Table 1. Articles included in the systematic review.
| Authors/ Year/ Country | Design/ sample size N/n* | Aim of the research | Socio-demographic characteristics of the infant | Socio-demographic characteristics of the family | Infants’ feeding patterns (0-6 months) | Properties of water | Effective factors | Starting age of water intake (0-6 months) | Frequency and amount of water consumption (0-6 months old) | Reasons for water consumption in infants (0-6 months old) | S Stduies Quality Assessment |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Yüzügüllü et al., (2018) 11, Turkey | Cross sectional studies/ N=284 | This study was conducted in Çukurova county of Adana province To investigate mothers’ sociodemographic and psychopathological characteristics that affect their exclusive breastfeeding status for the first six months. | Gender % (n): Male: 50 (142) Female: 50 (142) | Mother’s age % (n): ≤19 years: 1,1 (3) 20-24 years: 11,6 (33) 25-29 years: 23,9 (68) 30-34 years: 40,5 (115) 35-39 years: 16,5 (47) ≥40 years: 6,3 (18) Mother's educational status % (n): Illiterate: 0,4 (1) Literate: 0,4 (1) Primary school: 11,3 (32) Middle school: 27,8 (79) High school: 27,8(79) College/university: 32,4 (92) Mother’s working status % (n) Working: 18,3 (52) Not working: 68,0 (193) Working but on leave: 13,7 (39) | Breast milk: 37 % Formula: 48,7 % | - | - | The rate of those who give breast milk and water in the first six months is 2.5 %. | 5/8 | ||
| Özgürhan et al. (2020) 12/ Turkey | Descriptive, prospective/ n:355 | The aim of this study was to examine the factors leading mothers to discontinue exclusive breastfeeding within the first six months of life. | Gender (male/ female) (n) 175/180 Height (cm) (mean ± SD) 50.1±1.2 Weight (g) (mean ± SD) 3201.4±469.2 Head circumference (cm) (mean ± SD) 34.9±0.8 | Mother Age (years) (mean ± SD) 28.3±5.2 Delivery method Vaginal/cesarean section (n) 179/176 | Breastfeeding at 1-month-old: 68.4 %; Breastfeeding at 4-months-old: 56.5 % Breastfeeding at 6 months-:35.2 % | six months: 26 (7.3 %) | 8/9 | ||||
| Susanto et al (2021) 13/ Indonesıa | Cross-sectional study N: 470 n: 470 | Maternal and child health status (MCHS) plays an essential role in the exclusive breastfeeding practice (EBP), which in turn helps to determine the nutritional status and development of children (NSC & CD) aged 0-6 months. This study aimed to determine the prevalence and factors influencing EBP, NSC, and CD to MCHS in Jember, East Java, Indonesia. | Characteristics of the children Age(months) M±SD 3.91±1.63 Gender n (%) Boys 255 (54.3) Girls 215 (45.7) Weight of birth (gram) M±SD 062.90±459.78 Height of birth (cm) M±SD 49.04±2.71 | Characteristics of the mothers Age (years) M±SD 22.71±6.22 Education Not attending schools 13 (2.8) Elementary schools 141 (30.0) Junior high schools. 118 (25.1) Senior high schools. 151 (32.1) Diploma-3 7 (1.5) Bachelor 40 (8.5) Is the mother working? No 382 (81.3) Yes 88 (18.7) The family income per month (IDR) M±SD. 1547978.72±1172358.97 Parity status Primipara 170 (36.2) Multipara 300 (63.8) Type of family Elementary family 216 (46.0) Extended family 254 (54.0) | Exclusive breastfeeding 351 (74.7) No exclusive 119 (25.3) | - | - | Pre-lacteal feeds given n (%) (n= 126) Plain boiled water 3 (2.4) Post-lacteal feeds given n (%) (n= 124) Plain boiled water 3 (2.5) | 6/8 | ||
| Oiye et al., (2017) 26, Kenya | Quase-Experimental Studie** N= 143 n= 68 | The study aimed to compare exclusive breastfeeding practice between HIV-positive versus HIV-negative mothers using the maternal recall method and DO technique. | -Healthy babies -Infants with birth weight inferior to 2,500 g Gender (n): Male: 37 Female: 31 | Age of the mother (years) (mean ± SD): 25.6±6.4 Attended secondary school or above (n): 21 Living in the rural areas (n): 42 | Breast milk Supplementary food Exclusive breastfeeding rate maternal recall (DO technique): Six weeks: 76.9 % (13.8 %) 6 months: 59. % (24.2 %) Bias: 41 (63.1 %) | - | - | DO technique: Six weeks: 86.2 % Six months: 75.8 % | - | 7/9 | |
