Protocol of a systematic review to assess programs or curricula to train early care and education stakeholders on infant and young child feeding in the U.S.
Creators: name: Torian, Stacy
name: Palmquist, Aunchalee
name: Wouk, Kathryn
name: Bridgman, Jessica
name: Huntley, Daina
name: Brand, Cinya
name: Koyama, Natsumi
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2022

description: Background: Rationale: The rationale for this systematic review of breastfeeding education and curricula for the early care and education setting is to understand the data and research to inform recommendations for strategic policy changes. Summarizing the available data on existing approaches to breastfeeding education for early care and education stakeholders will guide future work to embed best practices for children and families utilizing human milk, ensuring this work is built on a data-supported foundation.
Objectives: Our primary objective is to explore the peer-reviewed literature on programs or curricula to train child care technical consultants, teachers, and directors and other early care and education stakeholders on infant and young child feeding.
Methods: Eligibility criteria: We will include articles in English addressing 1) infant feeding in early care and education settings and 2) policies, practices, or trainings related to breastfeeding practices in early care and education settings. To be included, articles must address both criteria; those addressing one but not the other will be excluded, as will studies conducted outside of the United States. The search will encompass the full range of English-language holdings available in each database (no date limits will be used). 
Information sources: A health sciences librarian (ST) developed the search strategy in collaboration with the research team’s subject matter experts. The initial strategy was developed for PubMed (U.S. National Library of Medicine, National Institutes of Health). It includes a combination of keywords and PubMed Medical Subject Headings (MeSH) related to 1) early care and education; 2) education, training, or policies; and 3) infant and young child feeding. The librarian tested the search strategy to ensure that it retrieved a group of relevant citations (n=3) previously identified by the subject matter experts. The PubMed search strategy was peer reviewed by another health sciences librarian with experience in systematic review search strategy development. After peer review, the PubMed strategy was translated for three databases: Cumulative Nursing and Allied Health Literature (CINAHL) Plus with Full Text (EBSCOhost), PsycINFO (EBSCOhost), and Scopus (Elsevier). No date limits were used. The search results were limited to English. Complete strategies for each database are listed in Appendix A.
We will attempt to obtain full-text articles for all studies that potentially meet inclusion criteria. If we are unable to obtain a full-text article via library subscriptions or interlibrary loan services, we will attempt to contact study authors for a copy. Other search methods, including grey literature searching and forward and backward citation searching, will not be conducted; however, citations for any systematic reviews identified by our search will be reviewed for possible inclusion of individual articles.
Search strategy: Full search strategies are presented in Appendix A.
Study records: Data management: Citations were exported from each database and imported into Endnote where they were deduplicated. Citations were then uploaded into Covidence for screening and extraction.
Selection process: Two independent reviewers will be used for selecting studies at each phase of the review (abstract and title screening and full text review). A third investigator will work with the two reviewers to resolve any discrepancies through consensus regarding inclusion or exclusion. 
Data collection process: Two investigators will extract data from each article meeting inclusion criteria. Data will be extracted on PICO items listed below. One investigator will perform a quality assessment of the included studies using the Cochrane Collaboration’s tool for examining potential risk of bias.
Data items: Study aim and design; setting; study population; intervention/curricula characteristics; comparison group characteristics if available; outcomes; strengths and weaknesses.