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Background: Twenty five to forty percent of children will be infected with HIV in the absence of any form of intervention which is Prevention of Mother to Child Transmission (PMTCT). Objectives: This study determined the infant feeding knowledge and practices among HIV positive mothers attending HIV treatment centers in Lagos. Methods: A descriptive crosssectional design was used for the study. A multistage sampling technique was used to select / recruit 290 HIV positive mothers with babies between the ages of 2weeks to 18months, attending PMTCT services into the study Pre-tested interviewer administered structured questionnaire was used to collect data and analysis was done using Epi-info software. Chi-square and Fischer exact tests were used to determine association between the dependent and independent variables. The pvalue was set at 0.05. Results: Majority of the respondents (58.9%) were within the age range of 31 40 years and about half had a secondary school level of education. Exclusive formula feeding (40.3%) and exclusive breast feeding (42.4%) were feeding options known by the majority of the respondents. More than half (55.5%) of the mothers had a good knowledge of infant feeding options. Exclusive breastfeeding (EBF) was practiced by majority (55.5%) of the respondents, 21.4% practiced exclusive formula feeding (EFF) while only 6% practiced mixed feeding (MF). Knowledge of infant feeding options and the attitude towards exclusive breast feeding being enough in the first 6 months of life were associated with infant feeding options practiced; those with good knowledge of infant feeding options did not practice MF (9.7%) (p = 0.013). Conclusion: knowledge of infant feeding options was good and poor knowledge was associated with exclusive formula feeding. Majority practiced EBF. Educational programmes targeted at improving the knowledge of HIV and infant feeding options as well as strengthening of counseling sessions at PMTCT clinic would help reduce the risk of HIV transmission to the child.
Subject(s)
Breast Feeding , Health Knowledge, Attitudes, Practice , HIV Seropositivity , Infectious Disease Transmission, VerticalABSTRACT
@#Nutrition in infancy contributes to a significant portion on the notion of the importance of nutrition during the first 1000 days of life. A vast pool of literature exists on the importance of nutrition during this phase of life with future diseases, obesity and mental health. However, despite the availability of many guidelines and policies revolving around infant feeding practices, adherence to it remains poor. This review explains factors that influence infant feeding practices from an ecological point of view. A Bronfenbrenner ecological model was used to argue the influence and interaction of various ecological factors on infant feeding practices. The review highlights that the way these factors affect infant feeding differs according to populations and settings. This review suggests the need for more robust and population sensitive interventions to improve infant feeding practices globally.
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Background@#Breastfeeding is the ideal food source for all newborns globally. Proper feeding of infants and young children promotes optimal growth and development, especially in the critical window from birth to 2 years of age. Exclusive breastfeeding for 6 months and continued breastfeeding for the first 2 years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe.@*Objective@#To assess the indicators of infant feeding practices among 0- 23 months old children.@*Materials and Methods@#The NNS V was implemented in 21 aimags (provinces) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design [1]. The infant and young child feeding indicators assessed in the NNS V were based on the mother’s or caretaker’s report of breastfeeding and consumption of foods and fluids by the child during the day or night prior to being interviewed.@*Results@#83.7% of children under 2 years started breastfeeding within 1 hour of birth and though almost all children were ever breastfed (97.9%), a slightly higher percentage of girls were ever breastfed overall and within 1 hour of birth. Children 0-5 months were categorized according to whether they were exclusively breastfed or predominantly breastfed, with the former only allowing vitamins, mineral supplements, and medicine and the latter also including plain water and non-milk liquids. Among children 0-5 months of age, 58.3% were exclusively breastfed and 65.3% were predominantly breastfed, having received other liquids or foods in addition to breast milk. The prevalence of exclusive breastfeeding was lowest in the 4th wealth index quintile (46.5%) and wealthiest quintile (54.0%) households.@*Conclusions@#Exclusive breastfeeding and early initiation of breastfeeding practices are unacceptably low in Mongolia; 20% of newborns are not breastfed within 1 hour of birth and more than 40% of infants under 6 months of age are not exclusively breastfed and therefore, not receiving optimum nutritional and immunity benefits from breast milk. Strengthening IYCF counselling in all regions and wealth quintiles to support women to practice optimal breastfeeding, along with counselling and awareness of timely and adequate complementary feeding for children under 2 years of age, should be a top priority for public health and as it is a key strategy to reduce malnutrition in children.
