Evaluación de las conductas de lactancia materna y las prácticas de alimentación complementaria de las madres turcas y las madres refugiadas sirias / Evaluation of breastfeeding behaviors and complementary feeding practices of Turkish and Syrian refugee mothers

Objetivos: el objetivo de este estudio fue comparar la lactancia y los factores relacionados (edad, nivel educativo, edad al momento del primer embarazo, etc.) y las prácticas de alimentación complementaria de las madres refugiadas sirias y las madres turcas. Materiales y métodos: este estudio descriptivo y comparativo analizó las características nutricionales de los bebés de 9 a 60 meses de edad cuyas madres fueran turcas o refugiadas sirias que asistieron al Hospital Público de Kiziltepe entre enero y julio de 2022. Resultados: se incluyó a 204 madres (126 turcas y 78 sirias). La edad promedio de las madres turcas era 27,60 ± 5,17 años y la de las refugiadas sirias, 28,91 ± 5,62 años, sin una diferencia significativa entre ambos grupos (p: 0,091). La lactancia materna posparto fue del 91,3 % y la duración de la lactancia fue de 12 meses (0-24) en las ciudadanas turcas, mientras que, en las refugiadas sirias, fue del 84,6 % y 9 meses (0-24), respectivamente (consumo de leche materna, p: 0,144; tiempo de consumo, p: 0,161; sin diferencias estadísticas). El 23,8 % de las ciudadanas turcas y el 5,1 % de las refugiadas sirias recibieron capacitación sobre la lactancia, con una diferencia significativa entre ambos grupos (p: 0,001). Conclusión: en los grupos de refugiadas, las prácticas de nutrición infantil y materna se ven alteradas. En colaboración con las organizaciones locales e internacionales y los organismos estatales que ayudan a los grupos de refugiados se podrían mejorar las prácticas de nutrición maternoinfantil y reducir las brechas.

Objectives: The purpose of this study was to compare breastfeeding and related factors (age, level of education, age at first pregnancy, etc.), and complementary feeding practices between Syrian refugee and native Turkish mothers. Material and methods: This descriptive-comparative study examined the nutritional characteristics of infants aged 9 to 60 months whose mothers were Turkish or Syrian refugees who attended Kiziltepe State Hospital between January 2022 and July 2022. Results: 204 mothers (126 Turkish and 78 Syrian) who had a child aged 9-60 months were included. The average age of the mothers was 27.60 ± 5.17 years for Turkish citizens and 28.91 ± 5.62 for Syrian refugees, without significant difference between the two groups (p: 0.091). Postpartum breastfeeding was 91.3% and breastfeeding duration was 12 (0-24) months in Turkish citizens; in Syrian refugees, breastfeeding was 84.6% and average breastfeeding time was 9 (0- 24) months (respectively, breast milk intake p: 0.144, uptake time p: 0.161; no statistical difference). Breastfeeding training was received by 23.8% of Turkish citizens and 5.1% of Syrian refugees; there was a significant difference between the two groups (p: 0.001). Conclusion: In refugee groups, infant and maternal nutrition practices are disrupted. Working in conjunction with local and international organizations and state agencies that give help to refugee groups, the appropriate interventions, initiatives, supports, and awareness-raising activities would strive to improve practices in mother and baby nutrition and narrow gaps.

Practice of exclusive breastfeeding and its associated factors in a suburban area in Angola: a cross-sectional study

ABSTRACT BACKGROUND: Exclusive breastfeeding for six months is one of the measures with highest impact on prevention of child deaths. The determinants of breastfeeding practices are complex and differ between populations. This study aimed to identify factors associated with the prevalence of exclusive breastfeeding in a suburban area in Angola. DESIGN AND SETTING: Population-based cross-sectional study in the municipality of Cacuaco, Luanda. METHODS: A random sample of children under two years of age and their mothers was included. ­Prevalence ratios (PR) were estimated using Poisson regression based on a hierarchical model. RESULTS: 749 children and their mothers were surveyed, including 274 children under six months. Theprevalence of exclusive breastfeeding among children under six months was 51.5% (95% confidence interval, CI, 46.3-56.6%). Four variables were positively associated with exclusive breastfeeding at ages of under six months: number of prenatal visits (PR 1.11 for each visit after the first one; 95% CI 1.04-1.18), maternal occupation (other occupations versus self-employed) (PR 1.54; 95% CI 1.05-2.26), younger child age (PR 0.77 for each month; 95% CI 0.71-0.84) and female child (PR 1.34; 95% CI 1.02-1.76). CONCLUSIONS: Our findings showed that the prevalence of exclusive breastfeeding at six months was satisfactory, according to international recommendations. Factors associated with exclusive breastfeeding practices that had never been surveyed before in Angola were identified through this study. These data are particularly relevant in the context of high infant mortality and may be useful in planning actions aimed at improving child health through promotion of exclusive breastfeeding, in Angola and other countries.