| Demir et al. (2020) 27/ Turkey | Descriptive/ N: 187 | This study was planned to determine the breastfeeding status of the mothers who applied to family health centers (FHC) and who have 0-24 months old baby and child, the feature of giving water to their baby, the time to start giving regular water, and what type of water they prefer to give their child. | Median months of infants and children: 11.0 (5.0-20.0) 0-24 months-old babies | The mean age of 187 mothers participating in the study was 29.1±5.0 years, 65.2 % of the mothers stated they had a high level of education, 63.1 % did not work, and 84.5 % stated that their income level was not high. | Mothers with low education levels; -tap water 21 (33.9 %), -packaged water 13 (21.0 %) -boiled water 28 (45.2 %) Mothers with a high level of education; -tap water 21 (19.3 %), -packaged water 16 (14.7 %) -boiled water 72 (66.1 %) Of the mothers, 58.5 % stated that they preferred to give boiled water when giving water to their babies for the first time. Also, 62.6 % of the participants stated that they never gave tap water to their children, and mothers who gave tap water to their children stated that they gave it to their babies for the first time when they were 8.0 (5.0-11.0) months old. | The rate of giving water in the first six months was found to be higher in mothers with lower education levels than in mothers with higher education levels (p=0.001). Those with higher education levels stated that they mostly preferred boiled water when giving water to their baby for the first time (p = 0.026). It has been observed that working mothers have lower rates of giving water to their babies in the first six months than non-working mothers. A statistically significant difference was found between the income levels of the mothers and the status of giving tap water to their babies. (p = 0.020). | Of the mothers, 62.6% stated that they gave water to their babies in the first six months and 14.5 % of them reported they gave sweetened water to their babies in the first days. Also, 34.2 % of the participants stated that they gave water to their babies for reasons other than the transition to complementary foods or formula supplements. Mothers stated that they started giving water to their babies regularly when they were 5.0 (2.0-6.0) months old. | Included infants aged six months and younger were found to consume 100.0 (50.0-100.0) mL of water within 24 hours. | First reason of the non-working mothers for giving water to the infants -Complementary food/formula supplement 56 (52.8 %) -Other 50 (47.2 %) First reason of working mothers for giving water -Complementary food/formula supplement 51 (78.5 %) -Other 14 (21.5%) In addition, 34.2 % of the participants stated that they gave water to their babies for reasons other than the transition to complementary foods or formula supplements. | (5/9 | |
| Yılmaz (2019) 28/ Turkey | Descriptive /N:164 | This study aimed to examine the feeding patterns of 0-24-month-old infants hospitalized in the infant service of a state hospital. | 0-24-months-old healthy babies Gender: Girl: 65 (39.6 %) Boy: 99 (60.4 %) Month: 0-6: 61 (37.2 %) | Average age of the mothers: 26.82 ± 5.47 Education level of the mother Primary school 79 (48.2 %) Middle School 30 (18.3 %) High School 13 (7.9 %) Literate 32 (19.5 %) Illiterate 10 (6.1 %) Mother’s Job Housewife: 164 (100 %) Family type Elementary family: 111 (67.7 %) Family type: 53 (32.3 %) Perceived income status Bad 126 (76.8 %) Medium 34 (20.8 %) Good 4 (2.4 %) | 0-6 month Exclusive breastfeeding: 18 (29, 5 %) Breastfeeding + water: 14 (23,0 %) Breastfeeding + Formula feeding: 20 (32,7 %) Breastfeeding + complementary feeding: 5 (8,2 %) Breastfeeding + Formula feeding + complementary feeding: 2 (3,3 %) Other: 2 (3,3 %) | Before six months: 116 (70.7 %) | 6/9 | ||||