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Background: India is home to the largest number of underweight and stunted children in the world. While several studies have focused on the determinants of child’s nutrition status in India, little attention has been given to the aspect of rural-urban variation in child’s nutritional status. Bearing in mind that around 70% of India’s population resides in the rural area, the study of rural-urban divergence in nutritional status as indicator can be appreciated naturally. Objective: The objective of the study is to compare the feeding practices of children in the initial six months of life in rural and urban setting and to find out any relation between early feeding practices and nutritional status of young children. Materials and Methods: A community-based study was conducted for 2 months in the field practice areas of a tertiary care hospital. Multistage random sampling technique was used for the selection of study subjects. A total of 117 under-five children were studied equally from rural and urban area. A pre-designed pre-tested proforma was used to assess the feeding practices. Stunting and underweight were used to proxy the child nutrition status. Data were evaluated on SPSS version 17. Chi-square test was used to compare the feeding practices and to find out their association with nutritional status in the two areas. Results: Undernutrition was found in children who initiated early artificial feeds, i.e., in the first 6 months of life, were given over diluted milk, were bottle fed, and had inappropriate weaning practices in both the areas. Conclusions: Faulty feeding practices were found in both areas, but some of the parameters were still better in urban areas. Faulty feeding practices were found to be a significant predictor for undernutrition.
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Abstract Objective: To analyze the prevalence of ultra-processed food intake among children under one year of age and to identify associated factors. Methods: A cross-sectional design was employed. We interviewed 198 mothers of children aged between 6 and 12 months in primary healthcare units located in a city of the metropolitan region of São Paulo, Brazil. Specific foods consumed in the previous 24 h of the interview were considered to evaluate the consumption of ultra-processed foods. Variables related to mothers' and children's characteristics as well as primary healthcare units were grouped into three blocks of increasingly proximal influence on the outcome. A Poisson regression analysis was performed following a statistical hierarchical modeling to determine factors associated with ultra-processed food intake. Results: The prevalence of ultra-processed food intake was 43.1%. Infants that were not being breastfed had a higher prevalence of ultra-processed food intake but no statistical significance was found. Lower maternal education (prevalence ratio 1.55 [1.08-2.24]) and the child's first appointment at the primary healthcare unit having happened after the first week of life (prevalence ratio 1.51 [1.01-2.27]) were factors associated with the consumption of ultra-processed foods. Conclusions: High consumption of ultra-processed foods among children under 1 year of age was found. Both maternal socioeconomic status and time until the child's first appointment at the primary healthcare unit were associated with the prevalence of ultra-processed food intake.
Resumo: Objetivo: Analisar a prevalência do consumo de alimentos ultraprocessados entre crianças com menos de um ano e identificar os fatores associados. Métodos: Foi realizado um estudo transversal. Entrevistamos 198 mães de crianças com idades entre 6 e 12 meses em unidades de atenção primária à saúde localizadas em Embu das Artes, uma cidade da região metropolitana de São Paulo, Brasil. Alimentos específicos consumidos nas 24 horas anteriores à entrevista foram considerados para avaliar o consumo de alimentos ultraprocessados. As variáveis relacionadas às características das mães e crianças e as unidades de atenção primária à saúde foram agrupadas em três blocos de influência cada vez mais proximal com o resultado. Foi realizada uma análise de regressão de Poisson de acordo com um modelo estatístico hierárquico para determinar os fatores associados ao consumo de alimentos ultraprocessados. Resultados: A prevalência de consumo de alimentos ultraprocessados foi 43,1%. As crianças que não eram amamentadas apresentaram maior prevalência de consumo de alimentos ultraprocessados, porém não foi encontrada diferença estatística. Menor nível de escolaridade materna (RP 1,55 [1,08-2,24]) e o fato de a primeira consulta da criança na unidade de atenção primária à saúde acontecer na primeira semana de vida (RP 1,51 [1,01-2,27]) foram fatores associados ao consumo de alimentos ultraprocessados. Conclusões: Foi encontrado consumo elevado de alimentos ultraprocessados entre crianças com menos de um ano. A situação socioeconômica materna e o tempo da primeira consulta da criança na unidade de atenção primária à saúde foram associados à prevalência de consumo de alimentos ultraprocessados.
