An exploration of complementary feeding of infants and young children in the rural area of Muhoroni, Nyanza province, Kenya: a descriptive study.

PubMed

Harvey, Sophie; Callaby, Jo; Roberts, Lesley

2017-08-01

Inappropriate infant and young child feeding practices contribute to malnutrition, infection and long-term development limitation. To explore complementary feeding and food safety in Muhoroni District, Nyanza Province in rural Kenya. To compare practices with the Infant and Young Child Feeding (IYCF) guidelines, and identify associations with inappropriate practices. Between January and April 2014, a questionnaire completed by primary caregivers of children aged 6-23 months asked about foods the child had received in the previous 24 hours, the introduction of complementary foods, and the food hygiene practices undertaken by the caregiver. The most recent World Health Organization IYCF core indicators (continued breastfeeding at 1 year; minimum dietary diversity; minimum meal frequency; minimum acceptable diet) were determined for 400 children. These indicators were compared with demographic indicators in multivariate analyses to identify associations with appropriate complementary feeding practices. A total of 55.2% of children aged 12-15 months continued to be breastfed at the time of questioning. Of the study population, 61.5% achieved minimum dietary diversity, 70.8% achieved minimum meal frequency and 43.0% achieved minimum acceptable diet. Older children were more likely to achieve minimum dietary diversity and minimum acceptable diet; however, they were also less likely to achieve minimum meal frequency. High levels of hygiene practices were reported in all areas of food safety. Complementary feeding indicators were higher than nationally, although less than half of children (43.0%) were receiving a minimum acceptable diet. Further work should explore the potential relationship between age and adequate infant feeding.

Responsive feeding and child interest in food vary when rural Malawian children are fed lipid-based nutrient supplements or local complementary food.

PubMed

Flax, Valerie L; Mäkinen, Samppa; Ashorn, Ulla; Cheung, Yin Bun; Maleta, Kenneth; Ashorn, Per; Bentley, Margaret E

2013-07-01

Caregiver and child behaviours during feeding have been used to measure responsiveness, which has been recognised as important for child growth and development. The aims of this study were to understand how caregiver and child behaviours differ when feeding lipid-based nutrient supplements (LNS) vs. local complementary food and to detect associations between behaviours and child interest in food. Sixteen moderately underweight 6-17-month-old Malawian children receiving 50 g/day of supplementary LNS for 12 weeks were videotaped during LNS (n = 32) and local complementary feeding (n = 28) episodes. Behaviours were coded at the level of the intended bite (1674 total bites). The analysis used regression models adjusted for within-subject correlation. Caregivers were less likely to allow children to self-feed and more likely to use physical pressure during LNS vs. complementary food bites. Positive caregiver verbalization was infrequent and did not differ by type of food. Higher odds of accepting a bite were associated with the bite containing LNS, odds ratio (OR) 3.05; 90% confidence interval (CI) (1.98, 4.71), the child self-feeding, OR 5.70; 90% CI (2.77, 11.69), and positive caregiver verbalization, OR 2.46; 90% CI (1.26, 4.80), while lower odds of acceptance were associated with negative child verbalization during feeding, OR 0.27; 90% CI (0.17, 0.42). In this sample, caregivers used more responsive feeding practices during bites of local complementary food and were more controlling when feeding LNS. Responsive caregiver behaviours predicted child acceptance of food. These results could be used to design interventions in Malawi to improve responsive feeding practices in general and during LNS use. © 2011 John Wiley & Sons Ltd.

Promotion and advocacy for improved complementary feeding: can we apply the lessons learned from breastfeeding?

PubMed

Piwoz, Ellen G; Huffman, Sandra L; Quinn, Victoria J

2003-03-01

Although many successes have been achieved in promoting breastfeeding, this has not been the case for complementary feeding. Some successes in promoting complementary feeding at the community level have been documented, but few of these efforts have expanded to a larger scale and become sustained. To discover the reasons for this difference, the key factors for the successful promotion of breastfeeding on a large scale were examined and compared with the efforts made in complementary feeding. These factors include definition and rationale, policy support, funding, advocacy, private-sector involvement, availability and use of monitoring data, integration of research into action, and the existence of a well-articulated series of steps for successful implementation. The lessons learned from the promotion of breastfeeding should be applied to complementary feeding, and the new Global Strategy for Infant and Young Child Feeding provides an excellent first step in this process.

Infant and young child feeding practice among mothers with 0-24 months old children in Slum areas of Bahir Dar City, Ethiopia.

PubMed

Demilew, Yeshalem Mulugeta; Tafere, Tadese Ejigu; Abitew, Dereje Berhanu

2017-01-01

Adequate nutrition during infancy and early childhood is essential to ensure the health, growth and development of children. However, infant feeding practice is suboptimal in Bahir Dar City, Ethiopia. The slum area is a heavily populated urban informal settlement characterized by substandard housing, squalor, with a lack of reliable sanitation services, supply of clean water, reliable electricity, law enforcement and other basic services. Residents of the slum area were poor and less educated. This further compromises infant feeding practice. The aim of this study was to assess infant and young child feeding practice among mothers with 0-24 month old children in the study area. A community based cross-sectional study was conducted among 423 mothers with 0-24 month old children from June 01-30 / 2016. Simple random sampling technique was used to select the respondents. Infant and young child feeding practice was assessed using the fifteen World Health Organisation (WHO) criteria. The prevalence of exclusive breastfeeding practice was 113 (84%). Sixty (15%) mothers gave prelacteal feeds and, 96 (23%) mothers used a bottle to feed their index child. Appropriate complementary feeding practice was only 20 (7%). Thirty nine out of forty mothers introduced complementary food timely, 131 (47%) of mothers gave the minimum meal frequency, and 20 (7%) children took the minimum food diversity and acceptable diet. Independent predictors for complementary feeding practice were having secondary and above education of the mother, receiving postnatal care, possession of radio and giving birth at hospital. In this study infant and young child feeding (IYCF) practice was poor. Therefore, there is a need for strengthening the promotion on IYCF practice during postnatal care and using mass media to giving emphasis for optimal complementary feeding practices, especially for mothers with a lower educational status.

Complementary Feeding: Review of Recommendations, Feeding Practices, and Adequacy of Homemade Complementary Food Preparations in Developing Countries – Lessons from Ethiopia

PubMed Central

Abeshu, Motuma Adimasu; Lelisa, Azeb; Geleta, Bekesho

2016-01-01

Breastfeeding provides the ideal food during the first 6 months of life. Complementary feeding starts when breast milk is no longer sufficient by itself, where the target age is for 6–23 months. The gap between nutritional requirement and amount obtained from breast milk increases with age. For energy, 200, 300, and 550 kcal per day is expected to be covered by complementary foods at 6–8, 9–11, and 12–23 months, respectively. In addition, the complementary foods must provide relatively large proportions of micronutrients such as iron, zinc, phosphorus, magnesium, calcium, and vitamin B6. In several parts of the developing world, complementary feeding continues as a challenge to good nutrition in children. In Ethiopia, only 4.2% of breastfed children of 6–23 months of age have a minimum acceptable diet. The gaps are mostly attributed to either poor dietary quality or poor feeding practices, if not both. Commercial fortified foods are often beyond the reach of the poor. Thus, homemade complementary foods remain commonly used. Even when based on an improved recipe, however, unfortified plant-based complementary foods provide insufficient key micronutrients (especially, iron, zinc, and calcium) during the age of 6–23 months. Thus, this review assessed complementary feeding practice and recommendation and reviewed the level of adequacy of homemade complementary foods. PMID:27800479

Theory-Driven Process Evaluation of a Complementary Feeding Trial in Four Countries

ERIC Educational Resources Information Center

Newman, Jamie E.; Garces, Ana; Mazariegos, Manolo; Hambidge, K. Michael; Manasyan, Albert; Tshefu, Antoinette; Lokangaka, Adrien; Sami, Neelofar; Carlo, Waldemar A.; Bose, Carl L.; Pasha, Omrana; Goco, Norman; Chomba, Elwyn; Goldenberg, Robert L.; Wright, Linda L.; Koso-Thomas, Marion; Krebs, Nancy F.

2014-01-01

We conducted a theory-driven process evaluation of a cluster randomized controlled trial comparing two types of complementary feeding (meat versus fortified cereal) on infant growth in Guatemala, Pakistan, Zambia and the Democratic Republic of Congo. We examined process evaluation indicators for the entire study cohort (N = 1236) using chi-square…

Psychosocial Care in Complementary Feeding of Children: A Comparative Study of the Urban and Rural Communities of Osun State, Nigeria

ERIC Educational Resources Information Center

Ogunba, Beatrice Olubukola

2010-01-01

This study investigated psychosocial care in complementary feeding of children under two years of age. The cross-sectional study was carried out in Osun State of Nigeria within Sub-Saharan Africa, and 450 mothers were interviewed of which 337 were from the urban and 113 from the rural communities. Results revealed that 37.4% of the respondents…

Complementary feeding patterns among ethnic groups in rural western China.

PubMed

Qu, Peng-Fei; Zhang, Ya; Li, Jia-Mei; Zhang, Ruo; Yang, Jiao-Mei; Lei, Fang-Liang; Li, Shan-Shan; Liu, Dan-Meng; Dang, Shao-Nong; Yan, Hong

This study investigated complementary feeding practices among four ethnic groups (Han, Uygur, Tibetan, and Zhuang) based on a cross-sectional survey in rural western China. In 2005, a stratified multistage cluster random sampling method was used to recruit 9712 children (7411 Han, 1032 Uygur, 678 Tibetan, and 591 Zhuang) between 6 and 35 months of age and their mothers from 45 counties in 10 provinces (autonomous regions, municipalities) in western China. The rates of early introduction (before 6 months) of complementary foods in four ethnic groups (Han, Uygur, Tibetan, and Zhuang) were 71.30%, 95.95%, 82.40%, and 72.30%, respectively. The Infant and Child Feeding Index (ICFI) for Uygur and Tibetan children was lower than that for Han children at all age groups. Uygur children were more likely to have unqualified ICFI compared with Han children in a multivariate logistic regression (odds ratio (OR)=5.138, 95% confidence interval (CI): 4.340-6.084). A higher level of maternal education, greater family wealth, and the availability of complementary feeding educational materials decreased the likelihood of an unqualified ICFI. The nutritional status of children (Han, Tibetan, and Zhuang) with qualified ICFI was better than that for children with unqualified ICFI. Appropriate interventions are required to improve complementary feeding practices in rural western China.

[Feeding practices in 6-to-24-month-old children in Yaoundé, Cameroon: relationship with their nutritional status].

PubMed

Ngo Um-Sap, S; Mbassi Awa, H; Hott, O; Tchendjou, P; Womga, A; Tanya, A; Koki Ndombo, P

2014-01-01

Shifting from breastfeeding to solid food is known as the complementary feeding period. When complementary feeding is inadequate, malnutrition results in most cases. These practices differ depending on cultural and religious backgrounds as well as geographical location. Ruel and Menon studied the relationship between feeding practices during diversification and nutritional status of children at 6 and 36 months, using a score called the Infant and Child Feeding Index (ICFI). This ICFI scored feeding practices such as breastfeeding, bottle-feeding, food diversity, and meal frequency, which has never been studied in Cameroon. The aim of this study was to describe actual feeding practices in children in our context as well as to investigate their relationship with children's nutritional status. We carried out a cross-sectional study throughout the month of January 2011 at the Chantal-Biya Foundation. Mothers completed a questionnaire on how their infants were fed at birth, the initiation of complementary food, and feeding practices for the 3 days before the survey. The children's anthropometric parameters were noted. All mothers coming for vaccination or vitamin A supplementation for their children aged between 6 and 24 months were enrolled in the study. We enrolled 197 mothers and their infants. Breastfeeding was the main feeding method at birth, but was exclusive until 6 months for only 15 % of the infants. Three-quarter of nursing mothers started adding complementary food at age 4-6 months, using pap. Half of the children did not receive animal products, fruits, or vegetables. When applying the ICFI to these practices, it appeared that the various diversification practices scored less than 8 for 50% of the population. A positive association was noted between the ICFI and nutritional status, as expressed by height-of-age Z-score (HAZ) and the weight-for-age Z-score (WAZ). We concluded that the codified feeding practices with respect to Ruel and Menon's ICFI are associated with the nutritional status of children between 6 and 24 months in Yaounde, Cameroon. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Nutritional status and complementary feeding among HIV-exposed infants: a prospective cohort study.

PubMed

Kamenju, Pili; Liu, Enju; Hertzmark, Ellen; Spiegelman, Donna; Kisenge, Rodrick; Kupka, Roland; Aboud, Said; Manji, Karim P; Duggan, Christopher; Fawzi, Wafaie W

2017-07-01

Complementary feeding is crucial for improving child survival and promoting growth and development, particularly among HIV-exposed children who have higher risk of morbidity and mortality than their un-exposed peers. This prospective study employed an infant and child feeding index (ICFI) to measure complementary feeding and determine its association with nutritional status among 2092 HIV-exposed infants followed from 6 to 24 months of age in Dar es Salaam, Tanzania. The ICFI measured both quality and quantity of complementary feeding, including current breastfeeding status, food consistency, dietary diversity scores (DDS), food group frequency score, and meal frequency. The ICFI score ranged from 0 to 9; the median score was 6 (Inter-Quartile Range, IQR= 4-7). After adjusting for potential confounders, high ICFI scores were associated with reduced risk of stunting (high vs. low tertile hazard ratio, HR: 0.72; 95% confidence interval, CI: 0.57, 0.91; P< 0.01) and underweight (high vs. low tertile HR: 0.79; 95% CI: 0.61, 1.02; P= 0.07). Low DDS were associated with higher risk of stunting (low vs. high tertile HR: 1.59; 95% CI: 1.23, 2.07; P< 0.01) and underweight (low vs. high tertile HR: 1.48; 95% CI: 1.12, 1.96; P= 0.01). In this setting, high DDS and ICFI scores were protective of stunting and underweight. We recommend for nutrition programs in low-income countries to emphasize educating HIV-exposed children's caregivers on the importance of dietary diversity and optimal complementary feeding to improve nutritional status in this important subpopulation. © 2016 John Wiley & Sons Ltd.

How well do WHO complementary feeding indicators relate to nutritional status of children aged 6-23 months in rural Northern Ghana?

PubMed

Saaka, Mahama; Wemakor, Anthony; Abizari, Abdul-Razak; Aryee, Paul

2015-11-23

Though the World Health Organization (WHO) recommended Infant and Young Child Feeding (IYCF) indicators have been in use, little is known about their association with child nutritional status. The objective of this study was to explore the relationship between IYCF indicators (timing of complementary feeding, minimum dietary diversity, minimum meal frequency and minimum acceptable diet) and child growth indicators. A community-based cross-sectional survey was carried out in November 2013. The study population comprised mothers/primary caregivers and their children selected using a two-stage cluster sampling procedure. Of the 1984 children aged 6-23 months; 58.2 % met the minimum meal frequency, 34.8 % received minimum dietary diversity (≥4 food groups), 27.8 % had received minimum acceptable diet and only 15.7 % received appropriate complementary feeding. With respect to nutritional status, 20.5 %, 11.5 % and 21.1 % of the study population were stunted, wasted and underweight respectively. Multiple logistic regression analysis revealed that compared to children who were introduced to complementary feeding either late or early, children who started complementary feeding at six months of age were 25 % protected from chronic malnutrition (AOR = 0.75, CI = 0.50 - 0.95, P = 0.02). It was found that children whose mothers attended antenatal care (ANC) at least 4 times were 34 % protected [AOR 0.66; 95 % CI (0.50 - 0.88)] against stunted growth compared to children born to mothers who attended ANC less than 4 times. Children from households with high household wealth index were 51 % protected [AOR 0.49; 95 % CI (0.26 - 0.94)] against chronic malnutrition compared to children from households with low household wealth index. After adjusting for potential confounders, there was a significant positive association between appropriate complementary feeding index and mean WLZ (β = 0.10, p = 0.005) but was not associated with mean LAZ. The WHO IYCF indicators better explain weight-for-length Z-scores than length-for-age Z-scores of young children in rural Northern Ghana. Furthermore, a composite indicator comprising timely introduction of solid, semi-solid or soft foods at 6 months, minimum meal frequency, and minimum dietary diversity better explains weight-for-length Z-scores than each of the single indicators.

Diarrhoea and Suboptimal Feeding Practices in Nigeria: Evidence from the National Household Surveys.

PubMed

Ogbo, Felix A; Page, Andrew; Idoko, John; Claudio, Fernanda; Agho, Kingsley E

2016-07-01

Globally, Nigeria has the largest burden of infectious diseases (including diarrhoea). Optimal feeding practices have been well-documented to protect against diarrhoea in other contexts; but this benefit has not been broadly studied in Nigeria. The study aimed to examine the association between diarrhoea and childhood feeding practices to provide country-specific evidence. Data from the Nigeria Demographic and Health Survey for the period spanning 1999-2013 were used. Prevalence of diarrhoea by infant and young child feeding indicators was estimated, and the association between diarrhoea and childhood feeding indicators was examined using multilevel regression analyses. Prevalence of diarrhoea was higher among children whose mothers did not initiate breast feeding within the first hour of birth, infants who were not exclusively breastfed, and infants who were prematurely introduced to complementary foods. Early initiation of breast feeding was significantly associated with lower risk of diarrhoea (RR 0.68, 95% confidence interval (CI) 0.63, 0.74). Exclusively breastfed infants were less likely to develop diarrhoea compared to non-exclusively breastfed infants (RR 0.61, 95% CI 0.44, 0.86). Predominant breast feeding was significantly associated with a lower risk of diarrhoea (RR 0.66, 95% CI 0.54, 0.80). Bottle feeding and introduction of complementary foods were associated with a higher risk of diarrhoea. Early initiation of breast feeding as well as exclusive and predominant breast feeding protect against diarrhoea in Nigeria, while bottle feeding and introduction of complementary foods were risk factors for diarrhoea. Community- and facility-based initiatives are needed to improve feeding practices, and to reduce diarrhoea prevalence in Nigeria. © 2016 John Wiley & Sons Ltd.

Determinants of inadequate complementary feeding practices among children aged 6-23 months in Ghana.

PubMed

Issaka, Abukari I; Agho, Kingsley E; Burns, Penelope; Page, Andrew; Dibley, Michael J

2015-03-01

To explore complementary feeding practices and identify potential risk factors associated with inadequate complementary feeding practices in Ghana by using the newly developed WHO infant feeding indicators and data from the nationally representative 2008 Ghana Demographic and Health Survey. The source of data for the analysis was the 2008 Ghana Demographic and Health Survey. Analysis of the factors associated with inadequate complementary feeding, using individual-, household- and community-level determinants, was done by performing multiple logistic regression modelling. Ghana. Children (n 822) aged 6-23 months. The prevalence of the introduction of solid, semi-solid or soft foods among infants aged 6-8 months was 72.6 % (95 % CI 64.6 %, 79.3 %). The proportion of children aged 6-23 months who met the minimum meal frequency and dietary diversity for breast-fed and non-breast-fed children was 46.0 % (95 % CI 42.3 %, 49.9 %) and 51.4 % (95 % CI 47.4 %, 55.3 %) respectively and the prevalence of minimum acceptable diet for breast-fed children was 29.9 % (95 % CI 26.1 %, 34.1 %). Multivariate analysis revealed that children from the other administrative regions were less likely to meet minimum dietary diversity, meal frequency and acceptable diet than those from the Volta region. Household poverty, children whose mothers perceived their size to be smaller than average and children who were delivered at home were significantly less likely to meet the minimum dietary diversity requirement; and children whose mothers did not have any postnatal check-ups were significantly less likely to meet the requirement for minimum acceptable diet. Complementary feeding was significantly lower in infants from illiterate mothers (adjusted OR=3.55; 95 % CI 1.05, 12.02). The prevalence of complementary feeding among children in Ghana is still below the WHO-recommended standard of 90 % coverage. Non-attendance of postnatal check-up by mothers, cultural beliefs and habits, household poverty, home delivery of babies and non-Christian mothers were the most important risk factors for inadequate complementary feeding practices. Therefore, nutrition educational interventions to improve complementary feeding practices should target these factors in order to achieve the fourth Millennium Development Goal.

Impact of maternal education about complementary feeding and provision of complementary foods on child growth in developing countries

PubMed Central

2011-01-01

Background Childhood undernutrition is prevalent in low and middle income countries. It is an important indirect cause of child mortality in these countries. According to an estimate, stunting (height for age Z score < -2) and wasting (weight for height Z score < -2) along with intrauterine growth restriction are responsible for about 2.1 million deaths worldwide in children < 5 years of age. This comprises 21 % of all deaths in this age group worldwide. The incidence of stunting is the highest in the first two years of life especially after six months of life when exclusive breastfeeding alone cannot fulfill the energy needs of a rapidly growing child. Complementary feeding for an infant refers to timely introduction of safe and nutritional foods in addition to breast-feeding (BF) i.e. clean and nutritionally rich additional foods introduced at about six months of infant age. Complementary feeding strategies encompass a wide variety of interventions designed to improve not only the quality and quantity of these foods but also improve the feeding behaviors. In this review, we evaluated the effectiveness of two most commonly applied strategies of complementary feeding i.e. timely provision of appropriate complementary foods (± nutritional counseling) and education to mothers about practices of complementary feeding on growth. Recommendations have been made for input to the Lives Saved Tool (LiST) model by following standardized guidelines developed by Child Health Epidemiology Reference Group (CHERG). Methods We conducted a systematic review of published randomized and quasi-randomized trials on PubMed, Cochrane Library and WHO regional databases. The included studies were abstracted and graded according to study design, limitations, intervention details and outcome effects. The primary outcomes were change in weight and height during the study period among children 6-24 months of age. We hypothesized that provision of complementary food and education of mother about complementary food would significantly improve the nutritional status of the children in the intervention group compared to control. Meta-analyses were generated for change in weight and height by two methods. In the first instance, we pooled the results to get weighted mean difference (WMD) which helps to pool studies with different units of measurement and that of different duration. A second meta-analysis was conducted to get a pooled estimate in terms of actual increase in weight (kg) and length (cm) in relation to the intervention, for input into the LiST model. Results After screening 3795 titles, we selected 17 studies for inclusion in the review. The included studies evaluated the impact of provision of complementary foods (±nutritional counseling) and of nutritional counseling alone. Both these interventions were found to result in a significant increase in weight [WMD 0.34 SD, 95% CI 0.11 – 0.56 and 0.30 SD, 95 % CI 0.05-0.54 respectively) and linear growth [WMD 0.26 SD, 95 % CI 0.08-0.43 and 0.21 SD, 95 % CI 0.01-0.41 respectively]. Pooled results for actual increase in weight in kilograms and length in centimeters showed that provision of appropriate complementary foods (±nutritional counseling) resulted in an extra gain of 0.25kg (±0.18) in weight and 0.54 cm (±0.38) in height in children aged 6-24 months. The overall quality grades for these estimates were that of ‘moderate’ level. These estimates have been recommended for inclusion in the Lives Saved Tool (LiST) model. Education of mother about complementary feeding led to an extra weight gain of 0.30 kg (±0.26) and a gain of 0.49 cm (±0.50) in height in the intervention group compared to control. These estimates had been recommended for inclusion in the LiST model with an overall quality grade assessment of ‘moderate’ level. Conclusion Provision of appropriate complementary food, with or without nutritional education, and maternal nutritional counseling alone lead to significant increase in weight and height in children 6-24 months of age. These interventions can significantly reduce the risk of stunting in developing countries and are recommended for inclusion in the LiST tool. PMID:21501443

[Obesity and complementary feeding time: a period at risk].

PubMed

Vidailhet, M

2010-12-01

Relation between rapid growth during the first months of life and secondary risk of excessive adiposity is well demonstrated. Many works have indicated a birth feeding effect on weight gain during the first year of life and a protective effect towards later childhood and adult obesity. However all these studies are observational and several works denied this protective effect. Concerning complementary feeding, 3 interventional, randomized, studies achieved between 4 and 6 months of age, showed a good regulation of caloric intake and no weight gain modification due to complementary foods. Most of others studies are observational and don't show any relation between time of introduction of complementary foods and later fat mass. However 3 recent studies indicate, respectively at 7, 10 and 42 years of age, an increased adiposity, suggesting the possibility of a programmed excessive fat gain induced by an early complementary foods introduction. Very few studies have evaluated, besides the time of weaning, the kind, quantity and caloric density of foods used as complements, whereas other recent studies show the importance of appetite differences since the first months of life and the importance of genetic influence on these variations. Others works have emphasized the possible role of an excessive protein intake during the first 2 years of life. So, it appears that it may be necessary to pay attention not only on the date, but also on the kind and quantity of complementary foods, particularly in infants at risk for obesity, because of parental obesity, rapid weight growth or an excessive appetite. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

[Guidelines for complementary feeding in healthy infants].