| Medoua et al. (2012) 35/ Kamerun | Cross-sectional/ n:44 | The present study measured breast milk and non-breast milk water intake using the dose-to-the-mother deuterium-oxide turnover technique to validate mothers’ reports of infant feeding practices. | Age of the infant (month): 2.7 ± 1.3 Infant’s birthweight (kg): 3.2 ± 0.6 Infant’s weight (kg): 6.1± 1.4 Infant’s length (cm): 56.0 ± 5.0 Gender ratio (male/female): 15/29 | Age of the mother (years):26.6 ± 5.1 Mother’s BMI (kg m2-1 ): 26.8 ± 3.7 | *The statements of the mothers were confirmed by the deuterium oxide technique. Expression of mothers and deuterium oxide results were given separately. The bias difference between the two data was also reported. Dietary recall since birth % (n) Exclusive breastfeeding (EBF): 45.4 % (20) Predominantly breastfeeding (PreBF): 15.9 % (7) Partial breastfeeding (ParBF): 38.6 % (17) Dose-to-the-mother deuterium-oxide turnover % (n) Exclusive breastfed (EBF): 11.4 % (5) Bias 34.06 % (15 ) Predominantly breastfed (PreBF): 45.4 % (20) Bias: -29.5 (13) Partially breastf ed (ParBF): 43.2 % (19) Bias: -4.6 (2) | - | - | Non-breast milk water intake (mL day-1 ) EBF:24.0 ± 13.4 PreBF:113.5 ± 41.8 ParBF:495.4 ± 223.9 Total:268.2 ± 250.3 | 6/8 | ||
| Onbaşı et al., 2011 36/ Turkey | Quasi-experimental study Intervention group (N:90) Control group (N:100) | Inform expectant mothers about breast-milk and breast-feeding via prenatal training and emphasize the advantages of the training. | Intervention group Birth weight 3,134 ± 613 Gender (Female) 56.7 % Type of birth 28.9 % Vaginal Control group Gender 56 % (Female) Birth weight 3,113 ±6 20 Type of birth 32 % Vaginal | Intervention group Mother’s average age n (%) 18-24 years 17 (18.9) 25-34 years 61 (67.8) 35 years and older 12 (13.3) Mother's educational status n (%) Illiterate 1 (1.1) Literate 1 (1.1) Primary school 35 (38.9) Middle School 13 (14.4) High school 22 (24.4) University 18 (20.0) Job n (%) Housewife 58 (64.4) Working 32 (35.6) Family structure n (%) Elementary family 79 (87.8) Extended family 11 (12.2) Control group; Mother age n (%) 18-24 years 15 (15.0) 25-34 years 64 (64.0) 35 years and over 21 (21.0) Mother's educational status n (%) Illiterate 4 (4.0) literate 1 (1.0) Primary school 30 (30.0) Middle School 17 (17.0) High school 27 (27.0) University 21 (21.0) Job n (%) Housewife 63 (63.0) Working 37 (37.0) Family structure n (%) Elementary family 82 (82.0) Extended family 18 (18.0) | Intervention group Only breastfeeding n(%): 6 months: 61 (67.8) Less than six months: 29 (32.2) Mean: 4.9 ± 1.8 Formula food/ complementary food use n (%): 29 (32.2) Control group Only breastfeeding n(%): 6 months: 28 (28.0) Less than six months: 72 (72.0) Mean: 3.2±2.4 Formula food/ complementary food use n (%): 72 (72.0) | - | Intervention group Water n (%) 25 (27.8) Control group Water n (%) 50 (50.0) | - | 7/9 | ||
| Kay et al (2018) 37/ US | Cross-Sectional Study N:3235 (n = 600) | The study used data from the Feeding Infants and Toddlers Study 2016 to describe the beverage consumption patterns of infants and young children (0-47.9 months) | Gender (%) Female: 50 % Male: 50 % Child’s race/ ethnicity (%) Hispanic: 16 White (non- Hispanic): 65 Black (non- Hispanic): 13 Other (non- Hispanic): 6.3 | Mother's education level (%) Less than a high school diploma or GED 4.1 Completed high school or GED 19 Some college/postsecondary 28 Completed college 38 Some graduate work/ degree 11 Household income level (%) Less than $10,000 9.3 $10,000 to $19,999 9.3 $20,000 to $34,999 18 $35,000 to $49,999 17 $50,000 to $74,999 20 $75,000 to $99,999 14 $100,000 to $149,999 8. 3 $150,000 or more 3.7 | Nutritional Pattern of the Infant: % (± SE) Breast milk 53.5 (2.8) Infant formula 62.2 (2.6) Whole milk 1,4 (0.6) Reduced fat milk 0.2 (0.2) Low-fat milk 0.2 (0,2) Non-fat milk 0.1 (0.1) | - | - | Water % (± SE) 10.0% (1.5) | - | 5/8 | |
