference Center

When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. This information might be about you, your preferences, or your device, and is mostly used to make the site work as you expect. The information does not usually identify you directly, but it can give you a more personalized web experience. Because we respect your right to privacy, you can choose not to allow some types of cookies. Click on the different category headings to learn more and change our default settings. Blocking some types of cookies may impact your experience of the site and the services we are able to offer.

More information

Allow All

Manage Consent Preferences

Targeting Cookies

Targeting Cookies

These cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Performance Cookies

Performance Cookies

These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.

Strictly Necessary Cookies

Always Active

These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms. You can set your browser to block or alert you about these cookies, but some parts of the site will not then work. These cookies do not store any personally identifiable information.

Back Button

Cookie List

Search Icon

Filter Icon

Clear

ApplyCancel

ConsentLeg.Interest

checkbox labellabel

checkbox labellabel

checkbox labellabel

Reject AllConfirm My Choices