PubMed

Romero-Velarde, Enrique; Villalpando-Carrión, Salvador; Pérez-Lizaur, Ana Berta; Iracheta-Gerez, Ma de la Luz; Alonso-Rivera, Carlos Gilberto; López-Navarrete, Gloria Elena; García-Contreras, Andrea; Ochoa-Ortiz, Erika; Zarate-Mondragón, Flora; López-Pérez, Gerardo Tiburcio; Chávez-Palencia, Clío; Guajardo-Jáquez, Manuel; Vázquez-Ortiz, Salvador; Pinzón-Navarro, Beatriz Adriana; Torres-Duarte, Karely Noemy; Vidal-Guzmán, José Domingo; Michel-Gómez, Pedro Luis; López-Contreras, Iris Nallely; Arroyo-Cruz, Liliana Verenice; Almada-Velasco, Pamela; Saltigeral-Simental, Patricia; Ríos-Aguirre, Alejandro; Domínguez-Pineda, Lorena; Rodríguez-González, Perla; Crabtree-Ramírez, Úrsula; Hernández-Rosiles, Vanessa; Pinacho-Velázquez, José Luis

A proper nutrition during the first two years of life is critical to reach the full potential of every human being; now, this period is recognized as a critical window for promoting optimal growth, development, and good health. Therefore, adequate feeding at this stage of life has an impact on health, nutritional status, growth and development of children; not only in the short term, but in the medium and long term. This paper provides recommendations on complementary feeding (CF) presented as questions or statements that are important for those who take care for children during this stage of life. For example: When to start complementary feedings: 4 or 6 months of age?; Exposure to potentially allergenic foods; Introduction of sweetened beverages; Use of artificial sweeteners and light products; Food introduction sequence; Food consistency changes according to neurological maturation; Number of days to test acceptance and tolerance to new foods; Amounts for each meal; Inadequate complementary feeding practices; Myths and realities of complementary feeding; Developmental milestones; Practice of "Baby Led Weaning" and practice of vegetarianism. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Timing of introduction of complementary food: short- and long-term health consequences.

PubMed

Przyrembel, Hildegard

2012-01-01

Complementary food is needed when breast milk (or infant formula) alone is no longer sufficient for both nutritional and developmental reasons. The timing of its introduction, therefore, is an individual decision, although 6 months of exclusive breastfeeding can be recommended for most healthy term infants. The new foods are intended to 'complement' ongoing breastfeeding with those dietary items whose intake has become marginal or insufficient. Both breastfeeding and complementary feeding can have direct or later consequences on health. The evaluation of consequences of both early and late introduction of complementary food can neither disregard the effect of breastfeeding compared to formula feeding nor the composition or quality of the complementary food. Possible short-term health effects concern growth velocity and infections, and possible long-term effects may relate to atopic diseases, type 1 and 2 diabetes, obesity and neuromuscular development. On the basis of the currently available evidence, it is impossible to exactly determine the age when risks related to the start of complementary feeding are lowest or highest for most of these effects, with the possible exception of infections and early growth velocity. The present knowledge on undesirable health effects, however, is mainly based on observational studies, and although some mechanisms have been proposed, further prospective studies have to clarify these unsolved issues. Even less evidence on the consequences of the timing of complementary food introduction is available for formula-fed infants. Copyright © 2012 S. Karger AG, Basel.

Micronutrient Status and Nutritional Intake in 0- to 2-Year-old Children Consuming a Cows' Milk Exclusion Diet.

PubMed

Kvammen, Janne A; Thomassen, Rut A; Eskerud, Mari B; Rugtveit, Jarle; Henriksen, Christine

2018-05-01

To study micronutrient status and nutritional intake from complementary feeding in children on a cows' milk exclusion (CME) diet. Fifty-seven children with cows' milk allergy, younger than 2 years, were included in a cross-sectional study. Blood was analyzed for micronutrient status. Complementary feeding was defined as all solids and liquids except of breast milk, and assessed by 3-day food diary. The results were analyzed according to 3 feeding patterns: mainly breast-fed (mBF), partially breast-fed, and no breast milk group (nBM). The children had a median age of 9 months and micronutrient status was within normal range for total homocysteine (p-tHcy), s-B12, s-folate, b-Hb, s-ferritin, s-zinc, and s-25(OH)D. There were no significant differences between feedings groups, except for B12-biomarkers. The mBF had higher p-tHcy (P < 0.000) and lower s-B12 (P = 0.002) compared nBM. Vitamin B12 deficiency (p-tHcy >6.5 μmol/L combined with s-B12 <250 pmol/L) was found in 12% of participants, most frequently among the mBF (36%) and none in nBM group (P = 0.009). Vitamin B12 intake from complementary feeding was negatively correlated with p-tHcy (r = -0.479, P = 0.001) and positively with s-B12 (r = 0.410, P = 0.003). Iron deficiency anemia was found in 5%. Iron intake correlated positively with b-Hb (r = 0.324, P = 0.02). Zinc deficiency was found in 7% and low 25(OH)D in 9%. Vitamin D intake was positively correlated with the use of supplements (r = 0.456, P = 0.001). The risk of B12 deficiency was high in mBF infants on CME diet, and complementary feeding was associated with better B12 status. Iron, zinc, and vitamin D deficiencies were present in all feeding groups. Complementary feeding should be introduced at 4 to 6 months of age. Vitamin D supplement is recommended to ensure adequate intake.

Characteristics attributed to complementary foods by caregivers in four countries of Latin America and the Caribbean.

PubMed

Dutta, Tanushree; Sywulka, Sara M; Frongillo, Edward A; Lutter, Chessa K

2006-12-01

Attributes that caregivers assign to complementary foods have been primarily described in the context of illness, but attributes assigned to foods in everyday circumstances must be understood to effectively promote good complementary feeding. This study aimed to understand how mothers judge complementary foods to be appropriate by cross-cultural examination of food perceptions in four different Latin American and Caribbean countries. We used semistructured interviews to assess attributes that mothers ascribed to a list of key foods, both home-made and manufactured, and reasons for feeding or not feeding them. We elicited attributes from 79 caregivers with children 6 to 24 months of age from two urban and perirban sites each in Brazil, Jamaica, Mexico, and Panama. Textual analysis based on six home foods common to the four countries and manufactured foods resulted in six attribute categories, five of which could be positive or negative (Nutrient Content, Effects on Child, Child's Response, Availability and Accessibility, and Other Food Attributes); one (Food Quality and Safety) was only negative. Analysis of attributes of home foods (chicken, eggs, beans, carrots, bananas or plantains, and oranges) revealed many beliefs that were common within and across countries, whereas analysis of the attributes of manufactured foods revealed that these foods were less known. The consistency of the attribute categories across countries and across home and manufactured foods suggests their relevance to planning programs to improve complementary feeding in Latin America and the Caribbean and possibly other developing countries. These results can be used programmatically to assess the need for and the focus of food education programs, and to indicate which countries will be more receptive to certain foods as a means of improving complementary feeding.

Cluster-randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth, and development among rural Indian toddlers

PubMed Central

Vazir, Shahnaz; Engle, Patrice; Balakrishna, Nagalla; Griffiths, Paula L.; Johnson, Susan L.; Creed-Kanashiro, Hilary; Rao, Sylvia Fernandez; Shroff, Monal R.; Bentley, Margaret E.

2012-01-01

Inadequate feeding and care may contribute to high rates of stunting and underweight among children in rural families in India. This cluster-randomized trial tested the hypothesis that teaching caregivers appropriate complementary feeding, and strategies for how to feed and play responsively through home-visits would increase children’s dietary intake, growth, and development compared to home-visit-complementary feeding education alone or routine care. Sixty villages in Andhra Pradesh were randomized into 3 groups1 of 20 villages with 200 mother-infant dyads in each group. The Control Group (CG), received routine Integrated Child Development Services (ICDS); the Complementary Feeding Group (CFG), received the ICDS plus the World Health Organization recommendations on breastfeeding and complementary foods; and the Responsive Complementary Feeding & Play Group (RCF&PG) received the same intervention as the CFG plus skills for responsive feeding and psychosocial stimulation. Both intervention groups received bi-weekly visits by trained village women. The groups did not differ at 3 months on socioeconomic status, maternal and child nutritional indices and maternal depression. After controlling for potential confounding factors using the mixed models approach, the twelve-month intervention to the CFG and RCF&PG significantly (p<0.05) increased median intakes of energy, protein, Vitamin-A, calcium (CFG), iron and zinc, reduced stunting (0.19, CI: 0.0–0.4) in the CFG (but not RCF&PG) and increased (p<0.01) Bayley Mental Development scores(Mean=3.1, CI: 0.8–5.3) in the RCF&PG (but not CFG) compared to CG. Community-based educational interventions can improve dietary intake, length (CFG), and mental development (RCF&PG) for children under two years in food-secure rural Indian families. PMID:22625182

Cluster-randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers.

PubMed

Vazir, Shahnaz; Engle, Patrice; Balakrishna, Nagalla; Griffiths, Paula L; Johnson, Susan L; Creed-Kanashiro, Hilary; Fernandez Rao, Sylvia; Shroff, Monal R; Bentley, Margaret E

2013-01-01

Inadequate feeding and care may contribute to high rates of stunting and underweight among children in rural families in India. This cluster-randomized trial tested the hypothesis that teaching caregivers appropriate complementary feeding and strategies for how to feed and play responsively through home-visits would increase children's dietary intake, growth and development compared with home-visit-complementary feeding education alone or routine care. Sixty villages in Andhra Pradesh were randomized into three groups of 20 villages with 200 mother-infant dyads in each group. The control group (CG) received routine Integrated Child Development Services (ICDS); the complementary feeding group (CFG) received the ICDS plus the World Health Organization recommendations on breastfeeding and complementary foods; and the responsive complementary feeding and play group (RCF&PG) received the same intervention as the CFG plus skills for responsive feeding and psychosocial stimulation. Both intervention groups received bi-weekly visits by trained village women. The groups did not differ at 3 months on socioeconomic status, maternal and child nutritional indices, and maternal depression. After controlling for potential confounding factors using the mixed models approach, the 12-month intervention to the CFG and RCF&PG significantly (P < 0.05) increased median intakes of energy, protein, Vitamin A, calcium (CFG), iron and zinc, reduced stunting [0.19, confidence interval (CI): 0.0-0.4] in the CFG (but not RCF&PG) and increased (P < 0.01) Bayley Mental Development scores (mean = 3.1, CI: 0.8-5.3) in the RCF&PG (but not CFG) compared with CG. Community-based educational interventions can improve dietary intake, length (CFG) and mental development (RCF&PG) for children under 2 years in food-secure rural Indian families. © 2012 Blackwell Publishing Ltd.

Contribution of inappropriate complementary foods to the salt intake of 8-month-old infants.

PubMed

Cribb, V L; Warren, J M; Emmett, P M

2012-01-01

Complementary feeding is a critical developmental time for establishing variety, and appropriate feeding practices are important. These include recommendations for a maximum intake of sodium (salt), because of the potential harmful effect of excessive intake on the developing kidneys and blood pressure in later life. Sodium intakes were examined to establish, if inappropriate complementary feeding practices were contributing to high intakes. Data were collected from a cohort of 1178 8-month-old infants born in 1991/92, participating in the Avon Longitudinal Study of Parents and Children, using a 3-day dietary records completed by their mothers. Sodium and energy intakes were calculated and infants were categorised into quartiles of sodium intake. Majority of infants were first introduced to solids around 3-4 months, with plain baby rice, rusks and other cereals being the first foods consumed during complementary feeding. In the whole sample, 70% consumed in excess, of 400 mg sodium per day, the maximum UK recommendation for children up to age 12 months. The mean sodium intake for the highest quartile was 1060 mg per day. Infants in this quartile were often consuming cows' milk as a main drink; eating three times the amount of bread compared with the lowest quartile and used salty flavourings such as yeast extract and gravy. Sodium intakes in this cohort of infants were higher than recommendations. Clear and practical education is needed on complementary feeding practice for mothers highlighting what foods to introduce and when. Manufacturers have a responsibility to reduce the sodium content of food products.

Complementary Feeding Interventions Have a Small but Significant Impact on Linear and Ponderal Growth of Children in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

PubMed

Panjwani, Anita; Heidkamp, Rebecca

2017-11-01

Background: World Health Assembly member states have committed to ambitious global targets for reductions in stunting and wasting by 2025. Improving complementary diets of children aged 6-23 mo is a recommended approach for reducing stunting in children <5 y old. Less is known about the potential of these interventions to prevent wasting. Objective: The aim of this article was to review and synthesize the current literature for the impact of complementary feeding interventions on linear [length-for-age z score (LAZ)] and ponderal [weight-for-length z score (WLZ)] growth of children aged 6-23 mo, with the specific goal of updating intervention-outcome linkages in the Lives Saved Tool (LiST). Methods: We started our review with studies included in the previous LiST review and searched for articles published since January 2012. We identified longitudinal trials that compared children aged 6-23 mo who received 1 of 2 types of complementary feeding interventions (nutrition education or counseling alone or complementary food supplementation with or without nutrition education or counseling) with a no-intervention control. We assessed study quality and generated pooled estimates of LAZ and WLZ change, as well as length and weight gain, for each category of intervention. Results: Interventions that provided nutrition education or counseling had a small but significant impact on linear growth in food-secure populations [LAZ standardized mean difference (SMD): 0.11; 95% CI: 0.01, 0.22] but not on ponderal growth. Complementary food supplementation interventions with or without nutrition education also had a small, significant effect in food-insecure settings on both LAZ (SMD: 0.08; 95% CI: 0.04, 0.13) and WLZ (SMD: 0.05; 95% CI: 0.01, 0.08). Conclusions: Nutrition education and complementary feeding interventions both had a small but significant impact on linear growth, and complementary feeding interventions also had an impact on ponderal growth of children aged 6-23 mo in low- and middle-income countries. The updated LiST model will support nutrition program planning and evaluation efforts by allowing users to model changes in intervention coverage on both stunting and wasting. © 2017 American Society for Nutrition.

[Breastfeeding, complementary feeding and risk of childhood obesity].

PubMed

Sandoval Jurado, Luis; Jiménez Báez, María Valeria; Olivares Juárez, Sibli; de la Cruz Olvera, Tomas

2016-11-01

To evaluate the pattern of breastfeeding and weaning as a risk of obesity in pre-school children from a Primary Care Unit. Cross-sectional analytical study LOCATION: Cancun, Quintana Roo (Mexico). Children from 2-4 years of age from a Primary Care Unit. Duration of total and exclusive breastfeeding, age and food utilized for complementary feeding reported by the mother or career of the child and nutritional status assessment evaluated by body mass index (BMI) ≥ 95 percentile. Determination of prevalence ratio (PR), odds ratio (OR), chi squared (x2), and binary logistic regression. The study included 116 children (55.2% girls) with a mean age of 3.2 years, with obesity present in 62.1%, Exclusive breastfeeding in 72.4% with mean duration of 2.3 months, and age at introducing solids foods was 5.0 months. There was a difference for breastfeeding and complementary feeding by gender sex (P<.05). A PR=3.9 (95% CI: 1.49-6.34) was calculated for exclusive breastfeeding and risk of obesity. The model showed no association between these variables and obesity in children CONCLUSIONS: Exclusive breastfeeding of less than three months is associated with almost 4 more times in obese children. There was a difference in age of complementary feeding, duration of breastfeeding, and formula milk consumption time for obese and non-obese children. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Complementary feeding and the early origins of obesity risk: a study protocol

PubMed Central

Muniandy, Naleena Devi; Allotey, Pascale A; Soyiri, Ireneous N; Reidpath, Daniel D

2016-01-01

Introduction The rise in the prevalence of childhood obesity worldwide calls for an intervention earlier in the life cycle. Studies show that nutrition during early infancy may contribute to later obesity. Hence, this study is designed to determine if the variation in complementary feeding practices poses a risk for the development of obesity later in life. A mixed methods approach will be used in conducting this study. Methods and analysis The target participants are infants born from January to June 2015 in the South East Asia Community Observatory (SEACO) platform. The SEACO is a Health and Demographic Surveillance System (HDSS) that is established in the District of Segamat in the state of Johor, Malaysia. For the quantitative strand, the sociodemographic data, feeding practices, anthropometry measurement and total nutrient intake will be assessed. The assessment will occur around the time complementary feeding is expected to start (7 Months) and again at 12 months. A 24-hour diet recall and a 2-day food diary will be used to assess the food intake. For the qualitative strand, selected mothers will be interviewed to explore their infant feeding practices and factors that influence their practices and food choices in detail. Ethics and dissemination Ethical clearance for this study was sought through the Monash University Human Research and Ethics Committee (application number CF14/3850-2014002010). Subsequently, the findings of this study will be disseminated through peer-reviewed journals, national and international conferences. PMID:27852704

Assessment of Salient Beliefs Affecting Mothers' Intention to Adherence to Dietary Diversity in their Children's Complementary Feeding.

PubMed

Karimi-Shahanjarini, Akram; Rahmani, Fatemeh; Roshanei, Ghodratollah; Mahdi Hazavehei, Seyyed M

2017-01-01

Providing a variety of foods has been emphasized as one of the most important features of optimal complementary feeding. This study investigated key beliefs that guide mothers' intention to adherence to dietary diversity in their 1-2-year-old children's complementary feeding. This was a cross-sectional study involving 290 mothers (mean age = 27, standard deviation = 5.32) with child 1-2-year-old attending maternal and child health section of health centers in Rasht, Iran. To represent the socioeconomic status of the participants, 6 centers out of 15 were selected from three different socioeconomic areas (low-, middle-, and high-income areas). Mothers completed a questionnaire assessing intention and belief-based items of theory of planned behavior. Correlations and multiple regression analyses were performed. The mean age of mothers was 27 ± 5.33 (27-43 years). Regression analyses revealed that among behavioral beliefs, the perception that adherence to dietary diversity would lead to improve children's growth was the significant predictor of intention (β = 0.13, P = 0.04). Regarding normative beliefs, perceived social pressure from health-care professionals to adherence to dietary diversity significantly predicted intention (β = 0.15, P = 0.01). Among control beliefs, the perception that daily pressures made difficult adherence to dietary diversity was the key determinant (β = 0.19, P = 0.01). Findings of this study represent the important beliefs that can be addressed in development planning aimed at modifying mothers' child complementary feeding practices.

An integrated nutrition and health program package on IYCN improves breastfeeding but not complementary feeding and nutritional status in rural northern India: A quasi-experimental randomized longitudinal study.

PubMed

Singh, Veena; Ahmed, Saifuddin; Dreyfuss, Michele L; Kiran, Usha; Chaudhery, Deepika N; Srivastava, Vinod K; Ahuja, Ramesh C; Baqui, Abdullah H; Darmstadt, Gary L; Santosham, Mathuram; West, Keith P

2017-01-01

Undernutrition below two years of age remains a major public health problem in India. We conducted an evaluation of an integrated nutrition and health program that aimed to improve nutritional status of young children by improving breast and complementary feeding practices over that offered by the Government of India's standard nutrition and health care program. In Uttar Pradesh state, through multi-stage cluster random sampling, 81 villages in an intervention district and 84 villages in a comparison district were selected. A cohort of 957 third trimester pregnant women identified during house-to-house surveys was enrolled and, following childbirth, mother-child dyads were followed every three months from birth to 18 months of age. The primary outcomes were improvements in weight-for-age and length-for-age z scores, with improved breastfeeding and complementary feeding practices as intermediate outcomes. Optimal breastfeeding practices were higher among women in intervention than comparison areas, including initiating breastfeeding within one hour of delivery (17.4% vs. 2.7%, p<0.001), feeding colostrum (34.7% vs. 8.4%, p<0.001), avoiding pre-lacteals (19.6% vs. 2.1%, p<0.001) and exclusively breastfeeding up to 6 months (24.1% vs. 15.3%, p = 0.001). However, differences were few and mixed between study arms with respect to complementary feeding practices. The mean weight-for-age z-score was higher at 9 months (-2.1 vs. -2.4, p = 0.0026) and the prevalence of underweight status was lower at 12 months (58.5% vs. 69.3%, p = 0.047) among intervention children. The prevalence of stunting was similar between study arms at all ages. Coefficients to show the differences between the intervention and comparison districts (0.13 cm/mo) suggested significant faster linear growth among intervention district infants at earlier ages (0-5 months). Mothers participating in the intervention district were more likely to follow optimal breast, although not complementary feeding practices. The program modestly improved linear growth in earlier age and weight gain in late infancy. Comprehensive nutrition and health interventions are complex; the implementation strategies need careful examination to improve feeding practices and thus impact growth. The trial was registered with ClinicalTrials.gov, NCT00198835.

An integrated nutrition and health program package on IYCN improves breastfeeding but not complementary feeding and nutritional status in rural northern India: A quasi-experimental randomized longitudinal study

PubMed Central

Ahmed, Saifuddin; Dreyfuss, Michele L.; Srivastava, Vinod K.; Ahuja, Ramesh C.; Baqui, Abdullah H.; Darmstadt, Gary L.; Santosham, Mathuram; West, Keith P.

2017-01-01

Background Undernutrition below two years of age remains a major public health problem in India. We conducted an evaluation of an integrated nutrition and health program that aimed to improve nutritional status of young children by improving breast and complementary feeding practices over that offered by the Government of India’s standard nutrition and health care program. Methods In Uttar Pradesh state, through multi-stage cluster random sampling, 81 villages in an intervention district and 84 villages in a comparison district were selected. A cohort of 957 third trimester pregnant women identified during house-to-house surveys was enrolled and, following childbirth, mother-child dyads were followed every three months from birth to 18 months of age. The primary outcomes were improvements in weight-for-age and length-for-age z scores, with improved breastfeeding and complementary feeding practices as intermediate outcomes. Findings Optimal breastfeeding practices were higher among women in intervention than comparison areas, including initiating breastfeeding within one hour of delivery (17.4% vs. 2.7%, p<0.001), feeding colostrum (34.7% vs. 8.4%, p<0.001), avoiding pre-lacteals (19.6% vs. 2.1%, p<0.001) and exclusively breastfeeding up to 6 months (24.1% vs. 15.3%, p = 0.001). However, differences were few and mixed between study arms with respect to complementary feeding practices. The mean weight-for-age z-score was higher at 9 months (-2.1 vs. -2.4, p = 0.0026) and the prevalence of underweight status was lower at 12 months (58.5% vs. 69.3%, p = 0.047) among intervention children. The prevalence of stunting was similar between study arms at all ages. Coefficients to show the differences between the intervention and comparison districts (0.13 cm/mo) suggested significant faster linear growth among intervention district infants at earlier ages (0–5 months). Interpretation Mothers participating in the intervention district were more likely to follow optimal breast, although not complementary feeding practices. The program modestly improved linear growth in earlier age and weight gain in late infancy. Comprehensive nutrition and health interventions are complex; the implementation strategies need careful examination to improve feeding practices and thus impact growth. Trial registration The trial was registered with ClinicalTrials.gov, NCT00198835. PMID:28931088

Impact of feeding and breastfeeding practices on the nutritional status of infants in a district of Andhra Pradesh, India.

PubMed

Meshram, I I; A, Laxmaiah; K, Venkaiah; N V, Brahmam G

2012-01-01

Infant feeding practices have a major role in determining the nutritional status of children and are associated with household socioeconomic and demographic factors. We did a cross-sectional household study to assess feeding practices of infants and young children in rural areas of Medak district, Andhra Pradesh. A total of 805 child-mother pairs were included using systematic random sampling. Age-specific feeding patterns were described using frequencies, proportions and survival analysis. Logistic regression was done with feeding practice as dependent and sociodemographic factors as independent variables. Breastfeeding was universal in the study area. Only 22% of mothers initiated breastfeeding within one hour whereas 44% initiated it within three hours after delivery. The median duration of exclusive breastfeeding was 5.5 months. Pre-lacteal use was high (44.7%). Only 41% of infants were exclusively breastfed for 6 months and 58% of infants (6-11 months) received complementary feeding at 6-9 months of age. Timely initiation of breastfeeding and exclusive breastfeeding for 6 months was significantly more likely among mothers belonging to scheduled castes and scheduled tribes (OR 0.27, 95% CI 0.10-0.76 and OR 0.24, 95% CI 0.08-0.76). Timely initiation of complementary feeding was more likely among scheduled caste and scheduled tribe communities (OR 0.24, 95% CI 0.11-0.54). Early initiation of breastfeeding (within an hour of birth) and other feeding practices were associated with community, type of family and education of mother. Efforts are needed to promote early initiation of breastfeeding, exclusive breastfeeding for 6 months and age-appropriate complementary feeding among infants. Copyright 2012, NMJI.

Data Analyses and Modelling for Risk Based Monitoring of Mycotoxins in Animal Feed

PubMed Central

van der Fels-Klerx, H.J. (Ine); Adamse, Paulien; Punt, Ans; van Asselt, Esther D.

2018-01-01

Following legislation, European Member States should have multi-annual control programs for contaminants, such as for mycotoxins, in feed and food. These programs need to be risk based implying the checks are regular and proportional to the estimated risk for animal and human health. This study aimed to prioritize feed products in the Netherlands for deoxynivalenol and aflatoxin B1 monitoring. Historical mycotoxin monitoring results from the period 2007–2016 were combined with data from other sources. Based on occurrence, groundnuts had high priority for aflatoxin B1 monitoring; some feed materials (maize and maize products and several oil seed products) and complete/complementary feed excluding dairy cattle and young animals had medium priority; and all other animal feeds and feed materials had low priority. For deoxynivalenol, maize by-products had a high priority, complete and complementary feed for pigs had a medium priority and all other feed and feed materials a low priority. Also including health consequence estimations showed that feed materials that ranked highest for aflatoxin B1 included sunflower seed and palmkernel expeller/extracts and maize. For deoxynivalenol, maize products were ranked highest, followed by various small grain cereals (products); all other feed materials were of lower concern. Results of this study have proven to be useful in setting up the annual risk based control program for mycotoxins in animal feed and feed materials. PMID:29373559

Baby-Led Introduction to SolidS (BLISS) study: a randomised controlled trial of a baby-led approach to complementary feeding.

