Search results for: infant and young child feeding

Authors: Otgonjargal Damdinbaljir

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Background: Infant feeding practices have a major role in determining the nutritional status of children and are associated with household socioeconomic and demographic factors. In 2010, Mongolia used WHO 2008 edition of Indicators for assessing infant and young child feeding practices for the first time. Objective: To evaluate the feeding status of infants and young children under 2 years old in Mongolia. Materials and Methods: The study was conducted by cluster random sampling. The data on breastfeeding and complementary food supplement of the 350 infants and young children aged 0-23 months in 21 provinces of the 4 economic regions of the country and capital Ulaanbaatar city were collected through questionnaires. The feeding status was analyzed according to the WHO 2008 edition of Indicators for assessing infant and young child feeding practices. Analysis of data: Survey data was analysed using the PASW statistics 18.0 and EPI INFO 2000 software. For calculation of overall measures for the entire survey sample, analyses were stratified by region. Age-specific feeding patterns were described using frequencies, proportions and survival analysis. Logistic regression was done with feeding practice as dependent and socio demographic factors as independent variables. Simple proportions were calculated for each IYCF indicator. The differences in the feeding practices between sexes and age-groups, if any, were noted using chi-square test. Ethics: The Ethics Committee under the auspices of the Ministry of Health approved the study. Results: A total of 350 children aged 0-23 months were investigated. The rate of ever breastfeeding of children aged 0-23 months reached up to 98.2%, while the percentage of early initiation of breastfeeding was only 85.5%. The rates of exclusive breastfeeding under 6 months, continued breastfeeding for 1 year, and continued breastfeeding for 2 years were 71.3%, 74% and 54.6%, respectively. The median time of giving complementary food was the 6th month and the weaning time was the 9th month. The rate of complementary food supplemented from 6th-8th month in time was 80.3%. The rates of minimum dietary diversity, minimum meal frequency, and consumption of iron-rich or iron-fortified foods among children aged 6-23 months were 52.1%, 80.8% (663/813) and 30.1%, respectively. Conclusions: The main problems revealed from the study were inadequate category and frequency of complementary food, and the low rate of consumption of iron-rich or iron-fortified foods were the main issues to be concerned on infant feeding in Mongolia. Our findings have highlighted the need to encourage mothers to enrich their traditional wheat- based complementary foods add more animal source foods and vegetables.

Keywords: complementary feeding, early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency

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Authors: Smriti Pahwa, Karishma Vats, Aditi Macwan, Jija Dutt, Sumukhi Vaid

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Age approporiate complementary feeding has been stressed upon for sound young child nutrition and appropriate growth. National Infant and Young Child Feeding guidelines, policies and programs indicate cognizance of the issue taken by the country’s government, policy makers and technical experts. However, it is important that ordinary people, the caregivers of young children too understand the importance of appropriate feeding. For this, an interface might be required where ordinary people could participate in assessing the gaps in IYCF as a first step to take subsequent action. In this context an attempt was made to extrapolate a citizen led learning level survey that has been involving around 25000 ordinary citizens to reach out to 600,000 children annually for over a decade in India. Based on this philosophy of involving ordinary people in simple assessments to produce understandable actionable evidence, a rapid diet assessment tool was developed and collected from caregivers of 90 < 3year children from two urban clusters in Ahmedabad and Baroda, Gujarat. Target sample for pilot was selected after cluster census. Around half the mothers reported that they had not yet introduced water or other fluids to their < 6 month babies. However, about a third were already feeding them food other than mother’s milk. Although complementary feeding was initiated in almost all (95%) children more than 6 months old, frequency was suboptimal in 60%; in 80% cases no measure was taken to either improve energy or nutrient density; only 33% were fed protective foods; Green Leafy Vegetables consumption was negligible (1.4%). Anganwadi food was not consumed. By engaging ordinary people to generate evidence and understand the gaps, such assessments have the potential to be used to generate useful evidence for action at scale as well as locally.

Keywords: citizen led, grass root engagement, IYCF (Infant and Young Child Feeding), rapid diet assessment, under nutrition

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Authors: Dawit Thomas

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Feeding and weaning practices vary from culture to culture and depend on different child-rearing values. The socio-cultural dimensions that influence the acceptable infant feeding practices are varied and complex. Understanding cultural differences in beliefs and practices relating to infant feeding is important to enhance designing programs for delivering successful psychological, social, physiological and economic well-being of mothers and infants. The main purpose of this study was exploring mothers infant feeding practices in the context of Hadiyya culture. After purposively selecting Harche Huyaya Uyaya Kebele eight infant feeding mothers were selected using snowball sampling technique. The study employed interviews and focus group discussion. The study found out early initiation and prolonged breastfeeding and early complementary feeding in some instances immediately after birth. In addition, infants were not forced to wean unless the mothers encounter pressing issues like pregnancy and health related problems. Furthermore, the main weaning techniques were putting unpleasant materials on the tip of nipples and sending infants to grandparents home. The study also found out gender difference in weaning, i.e., early initiation of weaning for girls. This can be indicative of gender-based bias on weaning practice. Finally, health extension workers, office of women and children affairs and Hadiyya Zone Tourism office should organize awareness raising programs to preserve vital infant feeding practices like prolonged breastfeeding and length of weaning. In addition, the offices should raise awareness among communities on negative side effects of sending infant to grandparents home that may weaken infant-mothers attachment and create favorable ground for the development of phobia.