Subject(s)
Humans , Male , Female , Infant , Adult , Young Adult , Primary Health Care/statistics & numerical data , Feeding Behavior , Food/statistics & numerical data , Socioeconomic Factors , Brazil , Poisson Distribution , Cross-Sectional Studies , Multivariate Analysis , Food Handling , Infant Food/statistics & numerical data , Mothers/statistics & numerical dataABSTRACT
Background: Infant feeding is an integral part of the reproductive process with important implications for the health of mothers and their babies. However, various practices exist in different communities. It is therefore pertinent to know the infant feeding practices among rural dwellers, as well as the factors that influence them.Methods: This study was a cross sectional survey. A total of 372 volunteering parturient women were recruited using a multi-stage stratified sampling technique. Ethical approval and respondents’ informed consent was obtained. A self-developed and validated questionnaire was used to collect data. Descriptive and inferential statistics was used to analyse data.Results: Findings revealed that majority (84.4%) of the respondents were aware of exclusive breastfeeding (EBF), but only about half (50.5%) ever practiced exclusive breastfeeding. Also, a significant percentage of the respondents introduced complimentary feeding to the baby immediately after birth while 29.3% of participants reported drinking palm wine which is mainly alcoholic to stimulate breast milk secretion. Occupation of parturient women was associated with the practice of EBF (p=0.002).Conclusions: Almost half of our studied parturient women do not engage in EBF. There is need for health care workers to strategically educate parturient women and their significant others on the numerous benefits of exclusive breast feeding.
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Background: Maternal and child under nutrition remain extensive in low and middle-income population groups. Safe delivery practices and adequate nutrition during infancy is essential to ensure health, growth, and development of a child. Early under nutrition has a long-lasting effect on physical and cognitive growth. So it is essential to assess and promote the healthy child feeding & caring practices in the vulnerable groups. Methods: Community-based cross-sectional study was conducted to enrol 160 mothers of infants by probability proportional to size (PPS) sampling procedure for 5 months in the field practicing areas of GSL Medical College. Primary data was collected through a validated questionnaire with variables of socio-demography, intra-natal, and infant feeding practices. Secondary data was obtained from MCP cards. The analysis was done using SPSS trial version 18, results were expressed as percentages and proportions and Chi-square test was used to assess the association. Results: Majorities (90%) of the deliveries are institutional and the proportion of low birth weight was found to be 12.5%. Breastfeeding was initiated within 1st hour after delivery among 75.6% infants and 79.1% of the infants of 6-11m were reportedly exclusively breast fed. Working status and literacy status of mother are significantly associated with infant feeding practices. Conclusions: In spite of many programmes targeted for promoting safe intra natal and infant feeding practices this study finds a relatively high proportion of faulty practices prevalent in rural areas.
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PURPOSE: To study whether breastfeeding and breastfeeding status during gluten introduction influences the age at diagnosis of celiac disease (CD). In addition to study, whether the timing of gluten introduction influences the age at diagnosis of CD. METHODS: It was a hospital based observational study. Total 198 patients diagnosed with CD as per modified European Society of Pediatric Gastroenterology, Hepatology and Nutrition (2012) criteria, aged between 6 months to 6 years were included. Detail history taken with special emphasis on breastfeeding and age of gluten introduction. Standard statistical methods used to analyze the data. RESULTS: Mean±standard deviation age of onset and diagnosis of CD in breastfed cases was 2.81±1.42 years and 3.68 ±1.55 years respectively as compared to 1.84±1.36 years and 2.70±1.65 years respectively in not breastfed cases (p<0.05). Those who had continued breastfeeding during gluten introduction and of longer duration had significantly delayed onset of disease. The age at onset of CD was under one year in 40.42% of the cases, who had started gluten before 6 months of age compared to only 12.58% of those who had started gluten later (p<0.001). The proposed statistical model showed that two variables, i.e., breast feeding status during gluten introduction and age at gluten introduction positively influencing the age at diagnosis of CD. CONCLUSION: Delayed gluten introduction to infant's diet along with continuing breastfeeding, delays symptomatic CD. However, it is not clear from our study that these infant feeding practices provide permanent protection against the disease or merely delays the symptoms.
