loading page

Lessons learned in implementing the Low Birthweight Infant Feeding Exploration (LIFE) study: a large, multi-site observational study
  • +17
  • Sunil Vernekar,
  • Sarah Somji,
  • Kingsly Msimuko,
  • S Yogeshkumar,
  • Rashmita Nayak B,
  • Shilpa Nabapure,
  • Varun Kusagir,
  • Friday Saidi,
  • Melda Phiri,
  • Eddah Kafansiyanji,
  • Christopher Sudfeld,
  • Rodrick Kisenge,
  • Robert Moshiro,
  • Danielle E. Tuller,
  • Linda Vesel,
  • Katherine E. A. Semrau,
  • Sangappa Dhaded,
  • Roopa Bellad M,
  • Tisungane Mvalo,
  • Karim Manji
Sunil Vernekar
KLE University

Corresponding Author:[email protected]

Author Profile
Sarah Somji
Muhimbili University of Health and Allied Sciences
Author Profile
Kingsly Msimuko
University of North Carolina Project Malawi
Author Profile
S Yogeshkumar
KLE University
Author Profile
Rashmita Nayak B
SCB Medical College & Hospital
Author Profile
Shilpa Nabapure
SS Institute of Medical Sciences and Research Center
Author Profile
Varun Kusagir
J J M Medical College
Author Profile
Friday Saidi
The University of North Carolina at Chapel Hill Department of Obstetrics and Gynecology
Author Profile
Melda Phiri
University of North Carolina Project Malawi
Author Profile
Eddah Kafansiyanji
University of North Carolina Project Malawi
Author Profile
Christopher Sudfeld
Harvard University T H Chan School of Public Health
Author Profile
Rodrick Kisenge
Muhimbili University of Health and Allied Sciences
Author Profile
Robert Moshiro
Muhimbili University of Health and Allied Sciences
Author Profile
Danielle E. Tuller
Harvard University T H Chan School of Public Health
Author Profile
Linda Vesel
Harvard University T H Chan School of Public Health
Author Profile
Katherine E. A. Semrau
Harvard University T H Chan School of Public Health
Author Profile
Sangappa Dhaded
KLE University
Author Profile
Roopa Bellad M
KLE University
Author Profile
Tisungane Mvalo
University of North Carolina Project Malawi
Author Profile
Karim Manji
Muhimbili University of Health and Allied Sciences
Author Profile

Abstract

Objective: Globally, early and optimal feeding practices and strategies for small and vulnerable infants are limited. We aim to share the challenges faced and implementation lessons learned from a complex, mixed methods research study on infant feeding. Design: A formative, multisite, observational cohort study using convergent parallel, mixed-methods design. Setting: 12 tertiary/secondary, public/private hospitals in India, Malawi, and Tanzania Population or Sample: Moderately low birthweight infants (MLBW; 1.50-2.49kg) Methods: We assessed infant feeding and care practices through: 1) assessment of in-facility documentation of 603 MLBW patient charts; 2) intensive observation of 148 MLBW infants during facility admission; and 3) prospective one-year follow-up of 1114 MLBW infants. Focus group discussions and in-depth interviews gathered perspectives on infant feeding among clinicians, families, and key stakeholders. Results: Hospital-level guidelines and provision of care for MLBW infants varied across and within countries. 89% of charts had missing data on time to first feed; 56% lacked discharge weights. Among 148 infants observed in-facility, 18.5% were discharged prior to meeting stated weight goals. Despite challenges during COVID, 90% of the prospective cohort was followed until 12 months of age. Conclusions: Enrolment and follow-up of this vulnerable population required additional effort from researchers and the community. Using a mixed-methods exploratory study allowed for a comprehensive understanding of MLBW health and evidence-based planning of targeted large-scale interventions. Multi-site partnerships in global health research, which require active and equal engagement, are instrumental in avoiding duplication and building a stronger, generalizable evidence base.
24 Mar 2023Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
25 Mar 2023Submission Checks Completed
25 Mar 2023Assigned to Editor
25 Mar 2023Review(s) Completed, Editorial Evaluation Pending
24 Jun 2023Editorial Decision: Accept