Impact of the Intensive Infant and Young Child Feeding Counseling Intervention Program on the Prevention of Wasting and Nutritional Edema in Infants and Children up to 5 Years Old: A Systematic Review and Meta-Analysis

Context 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. Objective 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. Data Sources 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. Data Extraction Two review authors independently assessed the search results, extracted data, and evaluated the risk of bias. Data Analysis 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). Conclusion 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. Systematic Review Registration PROSPERO registration No. CRD42021277429.