Call for authors - Systematic reviews on feeding of infants and young children 6–23 months of age

Background

In 2012, the World Health Assembly Resolution 65.6 endorsed a Comprehensive implementation plan for maternal, infant and young child nutrition, which specified six global nutrition targets for 2025.  Appropriate infant and young child feeding, essential to fostering healthy growth, is directly related to three of these six targets:  40% reduction in the number of under-5 who are stunted, reduce and maintain childhood wasting to less than 5%, and no increase in childhood overweight; and is fundamental to achieving SDG Targets 2.2, 2.1.1, 2.2.1, and 2.2.2.

In 2003, the Pan American Health Organization developed a set of 10 Guiding principles for complementary feeding of the breastfed child¹ and in 2005 WHO developed a set of 9 Guiding principles for feeding non-breastfed children 6-23 months of age.² While still useful, the Guiding principles documents need to be updated, taking into consideration the scientific literature published over the past 15 years. The documents were focused primarily on the prevention of undernutrition and did not address concerns over rising rates of childhood obesity and the development of NCDs.

The Department of Nutrition and Food Safety (NFS) is in a process of updating guidance on feeding of infants and young children 6 to 23 months of age. In 2019, WHO formed a Guideline Development Group (GDG) for this purpose and, in December of 2019, convened the first of several planned GDG meetings to review the evidence and update the guidelines. At the December 2019 meeting, a first set of priority questions for recommendations on complementary feeding was developed.

Scope

To inform the guidance on feeding infants and young children, WHO will commission several systematic reviews to retrieve, synthesize and assess the available evidence for the following priority questions.

1. Among children <24 months of age, does greater consumption of certain types of foods and beverages compared to less or no consumption of these foods increase the risk of adverse outcomes?
2. For infants, is the introduction of complementary feeding at 6 months of age, compared to earlier or later introduction, associated with beneficial or adverse nutrition, health and development outcomes?
   
3. For infants and young children 6-23 months of age, is more frequent or more varied consumption of fruits or vegetables, compared to less frequent or less varied consumption, associated with beneficial dietary and health outcomes?
4. For non-breastfed or mixed-fed (breastmilk and other milk) infants 6-11 months of age, is consumption of animal milk, compared to infant formula, associated with beneficial or adverse outcomes for health and development?
5. For young children who were breastfed in the 1st year of life, is breastfeeding in the 2nd year of life  compared to no breastfeeding after 12 months associated with beneficial or adverse health and development outcomes?
6. For young children 12-23 months of age, is full-fat animal milk compared to follow-on formula, low-fat milk, or plant-based milk associated with beneficial or harmful outcomes? 
   

Please also see the questions in PECO format at https://www.who.int/docs/default-source/nutritionlibrary/articles---call-for/callforauthors-complementaryfeeding-peco-questions.pdf.

Concept note and budget

Interested author(s)/teams are invited to submit a concept note (2-3 pages) by sending an email to WHO at nutrition@who.int no later than 10 April 2020. The subject heading of the email should read as, “Reviews on feeding infants and young children”. 

The concept note should include a proposal containing (preferably in a single pdf document) the following:

1. The lead author and host institution with overall responsibility for the review, and contributors.  The specific competencies and contributions of each author or team member should be explicitly stated.
2. Proposed question(s) to be addressed through systematic reviews, outlining the background and justification for the review, the search strategy and databases to be searched, definition of inclusion/exclusion criteria, process of data extraction and analytical approach.  This description should reflect the scope of work described below. Author(s)/teams may undertake one or more reviews. However, they need to demonstrate capacity to conduct the review(s) within the timeline above.  Successful authors will be required to submit a protocol prior to performing the review;
3. Budget (US $). This should outline the total amount for the review including an approximate breakdown of personnel vs. institutional/other costs. It is expected that WHO will provide technical input on the final protocols that will govern the systematic reviews. For the purpose of the concept note, it is not necessary to describe every detail of the systematic review.

Scope of work for review

• Experimental (randomized trial) and observational evidence
• No date or language restrictions in search strategy
• Geographic areas: Disaggregate studies conducted in low- and middle-income countries from those in high-income countries
• Age range: primarily 6-23 months (in cases noted, 2 – 10 years). Although guidance will pertain only to children aged <24 months, evidence in children up to age 10 may also be relevant given that evidence for infants and young children may be lacking or sparse.
• Outcome measures: those listed in the questions
• Comparators: those listed in the questions
  

Qualifications of the author(s) / review team

• Interested author(s)/teams must have experience with conducting complex systematic reviews and should provide references of systematic reviews that they have published in peer-review journals.
• Interested author(s)/teams should have members with complementary skills and competencies including knowledge of the technical area, statistical analysis and excellent writing capabilities.

Timeline

• 10 April 2020 - Interested authors or teams submit concept notes and budget
• 30 April 2020 - WHO review of proposals complete and authors/teams contacted
• 15 May 2020 - Contracts agreed (subject to WHO conditions including review of declarations of interest of members of the systematic review teams)
• 21 August 2020 - Draft systematic reviews  submitted
• 16 October 2020 - Final systematic reviews with GRADE tables submitted

²  Guiding principles for feeding non-breastfed children 6-24 months of age