PubMed

Daniels, Lisa; Heath, Anne-Louise M; Williams, Sheila M; Cameron, Sonya L; Fleming, Elizabeth A; Taylor, Barry J; Wheeler, Ben J; Gibson, Rosalind S; Taylor, Rachael W

2015-11-12

In 2002, the World Health Organization recommended that the age for starting complementary feeding should be changed from 4 to 6 months of age to 6 months. Although this change in age has generated substantial debate, surprisingly little attention has been paid to whether advice on how to introduce complementary foods should also be changed. It has been proposed that by 6 months of age most infants will have developed sufficient motor skills to be able to feed themselves rather than needing to be spoon-fed by an adult. This has the potential to predispose infants to better growth by fostering better energy self-regulation, however no randomised controlled trials have been conducted to determine the benefits and risks of such a "baby-led" approach to complementary feeding. This is of particular interest given the widespread use of "Baby-Led Weaning" by parents internationally. The Baby-Led Introduction to SolidS (BLISS) study aims to assess the efficacy and acceptability of a modified version of Baby-Led Weaning that has been altered to address potential concerns with iron status, choking and growth faltering. The BLISS study will recruit 200 families from Dunedin, New Zealand, who book into the region's only maternity hospital. Parents will be randomised into an intervention (BLISS) or control group for a 12-month intervention with further follow-up at 24 months of age. Both groups will receive the standard Well Child care provided to all parents in New Zealand. The intervention group will receive additional parent contacts (n = 8) for support and education on BLISS from before birth to 12 months of age. Outcomes of interest include body mass index at 12 months of age (primary outcome), energy self-regulation, iron and zinc intake and status, diet quality, choking, growth faltering and acceptability to parents. This study is expected to provide insight into the feasibility of a baby-led approach to complementary feeding and the extent to which this method of feeding affects infant body weight, diet quality and iron and zinc status. Results of this study will provide important information for health care professionals, parents and health policy makers. Australian New Zealand Clinical Trials Registry ACTRN12612001133820 .

Breast-feeding and complementary feeding practices in the first 6 months of life among Norwegian-Somali and Norwegian-Iraqi infants: the InnBaKost survey.

PubMed

Grewal, Navnit Kaur; Andersen, Lene Frost; Sellen, Daniel; Mosdøl, Annhild; Torheim, Liv Elin

2016-03-01

To examine breast-feeding and complementary feeding practices during the first 6 months of life among Norwegian infants of Somali and Iraqi family origin. A cross-sectional survey was performed during March 2013-February 2014. Data were collected using a semi-quantitative FFQ adapted from the second Norwegian national dietary survey among infants in 2006-2007. Somali-born and Iraqi-born mothers living in eastern Norway were invited to participate. One hundred and seven mothers/infants of Somali origin and eighty mothers/infants of Iraqi origin participated. Breast-feeding was almost universally initiated after birth. Only 7 % of Norwegian-Somali and 10 % of Norwegian-Iraqi infants were exclusively breast-fed at 4 months of age. By 1 month of age, water had been introduced to 30 % of Norwegian-Somali and 26 % of Norwegian-Iraqi infants, and infant formula to 44 % and 34 %, respectively. Fifty-four per cent of Norwegian-Somali and 68 % of Norwegian-Iraqi infants had been introduced to solid or semi-solid foods at 4 months of age. Breast-feeding at 6 months of age was more common among Norwegian-Somali infants (79 %) compared with Norwegian-Iraqi infants (58 %; P=0·001). Multivariate analyses indicated no significant factors associated with exclusive breast-feeding at 3·5 months of age. Factors positively associated with breast-feeding at 6 months were country of origin (Somalia) and parity (>2). Breast-feeding initiation was common among Iraqi-born and Somali-born mothers, but the exclusive breast-feeding period was shorter than recommended in both groups. The study suggests that there is a need for new culture-specific approaches to support exclusive breast-feeding and complementary feeding practices among foreign-born mothers living in Norway.

Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition.

PubMed

Agostoni, Carlo; Decsi, Tamas; Fewtrell, Mary; Goulet, Olivier; Kolacek, Sanja; Koletzko, Berthold; Michaelsen, Kim Fleischer; Moreno, Luis; Puntis, John; Rigo, Jacques; Shamir, Raanan; Szajewska, Hania; Turck, Dominique; van Goudoever, Johannes

2008-01-01

This position paper on complementary feeding summarizes evidence for health effects of complementary foods. It focuses on healthy infants in Europe. After reviewing current knowledge and practices, we have formulated these conclusions: Exclusive or full breast-feeding for about 6 months is a desirable goal. Complementary feeding (ie, solid foods and liquids other than breast milk or infant formula and follow-on formula) should not be introduced before 17 weeks and not later than 26 weeks. There is no convincing scientific evidence that avoidance or delayed introduction of potentially allergenic foods, such as fish and eggs, reduces allergies, either in infants considered at increased risk for the development of allergy or in those not considered to be at increased risk. During the complementary feeding period, >90% of the iron requirements of a breast-fed infant must be met by complementary foods, which should provide sufficient bioavailable iron. Cow's milk is a poor source of iron and should not be used as the main drink before 12 months, although small volumes may be added to complementary foods. It is prudent to avoid both early (<4 months) and late (>or=7 months) introduction of gluten, and to introduce gluten gradually while the infant is still breast-fed, inasmuch as this may reduce the risk of celiac disease, type 1 diabetes mellitus, and wheat allergy. Infants and young children receiving a vegetarian diet should receive a sufficient amount ( approximately 500 mL) of breast milk or formula and dairy products. Infants and young children should not be fed a vegan diet.

Complementary feeding at 4 versus 6 months of age for preterm infants born at less than 34 weeks of gestation: a randomised, open-label, multicentre trial.

PubMed

Gupta, Shuchita; Agarwal, Ramesh; Aggarwal, Kailash Chandra; Chellani, Harish; Duggal, Anil; Arya, Sugandha; Bhatia, Sunita; Sankar, Mari Jeeva; Sreenivas, Vishnubhatla; Jain, Vandana; Gupta, Arun Kumar; Deorari, Ashok K; Paul, Vinod K

2017-05-01

Evidence on the optimal time to initiation of complementary feeding in preterm infants is scarce. We examined the effect of initiation of complementary feeding at 4 months versus 6 months of corrected age on weight for age at 12 months corrected age in preterm infants less than 34 weeks of gestation. In this open-label, randomised trial, we enrolled infants born at less than 34 weeks of gestation with no major malformation from three public health facilities in India. Eligible infants were tracked from birth and randomly assigned (1:1) at 4 months corrected age to receive complementary feeding at 4 months corrected age (4 month group), or continuation of milk feeding and initiation of complementary feeding at 6 months corrected age (6 month group), using computer generated randomisation schedule of variable block size, stratified by gestation (30 weeks or less, and 31-33 weeks). Iron supplementation was provided as standard. Participants and the implementation team could not be masked to group assignment, but outcome assessors were masked. Primary outcome was weight for age Z-score at 12 months corrected age (WAZ 12 ) based on WHO Multicentre Growth Reference Study growth standards. Analyses were by intention to treat. The trial is registered with Clinical Trials Registry of India, number CTRI/2012/11/003149. Between March 20, 2013, and April 24, 2015, 403 infants were randomly assigned: 206 to receive complementary feeding from 4 months and 197 to receive complementary feeding from 6 months. 22 infants in the 4 month group (four deaths, two withdrawals, 16 lost to follow-up) and eight infants in the 6 month group (two deaths, six lost to follow-up) were excluded from analysis of primary outcome. There was no difference in WAZ 12 between two groups: -1·6 (SD 1·2) in the 4 month group versus -1·6 (SD 1·3) in the 6 month group (mean difference 0·005, 95% CI -0·24 to 0·25; p=0·965). There were more hospital admissions in the 4 month group compared with the 6 month group: 2·5 episodes per 100 infant-months in the 4 month group versus 1·4 episodes per 100 infant-months in the 6 month group (incidence rate ratio 1·8, 95% CI 1·0-3·1, p=0·03). 34 (18%) of 188 infants in the 4 month group required hospital admission, compared with 18 (9%) of 192 infants in the 6 month group. Although there was no evidence of effect for the primary endpoint of WAZ 12 , the higher rate of hospital admission in the 4 month group suggests a recommendation to initiate complementary feeding at 6 months over 4 months of corrected age in infants less than 34 weeks of gestation. Indian Council of Medical Research supported the study until Nov 14, 2015. Subsequently, Shuchita Gupta's salary was supported for 2 months by an institute fellowship from All India Institute Of Medical Sciences, and a grant by Wellcome Trust thereafter. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Breast-feeding and Infant Hospitalization for Infections: Large Cohort and Sibling Analysis.

PubMed

Størdal, Ketil; Lundeby, Karen M; Brantsæter, Anne L; Haugen, Margaretha; Nakstad, Britt; Lund-Blix, Nicolai A; Stene, Lars C

2017-08-01

Breast-feeding may protect against infections, but its optimal duration remains controversial. We aimed to study the association of the duration of full and any breast-feeding with infections the first 18 months of life. The Norwegian Mother and Child study (MoBa) is a prospective birth cohort which recruited expecting mothers giving birth from 2000 to 2009. We analyzed data from the full cohort (n = 70,511) and sibling sets (n = 21,220) with parental report of breast-feeding and infections. The main outcome measures were the relative risks (RRs) for hospitalization for infections from 0 to 18 months by age at introduction of complementary foods and duration of any breast-feeding. Although we found some evidence for an overall association between longer duration of full breast-feeding and lower risk of hospitalizations for infections, 7.3% of breast-fed children who received complementary foods at 4 to 6 months of age compared to 7.7% of those receiving complementary foods after 6 months were hospitalized (adjusted RR 0.95, 95% confidence interval 0.88-1.03). Higher risk of hospitalization was observed in those breast-fed 6 months or less (10.0%) compared to ≥12 months (7.6%, adjusted RR 1.22, 95% confidence interval 1.14-1.31), but with similar risks for 6 to 11 months versus ≥12 months. Matched sibling analyses, minimizing the confounding from shared maternal factors, showed nonsignificant associations and were generally weaker compared with the cohort analyses. Our results support the recommendation to fully breast-feed for 4 months and to continue breast-feeding beyond 6 months, and suggest that protection against infections is limited to the first 12 months.

Complementary feeding and the early origins of obesity risk: a study protocol.

PubMed

Muniandy, Naleena Devi; Allotey, Pascale A; Soyiri, Ireneous N; Reidpath, Daniel D

2016-11-15

The rise in the prevalence of childhood obesity worldwide calls for an intervention earlier in the life cycle. Studies show that nutrition during early infancy may contribute to later obesity. Hence, this study is designed to determine if the variation in complementary feeding practices poses a risk for the development of obesity later in life. A mixed methods approach will be used in conducting this study. The target participants are infants born from January to June 2015 in the South East Asia Community Observatory (SEACO) platform. The SEACO is a Health and Demographic Surveillance System (HDSS) that is established in the District of Segamat in the state of Johor, Malaysia. For the quantitative strand, the sociodemographic data, feeding practices, anthropometry measurement and total nutrient intake will be assessed. The assessment will occur around the time complementary feeding is expected to start (7 Months) and again at 12 months. A 24-hour diet recall and a 2-day food diary will be used to assess the food intake. For the qualitative strand, selected mothers will be interviewed to explore their infant feeding practices and factors that influence their practices and food choices in detail. Ethical clearance for this study was sought through the Monash University Human Research and Ethics Committee (application number CF14/3850-2014002010). Subsequently, the findings of this study will be disseminated through peer-reviewed journals, national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Assessment of Salient Beliefs Affecting Mothers’ Intention to Adherence to Dietary Diversity in their Children's Complementary Feeding

PubMed Central

Karimi-Shahanjarini, Akram; Rahmani, Fatemeh; Roshanei, Ghodratollah; Mahdi Hazavehei, Seyyed M.

2017-01-01

Background: Providing a variety of foods has been emphasized as one of the most important features of optimal complementary feeding. This study investigated key beliefs that guide mothers’ intention to adherence to dietary diversity in their 1–2-year-old children's complementary feeding. Methods: This was a cross-sectional study involving 290 mothers (mean age = 27, standard deviation = 5.32) with child 1–2-year-old attending maternal and child health section of health centers in Rasht, Iran. To represent the socioeconomic status of the participants, 6 centers out of 15 were selected from three different socioeconomic areas (low-, middle-, and high-income areas). Mothers completed a questionnaire assessing intention and belief-based items of theory of planned behavior. Correlations and multiple regression analyses were performed. Results: The mean age of mothers was 27 ± 5.33 (27–43 years). Regression analyses revealed that among behavioral beliefs, the perception that adherence to dietary diversity would lead to improve children's growth was the significant predictor of intention (β = 0.13, P = 0.04). Regarding normative beliefs, perceived social pressure from health-care professionals to adherence to dietary diversity significantly predicted intention (β = 0.15, P = 0.01). Among control beliefs, the perception that daily pressures made difficult adherence to dietary diversity was the key determinant (β = 0.19, P = 0.01). Conclusions: Findings of this study represent the important beliefs that can be addressed in development planning aimed at modifying mothers’ child complementary feeding practices. PMID:28479970

Introduction of complementary foods in Sweden and impact of maternal education on feeding practices.

PubMed

Klingberg, Sofia; Ludvigsson, Johnny; Brekke, Hilde K

2017-04-01

To describe the introduction of complementary foods in a population-based cohort in relation to recommendations and explore the possible impact of maternal education on infant feeding practices. Prospective data from the All Babies in Southeast Sweden (ABIS) cohort study were used. The ABIS study invited all infants born in south-east Sweden during October 1997-October 1999 (n 21 700) to participate. A questionnaire was completed for 16 022 infants. During the infants' first year parents continuously filed in a diary covering introduction of foods. Sweden. Infants (n 9727) with completed food diaries. Potatoes, vegetables, fruits/berries and porridge were the foods first introduced, with a median introduction between 19 and 22 weeks, followed by introduction of meat, cow's milk, follow-on formula and sour milk/yoghurt between 24 and 27 weeks. Early introduction of any food, before 16 weeks, occurred for 27 % of the infants and was more common in infants of mothers with low education. Overall, potatoes (14·7 %), vegetables (11·1 %), fruits/berries (8·5 %), porridge (7·4 %) and follow-on formula (2·7 %) were the foods most frequently introduced early. The majority of infants (≥70 %) were introduced to potatoes, vegetables, fruits/berries and porridge during concurrent breast-feeding, but introduction during concurrent breast-feeding was less common in infants of mothers with low education. Most infants were introduced to complementary foods timely in relation to recommendations. Low maternal education was associated with earlier introduction of complementary foods and less introduction during concurrent breast-feeding. Still, the results indicated exposure to fewer foods at 12 months in infants of mothers with low education.

Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya

PubMed Central

2011-01-01

Background The World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. Methods Data from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods. Results There was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence). Conclusions The study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning. PMID:21615957

Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya.

PubMed

Kimani-Murage, Elizabeth W; Madise, Nyovani J; Fotso, Jean-Christophe; Kyobutungi, Catherine; Mutua, Martin K; Gitau, Tabither M; Yatich, Nelly

2011-05-26

The World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. Data from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods. There was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence). The study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning.

Dietary Patterns during Complementary Feeding and Later Outcomes.

PubMed

Emmett, Pauline M

2016-01-01

Guidelines for healthy infant feeding provide advice on breastfeeding and complementary feeding. The Avon Longitudinal Study of Parents and Children (ALSPAC) derived dietary patterns in comparison to infant feeding guidelines and by using principal components analysis (PCA). The ALSPAC cohort was recruited during pregnancy. Parent-completed questionnaires assessed diet at age 6 and 15 months. Children were weighed and measured at 7 years of age and IQ was assessed at 8 years. A complementary feeding utility index was calculated in relation to 14 feeding recommendations. High scores on the index were due to longer breastfeeding, and feeding more fruit and vegetables and less ready-prepared baby foods. The index scores were positively related to IQ and 'healthy' dietary patterns in childhood. In infancy four dietary patterns were derived from PCA at each age. Three occurred at both ages: 'HM traditional' (home-made meat, vegetables and desserts), 'discretionary' (processed adult foods) and 'RM baby foods' (commercial ready-made baby foods). A 'breastfeeding' pattern was derived at 6 months, with fruit and vegetables included. At 15 months, a 'HM contemporary' pattern included cheese, fish, nuts, legumes, fruit and vegetables. The 'discretionary' and 'RM baby foods' patterns at both ages were negatively associated, while the 'breastfeeding' and 'HM contemporary' patterns were positively associated with IQ. These results suggest that infant diet influences cognitive development in children and may set a trend for later eating patterns. © 2016 Nestec Ltd., Vevey/S. Karger AG, Basel.

Impact of education and provision of complementary feeding on growth and morbidity in children less than 2 years of age in developing countries: a systematic review

PubMed Central

2013-01-01

Background About one third of deaths in children less than 5 years of age are due to underlying undernutrition. According to an estimate, 19.4% of children <5 years of age in developing countries were underweight (weight-for-age Z score <-2) and about 29.9% were stunted in the year 2011 (height-for-age Z score <-2). It is well recognized that the period of 6-24 months of age is one of the most critical time for the growth of the infant. Methods We included randomized, non-randomized trials and programs on the effect of complementary feeding (CF) (fortified or unfortified, but not micronutrients alone) and education on CF on children less than 2 years of age in low and middle income countries (LMIC). Studies that delivered intervention for at least 6 months were included; however, studies in which intervention was given for supplementary and therapeutic purposes were excluded. Recommendations are made for input to the Lives Saved Tool (LiST) model by following standardized guidelines developed by Child Health Epidemiology Reference Group (CHERG). Results We included 16 studies in this review. Amongst these, 9 studies provided education on complementary feeding, 6 provided complementary feeding (with our without education) and 1 provided both as separate arms. Overall, education on CF alone significantly improved HAZ (SMD: 0.23; 95% CI: 0.09, 0.36), WAZ (SMD 0.16, 95% CI: 0.05, 0.27), and significantly reduced the rates of stunting (RR 0.71; 95% CI: 0.56, 0.91). While no significant impact were observed for height and weight gain. Based on the subgroup analysis; ten studies from food secure populations indicated education on CF had a significant impact on height gain, HAZ scores, and weight gain, however, stunting reduced non-significantly. In food insecure population, CF education alone significantly improved HAZ scores, WAZ scores and significantly reduced the rates of stunting, while CF provision with or without education improved HAZ and WAZ scores significantly. Conclusion Complementary feeding interventions have a potential to improve the nutritional status of children in developing countries. However, large scale high quality randomized controlled trials are required to assess the actual impact of this intervention on growth and morbidity in children 6-24 months of age. Education should be combined with provision of complementary foods that are affordable, particularly for children in food insecure countries. PMID:24564534

Timing and Determinants of the Introduction of Complementary Foods in Kuwait: Results of a Prospective Cohort Study.

PubMed

Scott, Jane A; Dashti, Manal; Al-Sughayer, Mona; Edwards, Christine A

2015-08-01

The early introduction of complementary foods is common in Middle Eastern countries but little is known about the determinants of this practice in this region. This prospective cohort study conducted from October 2007 to October 2008 investigated the determinants of the very early (before 17 weeks) introduction of complementary foods in Kuwait and compared rates of this practice against rates reported in the mid-1990s. A total of 373 women were recruited from maternity hospitals in Kuwait City and followed to 26 weeks postpartum. Data on complementary feeding practices were available from 303 women. Multivariate logistic regression was used to estimate the association of very early introduction of complementary foods with infant sex and maternal characteristics including age, years of education, employment intentions at 6 months postpartum, parity, prepregnancy body mass index, and prepregnancy smoking status. All infants had received complementary foods by 26 weeks of age, with 30.4% receiving complementary foods before 17 weeks of age. Women born in other Arabic countries were less likely to introduce complementary foods before 17 weeks (adjusted odds ratio [adj OR] = 0.40; 95% confidence interval [CI], 0.22-0.73) than women born in Kuwait. Women who were exclusively formula feeding at 6 weeks postpartum were less likely to introduce complementary foods before 17 weeks (adj OR = 0.40; 95% CI, 0.23-0.71) than women who were still breastfeeding. Compared to the mid-1990s, fewer infants in Kuwait were receiving complementary foods before 17 weeks. Nevertheless, all infants had received complementary foods by 6 months of age. © The Author(s) 2015.

Household Food Security Is Associated with Infant Feeding Practices in Rural Bangladesh1,2

PubMed Central

Saha, Kuntal K.; Frongillo, Edward A.; Alam, Dewan S.; Arifeen, Shams E.; Persson, Lars Åke; Rasmussen, Kathleen M.

2008-01-01

Although household food security (HHFS) has been shown to affect diet, nutrition, and health of adults and also learning in children, no study has examined associations with infant feeding practices (IFP). We studied 1343 infants born between May 2002 and December 2003 in the Maternal and Infant Nutrition Intervention in Matlab study to investigate the effect of HHFS on IFP in rural Bangladesh. We measured HHFS using a previously developed 11-item scale. Cumulative and current infant feeding scales were created from monthly infant feeding data for the age groups of 1–3, 1–6, 1–9, and 1–12 mo based on comparison to infant feeding recommendations. We used lagged, dynamic, and difference longitudinal regression models adjusting for various infant and maternal variables to examine the association between HHFS and changes in IFP, and Cox proportional hazards models to examine the influence of HHFS on the duration of breast-feeding and the time of introduction of complementary foods. Better HHFS status was associated with poor IFP during 3–6 mo but was associated with better IFP during 6–9 and 9–12 mo of age. Although better HHFS was not associated with the time of introduction of complementary foods, it was associated with the type of complementary foods given to the infants. Intervention programs to support proper IFP should target mothers in food-secure households when their babies are 3–6 mo old and also mothers in food-insecure households during the 2nd half of infancy. Our results provide strong evidence that HHFS influences IFP in rural Bangladesh. PMID:18567765

Food Based Complementary Feeding Strategies for Breastfed Infants: What's the Evidence that it Matters?

PubMed Central

Krebs, Nancy F.

2015-01-01

The period of complementary feeding represents a major portion of the 1000 day critical window and thus impacts a period of substantial and dynamic infant development. This review highlights and synthesizes findings of several recent studies conducted to evaluate food based strategies on outcomes related to micronutrient status, growth and neurocognitive development. Particular emphasis is placed on interventions using meat or fortified products to impact iron and zinc intakes, due to the dependence of breastfed infants on complementary food choices to meet requirements for these two critical micronutrients. Regular consumption of modest amounts of meat or fortified cereals provides adequate absorbed zinc to meet estimated physiologic requirements, whereas homeostatic adaptation to lower zinc intake from unfortified cereal/plant staples is inadequate to meet requirements. Iron fortification of cereals may be somewhat more effective than meat to improve iron status, but neither prevents iron deficiency in breastfed infants, even in westernized settings. Improvements in the quality of complementary foods have had very modest effects on linear growth in settings where stunting is prevalent. Maternal education is strongly associated with both linear growth and with child neurodevelopment. The determinants of early growth faltering are more complex and intractable than ‘simple’ dietary deficiencies of micronutrients. Solutions to growth faltering in young children most likely need to be multi-factorial, and almost certainly will need to start earlier than the complementary feeding period. PMID:26549893

Inadequate feeding practices and impaired growth among children from subsistence farming households in Sidama, Southern Ethiopia.

PubMed

Gibson, Rosalind S; Abebe, Yewelsew; Hambidge, K Michael; Arbide, Isabel; Teshome, Aklilu; Stoecker, Barbara J

2009-07-01

Whether current child feeding practices and behaviours among rural households in Sidama, Southern Ethiopia conform to the World Health Organization (WHO) guiding principles for complementary feeding is uncertain. We assessed socio-demographic status, anthropometry, breastfeeding, complementary feeding practices and behaviours, and motor development milestones in a convenience sample of 97 breastfed children aged 6-23 months from three rural Sidama communities. Energy and nutrient intakes from complementary foods were also calculated from 1-day in-home weighed records. Prevalence of stunting ranged from 25% for infants aged 6-8 months to 52% for children aged 12-23 months, whereas for wasting, the corresponding prevalence was 10% and 14%, respectively. Very few children were exclusively breastfed up to 6 months of age (n = 2), or received solids/semi-solids for the recommended minimum number of times containing the recommended number of food groups. Responsive feeding was not practised and no cellular animal products were consumed. Median intakes of energy, and intakes and densities of micronutrients from complementary foods (but not protein) were below WHO recommendations, assuming average breast milk intakes; greatest shortfalls were for retinol, vitamin C and calcium densities. Mothers of stunted children were shorter and lighter, and from households of lower socio-economic status than non-stunted children (P < 0.05). Acquisition of some motor development milestones was delayed in stunted infants compared with their non-stunted counter-parts. In conclusion, interventions that address the WHO guiding principles for complementary feeding practices and behaviours, as well as prenatal influences on growth, are urgently required in this setting.

Comparison of the complementary feeding practices between mothers with twins and mothers with singletons.