Keywords: feeding, infant, practices, weaning

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Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

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Authors: Narendra Kumar

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This study uses data from the ‘National Family Health Survey (NFHS-3) 2005-06’ to investigate the predictors of infant and child mortality among low economic households in East and Northeast region. The cross tabulation, life table survival estimates and Cox proportional hazard model techniques have been used to estimate the predictors of infant and child mortality. The life table survival estimates for infant and child mortality shows that infant mortality in female child is lower in comparison to male child but with child mortality, the rates are higher for female in comparison to male child and the Cox proportional hazard model also give highly significant in female in comparison to male child. The infant and child mortality rates among poor households highest in the Central region followed by North and Northeast region and the lowest in South region in comparison to all regions of India. Education of respondent has been found a significant characteristics in both analyzes, further birth interval, respondent occupation, caste/tribe and place of delivery has substantial impact on infant and child mortality among low economic households in East and Northeast region. Finally these findings specified that an increase in parents’ education, improve health care services and improve socioeconomic conditions of low economic households which should in turn raise infant and child survival and should decrease child mortality among low economic households in India.

Keywords: infant, child, mortality, socio-economic, India

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Authors: Nicole Banton

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The maternal and infant mortality rate of Blacks is three times that of Whites in the US. Research indicates that breastfeeding lowers both. In this paper, the researcher examines how the ideas that Black/African American mothers had about breastfeeding before, during, and after pregnancy (postpartum) affected whether or not they initiated breastfeeding. The researcher used snowball sampling to recruit thirty African-American mothers from the Orlando area. At the time of her interview, each mother had at least one child who was at least three years old. Through in-depth face-to-face interviews, the researcher investigated how mothers’ healthcare providers affected their decision-making about infant feeding, as well as how the type of birth that she had (e.g., preterm, vaginal, c-section, full term) affected her actual versus idealized infant feeding practice. Through our discussions, we explored how pre-pregnancy perceptions, birth and postpartum experiences, social support, and the discourses surrounding motherhood within an African-American context affected the perceptions and experiences that the mothers in the study had with their infant feeding practice(s). Findings suggest that the pregnancy and birth experiences of the mothers in the study influenced whether or not they breastfed exclusively, combined breastfeeding and infant formula use, or used infant formula exclusively. Specifically, the interplay of invocation of agency (the ability to control their bodies before, during, and after birth), birth outcomes, and the interaction that the mothers in this study had with resources, human and material, had the highest impact on the initiation, duration, and attitude toward breastfeeding.

Keywords: African American mothers, maternal health, breastfeeding, birth, midwives, obstetricians, hospital birth, breast pumps, formula use, infant feeding, lactation consultant, postpartum, vaginal birth, c-section, familial support, social support, work, pregnancy

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Authors: Md Abdullah Al Mamun

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Background: The current situation of Ensuring WHO recommended feeding practices for infant and young children which is becoming a challenge nowadays in many developing countries, especially in areas where household food security is at risk. Because many households of the developing countries often encounter severe food insecurity hence provision of adequate child nutrition is threatened. Aim: The study aimed to assess the child feeding practices of 0-24 months childbearing mothers and explore their household food insecurity in a coastal region of Bangladesh. Methods: This study was conducted in Suborno Char (one of the coastal suburbs in Noakhali District in Bangladesh) from October 2019 to April 2020. A total of 400 mothers were selected with their children of 0-24 months following a cross sectional study sampling procedure of the population. Data were collected through a standard questionnaire and analyzed using statistical tests in SPSS version 20.0.0. Results: The frequency of exclusive breastfeeding, timely initiation of complementary feeding, and giving foods from four food groups to the children were 53.5%, 75.5%, and 22.2%, respectively. Mother's level of education showed a strong association with the child feeding practices of the mothers. Mothers of severely food insecure households showed lower odds in exclusive breastfeeding practice (COR 0.233 at 95% CI 0.083, 0.655; and AOR 0.478 at 95% CI 0.133, 1.713) than mothers of food secured households. Similar results have also been found in case of timely initiation of complementary feeding and minimum dietary diversity of the children.

Keywords: household food insecurity, exclusive breastfeeding, complementary feeding, maternal education, mothers age, household income

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Authors: Emmanuel Olamijuwon

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Despite laws against child marriage - a violation against child rights, the practice remains widespread in sub-Saharan Africa and globally partly because of persistent poverty, gender inequality, protection and the need to reinforce family ties. Using pooled data from the recent demographic and health surveys of 20-sub-Saharan African countries with a regional representative sample of 36,943 girls under 18 years, this study explores the prevalence, pattern and infant mortality implications of this marriage type while also examining its regional variations. Indications from the study are that child marriage is still very high in the region with variations above one-tenth in West, Central and Southern Africa regions except in the East African region where only about 7% of children under 18 were already married. Preliminary findings also suggest that about one-in-ten infant deaths were to child brides many of whom were residing in poor households, rural residence, unemployed and have less than secondary education. Based on these findings, it is, therefore, important that government of African countries addresses critical issues through increased policies towards increasing enrollment of girl children in schools as many of these girls are not likely to have any economic benefit to the region if the observed pattern continues.

