Age-appropriate feeding practices and nutritional status of infants attending child welfare clinic at a Teaching Hospital in Nigeria.

BACKGROUND: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. MATERIALS AND METHODS: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ≤12 months) and caregivers was systematically selected and studied. The data were analyzed using the MINITAB(®) 12.21 (USA) statistical software. RESULTS: All the infants studied were still on breast milk. Most of the mothers demonstrated correct body positioning (89.9) and attachment (78.7%) during breastfeeding, and effective suckling was demonstrated in 77.0%. Interestingly, none of the infants was either exclusively breastfed for 6 months or currently on exclusive breastfeeding. Furthermore, only 64 (58.2%) of the 110 infants that were more than 6 months of age had appropriately been started on complementary feeding from 6 months of age. Overall, most caregivers (88.7%) had "fair" to "good" infant feeding practices. The practices were significantly associated with their level of education, and their relationship with the infants. Up to 40.0% and 73.7% of the infants had varying degrees of wasting and stunting respectively. Infant feeding practices and the age of the infants emerged as the only factors significantly associated with stunting, while both the caregivers' practices and age of the infants emerged as significant predictors of wasting in the infants. CONCLUSION AND RECOMMENDATIONS: Barely 3 years to the 2015 target of the millennium development goals (MDGs), infant feeding and nutritional status still poses a serious threat to the dream of realizing the MDG-4. The Ministry of Health and relevant developing partners in this region should as a matter of urgency, formulate and implement a strong community-based public health intervention program to improve the knowledge and practices of mothers on infant feeding.

Achieving Millennium Development Goals 4 and 5 in Pakistan.

Pakistan is a signatory of many international development strategies including the Millennium Development Goals, and the government is committed to achieving a reduction in infant mortality rate from 72 to <55 per 1000 live births, the newborn mortality rate from 55 to <40 per 1000 live births and the maternal mortality rate from 276 per 100,000 to 140 per 100,000 live births by 2015. Maternal, newborn and child health play a key role in reducing poverty and promoting social and economic development. Improvement in maternal and child health is a priority agenda of the Government of Pakistan.

Maternal and perinatal complications in multiple versus singleton pregnancies: a prospective two years study.

OBJECTIVE: To test the hypothesis that women with multiple gestations are at increased risk of adverse maternal and perinatal outcomes when compared with singletons. DESIGN: From January 1999 to December 2000, all multiple pregnancies delivering > 28 weeks gestation in the labour ward of Mother and Child Health (MCH) Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, were taken as cases. Singleton pregnancy > or = 28 weeks gestation period delivered immediately after each case was chosen as control. Prenatal complications, gestation at delivery, mode of delivery, birth weight and perinatal morbidity and mortality of the two groups were compared. RESULTS: There were 6831 deliveries including 120 twins and 2 triplets. The data of the two triplets are presented separately and further comparison is between 120 twins and singleton controls. Pretem labour was the commonest prenatal complication in twin pregnancies (21 vs 62) followed by anaemia (11 Vs 39). The mean gestational age of singletons was 38.3 weeks compared to 35.9 weeks for twins. The mean birth weight of singletons was 2.9 kg vs 2.1 kg for twins. Six (4.9%) singletons and 46 (19.2%) twins had caesarean section. Thirty one (13%) of the twins and I (1.6%) singleton had vaginal breech delivery. Five (4%) singleton infants and 40 (17%) twins required admission. Ten singletons and 26 twins died perinatally resulting in a PNMR/1000 births of 82 and 108 respectively. CONCLUSION: Women with multiple gestations are at a higher risk of antepartum and intrapartum complications and their infants require special care. There is need to identify these cases early in order to provide good prenatal care and deliver them in hospitals with facilities for neonatal and maternal intensive care.

A controlled assessment of the in vitro fertilization performance of British women of Indian origin compared with white women.

OBJECTIVE: To compare the reproductive performance of Indian versus white women in IVF. DESIGN: Controlled comparative clinical study. SETTING: In vitro fertilization center based in university department in large tertiary level hospital. PATIENTS: Results from first IVF treatment cycles in 44 Indian patients were compared with results from 88 white patients, matched by age and body mass index, over the same treatment year. The patients were selected from a prospectively collected IVF databank. INTERVENTIONS: Standard luteal-phase start long GnRH analogue regime. Ovarian stimulation with FSH and hMG. Transvaginal ultrasound-guided oocyte recovery. In vitro fertilization and ET following established protocols. MAIN OUTCOME MEASURES: Rates of abandoned cycles, egg retrievals, ETs, clinical pregnancies, miscarriages, and live births were compared in the first IVF treatment cycle. Cumulative pregnancy rates (PRs) over three cycles in the two groups of patients were also compared. RESULTS: More cycles were abandoned in the Indian than in the white group: 22.7% versus 9.1%. The Indian live birth rate per cycle was worse: 9.1% versus 22.7%. The performance of the two groups was otherwise similar: ovarian stimulation with hMG and FSH required 26.0 required 26.0 ampules in the Indian group versus 24.6 ampules in the white group, mean number of follicles on the day of egg retrieval 8.7 versus 8.7, mean number of eggs 5.9 versus 5.8, fertilization rate 82.4% versus 82.5%; ET rate 73.5% versus 82.5, mean number of embryos transferred 2.1 versus 1.8, and clinical PR per cycle started 18.2% versus 27.3%. CONCLUSIONS: Under the same IVF regime, Indians performed worse than whites at the stage of ovarian stimulation (higher rate of abandoned cycles for poor response) and in live birth rate. Cumulative conception and live birth rates also tended to be worse in Indians than in whites.