Infant Feeding Practices in Kaski District, Pokhara.

Introduction: Children in developing countries are prone to infectious diseases due to insufficient and inappropriate feeding practices. Socio-demographic and socio-economic factors directly and indirectly play a role in influencing infant feeding practices. This study was conducted to assess the sociodemographic and economic factors associated with initiation of breastfeeding, complimentary feeding, and the various prelacteal feeds practiced in Kaski, Pokhara. Materials and Methods: In this prospective study, interviews were conducted to 500 mothers at Manipal Teaching Hospital who brought their child for treatment. The interviews were conducted in a questionnaire format relating to their demographic and financial statuses. Results: A total of 500 mothers were questioned, out of which 86.6% gave their child breastmilk as its first food. 47% initiated breastfeeding within half an hour of child’s birth. 86% gave Jaulo as the first complementary food to their children. About 26% of the mothers gave complementary feeding to their children before the recommended time of 6 months. Conclusion: Initiation of breastfeeding after life and complementary feeding practices overall has improved from previous studies. There is still need of making awareness campaigns and such in order to further improve this trend.

Anthropometric Measurements in Different Ethnic groups of Nepalese New Borns.

Introduction: There is a wide variation in normal birth weight, length and head circumference of newborns. The standards formulated by Western workers may not be very reliable to this part of world because of wide variations in normal range of length, weight and head circumference in different ethnic groups. This study aims to determine the anthropometric values – birth weight, length and head circumference in Term and Preterm newborns of different ethnic groups in this region of the country and to see if this can be used as a standard for taking the anthropometric measurements. Materials and Methods: A prospective study of 600 newborns born in Manipal Teaching Hospital, Pokhara from July 2009–June 2010. A detailed anthropometric measurement (weight, length, and head circumference) of all newborns was taken on 3rd day of life. Results: Six major Ethnic groups were noted Brahmin, Gurung, Dalit, Chettri, Magar and Newar. There were 54 % males and 46% females among which 18.16% were preterms, 20.66% small for gestation age, 81.50% term and 0.33% posterm. The mean weight, length and head circumference of term babies were 2.817±0.61 gms, 47.68±2.48 cm, 33.56±2.02 cm and for preterm babies it was 2.215± 0.41 gms, 46.36±2.39 cm, 32.23±2.03 cm respectively. There were 25% low birth weight (n=151, highest number in Brahmins-27%), 74.16% normal weight (n=445) and 0.66% over weight (n=4, all were gurungs) babies. In Term newborns weight, length and head circumference was noted to be highest in Gurungs (3.3004gms, 49.35cm, 34.72cm) and was statistically significant (p<0.000). Weight and length of Brahmins was lowest (2.578 gms, 45.49cm) and head circumference was lowest in Dalits (30.88cm, statistically significant<0.000). In case of preterms highest weight and length was seen in Magars (2.387gms, 47.90cm) but head circumference was highest in Gurungs (34.18cm) whereas weight was lowest in chettri (2.1609gms), length in Brahmin (44.61cm) and OFC in Dalits (29.92cm). These parameters were directly proportion with gestation age and was statistically significant (p<0.000). Conclusion: The present study highlights the mean weight, length and head circumference of term and preterm newborns in different ethnic groups and gestation age. These parameters were directly proportion to gestation age but were variable in different Ethnic groups. Therefore a study in larger population could give us a different standard for anthropometric measurements in Nepalese newborns.

A Scenario of Poisoning in Children in Manipal Teaching Hospital.

Objective: To see the pattern and prevalence of poisoning in children in Manipal Teaching Hospital, Pokhara. The cases were also considered in relevance to the age groups with various agents, the commonly observed clinical features in various poisonings and mortality. Study design: Hospital based retrospective study. Study period: 4 years (January 2006 – January 2010). Study place: Department of Paediatric, Manipal Teaching Hospital, Pokhara. Material and Methods: A detailed study of all the case files of the children admitted with various acute poisonings, where the causative agent was known, was done. Results: A total number of 94 children (56 males & 38 females) were admitted with poisoning (1.79% of the total admissions) during that period. Maximum number of children were of the preschool age group i.e. < 5 years (64.89%). Organophosphorus Compounds (OPC) (27%) and Kerosene Oil (23%) were the two most frequent agents involved. The other agents included Snake bite (19%), Drugs/ Chemicals (16%), Dhatura (12%), and Mushroom poisoning (3%). The most common nature of poisoning noted was accidental (95%). The mortality rate observed was 6.38%. Conclusion: OPC and Kerosene Oil poisoning were the two most common poisoning observed in this study comprising almost half the cases; accidental poisoning was the most common pattern noted and there was a male predominance. Early recognition and timely treatment can decrease the mortality.