Keywords: child marriage, infant mortality, Africa, child brides

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Authors: Terry Gomez

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This interpretive phenomenological qualitative study explored potential risks related to infant mental health with parental smartphone use while caring for infants. Data were collected through nine online interviews of first-time parents with infants under one-year-old. All parents reported using their smartphone during child-bonding activities such as playtime, feeding, and sleep-time. Results indicated that smartphone distractions appear to influence the synchrony of parent-child interactions. Infants displayed physical, verbal, or emotional reactions to parents’ smartphone distractions, indicating that smartphone use influences infants’ behaviors. Parents shared information on how smartphones helped them with their transition into parenthood. The findings of this study provide insights helpful to inform infant mental health professionals and parents about potential developmental consequences associated with parental technoference and absent presence.

Keywords: absent presence, infant mental health, parental distractions, smartphones, technoference

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Authors: M. Munirul Islam, Makhduma Khatun M., Janet M. Peerson, Tahmeed Ahmed, M. Abid Hossain Mollah, Kathryn G. Dewey, Kenneth H. Brown

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Information is required on the effects of dietary energy density (ED) and feeding frequency (FF) of complementary foods (CF) on food consumption during individual meals and time expended in child feeding. We evaluated the effects of varied ED and FF of CFs on food intake and time required for child feeding during individual meals. During 9 separate, randomly ordered dietary periods lasting 3-6 days each, we measured self-determined intakes of porridges by 18 healthy, breastfed children 8-11 mo old who were fed coded porridges with energy densities of 0.5, 1.0 or 1.5 kcal/g, during 3, 4, or 5 meals/d. CF intake was measured by weighing the feeding bowl before and after every meal. Children consumed greater amounts of CFs per meal when they received diets with lower ED (p = 0.044) and fewer meals per day (p < 0.001). Food intake was less during the first meal of the day than the other meals. Greater time was expended per meal when fewer meals were offered. Time expended per meal did not vary by ED, but the children ate the lower ED diets faster (p = 0.019). Food intake velocity was also greater when more meals were offered per day (p = 0.005). These results provide further evidence of young children’s ability to regulate their energy intakes, even during infancy; and they convey information on factors that affect the amount of time that caregivers must devote to child feeding.

Keywords: complementary foods, energy density, feeding frequency, young children

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Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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Authors: Taylor Brown

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The parent-child attachment bond begins early, often before the birth of the child. Both father and mother begin to form a bond with their child by selecting a name, preparing for the birth, etc. The biological mother carries the child and often breastfeeds the infant after birth. While fathers play an important role in caring for the child as well, the mother is traditionally seen as the caregiver with the primary role of caring for her baby. These core ideas could include how to form bonds, how to communicate emotions, and even how to create and maintain relationships. Mothers tend to shape their children’s minds based on their own. Studies have even shown that when mothers stroke their children’s bodies with their fingers, the child does calm down more than most other methods. The bond between mother and child is one that happens immediately and strengthens over time. This attachment affects the child’s overall development. The mother-child attachment style is directly linked to a multitude of patterns in adolescents, and later on, adults. The researcher believes that the subsequent patterns of communication in romantic relationships are included in the multitude. Awareness of these patterns and their effects could improve experiences in romantic relationships during young adulthood.

Keywords: emotion regulation, parenting, maternal, attachment, romantic

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Authors: G. C. Phiri, E. A. Heil, A. A. Kalimbira, E. Muehlhoff, C. Masangano, B. M. Mtimuni, J. Herrmann, M. B. Krawinkel, I. Jordan

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Background and objectives: High prevalence of undernutrition in Malawi is caused by poor complementary foods. Lack of knowledge of age appropriate food within the household might affect utilization of available resources. FAO-Malawi implemented nutrition education (NE) sessions in 200 villages in Kasungu and Mzimba districts from December 2012 to April 2013 targeting 15 caregivers per village of children aged 6-18 months, grandmothers, spouses and community leaders. Two trained volunteers per village facilitated 10 NE sessions on breastfeeding, food safety and hygiene and complementary feeding using locally available resources. This study assessed the reported dietary diversification practices of infant and young child after nutrition education and the factors that influenced adoption of the practice. Methodology: Questionnaire-based interviews with caregivers were conducted in 16 randomly selected villages (n=108) before training-(t1) and seven months after training-(t2). Knowledge score (KS) was calculated on the indicators breastfeeding, hygiene and complementary feeding. Count regression was performed using SPSS 22. Eight focus group discussions (FGDs) were separately conducted among caregivers and grandmothers in 4 villages. Content analysis was used to analyze FGDs data. Results: Following NE, caregivers' KS significantly increased (p<0.001) between t1 and t2 for breastfeeding (7.7 vs. 9.8, max=18), hygiene (3.8 vs. 5.9, max=7) and complementary feeding (10.2 vs. 16.2, max=26). Caregivers indicated that they stopped preparation of plain-refined maize meal porridge after they gained knowledge on dietary diversification of complementary foods. They learnt mushing and pounding of ingredients for enriched porridge. Whole-maize meal or potatoes were often enriched with vegetables, legumes, small fish or eggs and cooking oil. Children liked the taste of enriched porridge. Amount of enriched porridge consumed at each sitting increase among previously fussy-eater children. Meal frequency increased by including fruits as snacks in child’s diet. Grandmothers observed preparation of enriched porridge among the mothers using locally available foods. Grandmothers liked the taste of enriched porridge and not the greenish color of the porridge. Both grandmothers and mothers reported that children were playing independently after consuming enriched porridge and were strong and healthy. These motivated adoption of the practice. Conclusion: Increased knowledge and skill of preparation and utilisation of locally available foods promoted children’s dietary diversification. Children liking the enriched porridge motivated adoption of dietary diversification.

