Pilot study in young Thai children with delayed bottle-weaning at Queen Sirikit National Institute of Child Health: does it affect iron status?

BACKGROUND: Delayed bottle weaning or prolonged bottle-feeding affects the child's health. Many studies found the increased incidence of dental caries, obesity, and iron deficiency anemia (IDA) among these children. IDA is one of the health problems found in Thai children that reflects both poor health and malnutrition. The Royal College of Pediatricians of Thailand has recommended that parents wean bottle-feeding when children reach the age of 1 to 1½ years old. However, previous studies reported that only 8% of 1,038 Thai children aged 1-2 years successfully discontinued bottle-feeding. Therefore, we were interested to investigate parental knowledge and iron status in Thai children with prolonged bottle-feeding. OBJECTIVE: To evaluate parental knowledge of bottle weaning and iron status in Thai children aged 1½ to 2 years who were still bottle-fed. MATERIAL AND METHOD: A cross-sectional descriptive study was performed in 30 children who were bottle-fed, aged 1½ to 2 years, at Well-Child Clinic, Queen Sirikit National Institute of Child Health during the period of February 3rd-October 9th, 2012. The parents were interviewed using questionnaires on the practices and knowledge of bottle-feeding. Blood samples were collected for ferritin levels and complete blood count. RESULTS: The average age of the 30 children, who were still bottle-fed, was 19.3 ± 1.5 months old. The primary caregivers were parents living in Bangkok. All of the parents finished Bachelor's degree or higher. Almost all of the caregivers (28/30) of unweaned children understood that bottle weaning was recommended for children aged 12-18 months old, and the food recommendation for a one-year-old child was 3 meals of food and 2-3 meals of milk per day. Blood samples showed iron deficiency in 43% of the children with delayed bottle weaning, which included 7% oF IDA. CONCLUSION: Delayed bottle weaning in young children was related to iron depletion.

Preliminary study on assessment of lead exposure in Thai children aged between 3-7 years old who live in Umphang district, Tak Province.

BACKGROUND: Centers of Disease Control of the United States of America (CDC) informs Ministry of Public Health, Thailand that up to 13% of Burmese refugee children who are transferred to the United States of America during 2007-2009 have elevated blood lead levels (EBLL, Blood Lead Level > or = 10 microg/dl). These are children from a number of refugee camps in Tak Province; two camps are near Umphang but other camps are not. In June 2008, CDC, the result of investigation of Centers for Disease Control/Thailand Ministry of Public Health Collaboration (CDC/TUC) and International Organization for Migration, Thailand indicates that 33 of 64 children aged 6 months to 15 years (5.1%) who live in Mae La, Umpiem and Nupo camps have elevated blood lead level. However, no study on how Thai children who live nearby those camps are exposed to lead. Subsequently, Queen Sirikit National Institute of Child Health, Bangkok, Thailand contacts relevant organizations in Tak Province in order to investigate lead exposure and evaluate health status of Thai children who live close to Burmese refugee camps. OBJECTIVE: 1) Evaluation of lead exposure of Thai children who live nearby Burmese refugee camps; 2) Assessment of risk factors on lead exposure of the children as mentioned above. MATERIAL AND METHOD: The present study adopts a retrospective study based on information gathered from health assessment on 213 Thai children aged between 3-7 years old who live nearby Burmese refugee camps. The health assessment was conducted from April 30th, 2010 to May 5th, 2010. The information is from 3 sources. The first source is from blood sampling in order to assess lead level and ferritin level. The next source is from interview of persons who provide primary care in order to identify risk factors on lead exposure of target children. The last source is from physical examination and developmental assessment conducted by pediatricians and special nurses for child development in order to identify health and developmental problems. RESULTS: The population of the present study was 213 of Thai children are 3-7 years old, average age is 54.54 +/- 12.41 months-old. The average blood lead level is 7.71 +/- 4.62 microg/dl (range = 3-25 microg/dl). Elevated blood lead levels of all populations show that 57 children (26%) have blood lead level at 10 microg/dl or more. Analysis of odds by controlling all risk factors (adjusted OR) that effect on blood lead level (> or =10 microg/dl) indicates that only gender and source of drinking water are risk factors. To clarify, male children would have 2.8 times higher risk than female children. Children who drink water from tap and canal have 15 times and 72 times, respectively, higher risk than children drinking from bottle water. CONCLUSION: The result of the present study shows that 1 of 4 of Thai children at Umphang district, Tak Province who lived near Burmese refugee camps aged between 3-7 years old have blood lead level higher than concerning level. Thus, it is necessary to identify risk factors on lead exposure and policy of blood lead screening in some areas in Thailand.

Knowledge, attitudes and practices relating to plastic containers for food and drinks.

BACKGROUND: Plastic is widely used in daily life especially as food and drink containers. If these containers are used inappropriately, some chemicals such as bisphenol A, phthalate, and styrene from plastic may accumulate and impair organ function. OBJECTIVE: To assess knowledge, attitudes, and practices relating to plastic containers for food and drinks among parents and health personnel. MATERIAL AND METHOD: 100 parents and 100 health personnel from Queen Sirikit National Institute of Child Health are included in the present study. The questionnaires which contained 6 parts measuring knowledge, attitudes and practices about plastic containers for food and drinks are used to collect the data. RESULTS: There are no differences in knowledge, attitudes and practices relating to plastic containers between parents and health personnel. Even though, 80 percent of participants usually use plastic containers for food and drinks, their knowledge about plastic is inadequate. CONCLUSION: Parents and health personnel are aware of health effects of plastic containers, but they do not know how to use and purchase plastics properly.