Subject(s)
Humans , Infant , Age of Onset , Breast Feeding , Celiac Disease , Diagnosis , Diet , Gastroenterology , Glutens , Models, Statistical , Observational StudyABSTRACT
Aim: This study examined the nutritional knowledge, infant feeding practices of mothers and the nutritional status of children in Lagos State, Nigeria. Study Design: A cross sectional survey design was used. Place and Duration of Study: The study was conducted in three selected Local Government Areas (LGAs) of Lagos state. The LGAs were Ikeja, Shomolu and Ikorodu representing urban, sub-urban and rural areas respectively. Methodology: A validated questionnaire and group interview was used as the instrument for data collection. Data was collected from 300 randomly selected mothers of children aged 0 months to 24 months, who visited three Government- owned childcare centres in Lagos State, Nigeria. Anthropometric indices were used to determine the children’s nutritional status. The data obtained from mothers were analyzed using simple percentage and frequency counts. Epi Info 6 was used to analyze the anthropometric data. Results: The findings indicated that the mothers’ nutritional knowledge as revealed by the test score was fairly good. Majority (75%) of the respondents breastfed their children but only 14.7% of the mothers practiced exclusive breast feeding for six months, while 43.3% of the mothers in addition to breast feeding, included complementary foods for their children at 4-6 months of age. About 16% of the mothers introduced complementary feeding and solid foods to their infants before 6 months of age. Occupation type was the most (45%) influential factor affecting breast feeding and appropriate complementary feeding practices. Also, 16.3% of the children were stunted while the prevalence of underweight and wasting were 13% and 10% respectively. The chi-square test showed a statistically significant association (p<0.05) between mothers’ nutritional knowledge and the children’s nutritional status. Conclusion: These findings are of public health concern. It is therefore recommended that the duration of maternity leave should be increased. Women of child bearing age should be educated by trained nutritionists on the types of locally available foods that promote growth in children.
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Improper complementary feeding (CF) practice is one of the main reasons for malnutrition among Bangladeshi children aged less than two years. In this context, using the guidelines of the World Health Organization (WHO), this study assessed the CF practices among mothers in four selected slums (Tejgoan, Rayerbazar, Beribadh, and Jafrabad) of Dhaka city. This descriptive study, conducted during January-June 2010, included 120 mother-child pairs from the selected slums. Samples were selected conveniently, and the sociodemographic profiles of mothers in the four slums were similar. The mean (standard deviation) age of the children was 14.68±5.55 months. A questionnaire, developed following the guidelines of WHO for CF practices, was used for collecting data. Twenty-seven (23%) mothers were exclusively breastfeeding (EBF) their children. Among non-EBF mothers, 15 (16%) started CF after the recommended time. At 6-8 months of age, 2 (40%) of the EBF and 12 (67%) of the non-EBF mothers gave complementary foods twice a day to their children. In both the groups—9-11 months of age—about 70% mothers gave complementary foods twice a day to their children. The frequency of CF was acceptable (3 times a day) in 13 (81%) of the EBF and 32 (56%) of the non-EBF children at 12-23 months of age. Complementary foods given by 24 (89%) of the EBF and 86 (93%) of the non-EBF mothers to their children were not adequate in energy contents. Two (7%) EBF and 16 (17%) non-EBF mothers did not wash their hands after defaecation. Three (11%) EBF and 24 (26%) non-EBF mothers did not properly clean their hands and utensils before feeding. Nine (33%) EBF mothers did not wash their children’s hands. Fifty (54%) non-EBF mothers also did not do this. Feeding with psychosocial care practices was not perfect in either of the groups. The findings showed that, according to the WHO guidelines, the CF practices among mothers of children aged less than two years were very poor in the selected slums of Dhaka city. These findings indicate that there is a considerable gap between the recommendations of WHO and the energy intake among this group of children.
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Integration of infant- and child-feeding index (ICFI) addressing the multidimensional child-feeding practices into one age-specific summary index is gaining importance. This cross-sectional study was aimed at understanding the association between the ICFI and the nutritional status of 259 children, aged 6-23 months, who attended the paediatric outpatient department of the Dhaka Medical College Hospital in Bangladesh. The mean length-for-age z-score (LAZ) of children aged 12-23 months was significantly (p<0.05) higher among those who were at the upper ICFI tercile compared to those who were at the middle or lower ICFI tercile (-2.01 and -3.20 respectively). A significant correlation was found between the ICFI and the LAZ (r=0.24, p=0.01 and r=0.29, p=0.01) in children aged 6-8-months and 12-23-months. Multivariable analysis, after adjusting for potential confounders, also found a significant association between the ICFI and the LAZ (β=0.13, p=0.03). The predictive capability of the proposed ICFI on nutritional status of children, especially length-for-age, needs to be further evaluated prospectively among healthy children in the community.