A observação participante para avaliação de práticas alimentares de crianças desnutridas menores de dois anos / The role of participant observation for evaluating feeding practices of malnourished children under two years old / La observación participante en la evaluación de prácticas alimentarias de niños malnutridos menores de dos años

Objetivou-se descrever a utilização da observação participante (OP) para análise da alimentação de crianças desnutridas menores de dois anos. Foram analisados na íntegra oito diários de campo (DC) para identificar como a OP auxilia na avaliação das práticas alimentares de crianças dessa faixa etária. Os resultados foram agrupados nos seguintes temas: "A entrada em campo"; "O diário de campo: antes, durante e após as observações"; "A observação das práticas alimentares das crianças"; e "A observação que ultrapassa as práticas alimentares das crianças". Verificou-se in loco quais os alimentos preparados, oferecidos e consumidos pela criança, quem preparava, horários e locais das refeições, aspectos de higiene, interações mãe-criança, cuidados dispensados às crianças, situação social e redes de suporte das famílias. A OP revelou aspectos para além da alimentação como ato biológico e ampliou o entendimento sobre a situação da criança frente ao problema de saúde.

This study describes the use of participant observation to analyze the feeding of malnourished children under two years old. Eight field diaries were fully analyzed to identify the usefulness of this tool to evaluate feeding practices of children in this age group. The results were grouped according to the following themes: "Entry into the field"; "The field diary: before, during and after observations"; "Observing the children's feeding practices"; "Observing beyond the children's feeding practices". The kinds of foods prepared, offered and consumed by the child were recorded in loco, as well as who prepared food, the time and places where the meals occurred, hygiene aspects, mother-child interactions, daily childcare and families' social situation and support network. Participant observation revealed aspects beyond feeding as a biological act and improved the understanding of the children's health situation.

Se describió la utilización de observación participante (OP) para evaluar la alimentación de niños malnutridos menores de dos años. Se analizaron ocho diarios de campo (DC) para identificar cómo la OP auxilia en la evaluación de prácticas alimentarias de niños en este grupo de edad. Los resultados se agruparon en: Entrada en campo; El diario de campo: antes, durante y después de las observaciones; Observación de las prácticas alimentarias; y Observación que va más allá de las prácticas alimentarias. Se verificó in loco los alimentos preparados, ofrecidos y consumidos por el niño, quién los preparaba, los horarios y locales de las comidas, los aspectos de higiene, las interacciones madre-niño, los cuidados dispensados, la situación social y las redes de soporte de las familias. La OP reveló aspectos más allá de la alimentación como un acto biológico y amplió la comprensión sobre la situación del niño ante el problema de salud.

La desnutrición en la niñez argentina en los primeros años del siglo XXI: un abordaje cuantitativo / Child malnutrition in Argentina in the first part of the century: a quantitative approach

RESUMEN La desnutrición en la niñez conforma un importante problema de salud pública en Argentina, ya sea como causa básica de mortalidad/morbilidad o asociada a distintas patologías que inciden sobre la población infantil. Sin embargo, poco se conoce sobre su magnitud, tendencias y su distribución espacial. Este artículo procuró detectar estas situaciones considerando diferentes escalas geográficas. Se propuso un abordaje cuantitativo mediante la sistematización de estadísticas vitales (mortalidad), egresos hospitalarios (morbilidad), y de bajo peso al nacimiento (natalidad), sobre una población objetivo de 0 a 4 años de edad. Las fuentes de información utilizadas fueron las estadísticas de mortalidad (1999-2013), estadísticas de egresos hospitalarios (2000, 2005-2011) y estadísticas de nacidos vivos (1999-2012) provistos por la Dirección de Estadísticas e Información de Salud (DEIS) del Ministerio de Salud de la Nación. Los resultados advierten comportamientos diferenciados según la escala considerada. Como conclusión, se destaca la necesidad de integrar las vertientes de información analizadas para brindar un panorama más general sobre un problema que, si bien tiende a descender, alcanza magnitudes altas en las zonas más vulnerables. Ciertas áreas del norte presentan las peores condiciones y precisan un abordaje inmediato en materia de pobreza y salud infantil.