| Islam et. al. (2014) 38/ Bangladesh | Cross-Sectional Study/ N: 120 n:29 | The study aimed to detect the amount of arsenic in the human milk of lactating mothers and relate this with maternal and children’s urinary arsenic in arsenic-contaminated areas in Bangladesh. | Child’s gender, n (%): Male: 15 (51.7 %) Female 14 (48.3 %) Child’s birth weight in kg: 3.2 ± 0.6 | Mother’s average age: 24.6 ± 5.0 Religion Muslim: 19 (65.5) Hindu: 10 (34.5) Number of pregnancies: 2.5 ± 1.7 Number of live births: 2.4 ± 1.6 | Food given in the past 24 hours at six months: Breast milk: 26 (89.7) | Findings indicated that 96.5 % of 6-month-old babies were given water in the last 24 hours. | 6/8 | ||||
| Geçkil et al. (2012) 39/ Turkey | Quasi-experimental Intervention group: N:42 Control group: N:52 | This study was conducted to examine the effect of the "Breastfeeding Support and Monitoring Program" implemented by Family Health Staff on effective breastfeeding behaviors of mothers in the first six months after birth. | Month: Healthy infants under six months Gender Intervention: Girl: 47.6 % Boy:52.4 % Control Girl: 57.7 % Boy: 42.35 % | Intervention group; Mother’s average age: 29.52 ± 5.71 Mother’s level of education Primary School Graduate 24 (57.2 %) Graduate Of Secondary School 9 (21.4 %) High school and graduate 5 (11.9 %) Illiterate 4 (9.5 %) Mothers with health problems Yes 7 (16.7 %) No 35 (83.3 %) Control group Average mother age: 28.03 ± 5.30 Mother’s level of education Primary School Graduate 31 (59.6 %) Middle School 5 (9.6 %) High school and graduate 9 (17.3 %) Illiterate 7 (13.5 %) Mother's health problem Yes: 9 (17.3 %) No: 43 (82.7 %) | Intervention group Time to start complementary feeding: 5.81 ± 0.98 (n=38) Control group Time to start complementary feeding: 5.27 ± 1.51 (n=43) | Intervention group 5.04 ± 1.34 (n=42) Control group 2.78 ± 1.70 (n=47) (t=-6.888, p<0.001) | 6/9 | ||||
| Samuel et al., (2012) 40, India | Cohort study/ n=50 | This study was designed to measure rates of breastfeeding in infants born in a baby-friendly hospital in Bangalore, India, and to capture home based compliance to exclusive breastfeeding. | Body weight (kg) (mean ± SD): At delivery/birth: 2.7 ± 0.5 Month 1: 3.8 ± 0.6 Month 3: 5.6 ± 0.8 Month 6: 7.2 ± 1.0 Body length (cm) (mean ± SD): At delivery/birth: 49.6 ± 1.7 Month one: 53.2 ± 2.4 Month three: 60.8 ± 2.8 Month six: 65.8 ± 2.7 | Age of the mother (years) (mean ± SD): 23.0 ± 2.9 Parity (n): Primiparous: 38 Multiparous: 12 Educational level (n): Up to high school (10th grade): 24 12th grade and above: 26 Employment status (n): Employed outside home: 9 Homemaker: 41 Monthly household income (INR) (mean): 9000 | Breast milk, formula, and complementary feeding Mothers reported starting complementary foods (Infants exclusively breastfed were assessed by deuterium dilution method): Month one: 0 (56 %) Month three: 1 % (22 %) Month six: 64 % (14 %) | - | Month one | Deuterium Oxide technique: Month 1: 44% Month 3: 77% Month 6: 85% Intake of non-breastmilk water intake significantly increased from months one to six (p<0.01). | - | 8/11 | |
| Yılmaz et al. (2022)* 41/Turkey | Case/control Control group N:60 | This study aimed to investigate the effect of dietary factors on those diagnosed with “idiopathic” infantile urolithiasis. | Control Group month: 8.7 (2-24) Gestational age at delivery: term birth Control groups: Female/male: 23/37 | - | Control group: 29 (48 %) patients were breastfed exclusively. | - | Control group: 4.3 (1-6) months | - | 8/10 |
* Since the babies of the study group were diagnosed with urolithiasis, the control group was written.
** The water consumption of infants of HIV-negative mothers was examined.
N: sample in the article
n: number of 0-6 month-old babies in the sample