Education of family members to support weaning to solids and nutrition in infants born preterm

Review question

We wanted to find out whether providing education to family members on weaning premature babies would improve their growth and development. We defined premature babies as babies born more than three weeks before their due date.

Background

Weaning refers to the introduction of solid food in babies to complement their milk intake. Weaning is an important period of time for the growth of premature babies. They are normally smaller than expected for their age at this time. Hence, good nutrition during weaning can improve their growth and brain development, besides preventing future cardiovascular diseases. Nutrition education to family members may be needed to achieve good nutrition practices during weaning.

What we found

We examined the evidence available up to the 26 June 2018. No studies could be included in this review. The lack of eligible studies in this review is likely due to the scarce evidence in identifying the ideal weaning strategy for premature babies. We found two studies that investigated the ideal timing for weaning in premature babies. These, however, found conflicting results.

What does it mean?

As there were no eligible studies, impact of nutrition education in weaning of premature babies is unknown. .

Authors' conclusions: 

We were unable to assess the impact of nutrition education of family members in weaning of preterm infants as there were no eligible studies. This may be due to the lack of evidence to determine the ideal weaning strategies for preterm infants with regards to the time of initiating weaning and type of solids to introduce. Trials are needed to assess the many aspects of infant weaning in preterm infants. Long-term neurodevelopment and metabolic outcomes should also be assessed in addition to growth parameters.

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Background: 

Weaning refers to the period of introduction of solid food to complement breast milk or formula milk. Preterm infants are known to acquire extrauterine growth restriction by the time of discharge from neonatal units. Hence, the postdischarge and weaning period are crucial for optimal growth. Optimisation of nutrition during weaning may have long-term impacts on outcomes in preterm infants. Family members of preterm infants may require nutrition education to promote ideal nutrition practices surrounding weaning in preterm infants who are at high risk of nutritional deficit.

Objectives: 

To investigate the role of nutrition education of family members in supporting weaning in preterm infants with respect to their growth and neurodevelopment compared with conventional management.

Search strategy: 

We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 5), MEDLINE via PubMed (1966 to 26 June 2018), Embase (1980 to 26 June 2018), and CINAHL (1982 to 26 June 2018). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials (RCTs) and quasi-RCTs.

Selection criteria: 

RCTs and quasi-RCTs were eligible for inclusion if they examined the effects of nutrition education of family members as compared to conventional management for weaning of preterm infants up to one year of corrected gestational age. We defined prematurity as less than 37 completed weeks of gestation.

Data collection and analysis: 

At least two review authors independently screened potential studies for inclusion and planned to identify, extract data, and assess the quality of eligible studies. We resolved any differences in opinion through discussion with a third review author and consensus among all three review authors.

Main results: 

No eligible trials looking at the impact of nutrition education of family members in weaning of preterm infants fulfilled the inclusion criteria of this systematic review. Two studies investigating the ideal timing for weaning in premature infants reported conflicting results,

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