ABSTRACT Child malnutrition is an important public health problem in Argentina, both as a primary cause of mortality/morbidity and associated with different pathologies that affect children. However, little is known about its magnitude, trends and spatial distribution. This article seeks to detect such situations considering different geographic scales. A quantitative approach was applied, systematizing vital statistics (mortality), hospital discharges (morbidity), and low birth weight (natality) in children 0-4 years of age. Accordingly, the information sources used were mortality statistics (1999-2013), hospital discharge statistical records (2000, 2005-2011) and live birth statistics (1999-2012) provided by the Office of Statistics and Health Information (DEIS) [Dirección de Estadísticas e Información de Salud] of the National Ministry of Health. The results show differences according to the scale considered. The conclusions highlight the necessity of integrating the different sources of information analyzed in order to provide a more general overview of a problem that, albeit in decline, still registers high magnitudes in the most vulnerable areas. In this way, certain areas of northern Argentina evidence worse conditions, requiring immediate attention be paid to issues of poverty and child health.

Interdisciplinary management of infantile colic / Manejo interdisciplinario del cólico del lactante

Abstract Infantile colic is one of the main reasons for consultation in pediatric gastroenterology and pediatric nutrition services. This pathology has multiple etiologies such as family dysfunction, gastrointestinal alterations, food allergies or intolerances, food imbalance and improper eating habits. It is acute, of sudden onset, and tends to disappear between 3 and 6 months of age. To date there is no consensus on the management protocols of this condition or indicators of therapeutic efficacy. Medications, dietary regimens and dietary supplements specific to this pathology (anti-colic) have been developed for some years to help address this issue. This article presents a structural review of evidence on the fundamentals and progress in the treatment of infantile colic, and compiles the characteristics of this pathology, the medical and nutritional therapeutic measures, the clinical approach and the techniques to help the patient and his family. This study seeks to provide technical tools to health professionals whose target population is children younger than 2 years of age.

Resumen El cólico del lactante es uno de los principales motivos de consulta en los servicios de pediatría, gastroenterología y nutrición pediátrica. Esta patología posee múltiples características etiológicas como disfunción de la mecánica familiar, alteraciones gastrointestinales, alergias o intolerancias alimentarias, desbalance alimentario e inadecuados hábitos alimenticios. Es de carácter agudo, con inicio súbito que tiende a desaparecer entre los 3 y 6 meses de edad. Hasta el momento no existe un consenso sobre los protocolos de manejo de esta condición o sobre sus indicadores de eficacia terapéutica. Desde hace algunos años se han desarrollado fármacos, regímenes dietarios y complementos alimentarios específicos para esta patología (anticólico). Este trabajo es una revisión de la evidencia sobre los fundamentos y avances en el tratamiento del cólico del lactante en el que se recopilan las características de esta patología, las medidas terapéuticas médicas y nutricionales, el abordaje clínico y las técnicas para ayudar al paciente y su entorno familiar. El presente estudio busca brindar herramientas técnicas al profesional de la salud cuya población objeto de atención es menor de 2 años.

