Feeding Infants and Children from Birth to 24 Months Summarizing Existing Guidance (2020) / Chapter Skim
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2 Methodology
2 Methodology
Pages 21-36
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• Resources that include feeding recommendations have a wide range of formats, which sometimes made it challenging to de termine the original source of the guidance. • The committee's approach to describing communication and dissemination strategies primarily focused on the information provided within the guideline documents themselves, supple mented with exploratory scans for feeding guideline commu nication and dissemination materials.
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The search strategy depended on the website structure; dropdown menus, topic area groupings, and document search options were used to find potentially relevant guideline documents. Staff conducted targeted website searches during the last 2 weeks of November 2019.
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Association Service Guideline • Committee • CPG Infobase • Department of Health and Human • International Life Sciences Institute • U.S. Preventive Services Task Force Search inquiry to • ECRI Institute Guideline Trust Services, Agency for Healthcare Research • La Leche League International • United States Lactation Consultant international • International Guideline Library and Quality • La Leche League USA Association • FAO Catalog experts • GuidelineCentral • Department of Health and Human • March of Dimes • Wellstart International • Committee • NICE Evidence Search Services, Assistant Secretary for Health • National Alliance for Hispanic Health • World Health Organization expertise • PubMed 156 Unique Documents to be Screened 113 Excludedb 43 Included FIGURE 2-1 Flow diagram of guideline document search and screening process.
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. 92 countries with food-based dietary guidelinesa 50 excluded because they were not classified as high-income countriesb 42 high-income countries with food based dietary guidelinesa,b 21 excluded because English language guidelines were not available 12 excluded because guidelines were not relevant to the 0-2 year population 3 guidelines could not be located 6 high-income countries with English language food-based dietary guidelines that include guidance for 0 3 countries referenced 2 countries with other 2 yearsa,b other resources for the 0-2 resources for the 0-2 year year population population included 8 high-income countries with English 1 country's resource could language food-based dietary not be located guidelines or related resources that include feeding guidance for 0-2 yearsa,b,c FIGURE 2-2 Flow diagram of how the Food and Agriculture Organization of the United Nations' catalog of national food-based guidelines was used to identify potentially relevant guideline documents.
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The committee also took advantage of its expertise to identify potentially relevant resources not identified through other search approaches. Database Searches As an adjunct to its targeted website searches, the following databases were used to search for relevant guideline documents: CPG Infobase, ECRI Institute Guideline Trust, International Guideline Library, GuidelineCentral, NICE Evidence Search, and PubMed.
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"breast milk" OR 2 2 breastmilk breastfeed* OR 6 2 breastfed*
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Because the total number of documents screened came from database searches, a search of food-based dietary guidelines, expert input, and targeted website searches, the cumulative total in the right-hand column does not correspond to the numbers presented in Figure 2-1. b CPG Infobase: Clinical Practice Guidelines available at https://joulecma.ca/cpg/homepage (accessed May 20, 2020)
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Document-Level Eligibility Criteria Eligibility criteria used to screen the identified guideline documents are presented in Table 2-2. Screening focused on whether or not the identified document contained any recommendations on what or how to feed infants and children younger than 2 years of age; feeding recommendations encompassed human milk, infant formula, other foods and beverages, and supplements.
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Government agencies, for instance, may publish a set of publicfacing guideline documents informed by a separate scientific report. Professional organizations often publish position papers, policy statements, or practice papers or guidelines accompanied by a narrative review.
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Communication materials typically include lay-friendly feeding guidance, but do not typically provide the methodological or scientific underpinning of each recommendation. Although these types of materials often provide specific feeding recommendations, the committee did not consider these resources to be eligible guideline documents.
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. This guideline document provided guidance related to what and how to feed infants; however, the document was ultimately excluded because the recommendations were focused on clinical management and did not align with the committee's interpretation of its charge.
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Document-Level Abstraction The following information was abstracted from each of the eligible guideline documents and resources: • Organization(s) -- The agencies, organizations, or groups that pub lished, released, or otherwise directly participated in the develop ment of the guideline document were recorded.
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° Other: This option was selected when the type of evidence that mapped to the recommendation did not fall into any of the above categories (e.g., a guideline document noting that the recommendation was informed by reports from other organiza tions; a guideline document describing recommendations based
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CAPTURING GUIDANCE ON COMMUNICATION AND DISSEMINATION As part of the document-level abstraction, each guideline document was reviewed for statements, sections, and appendixes providing guidance on who should know about the recommendations, who should communicate that information, and how that information should be communicated. Recognizing that the guidance on communication and dissemination within guideline documents themselves was relatively sparse, the committee
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SUMMARY The committee undertook a multipronged approach to find documents and resources from authoritative agencies, organizations, and groups that provide recommendations on what and how to feed infants and young children. Potentially relevant materials were identified through targeted website searches, food-based dietary guideline searches, expert input, and guideline database searches.
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