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A community-based, cross-sectional descriptive study was conducted during June-July 2008 to assess the infant- and young child-feeding (IYCF) practices in Bankura district, West Bengal, India. In total, 647 children aged less than two years selected through revised 40-cluster sampling using the indicators of the Integrated Management of Neonatal and Childhood Illness (IMNCI) and World Health Organization. The proportions of infants with early initiation of breastfeeding (13.6%) and exclusive breastfeeding under six months (57.1%) and infants who received complementary feeding at the age of 6-8 months (55.7%) were low. Appropriate feeding as per the IMNCI protocol was significantly less among infants aged 6-11 months (15.2%) and children aged 12-23 months (8.7%) compared to infants aged less than six months (57.1%), which could be attributable to low frequency and amount of complementary feeding. The main problems revealed from the study were late initiation of breastfeeding, low rates of exclusive breastfeeding, and inappropriate complementary feeding practices.
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Child health is widely affected by nutritional status, and there is growing interest surrounding the possibility that child nutritional status and infant feeding practices may be linked to obesity in adulthood, increasing risks of metabolic complications. Prospective studies enable appropriate investigation and evaluation of the determinants of childhood development. The present paper therefore aimed to provide a review of the main evidence to date from longitudinal studies concerning the associations of infant feeding practices, patterns of childhood growth and nutritional status exhibited in adult life.
A saúde infantil é amplamente afetada pelo estado nutricional. Há um interesse crescente acerca da possibilidade do estado nutricional apresentado pela criança e das práticas alimentares na primeira infância estarem relacionados à obesidade em indivíduos adultos, aumentando os riscos para complicações metabólicas. Sabe-se que estudos prospectivos possibilitam a investigação e a avaliação apropriadas de determinantes do desenvolvimento infantil. Consequentemente, o presente artigo objetivou revisar as principais evidências disponíveis a partir de estudos longitudinais sobre associações entre práticas alimentares na primeira infância, padrões de crescimento infantil e estado nutricional verificados durante a vida adulta.
Subject(s)
Adult , Child , Female , Humans , Infant , Male , Child Development/physiology , Feeding Behavior , Infant Nutritional Physiological Phenomena/physiology , Nutritional Status/physiology , Obesity/etiology , Birth Weight , Body Mass Index , Energy Intake , Follow-Up Studies , Infant Food , Longitudinal Studies , Obesity/prevention & control , Risk FactorsABSTRACT
Although breastfeeding is recognized to be vital to the health and well-being of children and women, the rate of breastsfeeding among Korean women has continuously decreased. One barrier to breastfeeding has been identified to be associated with health care providers. Health care professionals do not give sufficient advice and encouragement, next do hospitals provide supportive environments for breastfeeding by separating infants from mothers or providing formula. The purpose of this study was to investigate prenatal breastfeeding education and infant feeding practices in public health centers and baby-friendly hospitals. A telephone survey was carried out on 57 public health centers located in the Seoul and Chungcheong areas and 13 baby-freindly hospitals from February to April in 2000. Among the public health centers, 43.8% offered periodic prenatal education for pregnant women who visited the centers. Most of them used leaflets or pamphlets developed by the Ministry of Health and Welfare or UNICEF. Twenty six percent of the public health centers developed their own educational materials. All of the 13 baby-friendly hospitals gave additional fluids to infants, did not allow mothers and infants to stay together 24 hours a day, and did not foster the establishment of breatfeeding support groups among the mothers. Most of the baby-friendly hospitals gave artificial teats, did not help mothers initiate breastfeeding within a half-hour of birth. Findings indicate that current practices even in the baby-friendly hospitals are not consistent with the '10 steps to success breastfeeding'. Therefore, deliberate efforts should be made to incorporate adequate breastfeeding education into prenatal program in both public health centers and hospitals, and create environments to support breastfeeding in hospitals, even in baby-friendly hospitals.