Estudio Transversal: Desnutrición, Anemia y su Relación con Factores Asociados en Niños de 6 a 59 Meses, Cuenca 2015 / Cross Sectional Research: Malnutrition, Anemia and its Relation with Associated Factors in Children aged 6 to 59-months old, Cuenca 2015

INTRODUCCIÓN: La prevalencia de desnutrición y anemia a nivel nacional en niños preescolares es del 34.1% y 25% respectivamente. El objetivo del presente estudio fue establecer la prevalencia de desnutrición, anemia y su relación con factores asociados (prematurez, bajo peso y baja talla al nacer) en niños de 6 a 59 meses de edad de la parroquia Sinincay (Azuay-Ecuador) durante el año 2015. MÉTODO: Estudio transversal de prevalencia y factores asociados en una población de niños registrados en la matriz del sistema de vigilancia alimentaria y nutricional de enero a julio de 2015. Los datos de filiación se obtuvieron por interrogatorio, la antropometría fetal y edad gestacional fue obtenida de la historia clínica. La antropometría infantil se determinó por observación directa y la presencia de anemia se determinó por el valor de hemoglobina en sangre. Para el análisis se empleó la estadística básica descriptiva, chi-cuadrado y razón de prevalencia con intervalo de confianza al 95%; valores de P 0.05 fueron utilizados para definir significancia estadística. RESULTADOS: Se estudiaron 737 niños, el 47.6% fueron niñas y el 52.4% niños; los lactantes constituyeron el 35.8% y los pre-escolares el 64.2%. El estudio reveló que el 5% de la población padece desnutrición global, el 20.8% desnutrición crónica moderada y el 2.8% desnutrición crónica severa. La prevalencia de anemia fue del 2.4% en niños con bajo peso y de 10.8% en niños con baja talla. Se encontró relación significativa entre anemia, bajo peso al nacer y baja talla al nacer con bajo peso y baja talla según OMS (P<0.05); además de relación entre prematurez y baja talla OMS (P<0.05). CONCLUSIÓN: La prevalencia de desnutrición y sus factores asociados sigue la tendencia reportada en estudios similares. Ésta investigación abre las puertas a intervenciones que permitan detectar factores determinantes de desnutrición y para lograr la "Desnutrición Cero.(au)

BACKGROUND: Prevalence of malnutrition and anemia in Ecuadorian children are 34.1 % and 25% respectively. The objective was to establish the prevalence of malnutrition, anemia and its relation with associated factors (prematurity, low weight at birth and short length at birth) in children aged 6 to 59-months at Sinincay during 2015. METHOD: A cross sectional research that included associated factors of a children population registered in a surveillance nutrition program from January to July of 2015. Filiation data came from direct interview, measurement at birth and gestational age were collected from medical records. Current anthropometry was determined by direct observation and diagnosis of anemia was established by blood-hemoglobin levels. Analysis was performed using basic statistics, chi-square test and prevalence ratio with a 95% confidence interval; P<0.05 were used to determine statistical significance. RESULTS: 737 children were studied, 47.6% of them were female and 52.4% were male children; breastfeeding infants and preschool-aged children were 35.8% and 64.2% respectively. This research revealed that 5% of children had global maltnutrition, 20.8% of them had moderate chronic malnutrition and 2.8% suffered severe malnutrition. Prevalence of anemia was 2.4% in low-weight children and 10.8% in short-height children. Significant relation was established between anemia, low weight at birth, short length and low-weight and short-length at birth according to WHO (P 0.05); furthermore, prematurity and short-length showed this relation as well (P<0.05). CONCLUSION: Prevalence of malnutrition and its associated factors are similar to those reported in other studies. This research encourages the development of new interventions that may detect determinant factors in malnutrition and thereby reach the optimal nutritional status among children population.(au)

El Sistema de Salud de Chile: una tarea pendiente / The Chilean Health Care System: The task ahead

