Feeding Infants and Children from Birth to 24 Months Summarizing Existing Guidance (2020) / Chapter Skim
Currently Skimming:
3 Characteristics of Included Guideline Documents
3 Characteristics of Included Guideline Documents
Pages 37-62
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 37... ...
. Of the 156 potentially relevant resources the committee screened using its eligibility criteria, 43 guideline documents were ultimately included.
|
From page 38... ...
The list of excluded documents and rationale for exclusion are provided in Appendix A TABLE 3-1 Characteristics of Included Guideline Documents Target Country, Target Organization(s)
|
From page 39... ...
CHARACTERISTICS OF INCLUDED GUIDELINE DOCUMENTS 39 Includes Guidance on Includes Evidence Communication Author Stated Assessment and/or Includes Research COIs Methodologya Criteria Disseminationb Recommendations No Not specified -- Yes No Yes Not specified -- Yes No Yes Literature reviewc -- No No Yes Literature review -- Yes Yes No Not specified -- No No Yes Not specified -- Yes No Yes Literature review -- No No Yes Not specified -- Yes No continued
|
From page 40... ...
: Classifications, consequences, and preventive strategies AAPD AAPD, 2017 Policy on dietary United Health care recommendations for States providers infants, children, and adolescents ABM Taylor and ABM Clinical United Health care ABM, 2018 Protocol 29: Iron, States Providers zinc, and vitamin D supplementation during breastfeeding AHAd Gidding et al., Dietary recommendations United Health care 2005 for children and States providers adolescents AND AND, 2016 Position of the Academy United Health care of Nutrition and States providers Dietetics: Vegetarian diets Australian NHMRC, Infant feeding guidelines Australia Health care government, 2012 providers NHMRC Breastfeeding Health Canada Nutrition for Canada Health care Committee for et al., 2014 healthy term infants: providers Canada; CPS; Recommendations from Dietitians of six to 24 months Canada; HC Health Canada Nutrition for Canada Health care et al., 2015f healthy term infants: providers Recommendations from birth to 6 months
|
From page 41... ...
CHARACTERISTICS OF INCLUDED GUIDELINE DOCUMENTS 41 Includes Guidance on Includes Evidence Communication Author Stated Assessment and/or Includes Research COIs Methodologya Criteria Disseminationb Recommendations No Literature review -- Yes No No Literature review -- Yes No No Review of National No Yes evidence Guidelines Clearinghouse Yes Not specified -- Noe No Yes Not specified -- Yes No No Commissioned NHMRC system Yes No systematic review; literature review No Not specified -- Yes No No Not specified -- Yes No continued
|
From page 42... ...
42 FEEDING INFANTS AND CHILDREN FROM BIRTH TO 24 MONTHS TABLE 3-1 Continued Target Country, Target Organization(s) Citation Guideline Title Region Audience CPS Abrams et al., Timing of introduction Canada Health care 2019 of allergenic solids for providers infants at high risk Amit et al., Vegetarian diets in Canada Health care 2010g children and adolescents providers Godel et al., Vitamin D Canada Health care 2007h supplementation: providers Recommendations for Canadian mothers and infants Grueger et al., Weaning from the breast Canada Health care 2013g providers Unger et al., Iron requirements in the Canada Health care 2019 first 2 years of life providers EFSA EFSA Panel on Appropriate age range Europe Policy makers Nutrition et for introduction of al., 2019 complementary feeding into an infant's diet ESPGHAN Braegger et al., Vitamin D in the healthy Europe Health care 2013 European pediatric providers population Domellöf et al., Iron requirements of Europe Not specified 2014 infants and toddlers Fewtrell et al., Complementary feeding: Europe Health care 2017 A position paper by providers ESPGHAN Fidler Mis et Sugar in infants, children, Europe Health care al., 2017 and adolescents: A providers; position paper of the policy makers ESPGHAN Committee on Nutrition Hojsak et al., Young child formula: A Europe Not specified 2018 position paper by the ESPGHAN Committee on Nutrition Szajewska et Gluten introduction and Europe Not specified al., 2016 the risk of celiac disease
|
From page 43... ...
CHARACTERISTICS OF INCLUDED GUIDELINE DOCUMENTS 43 Includes Guidance on Includes Evidence Communication Author Stated Assessment and/or Includes Research COIs Methodologya Criteria Disseminationb Recommendations No Not specified -- No No No Literature review Canadian No No Task Force on Preventive Health Care No Not specified Canadian No Yes Task Force on Preventive Health Care No Literature review -- Yes No No Not specified -- No No Yes Systematic review Tool proposed by No No the U.S. National Toxicology Program Office of Health Assessment and Translation Yes Literature review -- Yes No Yes Literature review -- Yes Yes Yes Systematic -- No Yes literature search Yes Systematic -- Yes Yes literature search Yes Systematic -- No No literature review Yes GRADE GRADE No Yes procedures continued
|
From page 44... ...