PubMed

Bentil, Helena Joycelyn; Steiner-Asiedu, Matilda; Lartey, Anna

2016-01-01

Several studies have been done on infant feeding practices but few have focused on twins. The aim of this study was to compare the complementary feeding practices between mothers with twins and mothers with singletons. Mother-infant pairs (50 mother-twin pairs and 50 mother-singleton pairs) with children aged 6 to 23 months were recruited from two public health clinics and communities in Tema and Ashaiman. Information was collected on the background characteristics of the mothers. Recumbent length and weight of the children were measured. Dietary information on the infants was collected using 24 hour recall. The differences between two groups were tested using independent t-student test for continuous variables and chi-square test for categorical variables. The minimum dietary diversity (4+ food groups) was met by only 32% of the twins and 40% of the singletons, and 28% of the twins and 38% of the singletons met the requirement for minimum acceptable diet (minimum dietary diversity and the minimum meal frequency). Minimum meal frequency was met by 78% of the twins and 76% of the singletons. There were no significant differences between the two groups of infants. Prevalence of undernutrition was not significantly different among the two groups (twins versus singletons: underweight-26% versus 24%, stunting-20% versus 24% and wasting-14% versus 10%. Complementary feeding practices were suboptimal in both groups of mothers requiring interventions to improve infant feeding practices.

Assessment of complementary feeding of Canadian infants: effects on microbiome & oxidative stress, a randomized controlled trial.

PubMed

Qasem, Wafaa; Azad, Meghan B; Hossain, Zakir; Azad, Elnaz; Jorgensen, Sarah; Castillo San Juan, Sandra; Cai, Chenxi; Khafipour, Ehsan; Beta, Trust; Roberts, L Jackson; Friel, James

2017-02-14

The World Health Organization recommends exclusive breastfeeding until 6 months followed by introduction of iron-rich complementary foods (CFs). The aim of this study was to determine the impact of different iron-rich CFs on infant gut inflammation and microbiota. Eighty-seven exclusively breastfed infants were randomly assigned to receive one of the following as their first CF: iron-fortified cereal (Cer), iron-fortified cereal with fruit (Cer + Fr), or meat (M). Urine and stool samples were collected to assess reactive oxygen species (ROS) generation, gut microbiota and inflammation. Fecal iron differed across feeding groups (p < 0.001); levels were highest in the Cer group and lowest in M group. A significant increase of fecal ROS formation (p < 0.002) after the introduction of CFs was observed, but did not differ across feeding groups. Fecal calprotectin increased within all groups after the introduction of CFs (p = 0.004). Gut microbiota richness increased after introduction of M or Cer + Fr. Regardless of feeding group, Coriobacteriaceae were positively correlated with ROS and Staphylococcaceae were negatively correlated with calprotectin. Choice of first CF may influence gut inflammation and microbiota, potentially due to variations in iron absorption from different foods. Further research is warranted to fully characterize these associations and to establish implications for infant health. This study was registered in the ClinicalTrial.gov registry (Identifier No. NCT01790542 ). This study was registered in the ClinicalTrial.gov registry under the name "Assessment of Complementary Feeding of Canadian Infants" (Identifier No. NCT01790542 ) February 6, 2013.

Malnutrition among vaccinated children aged 0-5 years in Batouri, Republic of Cameroon.

PubMed

Nagahori, Chikako; Kinjo, Yoshihide; Tchuani, Jean Paul; Yamauchi, Taro

2017-12-01

Malnutrition continues to contribute to a high infant mortality rate. This study aimed to determine the prevalence of malnutrition and its potential association with the time at which complementary feeding was introduced among children aged 0-5 years in Batouri, Republic of Cameroon. Mothers (n=212) were interviewed using a structured questionnaire. Child height or length, and weight measurements were determined and the appropriate Z -scores calculated. Multiple regression analysis was performed with the values of all nutritional status indicators as dependent variables and the time of commencing complementary feeding, and the child's age and sex, as independent variables. The prevalence of stunting (height/length for age<-2 standard deviation [SD]), underweight (weight for age<-2SD), and wasting (weight for height/length<-2SD) was 45.8%, 30.2%, and 11.3%, respectively. Even taking into consideration the biological variables, there was a significant association in the effects of time of starting complementary foods on the nutritional status indicators. Furthermore, adding socio-economic variables did not produce a rise in adjusted R 2 values for all age group models concerned. Approximately 30% of the children in the study region were underweight, and approximately half of the children exhibited stunting, indicating chronic malnutrition. Commencing complementary feeding at an appropriate time had a positive effect on nutritional status from approximately 2 years of age.

Complementary feeding with cowpea reduces growth faltering in rural Malawian infants: A blind, randomized controlled clinical trial

USDA-ARS?s Scientific Manuscript database

Growth faltering is common in rural African children and is attributed to inadequate dietary intake and environmental enteric dysfunction (EED). We tested the hypothesis that complementary feeding with cowpea or common bean flour would reduce growth faltering and EED in 6-mo-old rural Malawians com...

Predicting mothers' decisions to introduce complementary feeding at 6 months. An investigation using an extended theory of planned behaviour.

PubMed

Hamilton, Kyra; Daniels, Lynne; White, Katherine M; Murray, Nicole; Walsh, Anne

2011-06-01

In Australia and other developed countries there is poor adherence to guidelines recommending the introduction of complementary feeding to infants at 6 months of age. We aimed to investigate, via adopting a theory of planned behaviour framework and incorporating additional normative and demographic influences, mothers' complementary feeding intentions and behaviour. Participants were 375 primiparas who completed an initial questionnaire (infant age 13±3 weeks) that assessed the theory of planned behaviour constructs of attitude, subjective norm, and perceived behavioural control, as well as group norm and additional maternal and infant variables of mothers' age, education level, weight status perception, current maternal feeding practices, and infant birth weight. Approximately, 3 months after completion of the main questionnaire, mothers completed a follow-up questionnaire that assessed the age in months at which the infant was first introduced to solids. The theory of planned behaviour variables of attitude and subjective norm, along with group norm, predicted intentions, with intention, mothers' age (older more likely), and weight status perception (overweight less likely) predicting behaviour. Overall, the results highlight the importance of attitudes, normative influences, and individual characteristics in complementary feeding decision-making which should be considered when designing interventions aimed at improving adherence to current maternal feeding guidelines. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Sex differences in nutritional status of HIV-exposed children in Rwanda: a longitudinal study.

PubMed

Condo, Jeanine U; Gage, Anastasia; Mock, Nancy; Rice, Janet; Greiner, Ted

2015-01-01

To examine sex differences in nutritional status in relation to feeding practices over time in a cohort of HIV-exposed children participating in a complementary feeding programme in Rwanda. We applied a longitudinal design with three measurements 2-3 months apart among infants participating in a complementary feeding programme who were 6-12 months old at baseline. Using early feeding practices and a composite infant and child feeding index (ICFI) as indicators of dietary patterns, we conducted a multivariate analysis using a cross-sectional time series to assess sex differences in nutritional status and to determine whether there was a link to discrepancies in dietary patterns. Among 222 boys and 258 girls, the mean (±SD) Z-score of stunting, wasting and underweight was -2.01 (±1.59), -0.15 (±1.46), -1.19 (±1.29) for boys; for girls they were -1.46 (±1.56), 0.22 (±1.29), -0.63 (±1.19); all sex differences in all three indicators were statistically significant (P < 0.001). However, there were only minor differences in early feeding practices and none in the ICFI by sex. HIV-exposed male children may be at higher risk of malnutrition in low-resource setting countries than their female counterparts. However, at least in a setting where complementary foods are being provided, explanations may lie outside the sphere of dietary patterns. © 2014 John Wiley & Sons Ltd.

Complementary feeding of infants in their first year of life: focus on the main pureed baby foods.

PubMed

Souza, Fabíola Isabel Suano de; Caetano, Michelle Cavalcante; Ortiz, Thaís Tobaruela; Silva, Simone Guerra Lopes da; Sarni, Roseli Oselka Saccardo

2014-01-01

To evaluate the complementary feeding practices for infants, focusing on the main pureed baby foods, and verify adherence to the guidelines adopted in Brazil. Through cross-sectional study, aspects of complementary feeding of 404 healthy infants between 4 and 9 months of age (São Paulo, Curitiba and Recife) were evaluated. Socio-demographic data, history and food habits were collected. Mothers described three recipes (preparations) usually used in key baby foods. The findings were compared with those recommended by the Brazilian Society of Pediatrics. The average age was 6.9 ± 1.6 months. Among infants, 241/404 (59.6%) were still breastfeeding. Among those who received another type of milk, 193/368 (52.4%) received whole cow's milk, while 151/368 (41.0%) drank infant or follow-on formulas. Regarding baby food recipes salted reported by mothers, it was seen that 30% and 60% contained meat and vegetables, respectively. The percentages less suitable for feeding in general were observed for use of cow's milk and added sugar, chocolate and cereal in feeding bottles; 79% and 80.5% of the families interviewed would adopted such practices. The early termination of exclusive/predominant breastfeeding and the practice of an inadequate transition diet have shown a picture of quantitatively and qualitatively inadequate feeding, with the risk of causing serious nutritional problems in later ages, such as anemia and vitamin A deficiency, or excess of nutrients, leading to obesity, diabetes and dyslipidemias.

Complementary feeding recommendations based on locally available foods in Indonesia.

PubMed

Fahmida, Umi; Santika, Otte; Kolopaking, Risatianti; Ferguson, Elaine

2014-12-01

Affordable, locally contextual complementary feeding recommendations (CFRs) that take into account cultural diversity and differences in food availability will be more likely to result in long-term improvements in complementary feeding practices than general recommendations. More objective approaches, such as linear programming (LP), have been recommended to identify optimal but CFRs to meet nutrient requirements given local food availability, food patterns, food portions, and cost. To present results of our previous studies in which we developed CFRs using LP and to provide an example of how these CFRs can be put into practice in a community intervention trial in Indonesia. Dietary data were obtained using single 24-hour dietary recall or 1-day weighed diet record combined with 1-day 24-hour recall and 5-day food intake tally. With the use of the LP approach, nutrient intakes were optimized while ensuring that a realistic diet was selected by using constraints such as the diet's energy content, food patterns, food portions, and cost. The price per 100 g of edible portion was obtained from market surveys in two or three local markets in each study area. LP analysis was performed using Super Solver in MS Excel or Optifood software. Iron, zinc, calcium, and niacin were problem nutrients in all age groups of children (6 to 8, 9 to 11, and 12 to 23 months) in both rural and periurban areas, except among children of higher socioeconomic status in urban areas. Thiamin and folate were also problem nutrients found in some settings. Animal-source foods (meat, fish, poultry, and eggs [MFPE] and fortified foods were the nutrient-dense foods identified by LP to fill the nutrient gaps of these problem nutrients. Iron, calcium, zinc, niacin, and potentially folate and thiamine are typical "problem nutrients" in complementary foods of Indonesian children. However, the extent of dietary inadequacy varies across age groups, area, and socioeconomic level. MFPE and fortified foods can improve micronutrient adequacy in complementary feeding diets and should be promoted in CFRs.

Development of complementary feeding recommendations for 12-23-month-old children from low and middle socio-economic status in West Java, Indonesia: contribution of fortified foods towards meeting the nutrient requirement.

PubMed

Fahmida, Umi; Santika, Otte

2016-07-01

Inadequate nutrient intake as part of a complementary feeding diet is attributable to poor feeding practices and poor access to nutritious foods. Household socio-economic situation (SES) has an influence on food expenditure and access to locally available, nutrient-dense foods and fortified foods. This study aimed to develop and compare complementary feeding recommendations (CFR) for 12-23-month-old children in different SES and evaluate the contribution of fortified foods in meeting nutrient requirements. A cross-sectional survey was conducted in low and medium SES households (n 114/group) in urban Bandung district, West Java province, Indonesia. Food pattern, portion size and affordability were assessed, and CFR were developed for the low SES (LSES) and middle SES (MSES) using a linear programming (LP) approach; two models - with and without fortified foods - were run using LP, and the contribution of fortified foods in the final CFR was identified. Milk products, fortified biscuits and manufactured infant cereals were the most locally available and consumed fortified foods in the market. With the inclusion of fortified foods, problem nutrients were thiamin in LSES and folate and thiamin in MSES groups. Without fortified foods, more problem nutrients were identified in LSES, that is, Ca, Fe, Zn, niacin and thiamin. As MSES consumed more fortified foods, removing fortified foods was not possible, because most of the micronutrient-dense foods were removed from their food basket. There were comparable nutrient adequacy and problem nutrients between LSES and MSES when fortified foods were included. Exclusion of fortified foods in LSES was associated with more problem nutrients in the complementary feeding diet.

Infant Gut Microbiota Development Is Driven by Transition to Family Foods Independent of Maternal Obesity.

PubMed

Laursen, Martin Frederik; Andersen, Louise B B; Michaelsen, Kim F; Mølgaard, Christian; Trolle, Ellen; Bahl, Martin Iain; Licht, Tine Rask

2016-01-01

The first years of life are paramount in establishing our endogenous gut microbiota, which is strongly affected by diet and has repeatedly been linked with obesity. However, very few studies have addressed the influence of maternal obesity on infant gut microbiota, which may occur either through vertically transmitted microbes or through the dietary habits of the family. Additionally, very little is known about the effect of diet during the complementary feeding period, which is potentially important for gut microbiota development. Here, the gut microbiotas of two different cohorts of infants, born either of a random sample of healthy mothers (n = 114), or of obese mothers (n = 113), were profiled by 16S rRNA amplicon sequencing. Gut microbiota data were compared to breastfeeding patterns and detailed individual dietary recordings to assess effects of the complementary diet. We found that maternal obesity did not influence microbial diversity or specific taxon abundances during the complementary feeding period. Across cohorts, breastfeeding duration and composition of the complementary diet were found to be the major determinants of gut microbiota development. In both cohorts, gut microbial composition and alpha diversity were thus strongly affected by introduction of family foods with high protein and fiber contents. Specifically, intake of meats, cheeses, and Danish rye bread, rich in protein and fiber, were associated with increased alpha diversity. Our results reveal that the transition from early infant feeding to family foods is a major determinant for gut microbiota development. IMPORTANCE The potential influence of maternal obesity on infant gut microbiota may occur either through vertically transmitted microbes or through the dietary habits of the family. Recent studies have suggested that the heritability of obesity may partly be caused by the transmission of "obesogenic" gut microbes. However, the findings presented here suggest that maternal obesity per se does not affect the overall composition of the gut microbiota and its development after introduction of complementary foods. Rather, progression in complementary feeding is found to be the major determinant for gut microbiota establishment. Expanding our understanding of the influence of complementary diet on the development and establishment of the gut microbiota will provide us with the knowledge to tailor a beneficial progression of our intestinal microbial community.

Infant Gut Microbiota Development Is Driven by Transition to Family Foods Independent of Maternal Obesity

PubMed Central

Laursen, Martin Frederik; Andersen, Louise B. B.; Michaelsen, Kim F.; Mølgaard, Christian; Trolle, Ellen; Bahl, Martin Iain

2016-01-01

ABSTRACT The first years of life are paramount in establishing our endogenous gut microbiota, which is strongly affected by diet and has repeatedly been linked with obesity. However, very few studies have addressed the influence of maternal obesity on infant gut microbiota, which may occur either through vertically transmitted microbes or through the dietary habits of the family. Additionally, very little is known about the effect of diet during the complementary feeding period, which is potentially important for gut microbiota development. Here, the gut microbiotas of two different cohorts of infants, born either of a random sample of healthy mothers (n = 114), or of obese mothers (n = 113), were profiled by 16S rRNA amplicon sequencing. Gut microbiota data were compared to breastfeeding patterns and detailed individual dietary recordings to assess effects of the complementary diet. We found that maternal obesity did not influence microbial diversity or specific taxon abundances during the complementary feeding period. Across cohorts, breastfeeding duration and composition of the complementary diet were found to be the major determinants of gut microbiota development. In both cohorts, gut microbial composition and alpha diversity were thus strongly affected by introduction of family foods with high protein and fiber contents. Specifically, intake of meats, cheeses, and Danish rye bread, rich in protein and fiber, were associated with increased alpha diversity. Our results reveal that the transition from early infant feeding to family foods is a major determinant for gut microbiota development. IMPORTANCE The potential influence of maternal obesity on infant gut microbiota may occur either through vertically transmitted microbes or through the dietary habits of the family. Recent studies have suggested that the heritability of obesity may partly be caused by the transmission of “obesogenic” gut microbes. However, the findings presented here suggest that maternal obesity per se does not affect the overall composition of the gut microbiota and its development after introduction of complementary foods. Rather, progression in complementary feeding is found to be the major determinant for gut microbiota establishment. Expanding our understanding of the influence of complementary diet on the development and establishment of the gut microbiota will provide us with the knowledge to tailor a beneficial progression of our intestinal microbial community. PMID:27303699

Complementary feeding patterns in a developing country: a cross-sectional study across Lebanon.

PubMed

Batal, M; Boulghourjian, C; Akik, C

2010-02-01

This first, large-scale study on complementary feeding in Lebanon analysed the timing and types of food introduced to infants according to mothers' demographic and socioeconomic and infants' characteristics. A cross-sectional survey over 10 months found that the majority of infants were introduced to solid foods at or after 4 months of age. A large number of infants were given liquids other than breast or formula milk earlier. Women in employment outside the home were almost twice as likely to introduce solid foods before age 4 months. The most common starting food was cereals. More than half the children consumed starchy foods and fruits every day, but not meats and fish.

Infant and young child feeding practices in Chepang communities.

PubMed

Subedi, N; Paudel, S; Rana, T; Poudyal, A K

2012-05-01

Infant and young child feeding (IYCF) practices differ in communities due to difference in knowledge, culture, health service utilization, and other socio-economic factors. The objective of this study was to explore the knowledge and practices of Chepang mothers on ICYF and their correlates. Cross sectional descriptive study was conducted in Chepang communities of Makawanpur district. Quantitative methodology was used in which 360 mothers of under children under two were randomly selected. Logistic regression analysis of selected child feeding indicators were done to find their association with socio-economic and health related factors. Feeding practices of mothers were found better than their knowledge level. About 35% had knowledge about early initiation of breastfeeding. Exclusive breastfeeding and introduction of complementary foods at the age of six months were 81% and 90% respectively. Literate mothers were found initiating breastfeeding early than the illiterate (OR=2.61, 95% CI, 1.59-4.27). Growth monitoring service utilization was found to have significant association with exclusive breastfeeding practices (OR= 2.75; 95% CI, 1.30-5.78). Feeding diverse complementary foods was associated with average monthly family income and duration of food sufficiency. Feeding practices in Chepang community were associated with health and socioeconomic determinants. Some of the feeding practices were found good however, meal frequency for the children 9-23 months of age and feeding diverse foods for children 6-23 months were found lower which needs to be improved through health education programs. Qualitative studies are needed to explore cultural factors.

Are Commercial Complementary Food Distributions to Refugees and Migrants in Europe Conforming to International Policies and Guidelines on Infant and Young Child Feeding in Emergencies?

PubMed

Theurich, Melissa Ann; Grote, Veit

2017-08-01

In 2015, more than one million migrants and refugees arrived in Europe. Commercial complementary foods, processed foods marketed for infants and young children 6-23 months of age, were distributed by various humanitarian actors along migrant routes and in European refugee camps. Unsolicited donations and distributions of commercial complementary food products were problematic and divergent from international policies on infant and young child feeding during humanitarian emergencies. Interim guidance regarding commercial complementary foods was published during the peak of the emergency but implemented differently by various humanitarian actors. Clearer and more technical specifications on commercial complementary foods are needed in order to objectively determine their suitability for operational contexts in Europe and emergency nutrition assistance in the future.

Developmental outcomes among 18-month-old Malawians after a year of complementary feeding with lipid-based nutrient supplements or corn-soy flour

USDA-ARS?s Scientific Manuscript database

The major aim of this trial was to compare the development of 18-month-old infants who received complementary feeding for 1 year with either lipid-based nutrient supplements or micronutrient-fortified corn-soy porridge. Our secondary aim was to determine the socio-economic factors associated with de...

High consumption of commercial food products among children less than 24 months of age and product promotion in Kathmandu Valley, Nepal

PubMed Central

Huffman, Sandra L.; Adhikary, Indu; Upreti, Senendra Raj; Dhungel, Shrid; Champeny, Mary; Zehner, Elizabeth

2016-01-01

Abstract Commercially produced complementary foods can help improve nutritional status of young children if they are appropriately fortified and of optimal nutrient composition. However, other commercially produced snack food products may be nutritionally detrimental, potentially increasing consumption of foods high in salt or sugar and displacing consumption of other more nutritious options. Helen Keller International, in collaboration with the Nepal government, implemented a study to assess mothers' utilization of commercial food products for child feeding and exposure to commercial promotions for these products. A cross‐sectional survey was conducted among 309 mothers of children less than 24 months of age across 15 health facilities. Utilization of breastmilk substitutes was low, having been consumed by 6.2% of children 0–5 months of age and 7.5% of children 6–23 months of age. Approximately one‐fourth (24.6%) of children 6–23 months age had consumed a commercially produced complementary food in the prior day. Twenty‐eight percent of mothers reported observing a promotion for breastmilk substitutes, and 20.1% reported promotions for commercially produced complementary foods. Consumption of commercially produced snack food products was high at 74.1% of children 6–23 months. Promotions for these same commercially produced snack food products were highly prevalent in Kathmandu Valley, reported by 85.4% of mothers. In order to improve diets during the complementary feeding period, development of national standards for complementary food products is recommended. Nutritious snack options should be promoted for the complementary feeding period; consumption of commercially produced snack food products high in sugar and salt and low in nutrients should be discouraged. PMID:27061954

High consumption of commercial food products among children less than 24 months of age and product promotion in Kathmandu Valley, Nepal.

PubMed

Pries, Alissa M; Huffman, Sandra L; Adhikary, Indu; Upreti, Senendra Raj; Dhungel, Shrid; Champeny, Mary; Zehner, Elizabeth

2016-04-01

Commercially produced complementary foods can help improve nutritional status of young children if they are appropriately fortified and of optimal nutrient composition. However, other commercially produced snack food products may be nutritionally detrimental, potentially increasing consumption of foods high in salt or sugar and displacing consumption of other more nutritious options. Helen Keller International, in collaboration with the Nepal government, implemented a study to assess mothers' utilization of commercial food products for child feeding and exposure to commercial promotions for these products. A cross-sectional survey was conducted among 309 mothers of children less than 24 months of age across 15 health facilities. Utilization of breastmilk substitutes was low, having been consumed by 6.2% of children 0-5 months of age and 7.5% of children 6-23 months of age. Approximately one-fourth (24.6%) of children 6-23 months age had consumed a commercially produced complementary food in the prior day. Twenty-eight percent of mothers reported observing a promotion for breastmilk substitutes, and 20.1% reported promotions for commercially produced complementary foods. Consumption of commercially produced snack food products was high at 74.1% of children 6-23 months. Promotions for these same commercially produced snack food products were highly prevalent in Kathmandu Valley, reported by 85.4% of mothers. In order to improve diets during the complementary feeding period, development of national standards for complementary food products is recommended. Nutritious snack options should be promoted for the complementary feeding period; consumption of commercially produced snack food products high in sugar and salt and low in nutrients should be discouraged. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Household food security and infant feeding practices in rural Bangladesh.

PubMed

Owais, Aatekah; Kleinbaum, David G; Suchdev, Parminder S; Faruque, Asg; Das, Sumon K; Schwartz, Benjamin; Stein, Aryeh D

2016-07-01

To determine the association between household food security and infant complementary feeding practices in rural Bangladesh. Prospective, cohort study using structured home interviews during pregnancy and 3 and 9 months after delivery. We used two indicators of household food security at 3-months' follow-up: maternal Food Composition Score (FCS), calculated via the World Food Programme method, and an HHFS index created from an eleven-item food security questionnaire. Infant feeding practices were characterized using WHO definitions. Two rural sub-districts of Kishoreganj, Bangladesh. Mother-child dyads (n 2073) who completed the 9-months' follow-up. Complementary feeding was initiated at age ≤4 months for 7 %, at 5-6 months for 49 % and at ≥7 months for 44 % of infants. Based on 24 h dietary recall, 98 % of infants were still breast-feeding at age 9 months, and 16 % received ≥4 food groups and ≥4 meals (minimally acceptable diet) in addition to breast milk. Mothers' diet was more diverse than infants'. The odds of receiving a minimally acceptable diet for infants living in most food-secure households were three times those for infants living in least food-secure households (adjusted OR=3·0; 95 % CI 2·1, 4·3). Socio-economic status, maternal age, literacy, parity and infant sex were not associated with infant diet. HHFS and maternal FCS were significant predictors of subsequent infant feeding practices. Nevertheless, even the more food-secure households had poor infant diet. Interventions aimed at improving infant nutritional status need to focus on both complementary food provision and education.

PUFA and LC-PUFA intake during the first year of life: can dietary practice achieve a guideline diet?

PubMed

Schwartz, J; Dube, K; Alexy, U; Kalhoff, H; Kersting, M

2010-02-01

An appropriate supply of n-3 long-chain polyunsaturated fatty acids (LC-PUFAs) during early childhood may enhance cognitive development. Little attention is paid to the fatty acid (FA) supply during the complementary feeding period. We examined the polyunsaturated fatty acids (PUFAs) and LC-PUFAs pattern in dietary practice of two study groups and evaluated the results against the present Dietary Guidelines in Germany. The food consumption and FA pattern of dietary practice in subjects from two prospective studies (n=102 and n=184, respectively) at the age of 3, 6 and 9 months was assessed by weighed diet records, and changes during the first year of life were compared with the food-based dietary guidelines for the first year of life. Dietary practice in the complementary feeding period was clearly dominated by commercial food products. The FA composition in dietary practice was different from the Guideline Diet and the ratio of n-6/n-3 PUFAs was less favorable. Consumption of breast milk or formula was still of major importance for the intake of LC-PUFAs in the complementary feeding period. LC-PUFAs are predominantly provided by breast milk and formula during the first year of life and consequently decrease when milk consumption decreases. For compensation, commercial complementary food might come closer to the Guideline Diet by lowering the n-6/n-3 PUFA ratio through appropriate vegetable oil along with an increase in total fat content up to the legal limit.