Keywords: behaviour change, complementary feeding, dietary diversification, IYCN

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Authors: Alcino Panguana

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All Portuguese-speaking African countries are in Sub-Saharan Africa, a region that has high infant mortality rates, being responsible for 49.6% of deaths in Portuguese-speaking African countries, Angola has levels of infant mortality among children, where 2017, 156 children who died before reaching 1 year of life in 1000 live births. Although there is an increase in studies that document trends and specific causes of infant mortality in each country, historical-comparative studies of infant mortality among these countries remain rare. Understanding the trend of this indicator is important for policymakers and planners in order to improve access to successful child survival operations. Lusophone Africa continues with high infant mortality rates in the order of 64 deaths per thousand births. Assuming heterogeneities that can characterize these countries, raise an analysis investigated indicator at the country level to understand the pattern and historical trend of infant mortality within Lusophone Africa from the year 2021. The result is to understand the levels and evolution of infant mortality in Portuguese-speaking African countries.

Keywords: child mortality, levels, trends, lusophone African countries

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Authors: Jacqueline R. Llamas, Agnes Regal

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Objective: To determine the breastfeeding knowledge and attitudes of fathers seen at the University of Santo Tomas Hospital. Design: Cross-sectional design. Setting: University of Santo Tomas Hospital (USTH). Participants: 156 fathers who were accompanying their wives/children at the USTH. Findings: Outcome of the Iowa Infant Feeding Attitude Scale showed fathers to be generally unbiased whether their child be fed breast milk or milk formula. About 85% agreed that breast milk is the ideal food for babies, 79% believed that breastfed babies are healthier than formula fed and 55% of them do not believe that breast milk lacks iron. About 80% agreed that it is easily digested, 87% are aware of the economical value and 57% agreed of its convenience. Breastfeeding support was noted when 55% of the fathers would encourage mothers to breastfeed so as not to miss the joys of motherhood, 91% believed that breastfeeding increased mother-infant bonding. About 57% do not feel left out whenever the mothers breastfeed. However, 46.6% support the decision of their wives to switch to formula feeding once they go back to work, 42% only find breastfeeding in public to be acceptable and 57% will not allow breast feeding to mothers who drink alcohol. Conclusion: In the study, although fathers’ attitude toward breastfeeding is unbiased towards breastfeeding or formula feeding, the majority of the fathers appreciate breastfeeding and its benefits. Also, how the father’s level of education, age, profession, household income and number of children had an effect on their attitude towards breastfeeding.

Keywords: father, breastfeeding, breast milk, knowledge

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Authors: Clementina Ebere Okoro, Olumuyiwa Adeyemi Owolabi, Doris Bola James, Aloysius Nwabugo Maduforo, Andrew Lingililani Mbewe, Christopher Osaruwanmwen Isokpunwu

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Poor dietary practices and malnutrition, including severe acute malnutrition among under-five children in Nigeria has remained a great public health concern. This study assessed infant and young child feeding practices and nutritional status of under-five children to determine the prevalence of malnutrition of under-five children in Kuje area council, Abuja. The study was a cross-sectional study. Multi-stage sampling techniques was used in selecting the population that was studied. Probability proportion by size was applied in choosing 30 clusters for the survey using ENA for SMART software 2011 version. Questionnaires were used to obtain information from the population, while appropriate equipment was used for measurements of anthropometric parameters. The data was also subjected to statistical analysis. Results were presented in tables and figures. The result showed that 96.7% of the children were breastfed, 30.6% had early initiation to breastfeeding within first hour of birth and 22.4% were breastfed exclusively up to 6 months, 69.8% fed infants’ colostrum, while 30.2% discarded colostrum. About half of the respondents (49.1%) introduced complementary feeding before six months and 23.2% introduced it after six months while 27.7% had age appropriate timely introduction of complementary feeding. The anthropometric result showed that the prevalence of global acute malnutrition (GAM) was 12.8%, severe wasting prevalence was 5.4%, moderate wasting was 7.4%, underweight was 24.4%, stunting was 40.3% and overweight was 7.0%. The result showed that there is a high prevalence of malnutrition among under-five children in Kuje

Keywords: malnutrition, under five children, breastfeeding, complementary feeding

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Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

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Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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Authors: Jin Li, Jing Sun, Xiangkun Cai, Lijuanwang, Yanbin Tang, Junsheng Huo

