Interventions to support breastfeeding for infants under six months with growth faltering

Background: Infants with growth faltering often require tailored interventions to support their breastfeeding. We systematically synthesised and examined evidence from qualitative studies on stakeholder perspectives about feasibility of breastfeeding interventions for infants aged <6months with growth faltering. Methods: We conducted a comprehensive search of six electronic databases in addition to manual searches to identify qualitative studies published during January 2000-June 2024 on interventions to support breastfeeding for infants aged <6m with growth faltering. Identified articles were screened in two stages against an inclusion criteria with titles and abstract screened first followed by full-text screening. Included studies were quality appraised using the Critical Appraisal Skills Programme checklist. The primary outcome was intervention feasibility. Results: Thirty studies, conducted in 15 countries were included. Interventions included pumping with machine, manual expression, cup/spoon/bottle supplementation, and minimal enteral feeding. Key factors that were seen to influence feasibility across interventions were: 1. Health service factors including availability of equipment, professional support, communication between healthcare professionals and mothers/parents, and consensus on interventions among healthcare professionals; 2. Mother and infant related factors including mothers’ motivation, preparedness and family support. Overall stakeholder perspectives reflected a dominance of health service factors across all interventions, acting as either a barrier or facilitator for uptake. Conclusions: Pumping breast milk with machine and manual expression were the most commonly reported interventions. There is a need to address health-service related barriers, both at policy and practice levels, to ensure feasibility of interventions to support breastfeeding for infants aged <6m with growth faltering. Key messages: • Pumping breast milk with machine and manual expression were the most commonly reported interventions to support breast feeding for infants aged <6 months with growth faltering. • Health service factors are key to ensure feasibility of interventions support breast feeding for infants aged <6 months with growth faltering.