The most important event in Chilean public health in the XXth Century was the creation of the National Health Service (NHS), in 1952. Systematic public policies for the promotion of health, disease prevention, medical care, and rehabilitation were implemented, while a number of more specific programs were introduced, such as those on infant malnutrition, complementary infant feeding, medical control of pregnant women and healthy infants, infant and adult vaccination, and essential sanitation services. In 1981, a parallel private health care system was introduced in the form of medical care financial institutions, which today cover 15% of the population, as contrasted with the public system, which covers about 80%. From 1952 to 2014, public health care policies made possible a remarkable improvement in Chile s health indexes: downward trends in infant mortality rate (from 117.8 to 7.2 x 1,000 live births), maternal mortality (from 276 to 18.5 x 100,000), undernourished children < 5 years old (from 63% to 0.5%); and upward trends in life expectancy at birth (from 50 to 79,8 years), professional hospital care of births (from 35% to 99.8%), access to drinking water (from 52% to 99%), and access to sanitary sewer (from 21% to 98.9%). This went hand in hand with an improvement in economic and social indexes: per capita income at purchasing power parity increased from US$ 3,827 to US$ 20,894 and poverty decreased from 60% to 14.4% of the population. Related indexes such as illiteracy, average schooling, and years of primary school education, were significantly improved as well. Nevertheless, compared with OECD countries, Chile has a relatively low public investment in health (45.7% of total national investment), a deficit in the number of physicians (1.7 x 1,000 inhabitants) and nurses (4.8 x 1,000), in the number of hospital beds (2.1 x 1,000), and in the availability of generic drugs in the market (30%). Chile and the USA are the two OECD countries with the lowest public investment in health. A generalized dissatisfaction with the current Chilean health care model and the need of the vast majority of the population for timely access to acceptable quality medical care are powerful arguments which point to the need for a universal public health care system. The significant increase in public expenditure on health care which such a system would demand requires a sustainable growth of the Chilean economy.

Iron and vitamin D status in breastfed infants and their mothers / 소아과

PURPOSE: We assessed the relationships between iron and vitamin D statuses in breastfed infants and their mothers and evaluated the determinants of iron and vitamin D deficiencies in breastfed infants. METHODS: Seventy breastfed infants aged 4-24 months and their mothers participated in this study from February 2012 to May 2013. Complete blood counts, total iron binding capacity, and levels of C-reactive protein, iron, ferritin, calcium, phosphate, alkaline phosphatase, and 25-hydroxyvitamin D (25(OH)D) in infants and their mothers were measured. RESULTS: A history of maternal prepregnancy anemia was associated with lower ferritin and 25(OH)D levels in both infants and their mothers. The 25(OH)D level of infants correlated with maternal 25(OH) D levels. The independent risk factors for iron deficiency in breastfed infants were the duration of breastfeeding (odds ratio [OR], 6.54; 95% confidence interval [CI], 1.09-39.2; P=0.04) and infant body weight (OR, 2.65; 95% CI, 1.07-6.56; P=0.04). The determinants for vitamin D deficiency were the infant's age (OR, 0.15; 95% CI, 0.02-0.97; P=0.046) and maternal 25(OH)D level (OR, 0.74; 95% CI, 0.59-0.92; P=0.01). CONCLUSION: A maternal history of prepregnancy anemia requiring iron therapy was associated with lower current ferritin and 25(OH)D levels in both infants and their mothers. Therefore, physicians should monitor not only iron but also vitamin D levels in infants who are breastfed by mothers who had prepregnancy anemia.

Efecto del estado nutricional neonatal en el riesgo de síndrome metabólico en niños obesos de 2 comunas de la Región del Bío-Bío / Effects of neonatal nutritional status on the risk for metabolic syndrome in Chilean obese children

Background: Neonatal malnutrition defined by birth weight (BW) is a risk factor for obesity and cardio-metabolic diseases in adults. Neonatal ponderal index (NPI) may have better diagnostic value than BW to establish nutritional status. Aim: To determine the effect of neonatal nutritional status, established by the three NPI curves available in Chile, on the risk of Metabolic Syndrome (MS) in obese school children. Material and Methods: A nested case/control study in a sample of 410 obese school children aged 10 to 16 years (57% males) was performed. The dichotomous response variable was the presence of MS defined as International Diabetes Federation (IDF) or Cook’s criteria. The exposure variable was having NPI < percentile (p) 10. Results: The frequency of MS was 36 and 39% according to the IDF and Cook criteria, respectively. The proportion of children with neonatal malnutrition exceeded 20%. A significantly increased risk for MS was only found when PNI was defined according to Lagos´s Table and MS was defined using IDF criteria. Having a PNI > p90, however, showed a trend towards a reduced risk of MS, which only reached significance using Lagos´s Table and Cook´s Criteria. Conclusions: Neonatal malnutrition defined by NPI is common in obese school children. The condition of neonatal under nutrition defined as PNI < p10 may be a risk factor for developing MS. Instead, having a NPI > p90 could be protective.

