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The problem
Intervention: Elimination of prelacteal feeding (any fluids or foods other than breast milk in the first three days after birth) through pro-breastfeeding interventions during antenatal care and maternity facility stays
Who it was tested with: Infants under six months of age in low- and middle-income countries (91,282 children from 85 nationally representative surveys).
Children or communities are compared with a group that did not receive the intervention, or followed over years. This is the design that best separates what the intervention did from everything else that changed.
"We conducted a retrospective cohort study using data from 85 nationally representative Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) in LMICs (2010-2019). We used Poisson models adjusting for sociodemographic indicators, antenatal care, birth assistance, and early initiation of breastfeeding to estimate the effects of the exposures on the outcomes." The use of large nationally representative datasets with adjusted statistical models examining the relationship between a defined exposure and two specific outcomes places this in the experimental tier, though the retrospective nature limits causal inference.
Retrospective observational design cannot prove causation; possible unmeasured confounding from maternal breastfeeding intention or infant feeding difficulties; cross-sectional measurement of feeding practices at survey time may not reflect actual feeding trajectory.
Across countries and designs
1 study · 4 countries
