Summary of findings 1. Nutrition education compared to conventional management in term‐born infants in the first year of life.
| Nutrition education compared to conventional management in term‐born infants in the first year of life | ||||||
| Patient or population: term‐born infants in the first year of life Setting: Middle‐ to low‐income settings Intervention: nutrition education Comparison: conventional management | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with conventional management | Risk with nutrition education | |||||
| Weight‐for‐age z score at 12 months of age (WAZ 12 months) Scale from 5 to ‐5 | Mean weight‐for‐age z score at 12 months of age ranged from ‐1.6 to 0.9 z score | MD 0.15 z score higher (0.07 higher to 0.22 higher) | ‐ | 2551 (6 RCTs) | ⊕⊕⊕⊝ Moderatea | Change from baseline value was used for 1 study. Endpoint values were used for the other 4 studies |
| Height‐for‐age z score at 12 months of age (HAZ 12 months) Scale from 5 to ‐5 | Mean height‐for‐age z score at 12 months of age ranged from ‐2 to ‐0.5 z score | MD 0.10 z score higher (0.02 higher to 0.17 higher) | ‐ | 3208 (7 RCTs) | ⊕⊕⊕⊝ Moderatea | Change from baseline value was used for 1 study. Endpoint values were used for the other 6 studies |
| Height‐for‐age z score at 18 months of age (HAZ 18 months) Assessed with z score Scale from 5 to ‐5 | Mean height‐for‐age z score at 18 months of age ranged from ‐2.2 to ‐0.5 z score | MD 0.16 z score higher (0.10 higher to 0.22 higher) | ‐ | 4813 (5 RCTs) | ⊕⊕⊝⊝ Lowb | |
| Prevalence of anaemia (serum haemoglobin < 110 g/L) at 12 months of age | Low | OR 1.32 (0.93 to 1.87) | 585 (2 RCTs) | ⊕⊕⊝⊝ Lowb | ||
| 10 per 100 | 13 per 100 (9 to 17) | |||||
| High | ||||||
| 50 per 100 | 57 per 100 (48 to 65) | |||||
| Death before 1 year of age | Low | RR 0.69 (0.44 to 1.08) | 4234 (4 RCTs) | ⊕⊕⊕⊝ Moderatea | This outcome was reported as a reason for loss to follow‐up in all 3 studies and was not formally reported as an outcome | |
| 3 per 1000 | 2 per 1000 (2 to 3) | |||||
| High | ||||||
| 26 per 1000 | 18 per 1000 (12 to 28) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; OR: odds ratio; RCT: randomised controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence. High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded one level for risk of bias (attrition bias imbalance in baseline demographics).
bDowngraded one level for risk of bias (attrition bias and imbalance in baseline demographics) and one level for substantial unexplained heterogeneity of 50% to 75%.