Determinantes socioeconómicos, inseguridad alimentaria y desnutrición crónica en población desplazada de primera infancia, Pereira, Colombia / Socioeconomic determinants, chronic food insecurity and malnutrition in displaced population of early childhood, Pereira, Colombia

Introducción: la desnutrición infantil y la falta de seguridad alimentaria son un problema de salud pública actual. Objetivos: Conocer la prevalencia de desnutrición crónica en los niños de 0 a 5 años de la población de las Colonias de Pereira y determinar la asociación con factores socioeconómicos y el nivel de inseguridad alimentaria doméstico. Materiales y métodos: Se realizó un estudio de corte transversal, prospectivo en niños de 0 a 5 años y sus familias. Se evaluó la seguridad alimentaria doméstica, variables nutricionales, socio-demográficas, socio-económicas y educativas de la familia. El análisis se hizo con SPSS 20.0 para Windows. Resultados: Se evaluaron 68 niños, el 51,5% eran hombres, con edad promedio 32,4 ± 17,2 meses (rango: 2,1 a 59,9 meses). El 11,8% de los niños tenían algún tipo de desnutrición, el 67,7% de las familias tenían inseguridad alimentaria, con baja capacidad económica para adquirir alimentos. La inseguridad alimentaria se asoció con más de una persona desempleada (p=0,014), aporte familiar a alimentos mensual menor a COP $150000 (p=0,004), comprar alimentos en tienda local (p=0,017) con frecuencia de compra alimentos diaria y quincenal. Discusión: Pese a la existencia de programas de intervención para mejorar las condiciones de alimentación de primera infancia, sigue existiendo inseguridad alimentaria y desnutrición. Se deben reforzar las estrategias que garanticen la alimentación diaria de los niños de 0 a 5 años.

Introduction: child malnutrition and food insecurity are a current public health problem. Objectives: To determine the prevalence of chronic malnutrition in children from 0-5 years old of the rural population of Pereira and determine the association of socioeconomic factors and the level of household food insecurity. Materials and Methods: We performed a prospective crosssectional study in children aged 0-5 years old and their families. We assessed household food security, nutritional, socio-demographic, socio-economic and educational variables of the family. The analyses were run with SPSS 20.0 for Windows. Results: We evaluated 68 children, 51.5% were men; with mean age 32.4 ± 17.2 months (range 2.1 to 59.9 months). The 11.8% of children were malnourished, 67.7% of families have food insecurity, with low economic capacity to purchase food. Food insecurity is associated with more than one-person unemployed (p=0.014), low family contribution to monthly food (low to COP $150,000, p=0.004), buy food at local store (p=0.017) with daily food purchase frequency. Discussion: Despite the existence of intervention programs to improve early childhood nutrition, there is still food insecurity and undernutrition. Strategies should be strengthened to ensure the daily diet of children.

Associação entre a qualidade de vida das mães e o estado nutricional de seus filhos / Association between mothers' quality of life and infants' nutritional status

OBJETIVO: Verificar associações entre a qualidade de vida das mães e o estado nutricional de seus filhos. MÉTODOS: Foi realizado um estudo caso-controle com mães de crianças com idade entre zero e cinco anos, moradoras da área de abrangência de uma unidade básica de saúde, no município de Porto Alegre. O cálculo de tamanho amostral foi estimado em 152 mães, sendo 76 mães com filhos em risco nutricional/desnutrição (casos) e 76 mães com filhos eutróficos (controles). Foram coletadas informações referentes à qualidade de vida das mães, medida através do instrumento da Organização Mundial da Saúde, e analisada a associação entre a qualidade de vida materna e o estado nutricional de seus filhos. RESULTADOS: Em relação ao domínio psíquico, para cada criança eutrófica cuja mãe tem baixa qualidade de vida existe uma chance de 5,4 crianças em risco nutricional/desnutrição com mães em igual condição. No domínio ambiental, para cada criança eutrófica cuja mãe tem baixa qualidade de vida existe uma chance de 2,9 crianças em risco nutricional/desnutrição com mães em igual condição. Em relação ao nível educacional, para cada criança eutrófica cuja mãe tem baixa qualidade de vida existe uma chance de 4,2 crianças em risco nutricional/desnutrição com mães em igual condição. CONCLUSÕES: A baixa qualidade de vida materna mostrou-se associada ao risco nutricional/desnutrição infantil e pode ser um fator de risco para o estado nutricional dos filhos.

