Dietary patterns and their changes in early childhood.

BACKGROUND: Early childhood is a critical period for shaping and influencing feeding behaviours which have implications for future health. Understanding the food consumption patterns and their shifts over time can provide guidance to health care providers and nutrition specialists who provide nutrition counselling and develop nutrition messages. OBJECTIVES: To examine feeding patterns of 1-5 year old children and their changes with age. METHODS: Across-sectional questionnaire study designed to obtain information on basic demographic indicators and feeding habits was conducted in Prague and all 13 regions of the Czech Republic. The carers of 1,130 children aged 1 to 5 years were approached in public places. Obtained data were computerized, descriptive statistics and t-tests for food intake frequency by age, breast-feeding status, sex, maternal education, and domicile were calculated. The difference was considered significant when P value was < 0.05. RESULTS: The median duration of breast-feeding of children not breast-fed at the time of the interview was 9 months; 29.5% one-year olds were still breast-fed at the time of the interview. Median number of meals per day was 4 in 1 and 5 year olds and 5 in children 2 to 4 years old. The diet of one-year-olds, albeit with lower fruit and vegetable consumption and low fish consumption, was close to recommendations. The milk and milk products, fruit, vegetable, and poultry intake frequency significantly decreased with age. The meat and grains groups, smoked meat and meat products, sweets, and fried food intake frequency significantly increased with age. Fish consumption remained low. Higher vegetable intake frequency was associated with breast-feeding, maternal education, and female sex. Higher fruit consumption was associated with breast-feeding and living in Prague. Higher meat group intake frequency was associated with male sex. CONCLUSIONS: Our data confirm that the dietary habits are formed early in the life. Enhancement of multi-channel delivery of nutrition messages for feeding of toddlers and pre-schoolers and for the improvement of family eating habits are needed.

The prevalence of wasting in Czech infants: a comparison of the WHO child growth standards and the Czech growth references.

The objective of this descriptive study was to evaluate the performance of the international World Health Organization (WHO) child growth standards in the Czech Republic and determine the prevalence of wasting among children using the 1991 Czech growth reference and the WHO growth standards. The study utilized the 2006 WHO Child Growth Standards and the 1991 Czech growth references. The WHO standards were based on a longitudinal study of 882 children aged 0-24 months and on cross-sectional studies of 6669 children aged 18-71 months. The 1991 Czech growth references were based on a cross-sectional survey including 90 910 children aged 0-18 years (34 164 were children aged < 5 years). The prevalence of wasting was significantly higher among Czech children when using the WHO growth standards compared with the Czech references. The prevalence of wasting among 0-5-month-old children was 15.5% among boys and 12.9% among girls compared with the expected 2.3% of the WHO standards. In the length category of 50 cm, 9.0% of boys and 9.9% of girls fell under the WHO wasting cut-off compared with the 3% from the Czech growth reference. The application of the WHO growth standards may results in a significant increase of Czech children classified in the category of wasting, especially among infants aged 0-5 months. The performance and potential impacts of the WHO growth standards should be evaluated further before their adoption in the Czech Republic and other countries with local growth references.

Home management of acute diarrhoea in Czech children.

OBJECTIVES: The aim of the study was to investigate home management of childhood acute diarrhoea. METHODS: A cross-sectional questionnaire study was conducted in Prague, Czech Republic. The caregivers of 210 children ages 6 to 59 months were approached in public places and interviewed about the knowledge and use of oral rehydration solution (ORS) and about management of the child's last episode of diarrhoea. RESULTS: Maternal knowledge of ORS (27.6%) and ORS use (1.9% during the child's last episode of diarrhoea) were low. They were positively associated with education level but not with the source of advice. Small volumes of ORS given and its refusal were issues. Increased amounts of fluid offered to 60% of children were significantly associated with higher maternal education and relatives/friends (76%) as a source of advice rather than a paediatrician (57.9%), the most frequent source of advice (78.1%). Black tea was the most common fluid given (86.2%) followed by plain or mineral water (41.9%). Breast-feeding of all breast-fed children was continued; low-lactose formula was given in 1 case only. Withholding food was rare (5.2%), but the diet of 75.2% cases was modified. Drugs were given to 52.4% children, most frequently smectite and/or probiotics, and antimicrobials were given to 6.4% cases.

Impact of breast-feeding promotion on infant feeding in the Czech Republic.

OBJECTIVES: To assess infant feeding practices, identify factors that influence the duration of exclusive breast-feeding, and evaluate the impact of the National Breastfeeding Promotion Programme in the Czech Republic. HYPOTHESIS: We predicted the positive effect of the program in terms of increased prevalence of breast-feeding at discharge from the hospital and 6 months later. DESIGN: Multicenter cross-sectional survey. Mothers were randomly selected and interviewed in maternity hospitals in 1998 and were reinterviewed 6 months later. SETTINGS: Nine maternity hospitals in 6 cities across the country and households. PARTICIPANTS: 1104 mothers who gave birth within the 38th to the 42nd week of pregnancy to a healthy child with a minimum birthweight 2500 g; 1019 mothers were reinterviewed 6 months later. INTERVENTION: The National Breastfeeding Promotion Programme implemented since 1991. VARIABLES MEASURED: Breast-feeding rates at discharge from the hospital and 6 months later, participation in prenatal classes, strategies related to breast-feeding promotion in the hospital, and support following discharge. ANALYSIS: Epi Info 6, SPSS (analysis of variance, F test), chi2. RESULTS: On leaving the hospital, 93.5% of newborns were exclusively breast-fed. Six months later, 23.1% of infants were breast-fed exclusively and 29.9% of infants were breast-fed while receiving complementary food. Participation in prenatal classes, first suckling within 2 hours of birth, breast-feeding on demand in the hospital, exclusive breast-feeding on leaving the hospital, and the duration of breast-feeding recommended by a pediatrician were positively related to the duration of exclusive breast-feeding (P <.001). CONCLUSIONS AND IMPLICATIONS: Compared with national data from the last 2 decades, the data from this study proved the increasing rates of breast-feeding at discharge from the hospital and 6 months later. The findings indicate the effectiveness of the National Breastfeeding Promotion Programme. However, further implementation of breast-feeding promotion strategies in health facilities coordinated by the Ministry of Health is needed.