Critiqueof Systematic Research Review
Critiqueof Systematic Review
Itis recommended by the World Health Organization that babies getbreastfed until they are six months old to have an optimal growth. Inspite the requirement, of three infants, only one of them gets breastmilk in the six months. The research is also inclusive of countrieswith the highest breastfeeding initiatives globally. Over a period offifteen years, breastfeeding rates have risen by a mere 6%. The milkhelps protect the babies against many illnesses like respiratorytract infections, gastroenteritis, otitis media, asthma, and atopicdermatitis. Studies have indicated that babies fed on breast milk hada lower risk of infantile obesity, but enhanced cognitive growth(Haroon, 2013).Additionally, breastfeeding helps protect babies against cancer anddiabetes, ear infections are reduced, it lowers the risk of stomachupset and diarrhea, and the infants attain the required weightsduring their growth.
Thesystematic review starts with a precise research problem, and theauthor is equipped with an exact method of finding the relevantmaterials for the study, which review the work to remove bias fromthe procedures used. This review answers the question on thepromotion of breastfeeding practices and inventions. The topic issuitable to be systematically reviewed because, it is wide and manyspecific studies have been carried out to enable the narrowing downof the research. Discussions on similar reviews and conclusions havealso been done.
Educationalinterventions have helped the exclusively breastfed rates to increaseas shown by previous authors. The previous reviews acted as a basis,and updates were made to account for the recent studies. In thereview, the intervention results were incorporated, leading topartial, predominant, and lack of breastfeeding(Haroon, 2013).It was inclusive of studies assessed for quality by the Child HealthEpidemiology Reference Group charged with assessments,recommendations, development, and education criteria.
Thedatabases investigated in the published literature include Medline,PubMed, EMBASE, Cochrane Library, and WHO. The files sought are thoseconcerned with the outcomes of interventions in promoting the ratesof breastfeeding that is, predominant, exclusive, or nobreastfeeding. Date and language limitations were enforced. Thedatabase searches produced a range of articles with a concentrationon the research problem.
Twoauthors made an evaluation of the articles independently usingidentified exclusion and inclusion criteria that were suitable forthe review. The concern for the researchers was how support andeducation impacted on the mothers’ initiatives to carry outexclusive breastfeeding for the newborns. The criteria for inclusioninvolved the quasi-experimental and the randomized controlled trials.The articles incorporated are those that argued the interventionsthrough support, or education that is given to mothers in theirprenatal, postnatal, or both. All types of deliveries were involved.For the non-English articles, the evaluation was done on theabstracts alone and not the whole article. The criteria for exclusionincluded cross-sectional, or the cohort studies(Haroon, 2013).Among those excluded were studies with interventions entailing lowweight babies, preterm infants, infants with prenatal infections,babies whose mothers abused drugs, and those found in the ICU. Thereview identified the effect of mother support and education onbreastfeeding. Therefore, articles involving interventions likepacifier or skin contact were not included.
Allthe included articles entailed double abstraction of data used in thedescription of study context and identifiers, study limitations anddesign, specifics of intervention, and the effects of outcomes intoan abstraction form, which is standardized according to CHERGguidelines for systematic review. Assessment and grading of eachstudy were then conducted. Revman 5.2 was applied for thequantitative studies through the meta-analysis process. The processmade an evaluation of the results of the various studies against eachother highlighting their significance to the entire research problem(Haroon, 2013).This helps the researchers compare various studies, and evaluatetheir outcomes in comparison to other studies. The combination ofmany studies and similar methods led to powerful results.
Theoutcome on breastfeeding that was used is the one defined by theWorld Health Organization. The outcomes entailed exclusive,predominant, partial and lack of breastfeeding at one day, less thanone month, and one to five months old. The outcomes were specificallydefined. Subgroup analysis was conducted according to group,individual, or joint counseling(Haroon, 2013).Another subgroup analysis was done and it based on the care level,that is, facility, community-based, or a combination. Lastly, ananalysis of the countries in which the interventions occurred wasdone. The classification was either developed or developing as perthe World Bank ranking.
Thesearch was carried out on October 15th, 2012, and an update was madeon December 8th,2013. An identification of five thousand abstracts and titles wasmade together with contacts of the experts of the subject. Thestudies were inclusive of both quasi and RCT’s studies. The authorsthen continued with the description of articles that included variouseducational, and counseling interventions(Haroon, 2013). The results andliterature review were detailed involving contacts with thespecialists in the field of breastfeeding. Screening of the articleswas done, and the qualifiers for the inclusion criteria underwentevaluation. In the article, the results of the impacts of educationon breastfeeding were explained in details according to thepredetermined outcomes, as compared to the subcategories. Theoccurrence of breastfeeding past six months was witnessed if thestudy reported it.
Theidentified limitation was on the quasi-experimental tests and RCTmethodology whereby most of them failed to employ, or did not specifyon blinding, hence affected the evidence’s quality. Wordage use insome articles proved ambiguity, making it hard to classify.Additionally, random assignments were not conducted hence made theinternal validity have a problem. Therefore, the establishment of acause and effect relationship became problematic. RCT methodology isalso full of limitations because it requires isolation of theintervention effect totally from other contaminants in the systembeing investigated, for high validity to be attained, which is adifficult task to be attained(Haroon, 2013).Other drawbacks in the conducting of RCT included much time andenergy consumption, and were expensive to carry out.
Thestudy made a conclusion that there was an increase in exclusivebreastfeeding. There was no lowered breastfeeding rates due to thepromotional interventions for breastfeeding in all the ages. Making acombination of group and individual counseling proved effective thanstandalone measures(Haroon, 2013).Community-based mediations and combined facility led to increasingbreastfeeding rates. The effects had a great impact in developingeconomies than the developed ones. This is as a result of less homefollow up and breastfeeding education in the developing economies’health systems than in the developed ones.
Exclusivebreastfeeding of infants is beneficial to their health. This articleexamines the outcomes of having breastfeeding interventions on theincrease in exclusive breastfeeding rates for the infants. As per thestudy, programs that encourage breastfeeding cause the rise inbreastfeeding rates, hence lowers none breastfeeding rates. It made aconclusion that combining group and individual counseling yielded themost effective results(Haroon, 2013).Therefore, to raise the rates of breastfeeding, patients should beprovided with group and individual education. In our hospital, thenursing fraternity is efficiently trained to help new mothers in theprocess of breastfeeding.
Thepatients who meet the set criteria will have a consultation orderedspontaneously for them. Group counseling is also provided in ourhospital. A free class about the unit is provided during theirpost-delivery stay in the hospital. Many issues includingbreastfeeding and its importance are discussed. A presentation ismade, and then a session for posting questions and answers is done.The mothers are educated on preparing for the breastfeeding taskmentally, physically, and emotionally. Physical preparation is donethrough having a balanced diet in the course of pregnancy and afterdelivery, the midwives examine the breasts in the case of anyproblem, and ensuring that the mother acquires a wardrobe convenientfor breastfeeding. To be prepared mentally and emotionally, themother is versed with reading materials on breastfeeding, and ensurethe maintenance of a positive attitude towards the entire process.When the patient goes home, they are given breastfeeding groups wherethey can attend at their convenience. As per the study, prenataleducation on breastfeeding helps raise the exclusive breastfeedingrates. Expansion of these programs into the developing economies willlead to a global increase in exclusive breastfeeding.
Haroon,D. (2013). Breastfeedingpromotion interventions and breastfeeding practices: a systematicreview. BioMed Central Ltd.