Nutrition education and introduction of broad bean-based complementary food improves knowledge and dietary practices of caregivers and nutritional status of their young children in Hula, Ethiopia.

PubMed

Negash, Canaan; Belachew, Tefera; Henry, Carol J; Kebebu, Afework; Abegaz, Kebede; Whiting, Susan J

2014-12-01

Nutritious complementary foods are needed in countries where undernutrition and stunting are major problems, but mothers may be reluctant to change from traditional gruels. To test whether a recipe-based complementary feeding education intervention would improve knowledge and practice of mothers with young children in Hula, Ethiopia. A baseline survey of 200 eligible, randomly selected mother-child pairs gathered data on sociodemographic characteristics, food security status, knowledge and practices concerning complementary feeding, food group intakes of children aged 6 to 23 months by 24-hour recalls, and children's anthropometric measurements. Twice a month for 6 months, women in the intervention group received an education session consisting of eight specific messages using Alive and Thrive posters and a demonstration and tasting of a local barley and maize porridge recipe containing 30% broad beans. The control group lived in a different area and had no intervention. At 6 months, knowledge and practice scores regarding complementary feeding were significantly improved (p < .001) in the intervention group but not in the control group. The intervention resulted in improvement of children's dietary diversity, as well as mean intake of energy and selected nutrients, compared with children in the control group. Changes in height and weight did not differ between the two groups. Community-based nutrition education over 6 months that included demonstration of a local porridge recipe with broad beans added improved the complementary feeding practices of caregivers and the nutritional status of their young children.

Maternal depression does not affect complementary feeding indicators or stunting status of young children (6-23 months) in Northern Ghana.

PubMed

Wemakor, Anthony; Iddrisu, Habib

2018-06-25

Maternal depression may affect child feeding practice which is an important determinant of child nutritional status. The objective of this study was to explore the association between maternal depression and WHO complementary feeding indicators [minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)] or stunting status of children (6-23 months) in Tamale Metropolis, Ghana. A community-based cross-sectional study was carried out involving 200 mother-child pairs randomly sampled from three communities in Tamale Metropolis, Ghana. The prevalence of MDD, MMF, and MAD were 56.5, 65.0, and 44.0% respectively and 41.0% of the children sampled were stunted. A third of the mothers (33.5%) screened positive for depression. Maternal depression did not influence significantly MDD (p = 0.245), MMF (p = 0.442), and MAD (p = 0.885) or children's risk of stunting (p = 0.872). In conclusion maternal depression and child stunting are prevalent in Northern Ghana but there is a lack of evidence of an association between maternal depression and child feeding practices or nutritional status in this study population. Further research is needed to assess the effect of maternal depression on feeding practices and growth of young children.

Growth and HIV-free survival of HIV-exposed infants in Malawi: A randomized trial of two complementary feeding interventions in the context of maternal antiretroviral therapy

USDA-ARS?s Scientific Manuscript database

The objective of this study was to compare the growth of HIV-exposed children receiving 1 of 2 complementary foods after prevention of mother-to-child HIV transmission through maternal lifelong antiretroviral therapy (ART). In rural Malawi, 280 HIV-infected pregnant women were consecutively identifi...

Food Consumption Patterns and Micronutrient Density of Complementary Foods Consumed by Infants Fed Commercially Prepared Baby Foods

PubMed Central

Reidy, Kathleen C.; Bailey, Regan Lucas; Deming, Denise M.; O’Neill, Lynda; Carr, B. Thomas; Lesniauskas, Ruta; Johnson, Wendy

2018-01-01

Nutrition is critically important in the first 1000 days, and while most American babies are fed commercial baby foods, there is little or no evidence from nationally representative data to understand the implications of such consumption. We used 24-hour dietary recall data for 505 infants from The Feeding Infants and Toddlers Study to describe food consumption patterns and micronutrient density of complementary foods consumed by infants fed commercially prepared baby food fruit, vegetables, and dinners and compared with those eaten by nonconsumers of these products. Results show that consumers were significantly more likely to report eating all vegetables (excluding white potatoes, 71% vs 51%), deep yellow vegetables (42% vs 18%), and fruits (79% vs 65%) and were less likely to report eating white potatoes (10% vs 24%), dark green vegetables (4% vs 20%), and sweets (23% vs 47%) than were nonconsumers. Nutrient density of the complementary foods of consumers was greater for fiber, potassium, vitamin A, vitamin C, vitamin E, and magnesium, but lower in sodium and vitamin D. We conclude that infants fed commercially prepared baby foods were more likely to eat vegetables and fruits, and their diets were higher in several micronutrients. These findings provide important insights on complementary feeding and are useful to support the development of evidence-based infant-feeding guidelines. PMID:29706668

Food Consumption Patterns and Micronutrient Density of Complementary Foods Consumed by Infants Fed Commercially Prepared Baby Foods.

PubMed

Reidy, Kathleen C; Bailey, Regan Lucas; Deming, Denise M; O'Neill, Lynda; Carr, B Thomas; Lesniauskas, Ruta; Johnson, Wendy

2018-03-01

Nutrition is critically important in the first 1000 days, and while most American babies are fed commercial baby foods, there is little or no evidence from nationally representative data to understand the implications of such consumption. We used 24-hour dietary recall data for 505 infants from The Feeding Infants and Toddlers Study to describe food consumption patterns and micronutrient density of complementary foods consumed by infants fed commercially prepared baby food fruit, vegetables, and dinners and compared with those eaten by nonconsumers of these products. Results show that consumers were significantly more likely to report eating all vegetables (excluding white potatoes, 71% vs 51%), deep yellow vegetables (42% vs 18%), and fruits (79% vs 65%) and were less likely to report eating white potatoes (10% vs 24%), dark green vegetables (4% vs 20%), and sweets (23% vs 47%) than were nonconsumers. Nutrient density of the complementary foods of consumers was greater for fiber, potassium, vitamin A, vitamin C, vitamin E, and magnesium, but lower in sodium and vitamin D. We conclude that infants fed commercially prepared baby foods were more likely to eat vegetables and fruits, and their diets were higher in several micronutrients. These findings provide important insights on complementary feeding and are useful to support the development of evidence-based infant-feeding guidelines.

Examination of facilitators and barriers to home-based supplemental feeding with ready-to-use food for underweight children in western Uganda

PubMed Central

Jilcott, Stephanie B.; Myhre, Jennifer A.; Adair, Linda S.; Thirumurthy, Harsha; Bentley, Margaret E.; Ammerman, Alice S.

2013-01-01

Poor complementary feeding practices and low quality complementary foods are significant causes of growth faltering and child mortality throughout the developing world. Ready-to-use foods (RUF) are energy dense, lipid-based products that do not require cooking or refrigeration, that have been used to prevent and treat malnutrition among vulnerable children. The effectiveness of these products in improving child nutritional status depends on household use by caregivers. To identify the key facilitators and barriers that influence appropriate in-home RUF consumption by supplemental feeding program beneficiaries, we conducted individual interviews among caregivers (n=80), RUF producers (n=8) and program staff (n=10) involved in the Byokulia Bisemeye mu Bantu (BBB) supplemental feeding program in Bundibugyo, Uganda. By documenting caregiver perceptions and feeding practices related to RUF, we developed a conceptual framework of factors that affect appropriate feeding with RUF. Findings suggest that locally produced RUF is well received by caregivers and children, and is perceived by caregivers and the community to be a healthy supplemental food for malnourished children. However, child feeding practices, including sharing of RUF within households, compromise the nutrient delivery to the intended child. Interventions and educational messages informed by this study can help to improve RUF delivery to targeted beneficiaries. PMID:22136223

Complete coverage and covering completely: Breast feeding and complementary feeding: Knowledge, attitude, and practices of mothers.

PubMed

Jain, Sunil; Thapar, R K; Gupta, R K

2018-01-01

Knowing current trends for timely comprehensive action for health promotion practices is an important prerequisite for medical practitioners and policy makers. A survey of mothers at a Tertiary Care Hospital in central India. On the knowledge front >83.75% of the mothers studied showed good knowledge about breastfeeding and complementary feeding. Similar, but not as encouraging, were the results about attitude, with 76.25% of mothers having a positive attitude. The results of the practices part were varied. The WHO indicators assessed were 'early initiation of breastfeeding' (68.75%), 'exclusive breastfeeding under 6 months' (85%) (however exclusive breast feeding for first 6 months was carried out by only 36.25%), 'introduction of solid, semi-solid or soft foods' (48.75%), 'continued breastfeeding at 1 year' (63.75%) and 'continued breastfeeding at 2 years' (6.25%). There is a discrepancy between knowledge and practices. The exclusive breast feeding rates are far from the ideal and there is a decline of continued breast feeding beyond 15 months. This calls for sustained efforts with the aim - 'cover all and cover completely'. The ideal WHO indicator for exclusive breast feeding should be 'exclusive breastfeeding for first 6 months' which will provide information about the completeness of this ideal practice.

Fatty acid supply with complementary foods and LC-PUFA status in healthy infants: results of a randomised controlled trial.

PubMed

Libuda, Lars; Mesch, Christina M; Stimming, Madlen; Demmelmair, Hans; Koletzko, Berthold; Warschburger, Petra; Blanke, Katharina; Reischl, Eva; Kalhoff, Hermann; Kersting, Mathilde

2016-06-01

Introduction of complementary food usually leads to decreasing intakes of long-chain n-3 polyunsaturated fatty acids (n-3 LC-PUFA), compared to full breastfeeding. In the randomised controlled PINGU intervention trial, we tested the effects of complementary foods with different contents of alpha-linolenic acid (ALA) and docosahexaenoic acid (DHA) on term infant LC-PUFA status. Healthy infants born at term were randomised to receive from the introduction of complementary feeding at the age of 4 to 6 months until age of 10 months ready-made complementary meals either with ALA-rich rapeseed oil (intervention group (IG)-R), with salmon twice weekly to provide preformed DHA (IG-F), or with linoleic acid-rich corn oil (control group, CG). Fatty acid composition was assessed in erythrocyte (RBC) and plasma glycerophospholipids. Complete data of fatty acids in RBC (plasma) were available from 158 (155) infants. After intervention, infants assigned to IG-F showed higher RBC and plasma percentages of eicosapentaenoic acid (EPA), DHA, and total n-3 LC-PUFA than CG (each p < 0.001). In IG-R, levels of ALA and the ratio of ALA to LA in plasma and RBC (all p < 0.0001) as well as RBC-EPA (p < 0.0001) were higher than in CG, while DHA levels did not differ between IG-R and CG. Regular fish consumption during complementary feeding enhances infant EPA and DHA status. The usage of rapeseed oil in small amounts concordant with EU-law for commercial meals enhances endogenic EPA-synthesis, but does not affect DHA status. Provision of oily fish with complementary feeds is advisable to prevent a decline of DHA status. www.clinicaltrials.gov , identifier: NCT01487889, title: Polyunsaturated fatty acids in child nutrition-a German multimodal optimisation study (PINGU).

The association of breastfeeding duration with later maternal feeding styles in infancy and toddlerhood: a cross-sectional analysis

PubMed Central

2013-01-01

Background Breastfeeding modestly reduces obesity risk, yet the mechanisms are not well understood. The goal of the current research was to evaluate the association of breastfeeding duration with a wide range of maternal feeding approaches in late infancy and toddlerhood. Methods A secondary analysis of cross-sectional data from an ethnically-diverse sample of 154 mothers of infants (aged 7–11 months) and toddlers (aged 12–24 months) was performed. Breastfeeding history was self-reported where 75% of mothers had weaned by the time of the interview. Multiple dimensions of maternal feeding approaches were measured using the Infant Feeding Styles Questionnaire which assesses pressuring, restriction, responsive, laissez-faire, and indulgent approaches to feeding. Analyses were performed separately for infants and toddlers and adjusted for maternal education level, ethnicity, and marital status. Results Mothers of infants who breastfed for longer durations tended to report greater responsiveness to infant satiety cues (p≤0.01) and reduced pressuring in feeding complementary foods (p<0.05). Mothers of toddlers who breastfed for longer durations tended to report reduced pressuring in feeding complementary foods (p<0.01). Conclusion These results suggest that breastfeeding may shape maternal feeding approaches related to responsiveness to infant cues as infants enter a period of complementary feeding, even after considering a range of demographic characteristics previously associated with breastfeeding behaviors. That responsiveness to feeding cues was not associated with breastfeeding duration in the toddler sample suggests that some aspects of this association might be isolated to infancy. PMID:23621981

Marketing complementary foods and supplements in Burkina Faso, Madagascar, and Vietnam: lessons learned from the Nutridev program.

PubMed

Bruyeron, Olivier; Denizeau, Mirrdyn; Berger, Jacques; Trèche, Serge

2010-06-01

Sustainable approaches to improving infant and young child feeding are needed. The Nutridev program worked in Vietnam, Madagascar, and Burkina Faso to test different strategies to improve complementary feeding using fortified products sold to families. To review the experiences of programs producing and marketing fortified complementary foods and to report on the feasibility of local production and marketing of fortified complementary foods to increase usage of high-quality foods among children of low-income families in a self-sustaining manner. Project documents, surveys of mothers, and production and sales reports were reviewed. Nutridev experience in Vietnam, Madagascar, and Burkina Faso demonstrates that it is possible to produce affordable, high-quality complementary foods and supplements locally in developing countries. Strategies to make products readily available to the targeted population and to convince this population to consume them yielded mixed results, varying greatly based on the strategy utilized and the context in which it was implemented. In several contexts, the optimal approach appears to be strengthening the existing food distribution network to sell complementary foods and supplements, with the implementation of a temporary promotion and nutrition education network in partnership with local authorities (e.g., health services) to increase awareness among families about the fortified complementary food product and optimal feeding practices. In urban areas, where the density of the population is high, design and implementation of specific networks very close to consumers seems to be a good way to combine economic sustainability and good consumption levels.

The evaluation of knowledge and activities of primary health care professionals in promoting breast-feeding.

PubMed

Leviniene, Giedra; Petrauskiene, Ausra; Tamuleviciene, Egle; Kudzyte, Jolanta; Labanauskas, Liutauras

2009-01-01

The objective of this study was to evaluate the knowledge and activities of Kaunas primary health care center professionals in promoting breast-feeding. A total of 84 general practitioners and 52 nurses participated in the survey, which was carried out in Kaunas primary health care centers in 2006. Data were gathered from the anonymous questionnaire. Less than half of general practitioners (45.1%) and 65% of nurses were convinced that baby must be exclusively breast-fed until the age of 6 months, but only 21.6% of general practitioners and 27.5% of nurses knew that breast-feeding with complementary feeding should be continued until the age of 2 years and longer. Still 15.7% of general practitioners and 25% of nurses recommended pacifiers; 7.8% of general practitioners advised to breast-feed according to hours. Half of the health professionals recommended additional drinks between meals; one-third of them--to give complementary food for the babies before the age of 6 months. One-third (29.6%) of the health professionals surveyed recommended mothers to feed their babies more frequently in case the amount of breast milk decreased. The survey showed that knowledge of medical personnel in primary health care centers about the advantages of breast-feeding, prophylaxis of hypogalactia, and duration of breast-feeding was still insufficient.

How Feasible Is Baby-Led Weaning as an Approach to Infant Feeding? A Review of the Evidence

PubMed Central

Cameron, Sonya L.; Heath, Anne-Louise M.; Taylor, Rachael W.

2012-01-01

Baby-Led Weaning (BLW) is an alternative method for introducing complementary foods to infants in which the infant feeds themselves hand-held foods instead of being spoon-fed by an adult. The BLW infant also shares family food and mealtimes and is offered milk (ideally breast milk) on demand until they self-wean. Anecdotal evidence suggests that many parents are choosing this method instead of conventional spoon-feeding of purées. Observational studies suggest that BLW may encourage improved eating patterns and lead to a healthier body weight, although it is not yet clear whether these associations are causal. This review evaluates the literature with respect to the prerequisites for BLW, which we have defined as beginning complementary foods at six months (for safety reasons), and exclusive breastfeeding to six months (to align with WHO infant feeding guidelines); the gross and oral motor skills required for successful and safe self-feeding of whole foods from six months; and the practicalities of family meals and continued breastfeeding on demand. Baby-Led Weaning will not suit all infants and families, but it is probably achievable for most. However, ultimately, the feasibility of BLW as an approach to infant feeding can only be determined in a randomized controlled trial. Given the popularity of BLW amongst parents, such a study is urgently needed. PMID:23201835

The timing of introduction of complementary foods and later health.

PubMed

Agostoni, Carlo; Przyrembel, Hildegard

2013-01-01

Complementary food is needed when human milk (or infant formula) alone is no longer sufficient for nutritional reasons. The timing of introduction needs to be determined on an individual basis although 6 months of exclusive breastfeeding can be recommended for most healthy term infants. Solid foods are intended to 'complement' ongoing breastfeeding with those dietary items whose intake has become marginal or insufficient. Both breastfeeding and complementary feeding can have direct or later consequences on health. Possible short-term health effects concern growth velocity and infections while possible long-term effects may relate to obesity, cardiovascular disease, autoimmunity (celiac disease and type 1 diabetes) and atopic disorders. For most of these it is impossible on the basis of the available evidence to conclude on the age when risks related to the start of complementary feeding are lowest or highest, with the possible exception of infections and early growth velocity. For undesirable health consequences, whilst potential mechanisms are recognized, the evidence from mostly observational studies is insufficient and requires more and prospective research. While the 6-month goal is desirable, introduction of suitable complementary food after 4 completed months with ongoing breastfeeding can be considered without adverse health consequences for infants living in affluent countries. Even less evidence on the consequences of the timing of complementary food introduction is available for formula-fed infants. Copyright © 2013 S. Karger AG, Basel.

Tools to improve planning, implementation, monitoring, and evaluation of complementary feeding programmes.

PubMed

Untoro, Juliawati; Childs, Rachel; Bose, Indira; Winichagoon, Pattanee; Rudert, Christiane; Hall, Andrew; de Pee, Saskia

2017-10-01

Adequate nutrient intake is a prerequisite for achieving good nutrition status. Suboptimal complementary feeding practices are a main risk factor for stunting. The need for systematic and user-friendly tools to guide the planning, implementation, monitoring, and evaluation of dietary interventions for children aged 6-23 months has been recognized. This paper describes five tools, namely, ProPAN, Optifood, Cost of the Diet, Fill the Nutrient Gap, and Monitoring Results for Equity System that can be used in different combinations to improve situation analysis, planning, implementation, monitoring, or evaluation approaches for complementary feeding in a particular context. ProPAN helps with development of strategies and activities designed to change the behaviours of the target population. Optifood provides guidance for developing food-based recommendations. The Cost of the Diet can provide insight on economic barriers to accessing a nutritious and balanced diet. The Fill the Nutrient Gap facilitates formulation of context-specific policies and programmatic approaches to improve nutrient intake, through a multistakeholder process that uses insights from linear programming and secondary data. The Monitoring Results for Equity System helps with analysis of gaps, constraints, and determinants of complementary feeding interventions and adoption of recommended practices especially in the most vulnerable and deprived populations. These tools, and support for their use, are readily available and can be used either alone and/or complementarily throughout the programme cycle to improve infant and young child-feeding programmes at subnational and national levels. © 2017 John Wiley & Sons Ltd.

[Complementary feeding].

PubMed

Pérez Lizaur, Ana Bertha

2011-01-01

According to PAHO and WHO, supplementary feeding is the process that begins when human milk is insufficient to meet the nutritional needs of an infant and requires other foods and liquids. The decision to begin complementary feeding depends on socio-economic, physiological, nutritional and psychological factors. The maturation of the neuromuscular, gastrointestinal and renal system influences the chances of success of supplementary feeding. Reflexes and skills in a child with normal development can be expected and the consistency of foods can provide a way to, on one hand allow the ingestion of food and the other to allow the children to exercise their reflexes to enhance neuromuscular maturation. WHO recommends exclusive breastfeeding promotion to six months, as there are several benefits to mother and child; in Mexico, the NOM-043-SSA2-2005 promotes complementary feeding from 6 months. It should be noted that the order of introduction is not definitive and that the literature shows different patterns of input according to the needs of children and their socio-economic and cultural environment. Parents and caregivers select and buy food, model, and establish rules of behavior at home related to food. Evidence suggest that environmental factors acting at an early stage of development of small modeling preferences and eating behaviors.

Risk factors for severe acute malnutrition in children below 5 y of age in India: a case-control study.

PubMed

Mishra, Kirtisudha; Kumar, Praveen; Basu, Srikanta; Rai, Kiran; Aneja, Satinder

2014-08-01

To determine the possible risk factors for severe acute malnutrition (SAM) in children below 5 y admitted in a hospital in north India. This case-control study was conducted in a medical college hospital in children below 5 y of age. All cases of SAM (diagnosed as per WHO definition) between 6 and 59 mo of age were compared with age-matched controls with weight for height above -2SD of WHO 2006 growth standards. Data regarding socio-demographic parameters, feeding practices and immunization were compared between the groups by univariable and multivariable logistic regression models. A total of 76 cases and 115 controls were enrolled. Among the 14 factors compared, maternal illiteracy, daily family income less than Rs. 200, large family size, lack of exclusive breast feeding in first 6 mo, bottle feeding, administration of pre-lacteals, deprivation of colostrum and incomplete immunization were significant risk factors for SAM. Regarding complementary feeding, it was the consistency, rather than the age of initiation, frequency and variety which showed a significant influence on occurrence of SAM. Multivariate analysis revealed that the risk of SAM was independently associated with 6 factors, namely, illiteracy among mothers, incomplete immunization, practice of bottle feeding, consistency of complementary feeding, deprivation of colostrum and receipt of pre-lacteals at birth. The present study identifies certain risk factors which need to be focused on during health planning and policy making related to children with SAM in India.

Infant and Young Child Feeding in Developing Countries

ERIC Educational Resources Information Center

Arabi, Mandana; Frongillo, Edward A.; Avula, Rasmi; Mangasaryan, Nune

2012-01-01

Feeding practices are important determinants of growth and development of children. Using infant and young child feeding indicators and complementary feeding guidelines, 7 practices in 28 countries are described, showing substantial variation across countries. Only 25% of 0- to 5-month-olds were exclusively breastfed, and only half of 6- to…

The role of care in nutrition programmes: current research and a research agenda.

PubMed

Engle, P L; Bentley, M; Pelto, G

2000-02-01

The importance of cultural and behavioural factors in children's nutrition, particularly with regard to feeding, has been recognized only recently. The combination of evidence regarding the importance of caregiving behaviour for good nutrition, and improved strategies for measuring behaviour have led to a renewed interest in care. The UNICEF conceptual framework suggests that care, in addition to food security and health care services, are critical for children's survival, growth and development. The present paper focuses on the care practice of complementary feeding, specifically behavioural factors such as parental interaction patterns, feeding style and adaptation of feeding to the child's motor abilities (self-feeding or feeding by others). Three kinds of feeding styles (Birch & Fisher, 1995) are identified: controlling; laissez-faire; responsive. Probable effects of each feeding style on nutrient intake are described. A number of studies of feeding behaviour have suggested that the laissez-faire style is most frequently observed among families and communities with a higher prevalence of malnourished children. Nutrition interventions that have been able to show significant effects on outcomes, such as the Hearth Model in Vietnam (Sternin et al. 1997), have usually incorporated behavioural components in their intervention. At this time, there have been no tests of the efficacy of behavioural interventions to improve feeding practices. Research is needed to understand behavioural factors in complementary feeding, and to identify and test intervention strategies designed to improve nutrient intake of young children. Finally, the paper concludes with a discussion of how nutrition programmes might change if care were incorporated.

Perceptions of Primary Care-Based Breastfeeding Promotion Interventions: Qualitative Analysis of Randomized Controlled Trial Participant Interviews

PubMed Central

Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-01-01

Abstract Objective This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. Subjects and Methods A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Results Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Conclusions Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates. PMID:22621223

Perceptions of primary care-based breastfeeding promotion interventions: qualitative analysis of randomized controlled trial participant interviews.

PubMed

Andaya, Elise; Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-12-01

This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates.

Complementary feeding: clinically relevant factors affecting timing and composition.

PubMed

Krebs, Nancy F; Hambidge, K Michael

2007-02-01

Exclusive breastfeeding for the first 6 mo of life followed by optimal complementary feeding are critical public health measures for reducing and preventing morbidity and mortality in young children. Clinical factors, such as birth weight, prematurity, and illness, that affect the iron and zinc requirements of younger infants are discussed. Maternal diet and nutritional status do not have a strong effect on the mineral content of human milk, but physiologic changes in milk and the infants' status determine the dependence of the infant on complementary foods in addition to human milk to meet iron and zinc requirements after 6 mo. The nature of zinc absorption, which is suitably characterized by saturation response modeling, dictates that plant-based diets, which are low in zinc, are associated with low absolute daily absorbed zinc, which is inadequate to meet requirements. Foods with a higher zinc content, such as meats, are much more likely to be sufficient to meet dietary requirements. Current plant-based complementary feeding patterns for older fully breastfed infants in both developed and developing countries pose a risk of zinc deficiency. The strong rationale for the potential benefits of providing meat as an early complementary food, and the examples of successful intervention programs, provide potent incentives to pursue broader implementation programs, with concurrent rigorous evaluation of both efficacy and effectiveness.