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In order to improve the malnutrition of infants and young children in poor rural areas of China, Chinese government implement a project on improvement of children's nutrition in poor rural areas. Each infant or young child aged 6 to 23 months in selected poor rural areas of China was provided a package of Yingyangbao (YYB) per day, which is a full fat soy powder mixed with multiple micronutrient powders. A technical direction to implement this project comprehensively in poor rural areas of China will be provided by assessing the nutritional status of infants and feeding practices of caregiver. The nutritional intervention was conducted using Yingyangbao for infants aged 6 to 23 months in six poor counties of Shanxi, Yunnan and Hubei Provinces. The caregiver or parents of infants were educated on feeding knowledge and practice. A total of 1840 infants were assessed before the intervention and 1789 infants one year later. The length, weight, hemoglobin concentration of infants were measured to evaluate nutritional status before and after the intervention respectively. The questionnaires were designed to collect data for the basic demographic information and feeding practices. The average weight of infants aged 6 to 23 months increased from 9.59 ± 1.54kg to 9.73 ± 1.61kg one years later (p<0.01), and the average length from 76.0±6.0 to 77.0±6.1(p<0.01). The weight and length of infants aged 12 to 17 months had most obviously improving effect among the three age groups. Before the intervention, the hemoglobin concentration value of infants was 11.7±1.2g/L, and the anemia prevalence was 32.9%. One year later, the hemoglobin concentration value of the infants was increased to 12.0±1.1g/dL, and the anemia prevalence was decreased to 26.0%. There were both statistically significant (p <0.01). The anemia prevalence of infants aged 18 to 23 months had most obviously improving effect，which decreased from 25.0% to 17.2%(p<0.01). The proportion of infants aged 6 to 8 months who received solid, semi-solid or soft foods in time was increased from 89.4% to 91.6%, while there was no statistically significant. The proportion of 6-23 month-old infants who received minimum dietary diversity increased from 55.6% to 60.3%(p <0.01). The differences of the proportion of infants who received minimum meal frequency was no statistically significant between before and after the intervention. The nutritional intervention using Yingyangbao showed the significant effect for improving infants aged 6 to 23 months anemia status, weight and length. The feeding practices were improved through education in the process of nutritional intervention, while the effect is not significant. It is need for Chinese government to explore new publicity pattern.

Keywords: nutritional intervention, infants, nutritional status, feeding practice

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Authors: Matthew Heidman, Susan Dallabrida, Analice Costa

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For infant caregivers, choosing an infant formula for their child can be a difficult task in an already stressful environment of caring for a newborn. There exist several channels that influence purchasing decision of infant formula such as, friends and family and their experiences, health care professionals, social media influencers, as well as standard media marketing. This study sought to identify the key channels by which caregivers obtain information regarding infant formula and help them make their purchasing decision. A digital survey was issued for 90 days in the US (n=121) and 30 days in Mexico (n=88) targeting respondents with children ≤4 years of age. Respondents were asked two key questions regarding the influences on their purchasing decisions: 1) “When choosing a formula brand, what do you do to help you make your decision?”, and 2) “When choosing a formula brand, what is most important to you?”. A list of potential answers was provided for each question and respondents were asked to select all that apply to them. Lastly, respondents were provided a 5-point Likert scale and asked to respond to the statement 3) “I am more likely to buy a particular formula brand if my pediatrician recommends it to me”. For question 1, in the US and Mexico, 76% and 95% of respondents respectively, selected “I ask my pediatrician” which represented the top selection. For question 2, 52% and 45% of respondents respectively, selected “On package “Pediatrician Recommended” claim…” which also represented the top selection. For statement 3, 82% and 89% of respondents respectively, stated that they either “somewhat agree” or “strongly agree” with the statement. For infant caregivers, the pediatrician is a very important channel of influence when it comes to purchasing decision of infant formula. Caregivers clearly see the pediatrician as the arbiter of their child’s nutrition and seek their recommendations for infant formula use. For infant formula manufacturers, it is important that they see the pediatrician as the gatekeeper to this market, and they put resources into medical marketing communication to this health care professional group to ensure success.

Keywords: infant formula, pediatrician, purchasing driver, caregiver

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Authors: Priyanka Patil, Logan Manikam

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Background: The first 1000 days of life are a critical window and can result in adverse health consequences due to inadequate nutrition. South-Asian (SA) communities face significant health disparities, particularly in maternal and child health. Community-based interventions, often employing Participatory-Learning and Action (PLA) approaches, have effectively addressed health inequalities in lower-income nations. The aim of this study was to assess the feasibility of implementing a PLA intervention to improve infant feeding and care practices in SA communities living in London. Methods: Comprehensive analyses were conducted to assess the feasibility/fidelity of this pilot randomized controlled trial. Summary statistics were computed to compare key metrics, including participant consent rates, attendance, retention, intervention support, and perceived effectiveness, against predefined progression rules guiding toward a definitive trial. Secondary outcomes were analyzed, drawing insights from multiple sources, such as The Children’s-Eating-Behaviour Questionnaire (CEBQ), Parental-Feeding-Style Questionnaires (PFSQ), Food-diary, and the Equality-Impact-Assessment (EIA) tool. A video analysis of children's mealtime behavior trends was conducted. Feedback interviews were collected from study participants. Results: Process-outcome measures met predefined progression rules for a definitive trial, which deemed the intervention as feasible and acceptable. The secondary outcomes analysis revealed no significant changes in children's BMI z-scores. This could be attributed to the abbreviated follow-up period of 6 months, reduced from 12 months, due to COVID-19-related delays. CEBQ analysis showed increased food responsiveness, along with decreased emotional over/undereating. A similar trend was observed in PFSQ. The EIA tool found no potential discrimination areas, and video analysis revealed a decrease in force-feeding practices. Participant feedback revealed improved awareness and knowledge sharing. Conclusion: This study demonstrates that a co-adapted PLA intervention is feasible and well-received in optimizing infant-care practices among South-Asian community members in a high-income country. These findings highlight the potential of community-based interventions to enhance health outcomes, promoting health equity.

