Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries

Table of Contents Summary 25 1. Introduction 33 1.1 Importance of complementary feeding for child health 33 1.2 Guiding principles for complementary feeding 34 1.3 Scope and organization of this report 34 2. Energy and nutrients needed from complementary foods 35 2.1 Energy, protein and lipids 35 2.2 Micronutrients 35 3. Methods 36 3.1 Sources searched and search strategy 36 3.2 Measurement of the treatment effect of interventions 36 3.3 Evaluation of methodological quality and level of evidence 37 3.4 Number of relevant studies identified 38 4. Findings of the systematic review 38 4.1 Types of intervention strategies 38 4.1.1 Educational interventions 38 4.1.2 Provision of food offering extra energy (with or without micronutrient fortification) 43 4.1.3 Micronutrient fortification of complementary foods 43 4.1.4 Increasing energy density of complementary foods through simple technology 46 4.1.5 Categorization of results by intervention strategy 46 4.2 Growth outcomes 46 4.2.1 Interventions using educational approaches 46 4.2.2 Interventions in which provision of complementary food was the only treatment 49 4.2.3 Interventions in which provision of complementary food was combined with another strategy, usually education for mothers 51 4.2.4 Interventions in which complementary foods were fortified with additional micronutrients 53 4.2.5 Interventions to increase energy density of complementary foods 55 4.3 Morbidity outcomes 55 4.3.1 Interventions using educational approaches 55 4.3.2 Interventions in which provision of complementary food was the only treatment 57 4.3.3 Interventions in which provision of complementary food was combined with another strategy, usually education for mothers 57 4.3.4 Interventions in which complementary foods were fortified with additional micronutrients 58 4.3.5 Interventions to increase energy density of complementary foods 59 4.4 Child development 61 4.4.1 Interventions in which provision of complementary food was the only treatment 61 4.4.2 Interventions in which complementary foods were fortified with additional micronutrients 62 4.5 Micronutrient intake 63 4.5.1 Intervention studies using educational approaches 63 4.5.2 Interventions in which provision of complementary food was the only treatment 64 4.5.3 Interventions in which provision of complementary food was combined with another strategy, usually education for mothers 64 4.5.4 Interventions in which complemen