Regional differences in milk and complementary feeding patterns in infants participating in an international nutritional type 1 diabetes prevention trial.

PubMed

Nucci, Anita M; Virtanen, Suvi M; Sorkio, Susa; Bärlund, Sonja; Cuthbertson, David; Uusitalo, Ulla; Lawson, Margaret L; Salonen, Marja; Berseth, Carol L; Ormisson, Anne; Lehtonen, Eveliina; Savilahti, Erkki; Becker, Dorothy J; Dupré, John; Krischer, Jeffrey P; Knip, Mikael; Åkerblom, Hans K

2017-07-01

Differences in breastfeeding, other milk feeding and complementary feeding patterns were evaluated in infants at increased genetic risk with and without maternal type 1 diabetes (T1D). The Trial to Reduce IDDM in the Genetically at Risk is an international nutritional primary prevention double-blinded randomized trial to test whether weaning to extensively hydrolyzed vs. intact cow's milk protein formula will decrease the development of T1D-associated autoantibodies and T1D. Infant diet was prospectively assessed at two visits and seven telephone interviews between birth and 8 months. Countries were grouped into seven regions: Australia, Canada, Northern Europe, Southern Europe, Central Europe I, Central Europe II and the United States. Newborn infants with a first-degree relative with T1D and increased human leukocyte antigen-conferred susceptibility to T1D were recruited. A lower proportion of infants born to mothers with than without T1D were breastfed until 6 months of age in all regions (range, 51% to 60% vs. 70% to 80%). Complementary feeding patterns differed more by region than by maternal T1D. In Northern Europe, a higher proportion of infants consumed vegetables and fruits daily compared with other regions. Consumption of meat was more frequent in all European regions, whereas cereal consumption was most frequent in Southern Europe, Canada and the United States. Maternal T1D status was associated with breastfeeding and other milk feeding patterns similarly across regions but was unrelated to the introduction of complementary foods. Infant feeding patterns differed significantly among regions and were largely inconsistent with current recommended guidelines. © 2016 John Wiley & Sons Ltd.

Strengthening health services to deliver nutrition education to promote complementary feeding and healthy growth of infants and young children: formative research for a successful intervention in peri-urban Trujillo, Peru.

PubMed

Robert, Rebecca C; Creed-Kanashiro, Hilary M; Villasante, Ruben; Narro, M Rocio; Penny, Mary E

2017-04-01

Formative research is critical for developing effective nutrition-specific interventions to improve infant and young child (IYC) feeding practices and promote healthy growth. Health workers interact with caregivers during health facility visits, yet there is limited research about how to optimize delivery of such interventions during these visits. The extensive reach of IYC health services globally calls for research to address this gap. In Trujillo, Peru, formative research was conducted to explore complementary feeding practices with caregivers as well as health worker routines and interactions with caregivers related to feeding and healthy growth; results informed the development and delivery of an educational intervention. Multiple qualitative methods were used to collect data on a purposive sample of health workers and caregivers from three health facilities and communities: household trials followed. Complementary feeding messages with doable behaviours were developed, and three were selected as key to promote based on their nutritional impact and cultural acceptability. In the health facilities, medical consultation, well-child visits and nutrition consultation all dealt with aspects of IYC nutrition/growth during their interactions with caregivers but were independent and inconsistent in approach. A nutrition education strategy was developed based on consistency, quality and coverage in the IYC health services. We conclude that formative research undertaken in the community and IYC health services was critical to developing a successful and culturally relevant intervention to promote optimal complementary feeding practices and healthy growth during interactions between health workers and caregivers at routine health facility visits. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

Adherence to feeding guidelines among HIV-infected and HIV uninfected mothers in a rural district in Uganda.

PubMed

Babirye, J N; Nuwaha, F; Grulich, A E

2009-07-01

To describe the infant feeding behaviour of HIV-infected and HIV-uninfected mothers, and identify factors influencing adherence to infant feeding guidelines. Analytical cross-sectional study. Bushenyi, rural district in South-western Uganda One hundred and ninety four mothers who had a child less than 12 months of age. About half, 94 (48.5%), of these were HIV-infected. Proportion of mothers who exclusively breastfed, complementary fed, replacement fed, and adhered to feeding guidelines. Most (84.5%, 164/194) of the mothers had ever breastfed their infants, the rest had exclusively replacement fed since birth. Among children less than six months who were breastfeeding, 31.5% (34/108) were exclusively breastfeeding and the rest were mixed feeding. HIV-infected mothers were more likely than HIV-uninfected mothers to exclusively breastfeed (Crude Odds Ratio [COR], 3.61, 95% Confidence Interval [CI] 1.42-9.21). For infants older than six months, complementary feeding was more common among HIV-uninfected (100%) than HIV-infected mothers (41.7%; P < 0.001). Among infants of all ages, none of the HIV-uninfected and 45% of HIV-infected mothers were replacement feeding (p < 0.001). More than a half (59.8%) of the mothers adhered to infant feeding guidelines. The only independent predictor of adherence after multivariate analysis was mother ever attending infant feeding counselling (AOR 9.03; 95% CI 4.03-20.25). Only 35% of mothers reported ever attending infant feeding counselling. Infant feeding counselling was associated with improved adherence to feeding guidelines. Since infant feeding counselling is low in this population there is need for scale-up of this essential service.

A focused ethnographic assessment of Middle Eastern mothers' infant feeding practices in Canada.

PubMed

Jessri, Mahsa; Farmer, Anna P; Olson, Karin

2015-10-01

The aim of this study was to examine the barriers to following complementary feeding guidelines among Middle Eastern mothers and the cultural considerations of practitioners from an emic perspective. This is a two-phase focused ethnographic assessment of infant feeding among 22 Middle Eastern mothers in Western Canada who had healthy infants aged <1 year. Data were collected through four focus groups conducted in Arabic/Farsi, and were further complemented by comprehensive survey data collected in the second phase of study. Mothers' main criterion for choosing infant foods was whether or not foods were Halal, while food allergens were not causes for concern. Vitamin D supplements were not fed to 18/22 of infants, and mashed dates (Halawi), rice pudding (Muhallabia/Ferni) and sugared water/tea were the first complementary foods commonly consumed. Through constant comparison of qualitative data, three layers of influence emerged, which described mothers' process of infant feeding: socio-cultural, health care system and personal factors. Culture was an umbrella theme influencing all aspects of infant feeding decisions. Mothers cited health care professionals' lack of cultural considerations and lack of relevance and practicality of infant feeding guidelines as the main reasons for ignoring infant feeding recommendations. Early introduction of pre-lacteal feeds and inappropriate types of foods fed to infants among immigrant/refugee Middle Eastern mothers in Canada is cause of concern. Involving trained language interpreters in health teams and educating health care staff on cultural competency may potentially increase maternal trust in the health care system and eventually lead to increased awareness of and adherence to best practices with infant feeding recommendations. © 2013 John Wiley & Sons Ltd.

Infant Feeding Practices in Central Anatolia, Turkey

ERIC Educational Resources Information Center

Sanlier, Nevin; Unusan, Nurhan

2009-01-01

Infant feeding decisions are some of the most important choices parents make. Breast milk or formula is the first decision made in infant feeding. Complementary feeding is common among very young children in Turkey. Therefore, the aim of this research is to focus on the introduction of solid foods, and to determine the relationship between…

[Bases for adequate complementary feeding in infants and young children].

PubMed

Gil Hernández, A; Uauy Dagach, R; Dalmau Serra, J

2006-11-01

Infants can be exclusively breast fed or formula fed for the first 6 months of life and their nutritional requirements are completely fulfilled. However, from 6 months onwards, human milk is not sufficient to supply all the nutrients necessary for infants and young children. Therefore, adequate supplementary feeding, in terms of both quantity and quality, should be provided. The present article aims to describe the scientific bases for practical recommendations on complementary feeding during infancy and early childhood, which may be useful to pediatricians and should serve to improve the health status of the infant population in Spain. In this sense, the new international recommendations for energy, protein and other nutrient requirements are reviewed. In Spain, the law applicable to manufacturing infant cereals and homogenized infant foods is that published by the European Union in specific directives. However, taking into consideration new advances in knowledge of nutritional requirements, we have considered a number of issues that could be relevant for the manufacture of these foods. Finally, we propose a series of basic principles that should serve as a guide for the complementary feeding of infants (whether breast fed, formula fed, or receiving mixed feeding) and young children. These recommendations are particularly addressed to pediatricians working in primary health services.

Feeding patterns and stunting during early childhood in rural communities of Sidama, South Ethiopia

PubMed Central

Tessema, Masresha; Belachew, Tefera; Ersino, Getahun

2013-01-01

Introduction The period from birth to two years of age is a “critical window” of opportunity for the promotion of optimal growth, health and behavioral development of children. Poor child feeding patterns combined with household food insecurity can lead to malnutrition which is a major public health problem in developing countries like Ethiopia. Methods A community based cross-sectional study that involved 575 participants from rural Sidama was conducted from February to March 2011. A two-stage stratified sampling procedure was employed to select the required households. Multivariable logistic regression analyses were performed to compare stunting by feeding patterns and other characteristics. Results Only 14.4% of mothers fed their children optimally. Prevalence of stunting was higher for infants aged 6 to 8 months (43%) than for those in 0-5 months (26.6%) or 9-23 months (39%) category. Women who did not receive antenatal care(ANC) during pregnancy were 1.5 times more likely to practice pre-lacteal feeding and 2.8 and 1.9 times more likely to feed their children below minimum dietary diversity and minimum meal frequency, respectively (P=0.01). Mothers older than 18 years during the birth of index child were 86% less likely to feed their child below minimum meal frequency than their younger counterparts (P=0.01). Children who started complementary food either before or after the recommended 6 months time, were more likely to be stunted (P=0.01). Conclusion The feeding practices of most mothers did not meet WHO recommendations. Behavior change communication about the importance of optimal complementary feeding and ANC attendance should be strengthened through extensive use of the Health Extension Workers to reduce the level of child stunting in the study area. PMID:23646211

Effectiveness of different interventions in public nurseries based on food and nutrition education: promoting breast-feeding and healthy complementary feeding.

PubMed

Cândido, Naiara Abrantes; de Sousa, Taciana Maia; Dos Santos, Luana Caroline

2018-05-10

Food practices in the early years of life are important to form healthy eating habits; therefore, it is essential for the caregivers of infants to receive appropriate guidance. The present study aimed to investigate the effectiveness of different nutritional interventions on complementary feeding practices in municipal nurseries. Non-randomized controlled intervention study with education professionals and parents of infants (<2 years). Participants were divided into: control group (CG), standard food and nutrition education in writing; and intervention group (IG), the same information as the CG and face-to-face meetings (professionals, 8 h; parents, 5 h). Changes in professionals' knowledge on the subject and alterations in parents' beliefs, attitudes and intentions were assessed using questionnaires before and after the educational activities. Ten public nurseries in Nova Lima, Belo Horizonte, Minas Gerais, Brazil, 2015. Ninety professionals (fifty in CG; forty in IG) and 169 parents (ninety-seven in CG; seventy-two in IG). After the intervention, there was a significant increase in the mean number of correct responses given by professionals in the IG (12·2 v. 10·7; P=0·001). In addition, there were improvements among the parents of the IG in relation to beliefs (soups and broths do not nourish my child: P=0·012), attitudes (offer meat from the sixth month: P=0·032) and intentions (do not offer soups and broths: P=0·003; offer vegetables: P=0·018; offer meat: P<0·001). Face-to-face nutritional intervention had a significantly greater effect on the parameters evaluated, indicating the importance of adequate guidance in childcare services to support the introduction of complementary feeding.

The interactive association of dietary diversity scores and breast-feeding status with weight and length in Filipino infants aged 6-24 months.

PubMed

Wright, Melecia J; Bentley, Margaret E; Mendez, Michelle A; Adair, Linda S

2015-07-01

To assess how breast-feeding and dietary diversity relate to infant length-for-age Z-score (LAZ) and weight-for-age Z-score (WAZ). Breast-feeding, dietary and anthropometric data from the Cebu Longitudinal Health and Nutrition Survey were analysed using sex-stratified fixed-effects longitudinal regression models. A dietary diversity score (DDS) based on seven food groups was classified as low (<4) or high (≥ 4). The complementary feeding patterns were: (i) non-breast-fed with low DDS (referent); (ii) breast-fed with low DDS; (iii) non-breast-fed with high DDS; and (iv) breast-fed with high DDS (optimal). Interactions between age, energy intake and complementary feeding patterns were included. Philippines. Infants (n 2822) measured bimonthly from 6 to 24 months. Breast-feeding (regardless of DDS) was significantly associated with higher LAZ (until 24 months) and WAZ (until 20 months). For example, at 6 months, breast-fed boys with low DDS were 0.246 (95% CI 0.191, 0.302) sd longer and 0.523 (95% CI 0.451, 0.594) sd heavier than the referent group. There was no significant difference in size between breast-fed infants with high v. low DDS. Similarly, high DDS conferred no advantage in LAZ or WAZ among non-breast-fed infants. There were modest correlations between the 7-point DDS and nutrient intakes but these correlations were substantially attenuated after energy adjustment. We elucidated several interactions between sex, age, energy intake and complementary feeding patterns. These results demonstrate the importance of prolonged breast-feeding up to 24 months. The DDS provided qualitative information on infant diets but did not confer a significant advantage in LAZ or WAZ.

Breast-feeding duration: influence on taste acceptance over the first year of life.

PubMed

Schwartz, Camille; Chabanet, Claire; Laval, Caroline; Issanchou, Sylvie; Nicklaus, Sophie

2013-03-28

Early feeding experiences, e.g. related to milk feeding, can affect later food and taste preferences. However, consequences of breast-feeding on taste acceptance are under-investigated. The objective of the present study was to examine the impact of exclusive breast-feeding duration (DEB) on taste acceptance at 6 and 12 months in the same infants (n 122). Mothers recorded the DEB. Acceptance of solutions of each of the five basic tastes relative to water was evaluated in the laboratory at 6 and 12 months by the ingestion ratio (IR). Kendall correlations were calculated between the DEB and the IR. Only 16 % completed at least 6 months of exclusive breast-feeding; 79 % had begun complementary feeding by 6 months. At 6 months, infants preferred sweet, salty and umami solutions over water and were indifferent to sour and bitter solutions. The longer an infant was breast-fed, the more s/he accepted the umami solution at 6 months. At 12 months, infants preferred sweet and salty solutions over water and were indifferent to sour, bitter and umami solutions. The relationship between the DEB and acceptance of the umami solution was not observed at 12 months. No relationship was observed between the DEB and sweet, salty, sour and bitter taste acceptance at 6 or 12 months. The association between the DEB and umami taste acceptance at 6 months may relate to the higher glutamate content of human milk compared with formula milk. Beyond the acknowledged metabolic benefits of breast-feeding, this suggests that prolonged breast-feeding could also be associated with an impact on sensory preference at the beginning of complementary feeding.

The influence of early feeding practices on healthy diet variety score among pre-school children in four European birth cohorts.

PubMed

Jones, Louise; Moschonis, George; Oliveira, Andreia; de Lauzon-Guillain, Blandine; Manios, Yannis; Xepapadaki, Paraskevi; Lopes, Carla; Moreira, Pedro; Charles, Marie Aline; Emmett, Pauline

2015-07-01

The present study examined whether maternal diet and early infant feeding experiences relating to being breast-fed and complementary feeding influence the range of healthy foods consumed in later childhood. Data from four European birth cohorts were studied. Healthy Plate Variety Score (HPVS) was calculated using FFQ. HPVS assesses the variety of healthy foods consumed within and across the five main food groups. The weighted numbers of servings consumed of each food group were summed; the maximum score was 5. Associations between infant feeding experiences, maternal diet and the HPVS were tested using generalized linear models and adjusted for appropriate confounders. The British Avon Longitudinal Study of Parents and Children (ALSPAC), the French Etude des Déterminants pre et postnatals de la santé et du développement de L'Enfant study (EDEN), the Portuguese Generation XXI Birth Cohort and the Greek EuroPrevall cohort. Pre-school children and their mothers. The mean HPVS for each of the cohorts ranged from 2.3 to 3.8, indicating that the majority of children were not eating a full variety of healthy foods. Never being breast-fed or being breast-fed for a short duration was associated with lower HPVS at 2, 3 and 4 years of age in all cohorts. There was no consistent association between the timing of complementary feeding and HPVS. Mother's HPVS was strongly positively associated with child's HPVS but did not greatly attenuate the relationship with breast-feeding duration. Results suggest that being breast-fed for a short duration is associated with pre-school children eating a lower variety of healthy foods.

Comparison of Feeding Practices in Infants in the WIC Supplemental Nutrition Program Who Were Enrolled in Child Care as Opposed to Those with Parent Care Only.

PubMed

Kim, Juhee; Mathai, Rose Ann

2015-09-01

The environment or setting to which an infant is exposed is crucial to establishing healthy eating habits and to preventing obesity. This study aimed to compare infant feeding practices and complementary food type between parent care (PC) and childcare (CC) settings among infants receiving the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This study sampled 105 dyads of mothers and infants between 2 to 8 months of age from a WIC office in Central Illinois. Mothers completed a cross-sectional survey to assess their infant feeding practices and demographic characteristics. CC was defined as infants receiving 10 hours or more per week of care from a nonparental caregiver. Almost half of the infants (44%) were enrolled in CC. Infants in CC had an average of 29 hours of care per week compared with 0.64 hours in the PC group (p<0.01). There were no differences between the two groups in age, sex, race/ethnicity, preterm birth, and birth weight. Overall, there were no significant differences in breastfeeding initiation and duration. The average age at formula introduction was earlier for PC infants (0.90 ± 1.16 months) than for CC infants (1.66 ± 1.64 months) (p = 0.03). PC infants stopped breastfeeding at 1.96 ± 1.15 months compared with 2.31 ± 1.64 months for CC infants (p = 0.080). Among complementary foods introduced to infants, the primary food type was infant cereal, followed by baby food of fruits and vegetables, 100% fruit juice, and meat-based baby food. The timing of introduction and the types of complementary foods were similar between study groups. CC use is not a significant influence on breastfeeding rates, introduction of complementary foods, and types of complementary foods; however, it does influence when formula is introduced. The findings support the need for infant nutrition education and breastfeeding promotion targeting WIC mothers, regardless of their pattern of CC.

Transition in Infant and Young Child Feeding Practices in India.

PubMed

Puri, Seema

2017-01-01

Optimal infant and young child feeding, which includes initiation of breastfeeding within one hour of birth, exclusive breastfeeding for first six months, age appropriate complementary feeding after six months along with continued breastfeeding for 2 years and beyond, is a public health intervention to prevent child morbidity, mortality and malnutrition [1]. In India, even though institutional delivery rates are increasing, only 44% women are able to breastfeed their babies within one hour of delivery. While 65% children are exclusively breast fed for the first six months, the median duration of breastfeeding is 24.4 months and complementary feeding rates are 50%. To achieve optimal IYCF practices, each woman should have access to a community based IYCF counseling support system. Efforts are therefore needed to upgrade skill based training of health workers and revive and update the Baby Friendly Hospital Initiative (BFHI). To promote and sustain breastfeeding amongst working women, it is essential to ensure adequate maternity leave, crèches at work place, flexible working hours, and provision of physical space for breast feeding at work place. It is imperative to also create public awareness about the dangers of bottle and formula feeding and to provide accurate information on the appropriate complementary food to be given to infants. In conclusion, India needs to make serious efforts to overcome malnutrition with not only prioritized IYCF policies but also their effective implementation in place. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Breastfeeding in Mexico was stable, on average, but deteriorated among the poor, whereas complementary feeding improved: results from the 1999 to 2006 National Health and Nutrition Surveys.

PubMed

González de Cossío, Teresita; Escobar-Zaragoza, Leticia; González-Castell, Dinorah; Reyes-Vázquez, Horacio; Rivera-Dommarco, Juan A

2013-05-01

We present: 1) indicators of infant and young child feeding practices (IYCFP) and median age of introduction of foods analyzed by geographic and socioeconomic variables for the 2006 national probabilistic Health Nutrition Survey (ENSANUT-2006); and 2) changes in IYCFP indicators between the 1999 national probabilistic Nutrition Survey and ENSANUT-2006, analyzed by the same variables. Participants were women 12-49 y and their <2-y-old children (2953 in 2006 and 3191 in 1999). Indicators were estimated with the status quo method. The median age of introduction of foods was calculated by the Kaplan-Meier method using recall data. The national median duration of breastfeeding was similar in both surveys, 9.7 mo in 1999 and 10.4 mo in 2006, but decreased in the vulnerable population. In 1999 indigenous women breastfed 20.8 mo but did so for only 13.0 mo in 2006. The national percentage of those exclusively breastfeeding <6 mo also remained stable: 20% in 1999 and 22.3% in 2006. Nevertheless, exclusively breastfeeding <6 mo changed within the indigenous population, from 46% in 1999 to 34.5% in 2006. Between surveys, most breastfeeding indicators had lower values in vulnerable populations than in those better-off. Complementary feeding, however, improved overall. Complementary feeding was inadequately timed: median age of introduction of plain water was 3 mo, formula and non-human milk was 5 mo, and cereals, legumes, and animal foods was 5 mo. Late introduction of animal foods occurred among vulnerable indigenous population when 50% consumed these products at 8 mo. Mexican IYCFP indicate that public policy must protect breastfeeding while promoting the timely introduction of complementary feeding.

Behavioral Change Strategies for Improving Complementary Feeding and Breastfeeding.

PubMed

Osendarp, Saskia J M; Roche, Marion L

2016-01-01

Improving infant and young child feeding (IYCF) practices, including breastfeeding and complementary feeding, has been identified as one of the most effective interventions to improve child survival, stunting and wasting. Evidence from randomized controlled trials suggests that effective promotion of breastfeeding and complementary feeding, with or without food provision, has the potential to improve IYCF practices and child nutrition. However, in many countries, breastfeeding practices and complementary feeding practices are still far from optimal. The lack of implementation of available, effective, affordable interventions in scale-up programs is in part attributed to a lack of innovative, creative and effective behavioral change strategies that enable and encourage caregivers. Successful behavioral change strategies should be based on a rigorous situational analysis and formative research, and the findings and insights of formative research should be used to further design interventions that address the identified barriers and enablers, to select delivery channels, and to formulate appropriate and effective messages. In addition, successful behavioral change interventions should a priori define and investigate the program impact pathway to target behavioral change and should assess intermediary behavioral changes and indicators to learn why the expected outcome was achieved or not achieved by testing the program theory. The design of behavioral change communication must be flexible and responsive to shifts in societies and contexts. Performance of adequate IYCF also requires investments to generate community demand through social mobilization, relevant media and existing support systems. Applying these principles has been shown to be effective in improving IYCF practices in Vietnam, Bangladesh and Ethiopia and is recommended to be adopted by other programs and countries in order to accelerate progress in improving child nutrition. © 2016 S. Karger AG, Basel.

Infants Perceived as “Fussy” Are More Likely to Receive Complementary Foods Before 4 Months

PubMed Central

Bentley, Margaret; Borja, Judith; Davis Goldman, Barbara; Thompson, Amanda; Slining, Meghan; Adair, Linda

2011-01-01

OBJECTIVE: Our purpose was to assess early infant-feeding patterns in a cohort of low-income black mothers and to examine associations between maternal perception of infant temperament and complementary feeding (CF) before 4 months. METHODS: We used cross-sectional data from the 3-month visit (n = 217) of the Infant Care, Feeding and Risk of Obesity Study to assess relationships between early feeding of solids or juice and 6 dimensions of perceived infant temperament. Descriptive statistics were used to assess infant-feeding patterns, and logistic regression models were fit for each diet-temperament relationship found significant in the bivariate analyses. RESULTS: Seventy-seven percent of the infants were fed solid foods at 3 months, 25% were fed juice, and 6% were exclusively breastfed. In multivariable analyses, 2 dimensions of perceived infant temperament were associated with early feeding of solid foods (distress-to-limitations odds ratio [OR]: 1.97 [95% confidence interval (CI): 1.12–3.44]; activity-level OR: 1.75 [95% CI: 1.07–2.85]), whereas 1 dimension, low-intensity pleasure, was associated with early feeding of juice (OR: 0.51 [95% CI: 0.34–0.78]). Maternal characteristics significantly associated with early CF included breastfeeding, obesity, and depressive symptoms. CONCLUSIONS: Low-income black mothers may represent a priority population for interventions aimed at improving adherence to optimal infant feeding recommendations. That maternal perceptions of several domains of perceived infant temperament are related to early CF suggests that this is an important factor to include in future observational research and in the design of interventions. PMID:21220398

Infants perceived as "fussy" are more likely to receive complementary foods before 4 months.

PubMed

Wasser, Heather; Bentley, Margaret; Borja, Judith; Davis Goldman, Barbara; Thompson, Amanda; Slining, Meghan; Adair, Linda

2011-02-01

Our purpose was to assess early infant-feeding patterns in a cohort of low-income black mothers and to examine associations between maternal perception of infant temperament and complementary feeding (CF) before 4 months. We used cross-sectional data from the 3-month visit (n = 217) of the Infant Care, Feeding and Risk of Obesity Study to assess relationships between early feeding of solids or juice and 6 dimensions of perceived infant temperament. Descriptive statistics were used to assess infant-feeding patterns, and logistic regression models were fit for each diet-temperament relationship found significant in the bivariate analyses. Seventy-seven percent of the infants were fed solid foods at 3 months, 25% were fed juice, and 6% were exclusively breastfed. In multivariable analyses, 2 dimensions of perceived infant temperament were associated with early feeding of solid foods (distress-to-limitations odds ratio [OR]: 1.97 [95% confidence interval (CI): 1.12-3.44]; activity-level OR: 1.75 [95% CI: 1.07-2.85]), whereas 1 dimension, low-intensity pleasure, was associated with early feeding of juice (OR: 0.51 [95% CI: 0.34-0.78]). Maternal characteristics significantly associated with early CF included breastfeeding, obesity, and depressive symptoms. Low-income black mothers may represent a priority population for interventions aimed at improving adherence to optimal infant feeding recommendations. That maternal perceptions of several domains of perceived infant temperament are related to early CF suggests that this is an important factor to include in future observational research and in the design of interventions.