Keywords: child health, childhood obesity, community-based, infant nutrition

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Authors: Ahmed Ali Torad

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Background: Breast feeding maintains the maternal fetal immunological link, favours the transmission of immune-competence from the mother to her infant and is considered an important contributory factor to the neo natal immune defense system. Purpose: This study was conducted to investigate the effect of relaxation techniques on immunological properties of breast milk. Subjects and Methods: Thirty breast feeding mothers with a single, mature infant without any complications participated in the study. Subjects will be recruited from outpatient clinic of obstetric department of El Kasr El-Aini university hospital in Cairo. Mothers were randomly divided into two equal groups using coin toss method: Group (A) (relaxation training group) (experimental group): It will be composed of 15 women who received relaxation training program in addition to breast feeding and nutritional advices and Group (B) (control group): It will be composed of 15 women who received breast feeding and nutritional advices only. Results: The results showed that mean mother’s age was 28.4 ± 3.68 and 28.07 ± 4.09 for group A and B respectively, there were statistically significant differences between pre and post values regarding cortisol level, IgA level, leucocyte count and infant’s weight and height and there is only statistically significant differences between both groups regarding post values of all immunological variables (cortisol – IgA – leucocyte count). Conclusion: We could conclude that there is a statistically significant effect of relaxation techniques on immunological properties of breast milk.

Keywords: relaxation, breast, milk, immunology, lactation

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Authors: Hoi Yan Lau

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In Hong Kong, most families have working parents, and the primary caregivers of young children are helpers. This leads to a lack of interaction and language expression in children’s home environment, which affects their language development. This study aims to explore the effectiveness of parent-child reading in improving young children’s language skills. A 4-year-old girl and her mother are recruited to a 3 months’ parent-child reading program. There is a total of 26 reading sessions which target to enhance the parent’s skill of parent-child reading and to assess the child’s language ability. At the same time, the child’s use of language in normal classroom settings is analyzed by anecdotal records. It is shown that the parent is able to use more and better guiding questions during parent-child reading after this program, which in turn leads to more and longer response of the child during the reading sessions. The child also has an increase in Mean Length of Utterance and has a higher frequency of using complete sentences when interacting with other classmates in the classroom. It is worthwhile to further investigate the inclusion of promoting parent-child reading to enhance children’s language development in preschool curriculum planning.

Keywords: Hong Kong, language skills, parent-child reading, preschoolers

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Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

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Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

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Authors: Heiko Scholz

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When feeding high qualitysilagetoheifersfromthe age of two, there is a riskofenergyoversupply. Depending on the feeding valueorscarceavailability ofsilageorcorn silage diets withhighproportionsof straw is often incorporated. Foran energetically standardized young cattle supply of strawproportion can be more than 20% of dry matter. It was investigated whether the grinding of straw with the strawmillselective feeding significantly limits. The investigation has been carried out with young cattle in the second year. 78 animals were kept and fed under similar conditions in two groups. The experimental group (EG) consisted of cattle 12 to 15 months, and in the control group (CG), the cattle were 15 to 20 months old. The experimental feeding took place in five days of feed distribution, and residual feed were weighed. The ration of EG contained ground with the straw mill straw, and CG was further fed rotor-cut pressed straw. To determine the selective seizure samples of feed distributionandtheremainingfood with the particle separator boxandthecrude protein-and energy-content have been determined. The grinding of the straw increased the daily feed intake.IntheEGan increase infeed intakewas observedby grinding of the straw. Feed intakedirectlyon the day for changing the dietoflongonground straw increased by more than 2.0 kgofDMper animal. In the following days, the feed intakewasincreasedby 0.9kg DMper animal and day on average (7.4 vs. 8.3 kg DM per day). The results of the screen distribution of residual feed point to a differentiated feeding behavior between the groups. In the EG, the particle length of the residual feed to a large extent with the template matches. The acid-base-balance (NSBA)valuesofEGarewithin normal limits. Ifstrawsharesof25% and more are federations to young cattle (heifers), the theparticlelengthof straw has significant impact ontheselectivefeeding behavior. Aparticlelength of 1.5cmcompared to7.5 cmlongpreventedstrawcertainly discarding of the straw on the feeding barn. The feed intake increases whenshortstrawis mixed into theTMR.