44 FEEDING INFANTS AND CHILDREN FROM BIRTH TO 24 MONTHS TABLE 3-1 Continued Target Country, Target Organization(s) Citation Guideline Title Region Audience New Zealand New Zealand Healthy Smile, Healthy New Health care Dental Dental Child, 3rd edition Zealand providers Association; Association, New Zealand 2008 Ministry of Health New Zealand Ministry of Food and nutrition New Health care Ministry of Health, 2012 guidelines for healthy Zealand providers; Health infants and toddlers: A program background paper administrators Ministry of Companion statement New Health care Health, 2013 on vitamin D and sun Zealand providers exposure in pregnancy and infancy in New Zealand NICE NICE, 2008 Maternal and child United Health care nutrition: Public health Kingdom providers; guideline policy makers NIH/NIAIDi Togias et al., Addendum guidelines for United Health care 2017 the prevention of peanut States providers allergy in the United States: Report of the NIAID-sponsored expert panel PAHO/WHO PAHO/WHO, Guiding principles for General, Community 2003 complementary feeding of global leaders; health the breastfed child guidance care providers; policy makers; program administrators RCPCH RCPCH, 2019j Breastfeeding in the United Health care UK -- position statement Kingdom providers; policy makers
|
From page 45... ...
CHARACTERISTICS OF INCLUDED GUIDELINE DOCUMENTS 45 Includes Guidance on Includes Evidence Communication Author Stated Assessment and/or Includes Research COIs Methodologya Criteria Disseminationb Recommendations No Not specified -- Yes No No Literature review; -- Yes No best practices No Not specified -- No No No Rapid reviews NICE Yes Yes methodologies Yes Prepared GRADE Yes No literature review; supplementary documents; expert opinion; public comment period No Discussions at -- Yes No several technical consultations and documents on complementary feeding No Not specified -- Yes Yes continued
|
From page 46... ...
46 FEEDING INFANTS AND CHILDREN FROM BIRTH TO 24 MONTHS TABLE 3-1 Continued Target Country, Target Organization(s) Citation Guideline Title Region Audience RWJF-HERk Lott et al., Consensus statement: United Advocates; 2019 Healthy beverage States health care consumption in early providers; childhood parents and guardians Pérez-Escamilla Feeding guidelines United Early care et al., 2017 for infants and young States and education toddlers: A responsive providers; parenting approach health care providers; parents and guardians SACN SACN, 2018 Feeding in the first year United Policy makers of life Kingdom SACN; COT SACN and Assessing the health United Policy makers COT, 2018 benefits and risks of the Kingdom introduction of peanut and hen's egg into the infant diet before 6 months of age in the United Kingdom SIGENP; SIAIP; Alvisi et al., Recommendations on Italy Health care with support 2015 complementary feeding providers from experts for healthy full-term from SINPE infants and ESPGHAN USPSTF Moyer, 2014 Prevention of dental United Health care caries in children from States providers birth through age 5 years: U.S.
|
From page 47... ...
CHARACTERISTICS OF INCLUDED GUIDELINE DOCUMENTS 47 Includes Guidance on Includes Evidence Communication Author Stated Assessment and/or Includes Research COIs Methodologya Criteria Disseminationb Recommendations No Review of source -- Yes Yes documents, reports, and narrative literature reviews; expert panel meetings No Review of key -- Yes Yes studies and infant and toddler feeding guidelines from diverse countries; interviews with experts in the field; expert panel consensus No Literature GRADE No Yes searches based on SACN's Framework for the Evaluation of Evidence No Systematic review GRADE Yes No and a formal benefit–risk assessment using the Benefit-Risk Analysis for Foods (BRAFO) methodology Yes Not specified -- No No Yes Systematic review USPSTF grading Nol Yes system continued
|
From page 48... ...