Associations of Infant Feeding and Timing of Weight Gain and Linear Growth during Early Life with Childhood Blood Pressure: Findings from a Prospective Population Based Cohort Study

PubMed Central

Vrijkotte, Tanja G. M.; van Eijsden, Manon; Gemke, Reinoud J. B. J.

2016-01-01

Objective Small birth size and rapid postnatal growth have been associated with higher future blood pressure. The timing of these effects, the relative importance of weight gain and linear growth and the role of infant feeding need to be clarified. Methods We assessed how blood pressure relates to birth weight, infant and childhood growth and infant feeding (duration of exclusive breastfeeding and timing of introduction of complementary feeding) in 2227 children aged 5 years from a prospective cohort study (Amsterdam Born Children and their Development). Postnatal growth was represented by statistically independent measures of relative weight gain (weight gain independent of height) and linear growth in four age periods during infancy (0–1 month; 1–3 months; 3–6 months; 6–12 months) and from 12 months to 5 years. Results Lower birth weight was associated with higher childhood diastolic blood pressure (-0.38 mm Hg.SD-1; P = 0.007). Faster relative weight gain and linear growth after 1 month were positively associated with systolic and diastolic blood pressure. Associations of linear growth with systolic blood pressure ranged from 0.47 to 1.49 mm Hg.SD-1; P<0.01 for all. Coefficients were similar for different periods of infancy and also for relative weight gain and linear growth. Compared to breastfeeding <1 month, breastfeeding >1 month was associated with lower blood pressure (e.g. >6 months -1.56 mm Hg systolic blood pressure; P<0.001). Compared to >6 months, introduction of complementary feeding <6 months was associated with higher blood pressure (e.g. 4–6 months 0.91 mm Hg systolic blood pressure; P = 0.004). Conclusions After the age of one month faster growth in either weight or height is associated with higher childhood blood pressure. It is unknown whether faster weight gain and linear growth carry the same risk for adult hypertension and cardiovascular morbidity. Longer breastfeeding and delayed introduction of complementary feeding may be associated with lower adult blood pressure. PMID:27832113

Associations of Infant Feeding and Timing of Weight Gain and Linear Growth during Early Life with Childhood Blood Pressure: Findings from a Prospective Population Based Cohort Study.

PubMed

de Beer, Marieke; Vrijkotte, Tanja G M; Fall, Caroline H D; van Eijsden, Manon; Osmond, Clive; Gemke, Reinoud J B J

2016-01-01

Small birth size and rapid postnatal growth have been associated with higher future blood pressure. The timing of these effects, the relative importance of weight gain and linear growth and the role of infant feeding need to be clarified. We assessed how blood pressure relates to birth weight, infant and childhood growth and infant feeding (duration of exclusive breastfeeding and timing of introduction of complementary feeding) in 2227 children aged 5 years from a prospective cohort study (Amsterdam Born Children and their Development). Postnatal growth was represented by statistically independent measures of relative weight gain (weight gain independent of height) and linear growth in four age periods during infancy (0-1 month; 1-3 months; 3-6 months; 6-12 months) and from 12 months to 5 years. Lower birth weight was associated with higher childhood diastolic blood pressure (-0.38 mm Hg.SD-1; P = 0.007). Faster relative weight gain and linear growth after 1 month were positively associated with systolic and diastolic blood pressure. Associations of linear growth with systolic blood pressure ranged from 0.47 to 1.49 mm Hg.SD-1; P<0.01 for all. Coefficients were similar for different periods of infancy and also for relative weight gain and linear growth. Compared to breastfeeding <1 month, breastfeeding >1 month was associated with lower blood pressure (e.g. >6 months -1.56 mm Hg systolic blood pressure; P<0.001). Compared to >6 months, introduction of complementary feeding <6 months was associated with higher blood pressure (e.g. 4-6 months 0.91 mm Hg systolic blood pressure; P = 0.004). After the age of one month faster growth in either weight or height is associated with higher childhood blood pressure. It is unknown whether faster weight gain and linear growth carry the same risk for adult hypertension and cardiovascular morbidity. Longer breastfeeding and delayed introduction of complementary feeding may be associated with lower adult blood pressure.

Recommended Feeding and Dietary Practices To Improve Infant and Maternal Nutrition.

ERIC Educational Resources Information Center

Academy for Educational Development, Washington, DC.

The LINKAGES Project is intended to improve breastfeeding and related complementary feeding and maternal dietary practices. The project, in consultation with technical experts and program managers, identified a set of recommended feeding and dietary practices intended to break the cycle of poor health and nutrition that passes from generation to…

An energy-dense complementary food is associated with a modest increase in weight gain when compared with a fortified porridge in Malawian children aged 6-18 months

USDA-ARS?s Scientific Manuscript database

Poor complementary feeding practices are associated with stunting and growth faltering throughout the developing world. The objective was to compare the effect of using peanut-/soy-based fortified spread (FS) and corn porridge fortified with fish powder (FP) as complementary foods on growth in rural...

Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

PubMed Central

Ray, David M; Srinivasan, Indu; Tang, Shou-Jiang; Vilmann, Andreas S; Vilmann, Peter; McCowan, Timothy C; Patel, Akash M

2017-01-01

Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient’s work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions. PMID:28396724

Infants and young children feeding practices and nutritional status in two districts of Zambia.

PubMed

Katepa-Bwalya, Mary; Mukonka, Victor; Kankasa, Chipepo; Masaninga, Freddie; Babaniyi, Olusegun; Siziya, Seter

2015-01-01

Appropriate feeding is important in improving nutrition and child survival. Documentation of knowledge of caregiver on infant feeding is scanty in Zambia. The aim of this study was to describe feeding practices and nutritional status among infants and young children (IYC) in two districts in Zambia: Kafue and Mazabuka. A cross-sectional study was conducted between January and March 2006 using both quantitative and qualitative methods. A questionnaire was administered to caregiver of children aged under24 months. Lengths and weights of all children were measured. Focused group discussions were conducted in selected communities to assess parents or guardian knowledge, attitude and practice related to infant feeding. A total of 634 caregivers (361 from Kafue and 273 from Mazabuka) participated in the study. About 311/618 (54.0%) of the caregiver knew the definition and recommended duration of exclusive breastfeeding (EBF) and when to introduce complementary feeds. Two hundred and fifty-one (81.2%) out of 310 respondents had acquired this knowledge from the health workers. Only 145/481 (30.1%) of the respondents practiced exclusive breastfeeding up to six months with 56/626 (8.9%) of the mothers giving prelacteal feeds. Although 596/629 (94.8%) of the respondents reported that the child does not need anything other than breast milk in the first three days of life, only 318/630 (50.5%) of them considered colostrum to be good. Complementary feeds were introduced early before six months of age and were usually not of adequate quality and quantity. Three hundred and ninety-one (64%) out of 603 caregivers knew that there would be no harm to the child if exclusively breastfed up to six months. Most of the children's nutritional status was normal with 25/594 (4.2%) severely stunted, 10/596 (1.7%) severely underweight and 3/594 (0.5%) severely wasted. The caregiver in the communities knew about the recommended feeding practices, but this knowledge did not translate into good practice. Knowing that most of the mothers will breastfeed and have heard about appropriate breastfeeding, is important in the development of sustainable strategies required to improve feeding practices and, thus, nutritional status of children.

Emerging trends in breastfeeding practices in Singaporean Chinese women: findings from a population-based study.

PubMed

Hornbeak, Dana M; Dirani, Mohamed; Sham, Wai Kit; Li, Jialiang; Young, Terri L; Wong, Tien Yin; Chong, Yap Seng; Saw, Seang Mei

2010-02-01

This study records the prevalence and patterns of breastfeeding in Singaporean Chinese mothers who gave birth between 2000 and 2008. The Strabismus, Amblyopia and Refractive Error in Singaporean Children (STARS) study is a population-based survey conducted in South-Western Singapore. Disproportionate random sampling by 6-month age groups of Chinese children born from 2000 to 2008 was performed. The mothers (n = 3009) completed a standard questionnaire which recorded the initiation, content, method and duration of breastfeeding. World Health Organization (WHO) definitions for feeding content were used: Replacement (exclusive commercial formula or any liquid or solid/semi-solid food, excluding breast milk), Complementary (breast milk, solid/semi-solid foods, and any non-human liquid), and Exclusive (breast milk only, without additional food, drink or water). STARS-specific definitions for feeding method were used: Expressed (breast milk only fed via bottle, with no additional food or non-human liquid), Combination (breast milk and non-breast milk, fed via bottle and breast), and Direct (breast milk only fed via breast). Breastfeeding initiation (overall prevalence 77.0%) and duration increased over time, and were independently associated with higher maternal education: in 2000 and 2001, 68.6% of mothers initiated breastfeeding and 12.9% breast fed for or=6 months, vs 90.9% and 35.3%, respectively, of university-educated women (P <0.001). Expressed, Combination and Complementary feeding also increased, while Replacement feeding decreased (P <0.001). There was no difference in breastfeeding patterns by the child's gender. In a population-based sample of Singaporean Chinese mothers giving birth from 2000 to 2008, breastfeeding initiation and duration increased over time and were independently associated with higher maternal education. This increase was associated with increased milk expression and complementary feeding. Thus awareness of breastfeeding benefits is rising in Singapore, but future health policies may need to target less-educated mothers.

INFANT FEEDING IN THE FIRST TWO YEARS OF LIFE.

PubMed

Lopes, Wanessa Casteluber; Marques, Fúlvia Karine Santos; Oliveira, Camila Ferreira de; Rodrigues, Jéssica Alkmim; Silveira, Marise Fagundes; Caldeira, Antônio Prates; Pinho, Lucinéia de

2018-01-01

To analyze the prevalence of breastfeeding and the introduction of complementary food for zero to 24-month-old infants. This is a population-based cross-sectional study of children aged less than 24 months in Montes Claros, Minas Gerais, Brazil. Data were collected in 2015, by interviews with people in charge of infant care in the house. The questionnaire administered assessed the sociodemographic status of the family, maternal and infant characteristics and food consumption habits. Survival analysis was used to calculate median prevalence and duration of breastfeeding and the introduction of complementary feeding. With 180 days of life, 4.0% of the children were exclusively breastfed, 22.4% were mostly breastfed and 43.4% were fed breast milk as complementary food. In the third month of life, children were consuming water (56.8%), fruit juice or formula (15.5%) and cow's milk (10.6%). At the age of 12 months, 31.1% were consuming artificial juice and 50.0% were eating candies. Before the age of 1 year, 25.0% of them had already eaten instant noodles. The introduction of drinks, honey, sugar and candies as complementary food was found to be premature; and solid and semi-solid foods were almost appropriate. The habits described can directly affect the success of breastfeeding. Given that the inadequate eating practices identified can compromise the infant's health, actions that promote breastfeeding and provide guidance on the introduction of complementary foods are important.

Effectiveness of Baby Friendly Community Initiative (BFCI) on complementary feeding in Koibatek, Kenya: a randomized control study.

PubMed

Maingi, Mildred; Kimiywe, Judith; Iron-Segev, Sharon

2018-05-08

Appropriate infant and young child nutrition is critical for proper growth and development. In order to promote optimal nutrition at an early age, the World Health Organization (WHO) and UNICEF have developed the Baby Friendly Hospital Initiative (BFHI) to address poor breastfeeding practices in maternity wards. However, impact is limited in less developed countries like Kenya, where more than half of all births are home deliveries. Therefore, Kenya has explored the adoption of Baby Friendly Community Initiative (BFCI) in its rural settings. In contrast to the BFHI, the BFCI supports breastfeeding and optimal infant feeding in community. BFCI has been implemented in Koibatek, in rural Kenya. This study aimed at assessing the effectiveness of BFCI on complementary feeding practices of children aged 6-23 months, by comparing intervention and control groups. This was a randomized control study design that included 270 mother-infant pairs enrolled in the Baby Friendly Community Initiative (BFCI) project in Koibatek. Evaluation was carried out using structured questionnaires. A statistically significantly higher proportion of children in the intervention group compared to the control group attained minimum dietary diversity (77% vs. 58%; p = 0.001), minimum meal frequency (96% vs. 89%; p = 0.046) and minimum acceptable diet (77% vs. 61%; p = 0.005). The odds of attaining minimum dietary diversity, minimum meal frequency and minimum acceptable diet were statistically significantly higher for the intervention group compared to control group (OR: 4.95; 95%CI 2.44-10.03, p = < 0.001; OR: 14.84; 95%CI 2.75-79.9, p = 0.002; OR: 4.61; 95%CI 2.17-9.78, p = < 0.001 respectively). The BFCI intervention was successful in improving complementary feeding practices. Strengthening and prioritizing BFCI interventions could have a significant impact on child health outcomes in rural Kenya. ISRCTN03467700 . Registration 24 September 2014. Retrospectively registered.

Determinants of breast-feeding within the first 6 months post-partum in rural Vietnam.

PubMed

Duong, Dat V; Lee, Andy H; Binns, Colin W

2005-07-01

This study explored the determinants of breast-feeding practices within the first 6 months post-partum among women residing in rural Vietnam. The study was conducted in Quang Xuong district, in the Thanh Hoa Province of Vietnam. In the first phase, 463 women were prospectively studied at weeks 1, 16 and 24 post-partum. During the second phase, 16 focus group discussions were undertaken to obtain complementary information. Exclusive breast-feeding dropped from 83.6% at week 1 to 43.6% at week 16 and by week 24, no infant was exclusively breast-fed. A logistic regression analysis found 'mother's education level', 'mother's decision-making on breast-feeding', 'mother's comfort to breast-feed in public places', 'father's occupation', 'feeding preference of father' and 'having sufficient food for the family' significantly influenced the exclusive breast-feeding practice. Qualitative data provided in-depth information on factors relating to mother, infant, close relatives and providers. Providing appropriate training and supportive supervision on breast-feeding counselling to health workers and supporting working mothers to exclusively breast-feed their infants through community mobilization were recommended to improve breast-feeding in rural Vietnam.

Gaps in international nutrition and child feeding guidelines: a look at the nutrition and young child feeding education of Ghanaian nurses.

PubMed

Davis, Jennie N; Brown, Helen; Ramsay, Samantha A

2017-08-01

To examine the nutrition and young child feeding (YCF) education and training of nurses in public health clinics of Ghana's Komenda-Edina-Eguafo-Abrem region (KEEA) in relation to global health guidelines, and how nurses served as educators for caregivers with children aged 0-5 years. A qualitative study of semi-structured one-on-one and group interviews (n 21) following a questionnaire of closed- and open-ended questions addressing child feeding, nutrition and global health recommendations. Interviews were conducted in English, audio-recorded, transcribed and coded. Descriptive data were tabulated. Content analysis identified themes from open-ended questions. KEEA public health clinics (n 12). Nurses (n 41) purposefully recruited from KEEA clinics. A model capturing nurses' nutrition and YCF education emerged with five major themes: (i) adequacy of nurses' basic knowledge in breast-feeding, complementary feeding, iron-deficiency anaemia, YCF and hygiene; (ii) nurses' delivery of nutrition and YCF information; (iii) nurses' evaluation of children's health status to measure education effectiveness; (iv) nurses' perceived barriers of caregivers' ability to implement nutrition and YCF education; and (v) a gap in global health recommendations on YCF practices for children aged 2-5 years. Nurses demonstrated adequate nutrition and YCF knowledge, but reported a lack of in-depth nutrition knowledge and YCF education for children 2-5 years of age, specifically education and knowledge of YCF beyond complementary feeding. To optimize child health outcomes, a greater depth of nutrition and YCF education is needed in international health guidelines.

Evaluation of programs to improve complementary feeding in infants and young children.

PubMed

Frongillo, Edward A

2017-10-01

Evaluation of complementary feeding programs is needed to enhance knowledge on what works, to document responsible use of resources, and for advocacy. Evaluation is done during program conceptualization and design, implementation, and determination of effectiveness. This paper explains the role of evaluation in the advancement of complementary feeding programs, presenting concepts and methods and illustrating them through examples. Planning and investments for evaluations should occur from the beginning of the project life cycle. Essential to evaluation is articulation of a program theory on how change would occur and what program actions are required for change. Analysis of program impact pathways makes explicit the dynamic connections in the program theory and accounts for contextual factors that could influence program effectiveness. Evaluating implementation functioning is done through addressing questions about needs, coverage, provision, and utilization using information obtained from process evaluation, operations research, and monitoring. Evaluating effectiveness is done through assessing impact, efficiency, coverage, process, and causality. Plausibility designs ask whether the program seemed to have an effect above and beyond external influences, often using a nonrandomized control group and baseline and end line measures. Probability designs ask whether there was an effect using a randomized control group. Evaluations may not be able to use randomization, particularly for programs implemented at a large scale. Plausibility designs, innovative designs, or innovative combinations of designs sometimes are best able to provide useful information. Further work is needed to develop practical designs for evaluation of large-scale country programs on complementary feeding. © 2017 John Wiley & Sons Ltd.

Complementary Feeding Strategies to Facilitate Acceptance of Fruits and Vegetables: A Narrative Review of the Literature.

PubMed

Nicklaus, Sophie

2016-11-19

Complementary feeding (CF), which should begin after exclusive breastfeeding for six months, according to the World Health Organization (WHO), or after four months and before six months according to the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), is a period when the infant implicitly learns what, when, how, and how much to eat. At the onset of CF, the brain and the gut are still developing and maturing, and food experiences contribute to shaping brain connections involved in food hedonics and in the control of food intake. These learning processes are likely to have a long-term impact. Children's consumption of fruit and vegetables (FV) is below recommendations in many countries. Thus, it is crucial to establish preferences for FV early, when infants are learning to eat. The development of food preferences mainly starts when infants discover their first solid foods. This narrative review summarizes the factors that influence FV acceptance at the start of the CF period: previous milk feeding experience; timing of onset of CF; repeated exposures to the food; variety of foods offered as of the start of the CF period; quality and sensory properties of the complementary foods; quality of the meal time context; and parental responsive feeding.

Complementary Feeding Strategies to Facilitate Acceptance of Fruits and Vegetables: A Narrative Review of the Literature

PubMed Central

Nicklaus, Sophie

2016-01-01

Complementary feeding (CF), which should begin after exclusive breastfeeding for six months, according to the World Health Organization (WHO), or after four months and before six months according to the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), is a period when the infant implicitly learns what, when, how, and how much to eat. At the onset of CF, the brain and the gut are still developing and maturing, and food experiences contribute to shaping brain connections involved in food hedonics and in the control of food intake. These learning processes are likely to have a long-term impact. Children’s consumption of fruit and vegetables (FV) is below recommendations in many countries. Thus, it is crucial to establish preferences for FV early, when infants are learning to eat. The development of food preferences mainly starts when infants discover their first solid foods. This narrative review summarizes the factors that influence FV acceptance at the start of the CF period: previous milk feeding experience; timing of onset of CF; repeated exposures to the food; variety of foods offered as of the start of the CF period; quality and sensory properties of the complementary foods; quality of the meal time context; and parental responsive feeding. PMID:27869776

Infant Feeding Practices of Emirati Women in the Rapidly Developing City of Abu Dhabi, United Arab Emirates.

PubMed

Gardner, Hazel; Green, Katherine; Gardner, Andrew

2015-09-02

Rapid economic and cultural transition in the United Arab Emirates (UAE) has been accompanied by new challenges to public health; most notably a rapid rise in chronic disease. Breastfeeding is known to improve health outcomes in adulthood, is associated with reduced risk of developing chronic disease, and is therefore an important public health issue for this rapidly increasing population. Factors associated with infant feeding practices were examined in a cohort of 125 Emirati women and their infants, with data collected at birth and 3, 6 and 15 months postpartum by questionnaires and interviews. Participants were recruited in the Corniche Hospital, the main maternity hospital in the city of Abu Dhabi. Factors affecting the duration of breastfeeding and the introduction of complementary foods were investigated using univariate and multivariate statistics. Recommended infant feeding practices, such as exclusive breastfeeding for the first six months of life and timely introduction of appropriate complementary foods, were poorly adhered to. Factors implicated in early cessation of breastfeeding included: time to first breastfeed, mother's education level, employment status and early introduction of complementary foods.

Infant Feeding Practices of Emirati Women in the Rapidly Developing City of Abu Dhabi, United Arab Emirates

PubMed Central

Gardner, Hazel; Green, Katherine; Gardner, Andrew

2015-01-01

Rapid economic and cultural transition in the United Arab Emirates (UAE) has been accompanied by new challenges to public health; most notably a rapid rise in chronic disease. Breastfeeding is known to improve health outcomes in adulthood, is associated with reduced risk of developing chronic disease, and is therefore an important public health issue for this rapidly increasing population. Factors associated with infant feeding practices were examined in a cohort of 125 Emirati women and their infants, with data collected at birth and 3, 6 and 15 months postpartum by questionnaires and interviews. Participants were recruited in the Corniche Hospital, the main maternity hospital in the city of Abu Dhabi. Factors affecting the duration of breastfeeding and the introduction of complementary foods were investigated using univariate and multivariate statistics. Recommended infant feeding practices, such as exclusive breastfeeding for the first six months of life and timely introduction of appropriate complementary foods, were poorly adhered to. Factors implicated in early cessation of breastfeeding included: time to first breastfeed, mother’s education level, employment status and early introduction of complementary foods. PMID:26404348

Assessment of corporate compliance with guidance and regulations on labels of commercially produced complementary foods sold in Cambodia, Nepal, Senegal and Tanzania.

PubMed

Sweet, Lara; Pereira, Catherine; Ford, Rosalyn; Feeley, Alison B; Badham, Jane; Mengkheang, Khin; Adhikary, Indu; Sy Gueye, Ndèye Yaga; Coly, Aminata Ndiaye; Makafu, Cecilia; Zehner, Elizabeth

2016-04-01

National legislation and global guidance address labelling of complementary foods to ensure that labels support optimal infant and young child feeding practices. This cross-sectional study assessed the labels of commercially produced complementary foods (CPCF) sold in Phnom Penh (n = 70), Cambodia; Kathmandu Valley (n = 22), Nepal; Dakar Department (n = 84), Senegal; and Dar es Salaam (n = 26), Tanzania. Between 3.6% and 30% of products did not provide any age recommendation and 8.6-20.2% of products, from all sites, recommended an age of introduction of <6 months. Few CPCF products provided a daily ration (0.0-8.6%) and 14.5-55.6% of those that did exceeded the daily energy recommendation for complementary foods for a breastfed child from 6 to 8.9 months of age. Only 3.6-27.3% of labels provided accurate and complete messages in the required language encouraging exclusive breastfeeding, and almost none (0.0-2.9%) provided accurate and complete messages regarding the appropriate introduction of complementary foods together with continued breastfeeding. Between 34.3% and 70.2% of CPCF manufacturers also produced breastmilk substitutes and 41.7-78.0% of relevant CPCF products cross-promoted their breastmilk substitutes products. Labelling practices of CPCF included in this study do not fully comply with international guidance on their promotion and selected aspects of national legislation, and there is a need for more detailed normative guidance on certain promotion practices in order to protect and promote optimal infant and young child feeding. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Assessment of corporate compliance with guidance and regulations on labels of commercially produced complementary foods sold in Cambodia, Nepal, Senegal and Tanzania

PubMed Central

Sweet, Lara; Pereira, Catherine; Ford, Rosalyn; Feeley, Alison B; Mengkheang, Khin; Adhikary, Indu; Gueye, Ndèye Yaga Sy; Coly, Aminata Ndiaye; Makafu, Cecilia; Zehner, Elizabeth

2016-01-01

Abstract National legislation and global guidance address labelling of complementary foods to ensure that labels support optimal infant and young child feeding practices. This cross‐sectional study assessed the labels of commercially produced complementary foods (CPCF) sold in Phnom Penh (n = 70), Cambodia; Kathmandu Valley (n = 22), Nepal; Dakar Department (n = 84), Senegal; and Dar es Salaam (n = 26), Tanzania. Between 3.6% and 30% of products did not provide any age recommendation and 8.6−20.2% of products, from all sites, recommended an age of introduction of <6 months. Few CPCF products provided a daily ration (0.0−8.6%) and 14.5−55.6% of those that did exceeded the daily energy recommendation for complementary foods for a breastfed child from 6 to 8.9 months of age. Only 3.6−27.3% of labels provided accurate and complete messages in the required language encouraging exclusive breastfeeding, and almost none (0.0−2.9%) provided accurate and complete messages regarding the appropriate introduction of complementary foods together with continued breastfeeding. Between 34.3% and 70.2% of CPCF manufacturers also produced breastmilk substitutes and 41.7−78.0% of relevant CPCF products cross‐promoted their breastmilk substitutes products. Labelling practices of CPCF included in this study do not fully comply with international guidance on their promotion and selected aspects of national legislation, and there is a need for more detailed normative guidance on certain promotion practices in order to protect and promote optimal infant and young child feeding. PMID:27061960

Local-food-based complementary feeding for the nutritional status of children ages 6–36 months in rural areas of Indonesia

PubMed Central

Syahrul; Sulistyorini, Lantin; Rondhianto; Yudisianto, Alfi

2017-01-01

Purpose This study aimed to evaluate a pilot project of the Nursing Feeding Center “Posyandu Plus” (NFCPP) through local food-based complementary feeding (LFCF) program designed to improve the nutritional status of children aged 6–36 months at community health centers in Indonesia. Methods A quasi-experimental design was used to obtain data regarding the nutritional status of 109 children who participated in the project from 6 rural areas. The NFCPP was conducted for 9 weeks, comprising 2 weeks of preintervention, 6 weeks of intervention, and one week of postintervention. The LFCF intervention consisted of 12 sets of recipes to be made by mothers and given to their children 4 times daily over 6 weeks. The weight-for-age z score (WAZ), height-for-age z score (HAZ), weight-for-height z score (WHZ), and body mass index-for-age z score (BAZ) were calculated using World Health Organization Anthro Plus version 1.0.3. Results LFCF intervention significantly increased WHZ, WAZ, and BAZ scores but decreased HAZ scores (P<0.001). Average scores of WHZ (0.96±0.97) and WAZ (0.45±0.72) increased; BAZ increased (1.12±0.93) after 6 weeks of LFCF. WAZ scores postintervention were 50.5% of normal, and WHZ scores were 77.1% of normal. However, the HAZ score decreased by 0.53±0.52, which indicated 57.8% had short stature. Conclusion The NFCPP program with LFCF intervention can improve the nutritional status of children in rural areas. It should be implemented as a sustained program for better provision of complementary feeding during the period of lactation using local food made available at community health centers. PMID:29158766

An exploratory study of complementary and alternative medicine in hospital midwifery: models of care and professional struggle.