Keywords: straw mill, heifer, feed selection, dry matter intake

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Authors: Nyimas Annissa Mutiara Andini

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Every year, children develop hydrocephalus during the first year of life. If it is not treated, hydrocephalus can lead to brain damage, a loss in mental and physical abilities, and even death. To be treated, first, we have to do a proper diagnosis using some examinations especially to detect hydrocephalus earlier. One of the examination that could be done is using a head circumference measurement. Increased head circumference is a first and main sign of hydrocephalus, especially in infant (0-1 year age). Head circumference is a measurement of a child's head largest area. In this measurement, we want to get the distance from above the eyebrows and ears and around the back of the head using a measurement tape. If the head circumference of an infant is larger than normal, this infant might potentially suffer hydrocephalus. If early diagnosis and timely treatment of hydrocephalus could be done most children can recover successfully. There are some problems with early detection of hydrocephalus using regular tape for head circumference measurement. One of the problem is the infant’s comfort. We need to make the infant feel comfort along the head circumference measurement to get a proper result of the examination. For that, we can use a helpful stuff, like a hat. This paper is aimed to describe the possibility of using a head circumference measuring instrument for early detection of hydrocephalus in an infant with a mike hat, coloured-tape-in-hat. In the first life, infants’ head size is about 35 centimeters. First three months after that infants will gain 2 centimeters each month. The second three months, infant’s head circumference will increase 1 cm each month. And for the six months later, the rate is 0.5 cm per month, and end up with an average of 47 centimeters. This formula is compared to the WHO’s head circumference growth chart. The shape of this tape-in-hat is alike an upper arm measurement. This tape-in-hat diameter is about 47 centimeters. It contains twelve different colours range by age. If it is out of the normal colour, the infant potentially suffers hydrocephalus. This examination should be done monthly. If in two times of measurement there still in the same range abnormal of head circumference, or a rapid growth of the head circumference size, the infant should be referred to a pediatrician. There are the pink hat for girls and blue hat for boys. Based on this paper, we know that this measurement can be used to help early detection of hydrocephalus in an infant.

Keywords: head circumference, hydrocephalus, infant, mike hat

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Authors: Nemeh Ahmad Al-Akour, Ibrahem Alfaouri

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Objective: To examine the level of maternal awareness of SIDS and its prevention amongst Jordanian mothers in the north of Jordan, as well as to determine their SIDS-related infant care practices. Design: A cross-sectional design. Setting: The study was conducted in maternal out-patients clinics of two teaching hospitals and three maternal and child health clinic in three major health care centers in Northern Jordan. Participants: A total of 356 mothers of infants attending the maternal and child health clinics were included in this study. Measurements and findings: A self-administered questionnaire was used for collecting data study. In this study, 64%of mothers didn’t hear about SIDS, while only 7% of mothers were able to identify factors risk-reducing recommendations. Avoidance of prone sleeping was the most frequently identified recommendation (5%). There were 67.7% of mothers who put their infant in a lateral position to sleep, 61% used soft mattress surface for their babies sleep and 25.8% who shared a bed with their babies. Employed mother, mothers of higher age, and mothers living within a nuclear family were the only factors associated with maternal awareness of SIDS. Friends were the highest a source of knowledge of SIDS for mothers (44.7%). Key conclusions: There was a low level of awareness of SIDS and its associated risk factor among the mothers in Jordan. The mothers' misconception about smoking and sleeping position for their infants requires further efforts. Implications for practice: To ensure raising awareness of infant care practice regarding SIDS, a national educational intervention on SIDS risk reduction strategies and recommendations is necessary for maintaining a low rate of SIDS in the population.

Keywords: bed sharing, infant care, Jordan, sleep position, sudden infant death

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Authors: Klara Smith-Etxeberria

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main goal of this study was to analyze the predictive ability of some variables associated with the parental divorce process alongside attachment history with parents on both, mother-child and father-child relationship quality. Our sample consisted of 173 undergraduate and vocational school students from the Autonomous Community of the Basque Country. All of them belonged to a divorced family. Results showed that adequate maternal strategies during the divorce process (e.g.: stable, continuous and positive role as a mother) was the variable with greater predictive ability on mother-child relationships quality. In addition, secure attachment history with mother also predicted positive mother-child relationships. On the other hand, father-child relationship quality was predicted by adequate paternal strategies during the divorce process, such as his stable, continuous and positive role as a father, along with not badmouthing the mother and promoting good mother-child relationships. Furthermore, paternal negative emotional state due to divorce was positively associated with father-child relationships quality, and both, history of attachment with mother and with father predicted father-child relationships quality. In conclusion, our data indicate that both, paternal and maternal strategies for children´s adequate adjustment during the divorce process influence on mother-child and father-child relationships quality. However, these results suggest that paternal strategies during the divorce process have a greater predictive ability on father-child relationships quality, whereas maternal positive strategies during divorce determine positive mother-child relationships among young adults.

Keywords: father-child relationships quality, mother-child relationships quality, parental divorce process, young adulthood

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Authors: Baguma Daniel Kajura