AAFP = American Academy of Family Physicians; AAP = American Academy of Pediatrics; AAPD = American Academy of Pediatric Dentistry; ABM = Academy of Breastfeeding Medicine; AHA = American Heart Association; AND = Academy of Nutrition and Dietetics; COT = Committee on Toxicity of Chemicals in Food, Consumer Products, and the Environment; CPS = Canadian Paediatric Society; ESPGHAN = European Society for Paediatric Gastroenterology, Hepatology and Nutrition; GRADE = Grading of Recommendations Assessment, Development and Evaluation; HC = Health Canada; NIAID = National Institute of Allergy and Infectious Diseases; NICE = National Institute for Health and Care Excellence; NIH = National Institutes of Health; PAHO = Pan American Health Organization; RCPCH = Royal College of Paediatrics and Child Health; Recs. = recommendations; RWJF-HER = Robert Wood Johnson Foundation-Healthy Eating Research; SACN = Scientific Advisory Committee on Nutrition; SIAIP = Italian Society of Pediatric Allergology and Immunology; SIGENP = Italian Society of Gastroenterology, Hepatology and Pediatric Nutrition; SINPE = Italian Society for Parenteral and Enteral Nutrition; UK = United Kingdom; U.S.
|
From page 49... ...
h Reaffirmed in 2017. i This guideline document was developed using a coordinating committee representing 25 professional organizations and a 26-member expert panel.
|
From page 50... ...
Challenges Related to Summarizing Recommendations from Different Types of Guideline Documents The types of documents that contain feeding recommendations vary both within and between organizations, and have changed over time within an organization, which makes comparisons challenging. For some organi
|
From page 51... ...
The eligible guideline documents reflect the contributions of 26 different organizations.1 The types of collaboration between organizations varied. For instance, the Breastfeeding Committee for Canada, the Canadian Paediatric Society (CPS)
|
From page 52... ...
For instance, CPS participated in a collaborative guideline document in which a recommendation advised that pasteurized homogenized cow milk could be introduced at 9–12 months (Health Canada et al., 2014)
|
From page 53... ...
In situations where an organization had multiple publications with recommendations on a particular topic area, the guideline documents typically differed in scope. For instance, CPS participated in two collaborative guideline documents (Health Canada et al., 2014, 2015)
|
From page 54... ...
TARGET COUNTRY OR REGION The included guideline documents reflected the contributions of agencies, organizations, or groups from Australia, Canada, Europe, Italy, New Zealand, the United Kingdom, and the United States, along with global guidance from the World Health Organization. TARGET AUDIENCES Most of the eligible guideline documents targeted health care providers, including but not limited to physicians, nurse practitioners, nurses, dentists, registered dietitian nutritionists, and other nutrition professionals.
|
From page 55... ...
Stated document methodologies were not always consistent. For instance, some guideline documents stated using a "systematic review," whereas others described their methodology as "systematic literature search" or "systematic literature review." As the committee focused on the information provided within the guideline documents themselves, it was unable to discern if these differences in terminology reflected true methodological differences.
|
From page 56... ...
STATEMENTS OF RECOMMENDATION The committee broadly interpreted the concept of feeding recommendations as concluding or summary statements that provided specific guidance related to what or how to feed infants or young children. For many guideline documents, these statements were found in a section labeled "Recommendations." Other guideline documents, however, presented guidance under headings such as "Summary," "Policy Statement," "Conclusions," "Key Points," and "Anticipatory Guidance," or simply noted it as being "guidance for practice." In addition to how recommendations were labeled, their presentation varied across the guideline documents.
|
From page 57... ...
As the committee reviewed the format of recommendations in the eligible guideline documents, however, it became rapidly apparent that a more qualitative approach was needed. Some guideline documents, particularly those that broadly described feeding recommendations from birth to 24 months, often presented recommendations multiple times (e.g., across age groups)
|
From page 58... ...
In a unique situation, the committee was aware of key guidance that did not exist in the format that could be abstracted using the standard approach. In its search for eligible guideline documents, the committee identified an AAP clinical report on vitamin D (Wagner et al., 2008)
|
From page 59... ...
This option was selected when two or more references were cited as evidence in the narrative that mapped to the recommendation. One important caveat to this designation is that any type of document or resource could be cited; this includes citing previously published systematic reviews that were not prepared for the purposes of that specific guideline document.
|
From page 60... ...
The committee also notes that the inability to map a recommendation to its evidence, or use of a narrative review as opposed to a systematic review, should not be viewed as diminishing the importance or usefulness of important practical guidance. INCLUSION OF GUIDANCE ON COMMUNICATION AND DISSEMINATION The committee noted when a guideline document included guidance on communicating or disseminating the feeding recommendations.
|
From page 61... ...
, level of collaboration, scope of topics covered, target audiences, stated methodologies, presentation of recommendations, and mapping of evidence to each recommendation. Each of these variables affected the committee's ability to summarize the current state of feeding recommendations for infants and young children.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.