OBJECTIVE: Determine associations between the quality of life of mothers and the nutritional status of children. METHODS: case-control study involving 152 mothers of children aged zero to five years, living in the coverage area of a basic health unit in the city of Porto Alegre. The calculation of sample size was estimated as 152 mothers - 76 mothers with children at nutritional risk/malnutrition (cases) and 76 mothers with eutrophic children (controls). Information was collected regarding the quality of life of mothers, measured by the instrument of the World Health Organization, and the association between maternal quality of life and nutritional status of children was examined. RESULTS: In relation to the psychiatric realm, for each eutrophic child whose mother has lower quality of life there is a chance of 5.4 children at nutritional risk/malnutrition with mothers in the same condition. In the environmental field, for each eutrophic child whose mother has lower quality of life there is a chance of 2.9 children at nutritional risk/malnutrition with mothers in the same condition. Regarding educational level, for each eutrophic child whose mother has lower quality of life there is a chance of 4.2 children at nutritional risk/malnutrition with mothers in the same condition. CONCLUSIONS: Mothers' low quality of life was associated with an infant in nutritional risk/malnutrition and may be a risk factor for the nutritional status of children.

Socioeconomic Determinants of Nutritional Status of Children in Lao PDR: Effects of Household and Community Factors.

The prevalence of undernutrition among Lao children is among the highest in the region. However, the determinants of childhood undernutrition in Laos have not been fully analyzed. This paper, using the dataset of the Lao Multiple Indicator Cluster Survey 3, which is a nationally-representative sample in Laos, investigated the effects of socioeconomic factors at both household and community levels on the nutritional status of children. In the estimation, a multilevel linear model with random-intercepts was used for estimating the determinants of child anthropometric indices. The empirical results revealed that children from households in southern Laos and from ethnic minority groups were less-nourished. Level of education of parents, attitudes of mothers towards domestic violence, assets of household, local health services, and the condition of sanitation and water were considered to be important determinants of nutritional status of children. The pattern of growth-faltering in children by age was identified. Children aged 12-59 months were less-nourished than those aged 0-11 months. The empirical results were consistent with the collective household model which incorporates a decision-making process within the household. Since there is scarce evidence about the predictors of childhood undernutrition in Laos, the findings of this study will serve as a benchmark for future research.

Occult Pneumonia: An Unusual but Perilous Entity Presenting with Severe Malnutrition and Dehydrating Diarrhoea.

A three-month old boy was admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh, with the problems of acute watery diarrhoea with some dehydration and suspected dyseletrolytaemia, severe malnutrition, and reduced activity. Occult pneumonia was added to the problem list after demonstration of radiologic consolidation in right upper lung, despite the lack of clinical signs, both on admission and after correction of dehydration. The problem list was further expanded to include bacteraemia due to Staphylococcus aureus when the blood culture report was available. Severely-malnourished children may not exhibit typical clinical signs of pneumonia, and the possibility of existence of such problems should be remembered in the assessment and provision of care to hospitalized young children with severe malnutrition.

Analysis of the clinical characters and risk factors of feeding intolerance in neonates / 中国基层医药

Objective To describe the clinical characters and risk factors of feeding intolerance in neonates. Methods The data of all neonates hospitalized in the newborn ward from January 2003 to March 2007 were ana- lyzed.Results The incidence of feeding intolerance was 6.99 % in the term infants and 27.63 % in the premature infants,and this increased in low birth weight and small gestational age infants.The symptoms of feeding intoler- ance.such as vomiting,gastric residual,abdominal distension and defecation difficulty presented usually in the first week of enteral feeding.The neonates with smaller gestational age and lower birth weight often presented with gas- tric residual,abdominal distension and defecation difficulty,but the larger ones with vomiting.The incidence of feed- ing intolerance increased in asphyxia aegrotus.Conclusion The birth weight and gestational age are protection fac- tors of feeding intolerance in neonates,the asphyxia are risk factors.More attention should be paid to vomiting,gas- tric residual,abdominal distension and defecation difficulty of neonates,especially,in the first week of enteral feeding.