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The study explores socio-economic factors, health related and individual factors that influence the breastfeeding habits of mothers and their effect on the nutritional status of their infants in the Rwenzori region of Western Uganda. A cross-sectional research design was adopted, and it involved the use of self-administered questionnaires, interview guides, and focused group discussion guides to assess the extent to which socio-demographic factors associated with breastfeeding practices influence child malnutrition. Using this design, data was collected from 276 mother-paired infants out of the selected 318 mother-paired infants over a period of ten days. Using a sample size formula by Kish Leslie for cross-sectional studies N= Zα2 P (1- P) / δ2, where N= sample size estimate of paired mother paired infants. P= assumed true population prevalence of mother–paired infants with malnutrition cases, P = 29.3%. 1-P = the probability of mother-paired infants not having malnutrition, so 1-P = 70.7% Zα = Standard normal deviation at 95% confidence interval corresponding to 1.96.δ = Absolute error between the estimated and true population prevalence of malnutrition of 5%. The calculated sample size N = 1.96 × 1.96 (0.293 × 0.707) /0,052= 318 mother paired infants. Demographic and socio-economic data for all mothers were entered into Microsoft Excel software and then exported to STATA 14 (StataCorp, 2015). Anthropometric measurements were taken for all children by the researcher and the trained assistants who physically weighed the children. The use of immunization card was used to attain the age of the child. The bivariate logistic regression analysis was used to assess the relationship between socio-demographic factors associated with breastfeeding practices and child malnutrition. The multivariable regression analysis was used to draw a conclusion on whether or not there are any true relationships between the socio-demographic factors associated with breastfeeding practices as independent variables and child stunting and underweight as dependent variables in relation to breastfeeding practices. Descriptive statistics on background characteristics of the mothers were generated and presented in frequency distribution tables. Frequencies and means were computed, and the results were presented using tables, then, we determined the distribution of stunting and underweight among infants by the socioeconomic and demographic factors. Findings reveal that children of mothers who used milk substitutes besides breastfeeding are over two times more likely to be stunted compared to those whose mothers exclusively breastfed them. Feeding children with milk substitutes instead of breastmilk predisposes them to both stunting and underweight. Children of mothers between 18 and 34 years of age are less likely to be underweight, as were those who were breastfed over ten times a day. The study further reveals that 55% of the children were underweight, and 49% were stunted. Of the underweight children, an equal number (58/151) were either mildly or moderately underweight (38%), and 23% (35/151) were severely underweight. Empowering community outreach programs by increasing knowledge and increased access to services on integrated management of child malnutrition is crucial to curbing child malnutrition in rural areas.

Keywords: infant and young child feeding, breastfeeding, child malnutrition, maternal health

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Authors: Olufemi Samuel Shola, Oladapo Adenike Adesola

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Inadequate dietary intake has increased the susceptibility of under five children to malnutrition and infections. This study, therefore, assessed the feeding practices of children of 0-23 months of age among mothers in urban areas of Akure, Ondo State, Nigeria. Simple random sampling technique was used to select four hundred (400) mothers out of 710 mothers from 7 primary health care centres in Akure metropolis for the study. Data were collected using modified WHO 2003 Questionnaire on child feeding practices. Data were analyzed using descriptive statistics, while chi-square was used to determine the association between variables. Results showed that 52.0% of the children were males, with 47.5% in the 6-8 months age group. More than half (57.0%) of the mothers were between the ages of 20-29 years, and 45.0% had secondary education. Majority (94.3%) of the mothers breastfed their children in the last 24 hours preceding the survey. The feeding practices history of mothers showed that 28.0% and 53.7% of the mothers initiated breastfeeding less than 30 minutes and between 30 minutes to 1 hour after delivery, respectively. Also, 52.0% of mothers practiced exclusive breastfeeding for six months, while 26.2% breastfed from 6 months up to 2 years of age. Dietary diversity of the children age 6-23 months revealed that 68.7% of the children attained the minimum dietary diversity by consuming 4 or more food groups in the last 24 hours. There was a significant association (P < 0.05) between mothers’ education (n=180), occupation(n=41) and dietary diversity (n= 150) and meal frequency (n=209). Therefore, the study concluded that the duration of breastfeeding and time of introduction of complementary food did not meet WHO recommended guidelines. There is urgent need to launching more programmes.

Keywords: breastfeeding, mothers, child feeding, urban areas, ondo state, nigeria

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Authors: L. Bernabeo, T. Loftus

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Many children often experience phases of picky eating, food aversions and/or avoidance. For families with children who have special needs, these experiences are often exacerbated, which can lead to feelings that negatively impact a caregiver’s relationship with their child. Within the scope of speech language pathology practice, knowledge of both emotional and feeding development is key. This paper will explore the significance of “messy play” within typical feeding development, and the challenges that may arise if a child does not have the opportunity to engage in this type of exploratory play. This paper will consider several contributing factors that can result in a “picky eater.” Further, research has shown that individuals with special needs, including autism, possess a neurological makeup that differs from that of a typical individual. Because autism is a disorder of relating and communicating due to differences in the limbic system, an individual with special needs may respond to a typical feeding experience as if it is a traumatic event. As a result, broadening one’s dietary repertoire may seem to be an insurmountable challenge. This paper suggests that introducing new foods through exploratory play can help broaden and strengthen diets, as well as improve the feeding experience, of individuals with autism. The DIRFloortimeⓇ methodology stresses the importance of following a child's lead. Within this developmental model, there is a special focus on a person’s individual differences, including the unique way they process the world around them, as well as the significance of therapy occurring within the context of a strong and motivating relationship. Using this child-centered approach, we can support our children in expanding their diets, while simultaneously building upon their cognitive and creative development through playful and respectful interactions that include exposure to foods that differ in color, texture, and smell. Further, this paper explores the importance of exploration, self-feeding and messy play on brain development, both in the context of typically developing individuals and those with disordered development.

Keywords: development, feeding, floortime, sensory

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