Baby Food Pouches, Baby-Led Weaning, and Iron Status in New Zealand Infants: An Observational Study.

Iron deficiency in infants can impact development, and there are concerns that the use of baby food pouches and baby-led weaning may impair iron status. First Foods New Zealand (FFNZ) was an observational study of 625 New Zealand infants aged 6.9 to 10.1 months. Feeding methods were defined based on parental reports of infant feeding at "around 6 months of age": "frequent" baby food pouch use (five+ times per week) and "full baby-led weaning" (the infant primarily self-feeds). Iron status was assessed using a venepuncture blood sample. The estimated prevalence of suboptimal iron status was 23%, but neither feeding method significantly predicted body iron concentrations nor the odds of iron sufficiency after controlling for potential confounding factors including infant formula intake. Adjusted ORs for iron sufficiency were 1.50 (95% CI: 0.67-3.39) for frequent pouch users compared to non-pouch users and 0.91 (95% CI: 0.45-1.87) for baby-led weaning compared to traditional spoon-feeding. Contrary to concerns, there was no evidence that baby food pouch use or baby-led weaning, as currently practiced in New Zealand, were associated with poorer iron status in this age group. However, notable levels of suboptimal iron status, regardless of the feeding method, emphasise the ongoing need for paying attention to infant iron nutrition.

Serum and erythrocyte folate status of New Zealand women of childbearing age following a countrywide voluntary programme by the baking industry to fortify bread with folic acid.

OBJECTIVE: To estimate the folate status of New Zealand women of childbearing age following the introduction, in 2010, of a new voluntary folic acid fortification of bread programme. DESIGN: The 2011 Folate and Women's Health Survey was a cross-sectional survey of women aged 18-44 years carried out in 2011. The survey used a stratified random sampling technique with the Electoral Roll as the sampling frame. Women were asked about consumption of folic-acid-fortified breads and breakfast cereals in a telephone interview. During a clinic visit, blood was collected for serum and erythrocyte folate measurement by microbiological assay. SETTING: A North Island (Wellington) and South Island (Dunedin) city centre in New Zealand. SUBJECTS: Two hundred and eighty-eight women, of whom 278 completed a clinic visit. RESULTS: Geometric mean serum and erythrocyte folate concentrations were 30 nmol/l and 996 nmol/l, respectively. Folate status was 30-40 % higher compared with women of childbearing age sampled as part of a national survey in 2008/09, prior to the introduction of the voluntary folic acid bread fortification programme. In the 2011 Folate and Women's Health Survey, reported consumption of fortified bread and fortified breakfast cereal in the past week was associated with 25 % (P=0·01) and 15 % (P=0·04) higher serum folate concentrations, respectively. CONCLUSIONS: Serum and erythrocyte folate concentrations have increased in New Zealand women of childbearing age since the number of folic-acid-fortified breads was increased voluntarily in 2010. Consumption of fortified breads and breakfast cereals was associated with a higher folate status.

Rights of the child: to die?

The legal position of the child as a vulnerable individual requires us as a society to treat them with special consideration in regard to the sanctity of life. In UK law, euthanasia is currently illegal, although there are some moves afoot to have this changed for those who have reached majority (18 years of age in the UK).

Adults posing as children and gender dysmorphism: a case study.

This article explores a case of a female who presented herself as a male to an accident and emergency department, where her father collaborated with her. This case is explored from many perspectives. Safeguarding is considered from both the welfare of this young person, and from their desire to be admitted to a children's ward. Gender dysmorphisim is becoming increasingly more recognised in the UK, yet it remains rare and is considered here as many nurses will not have encountered it. In a challenging situation, as presented here, the role of the nurse remains unchanged and a family-centred care approach must continue to be practised, while ensuring the care environment is safe for all concerned.

Mentors need support to assess students on their placements.

Bob Price provides a pragmatic and welcome approach for mentors when undertaking practice-based assessments (learning zone August 8).

Factors involved in young people's decisions about their health care.

Many factors influence the process a young person goes through when deciding to consent to or refuse treatment. A young person's physiological and psychological development significantly affects his or her ability to make decisions and personal resilience may determine how they assess and manage risk. Parents and guardians also have an important role and a legal duty in this process, as does the power of the court when refusal of treatment is not considered acceptable. It is the responsibility of health professionals to support the young person and the family by providing knowledge and information that will help them in the decision-making process.

Parents' use of alternative therapies can be detrimental.

Your clinical article 'Traditional and complementary approaches to child health' (May 25) highlights some of the challenges faced by primary care nurses, particularly children's nurses in A&E and acute inpatient areas.