Optimising child feeding behaviours could improve child health in Guatemala, Honduras and El Salvador, where undernutrition rates remain high. However, the design of interventions to improve child feeding behaviours is limited by piecemeal, theoretically underdeveloped evidence on factors that may influence these behaviours. Between July 2018 and January 2020, we systematically searched Cochrane, Medline, EMBASE, Global Health and LILACS databases, grey literature websites and reference lists, for evidence of region-specific causes of child feeding behaviours and the effectiveness of related interventions and policies. The Behaviour Change Wheel was used as a framework to synthesise and map the resulting literature. We identified 2,905 records and included 68 relevant studies of mixed quality, published between 1964 and 2019. Most (n = 50) were quantitative, 15 were qualitative and three used mixed methods. A total of 39 studies described causes of child feeding behaviour; 29 evaluated interventions or policies. Frequently cited barriers to breastfeeding included mothers' beliefs and perceptions of colostrum and breast milk sufficiency; fears around child illness; and familial and societal pressures, particularly from paternal grandmothers. Child diets were influenced by similar beliefs and mothers' lack of money, time and control over household finances and decisions. Interventions (n = 22) primarily provided foods or supplements with education, resulting in mixed effects on breastfeeding and child diets. Policy evaluations (n = 7) showed positive and null effects on child feeding practices. We conclude that interventions should address context-specific barriers to optimal feeding behaviours, use behaviour change theory to apply appropriate techniques and evaluate impact using robust research methods.

中文翻译：

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是什么影响了北三角地区儿童的喂养？混合方法系统评价。

优化儿童喂养行为可以改善危地马拉、洪都拉斯和萨尔瓦多的儿童健康，这些国家的营养不良率仍然很高。然而，改善儿童喂养行为的干预措施的设计受到可能影响这些行为的因素的零碎、理论上不充分的证据的限制。2018年7月至2020年1月期间，我们系统地检索了Cochrane、Medline、EMBASE、Global Health和LILACS数据库、灰色文献网站和参考文献列表，以寻找儿童喂养行为的特定区域原因以及相关干预措施和政策有效性的证据。行为改变轮被用作综合和绘制所得文献的框架。我们确定了 2,905 条记录，纳入了 1964 年至 2019 年间发表的 68 项混合质量的相关研究。大多数 (n = 50) 是定量的，15 项是定性的，其中 3 项使用混合方法。共有 39 项研究描述了儿童喂养行为的原因；29 评估了干预措施或政策。经常提到的母乳喂养障碍包括母亲对初乳和母乳充足的信念和看法；对儿童疾病的恐惧；以及家庭和社会压力，尤其是来自祖母的压力。儿童饮食受到类似信念以及母亲缺乏金钱、时间和对家庭财务和决策的控制的影响。干预措施 (n = 22) 主要提供食品或补充剂并进行教育，这对母乳喂养和儿童饮食产生了混合影响。政策评估（n = 7）显示出对儿童喂养方式的积极影响和无效影响。我们的结论是，干预措施应解决最佳喂养行为的具体障碍，利用行为改变理论应用适当的技术，并使用稳健的研究方法评估影响。