PubMed

Adams, Jon

2006-02-01

Complementary and alternative medicine (CAM) is increasingly popular amongst midwives in Australia. A growing number of hospital midwives are personally integrating one or a range of CAM within their midwifery practice. Despite this trend we still know little about CAM in midwifery, particularly at a grass-roots level. This paper reports findings from one section of a larger exploratory study examining grass-root practitioners' understandings and experiences of complementary therapies in nursing and midwifery. Thirteen in-depth interviews were conducted with midwives working in New South Wales public hospitals and currently integrating CAM within their general midwifery practice. Analysis illustrates how midwives' explanations of, and affinity claims regarding, CAM feed into wider ongoing issues relating to professional autonomy and the relationship between midwifery and obstetrics.

Single nucleotide polymorphisms and haplotypes associated with feed efficiency in beef cattle

PubMed Central

2013-01-01

Background General, breed- and diet-dependent associations between feed efficiency in beef cattle and single nucleotide polymorphisms (SNPs) or haplotypes were identified on a population of 1321 steers using a 50 K SNP panel. Genomic associations with traditional two-step indicators of feed efficiency – residual feed intake (RFI), residual average daily gain (RADG), and residual intake gain (RIG) – were compared to associations with two complementary one-step indicators of feed efficiency: efficiency of intake (EI) and efficiency of gain (EG). Associations uncovered in a training data set were evaluated on independent validation data set. A multi-SNP model was developed to predict feed efficiency. Functional analysis of genes harboring SNPs significantly associated with feed efficiency and network visualization aided in the interpretation of the results. Results For the five feed efficiency indicators, the numbers of general, breed-dependent, and diet-dependent associations with SNPs (P-value < 0.0001) were 31, 40, and 25, and with haplotypes were six, ten, and nine, respectively. Of these, 20 SNP and six haplotype associations overlapped between RFI and EI, and five SNP and one haplotype associations overlapped between RADG and EG. This result confirms the complementary value of the one and two-step indicators. The multi-SNP models included 89 SNPs and offered a precise prediction of the five feed efficiency indicators. The associations of 17 SNPs and 7 haplotypes with feed efficiency were confirmed on the validation data set. Nine clusters of Gene Ontology and KEGG pathway categories (mean P-value < 0.001) including, 9nucleotide binding; ion transport, phosphorous metabolic process, and the MAPK signaling pathway were overrepresented among the genes harboring the SNPs associated with feed efficiency. Conclusions The general SNP associations suggest that a single panel of genomic variants can be used regardless of breed and diet. The breed- and diet-dependent associations between SNPs and feed efficiency suggest that further refinement of variant panels require the consideration of the breed and management practices. The unique genomic variants associated with the one- and two-step indicators suggest that both types of indicators offer complementary description of feed efficiency that can be exploited for genome-enabled selection purposes. PMID:24066663

The interactive association of dietary diversity scores and breast-feeding status with weight and length in Filipino infants aged 6–24 months

PubMed Central

Wright, Melecia J; Bentley, Margaret E; Mendez, Michelle A; Adair, Linda S

2016-01-01

Objective To assess how breast-feeding and dietary diversity relate to infant length-for-age Z-score (LAZ) and weight-for-age Z-score (WAZ). Design Breast-feeding, dietary and anthropometric data from the Cebu Longitudinal Health and Nutrition Survey were analysed using sex-stratified fixed-effects longitudinal regression models. A dietary diversity score (DDS) based on seven food groups was classified as low (<4) or high (≥4). The complementary feeding patterns were: (i) non-breast-fed with low DDS (referent); (ii) breast-fed with low DDS; (iii) non-breast-fed with high DDS; and (iv) breast-fed with high DDS (optimal). Interactions between age, energy intake and complementary feeding patterns were included. Setting Philippines. Subjects Infants (n 2822) measured bimonthly from 6 to 24 months. Results Breast-feeding (regardless of DDS) was significantly associated with higher LAZ (until 24 months) and WAZ (until 20 months). For example, at 6 months, breast-fed boys with low DDS were 0·246 (95 % CI 0·191, 0·302) SD longer and 0·523 (95 % CI 0·451, 0·594) SD heavier than the referent group. There was no significant difference in size between breast-fed infants with high v. low DDS. Similarly, high DDS conferred no advantage in LAZ or WAZ among non-breast- fed infants. There were modest correlations between the 7-point DDS and nutrient intakes but these correlations were substantially attenuated after energy adjustment. We elucidated several interactions between sex, age, energy intake and complementary feeding patterns. Conclusions These results demonstrate the importance of prolonged breast-feeding up to 24 months. The DDS provided qualitative information on infant diets but did not confer a significant advantage in LAZ or WAZ. PMID:25728248

Identifying determinants of effective complementary feeding behaviour change interventions in developing countries

PubMed Central

Fabrizio, Cecilia S; van Liere, Marti; Pelto, Gretel

2014-01-01

As stunting moves to the forefront of the global agenda, there is substantial evidence that behaviour change interventions (BCI) can improve infant feeding practices and growth. However, this evidence has not been translated into improved outcomes on a national level because we do not know enough about what makes these interventions work, for whom, when, why, at what cost and for how long. Our objective was to examine the design and implementation of complementary feeding BCI, from the peer-reviewed literature, to identify generalisable key determinants. We identified 29 studies that evaluated BCI efficacy or effectiveness, were conducted in developing countries, and reported outcomes on infant and young children aged 6–24 months. Two potential determinants emerged: (1) effective studies used formative research to identify cultural barriers and enablers to optimal feeding practices, to shape the intervention strategy, and to formulate appropriate messages and mediums for delivery; (2) effective studies delineated the programme impact pathway to the target behaviour change and assessed intermediary behaviour changes to learn what worked. We found that BCI that used these developmental and implementation processes could be effective despite heterogeneous approaches and design components. Our analysis was constrained, however, by the limited published data on how design and implementation were carried out, perhaps because of publishing space limits. Information on cost-effectiveness, sustainability and scalability was also very limited. We suggest a more comprehensive reporting process and a more strategic research agenda to enable generalisable evidence to accumulate. PMID:24798264

Association between maternal social capital and infant complementary feeding practices in rural Ethiopia.

PubMed

Kang, Yunhee; Kim, Jane; Seo, Eunkyo

2018-01-01

Few studies have explored the potential of social capital in improving child nutritional status; however, most components of pathways between social capital and nutritional status have remained unexplained. Complementary feeding practice is a strong mediator of child nutritional status. This study examined the association between complementary feeding practice and maternal social capital in rural Ethiopia, using cross-sectional data of infant aged 6-12 months and their mother pairs (n = 870). The Short Social Capital Assessment Tool was used to assess maternal structural (i.e., community group membership, having emotional/economic support from individuals, and citizenship activities) and cognitive social capital (i.e., trust, social harmony, and sense of belonging) in the past 12 months. Infant's dietary diversity score (DDS, range: 0-7), minimum dietary diversity (MDD), and minimum meal frequency (MMF) were assessed using a 24-hr dietary recall. Multivariable ordinal/binary logistic regression analyses were conducted. Having support from two or more individuals was associated with higher DDS (OR = 1.84) and meeting a minimum level of dietary diversity (MDD: OR = 5.20) but not with MMF, compared to those having no support. Having two or more group memberships was associated with higher DDS (OR = 2.2) but not with MDD or MMF, compared to those without group membership. Citizenship activities showed mixed associations with MMF and no association with DDS or MDD. Cognitive social capital showed no association with DDS or MDD and lower odds of meeting MMF (OR = 0.56). These mixed results call for further studies to examine other potential pathways (e.g., hygiene and caring behaviours) in which social capital could improve child nutritional status. © 2017 John Wiley & Sons Ltd.

Patterns and determinants of breastfeeding and complementary feeding practices of Emirati Mothers in the United Arab Emirates

PubMed Central

2013-01-01

Background Breastfeeding is the preferred method of feeding for the infant. The present study aimed at investigating the different infant feeding practices and the influencing factors in the United Arab Emirates (UAE). Methods A convenient sample of 593 Emirati mothers who had infants up to 2 years of age was interviewed. The interviews included a detailed questionnaire and conducted in the Maternal and Child Health Centers (MCH) and Primary Health Centers (PHC) in three cities. Results Almost all the mothers in the study had initiated breastfeeding (98%). The mean duration of breastfeeding was 8.6 months. The initiation and duration of breastfeeding rates were influenced by mother’s age (P<0.034)and education(P<0.01), parity(OR=2.13; P<0.001), rooming in(OR=21.70; P<0.001), nipple problem(P<0.010) and use of contraception(P<0.034). As for the feeding patterns, the results of the multiple logistic analyses revealed that rooming in (OR=4.48; P<0.001), feeding on demand (OR=2.29; P<0.005) and feeding more frequently at night (P<0.001) emerged as significant factors associated with exclusive or predominantly breastfeeding practices. Among the 593 infants in the study, 24.1% had complementary feeding, 25% of the infants were exclusively breastfed, and 49.4% were predominantly breastfed since birth. About 30% of the infants were given nonmilk fluids such as: Anis seed drink (Yansun), grippe water and tea before 3 months of age. The majority of the infants (83.5%) in the three areas received solid food before the age of 6 months. A variety of reasons were reported as perceived by mothers for terminating breastfeeding. The most common reasons were: new pregnancy (32.5%), insufficient milk supply (24.4%) and infant weaned itself (24.4%). Conclusions In conclusion, infant and young child feeding practices in this study were suboptimal. There is a need for a national community-based breastfeeding intervention programme and for the promotion of exclusive breastfeeding as part of a primary public health strategy to decrease health risks and problems in the UAE. PMID:23442221

Patterns of cultural consensus and intracultural diversity in Ghanaian complementary feeding practices.

PubMed

Kalra, Nikhila; Pelto, Gretel; Tawiah, Charlotte; Zobrist, Stephanie; Milani, Peiman; Manu, Grace; Laar, Amos; Parker, Megan

2018-01-01

Designing effective interventions to improve infant and young child (IYC) feeding requires knowledge about determinants of current practices, including cultural factors. Current approaches to obtaining and using research on culture tend to assume cultural homogeneity within a population. The purpose of this study was to examine the extent of cultural consensus (homogeneity) in communities where interventions to improve IYC feeding practices are needed to address undernutrition during the period of complementary feeding. A second, related objective was to identify the nature of intracultural variation, if such variation was evident. Selected protocols from the Focused Ethnographic Study for Infant and Young Child Feeding Manual were administered to samples of key informants and caregivers in a peri-urban and a rural area in Brong-Ahafo, Ghana. Cultural domain analysis techniques (free listing, caregiver assessment of culturally significant dimensions, and food ratings on these dimensions), as well as open-ended questions with exploratory probing, were used to obtain data on beliefs and related practices. Results reveal generally high cultural consensus on the 5 dimensions that were assessed (healthiness, appeal, child acceptance, convenience, and modernity) for caregiver decisions and on their ratings of individual foods. However, thematic analysis of caregiver narratives indicates that the meanings and content of the constructs connoted by the dimensions differed widely among individual mothers. These findings suggest that research on cultural factors that affect IYC practices, particularly cultural beliefs, should consider the nature and extent of cultural consensus and intracultural diversity, rather than assuming cultural homogeneity. © 2017 John Wiley & Sons Ltd.

Policy and public health recommendations to promote the initiation and duration of breast-feeding in developed country settings.

PubMed

Dyson, Lisa; Renfrew, Mary J; McFadden, Alison; McCormick, Felicia; Herbert, Gill; Thomas, James

2010-01-01

To develop policy and public health recommendations for implementation at all levels by individuals and organisations working in, or related to, the field of breast-feeding promotion in developed country settings, where breast-feeding rates remain low. Two research phases, comprising (i) an assessment of the formal evidence base in developed country settings and (ii) a consultation with UK-based practitioners, service managers and commissioners, and representatives of service users. The evidence base included three systematic reviews and an Evidence Briefing. One hundred and ten studies evaluating an intervention in developed country settings were assessed for quality and awarded an overall quality rating. Studies with a poor quality rating were excluded. The resulting seventy studies examined twenty-five types of intervention for breast-feeding promotion. These formed the basis of the second consultation phase to develop the evidence-based interventions into recommendations for practice, which comprised (i) pilot consultation, (ii) electronic consultation, (iii) fieldwork meetings and (iv) workshops. Draft findings were synthesised for two rounds of stakeholder review conducted by the National Institute for Health and Clinical Excellence. Twenty-five recommendations emerged within three complementary and necessary categories, i.e. public health policy, mainstream clinical practice and local interventions. The need for national policy directives was clearly identified as a priority to address many of the barriers experienced by practitioners when trying to work across sectors, organisations and professional groups. Routine implementation of the WHO/UNICEF Baby Friendly Initiative across hospital and community services was recommended as core to breast-feeding promotion in the UK. A local mix of complementary interventions is also required.

Improving the intake of nutritious food in children aged 6-23 months in Wuyi County, China – a multi-method approach

PubMed Central

Wu, Qiong; van Velthoven, Michelle H.M.M.T.; Chen, Li; Car, Josip; Rudan, Diana; Saftić, Vanja; Zhang, Yanfeng; Li, Ye; Scherpbier, Robert W.

2013-01-01

Aim To develop affordable, appropriate, and nutritious recipes based on local food resources and dietary practices that have the potential to improve infant feeding practices. Methods We carried out a mixed methods study following the World Health Organization’s evaluation guidelines on the promotion of child feeding. We recruited caregivers with children aged 6-23 months in Wuyi County, Hebei Province, China. The study included a 24-hour dietary recall survey, local food market survey, and development of a key local food list, food combinations, and recipes. Mothers tested selected recipes at their homes for two weeks. We interviewed mothers to obtain their perceptions on the recipes. Results The 24-hour dietary recall survey included 110 mothers. Dietary diversity was poor; approximately 10% of children consumed meat and only 2% consumed vitamin A-rich vegetables. The main reason for not giving meat was the mothers’ belief that their children could not chew and digest meat. With the help of mothers, we developed six improved nutritious recipes with locally available and affordable foods. Overall, mothers liked the recipes and were willing to continue using them. Conclusions This is the first study using a systematic evidence-based method to develop infant complementary recipes that can address complementary feeding problems in China. We developed recipes based on local foods and preparation practices and identified the barriers that mothers faced toward feeding their children with nutritious food. To improve nutrition practices, it is important to both give mothers correct feeding knowledge and assist them in cooking nutritious foods for their children based on locally available products. Further research is needed to assess long-term effects of those recipes on the nutritional status of children. PMID:23630143

Caterpillar cereal as a potential complementary feeding product for infants and young children: nutritional content and acceptability.

PubMed

Bauserman, Melissa; Lokangaka, Adrien; Kodondi, Kule-Koto; Gado, Justin; Viera, Anthony J; Bentley, Margaret E; Engmann, Cyril; Tshefu, Antoinette; Bose, Carl

2015-12-01

Micronutrient deficiency is an important cause of growth stunting. To avoid micronutrient deficiency, the World Health Organization recommends complementary feeding with animal-source foods. However, animal-source foods are not readily available in many parts of the Democratic Republic of Congo (DRC). In such areas, caterpillars are a staple in adult diets and may be suitable for complementary feeding for infants and young children. We developed a cereal made from dried caterpillars and other locally available ingredients (ground corn, palm oil, sugar and salt), measured its macro- and micronutrient contents and evaluated for microbiologic contamination. Maternal and infant acceptability was evaluated among 20 mothers and their 8-10-month-old infants. Mothers were instructed in the preparation of the cereal and asked to evaluate the cereal in five domains using a Likert scale. Mothers fed their infants a 30-g portion daily for 1 week. Infant acceptability was based on cereal consumption and the occurrence of adverse events. The caterpillar cereal contained 132 kcal, 6.9-g protein, 3.8-mg iron and 3.8-mg zinc per 30 g and was free from microbiologic contamination. Mothers' median ratings for cereal characteristics were (5 = like very much): overall impression = 4, taste = 5, smell = 4, texture = 4, colour = 5, and consistency = 4. All infants consumed more than 75% of the daily portions, with five infants consuming 100%. No serious adverse events were reported. We conclude that a cereal made from locally available caterpillars has appropriate macro- and micronutrient contents for complementary feeding, and is acceptable to mothers and infants in the DRC. © 2013 Blackwell Publishing Ltd.

Heat treatment of expressed breast milk is a feasible option for feeding HIV-exposed, uninfected children after 6 months of age in rural Zimbabwe.

PubMed

Mbuya, Mduduzi N N; Humphrey, Jean H; Majo, Florence; Chasekwa, Bernard; Jenkins, Alison; Israel-Ballard, Kiersten; Muti, Monica; Paul, Keriann H; Madzima, Rufaro C; Moulton, Lawrence H; Stoltzfus, Rebecca J

2010-08-01

In the context of a prevention of mother to child transmission of HIV program promoting exclusive breast-feeding (EBF) to 6 mo and offering HIV-PCR testing at approximately 6 mo, we ascertained the feasibility of expressing and heat-treating (EHT) all breast milk fed to HIV-exposed, uninfected infants following 6 mo of EBF. Twenty mother-baby pairs were enrolled from a hospital in rural Zimbabwe. Research nurses provided lactation, EHT, and complementary feeding counseling through 21 home visits conducted over an 8-wk period and collected quantitative and qualitative data on the mothers' EHT experiences, children's diets, and anthropometric measurements. Mothers kept daily logs of EHT volumes and direct breast-feeding episodes. Mothers successfully initiated and sustained EHT for 4.5 mo (range, 1-11 mo), feeding 426 +/- 227 mL/d (mean +/- SD). By wk 2 of follow-up, children were receiving EHT and Nutributter-enriched complementary foods that satisfied 100% of their energy requirements. During the 8-wk follow-up period, no growth faltering was experienced [changes in weight-for-age, weight-for-length, and length-for-age Z scores = +0.03 +/- 0.50; +0.77 +/- 1.59; and +0.02 +/- 0.85 (mean +/- SD), respectively]. Stigma was not a major deterrent, likely due to a social marketing campaign for EBF that promoted EHT as a practice to sustain breast-feeding for all women. This study provides evidence that resource-poor rural women can initiate and sustain EHT given family and health systems support. EHT provides a strategy for improving the diets of HIV-exposed but uninfected children after direct breast-feeding has ceased.

Complementary Feeding: Critical Considerations to Optimize Growth, Nutrition, and Feeding Behavior

PubMed Central

Young, Bridget E.; Krebs, Nancy F.

2014-01-01

This review focuses on complementary feeding (CF) in westernized settings where primary health concerns are risk of obesity and micronutrient inadequacy. The current evidence is reviewed for: (1) when CF should be introduced, (2) what foods (nutrients and food types) should be prioritized and avoided, and (3) how the infant should be fed. Special attention is paid to the underlying physiological differences between breast- and formula-fed infants that often result in distinctly different nutritional and health risks. This difference is particularly acute in the case of micronutrient inadequacy, specifically iron and zinc, but is also relevant to optimal energy and macronutrient intakes. Emphasis is placed on the complex interplay among infants’ early dietary exposures; relatively high energy and nutrient requirements; rapid physical, social and emotional development; and the feeding environment—all of which interact to impact health outcomes. This complexity needs to be considered at both individual and population levels and in both clinical and research settings. PMID:25105082

Additional Common Bean in the Diet of Malawian Children Does Not Affect Linear Growth, but Reduces Intestinal Permeability.

PubMed

Agapova, Sophia E; Stephenson, Kevin B; Divala, Oscar; Kaimila, Yankho; Maleta, Kenneth M; Thakwalakwa, Chrissie; Ordiz, M Isabel; Trehan, Indi; Manary, Mark J

2018-02-01

Chronic malnutrition, as manifested by linear growth faltering, is pervasive among rural African children. Improvements in complementary feeding may decrease the burden of environmental enteric dysfunction (EED) and thus improve growth in children during the critical first 1000 d of development. We tested the hypothesis that systematically including common bean or cowpea into complementary feeding would reduce EED and growth faltering among children in rural Malawi. This was a double-blind clinical trial in which children 12-23 mo of age were randomly assigned to receive complementary feeding with 1 of 3 foods: roasted cowpea or common bean flour, or an isoenergetic amount of corn-soy blend as a control food for 48 wk. Children aged 12-23 mo received 155 kcal/d and thereafter until 35 mo received 200 kcal/d. The primary outcomes were change in length-for-age z score (LAZ) and improvements in a biomarker of EED, the percentage of lactulose (%L) excreted as part of the lactulose:mannitol dual-sugar absorption test. Anthropometric measurements and urinary %L excretion were compared between the 2 intervention groups and the control group separately with the use of linear mixed model analyses for repeated measures. A total of 331 children completed the clinical trial. Compliance with the study interventions was excellent, with >90% of the intervention flour consumed as intended. No significant effects on LAZ, change in LAZ, or weight-for-length z score were observed due to either intervention legume, compared to the control. %L was reduced with common bean consumption (effect estimate was -0.07 percentage points of lactulose, P = 0.0007). The lactulose:mannitol test was not affected by the legume intervention. The addition of common bean to complementary feeding of rural Malawian children during the second year of life led to an improvement in a biomarker of gut health, although this did not directly translate into improved linear growth. This trial was registered at clinicaltrials.gov as NCT02472301.

Feeding in the first year of life - emerging benefits of introducing complementary solids from 4 months.

PubMed

Symon, Brian; Bammann, Michael

2012-04-01

Current World Health Organization guidelines recommend exclusive breastfeeding for the first 6 months of life. Breastfeeding conveys clear benefits to both mother and child. These benefits are likely to be amplified by prolonged feeding. This article outlines the emerging evidence that suggests possible benefits from introducing complementary solids from 4 months of age in developed countries. The human gut may have a critical early window during which it has an opportunity to develop immunological tolerance. Introducing complementary solids from 4 months of age may decrease the risk of food allergy and coeliac disease - immunological illnesses that have become a public health priority. The new draft National Health and Medical Research Council guidelines recommend introducing solids at around 6 months (22-26 weeks). However, given recent evidence, it may be appropriate to recommend the introduction of solids from 4 months of age in the Australian context.

Infant and young child feeding indicators across nine East and Southeast Asian countries: an analysis of National Survey Data 2000-2005.

PubMed

Dibley, Michael J; Senarath, Upul; Agho, Kingsley E

2010-09-01

To compare infant and young child feeding practices in children aged 0-23 months across nine East and Southeast Asian countries. Secondary analyses of cross-sectional data from available Demographic and Health Surveys (DHS; Indonesia, Philippines, Timor-Leste, Cambodia and Vietnam), Multiple Indicator Country Surveys (Lao People's Democratic Republic (Lao PDR) and Myanmar) and national nutrition surveys (Democratic People's Republic of Korea (DPR Korea) and Mongolia) conducted between 2000 and 2005. Seven countries from Southeast Asia and two from East Asia. Children aged 0-23 months with samples ranging from 826 to 5610 for DHS, and from 477 to 5860 for non-DHS data. More than 93 % of infants were ever breast-fed, and over 75 % were currently breast-fed except in the Philippines. Timely initiation of breast-feeding varied from 32 % in Indonesia to 46 % in Timor-Leste. Exclusive breast-feeding (EBF) rate in infants under 6 months of age ranged from 11 % in Myanmar to 60 % in Cambodia. EBF rates were also low in Vietnam (15.5 %) and Lao PDR (23 %), and varied between 30 % and 40 % in Indonesia, Philippines and Timor-Leste. The proportion of infants under 6 months of age who were given breast milk with non-milk liquids was high except in Indonesia and Timor-Leste. Bottle-feeding rates were lower in DPR Korea (3 %), Lao PDR (6 %) and Myanmar (6 %) and higher in the Philippines (49 %) and Mongolia (31 %). Timely complementary-feeding rate varied widely across countries (6-99 %). All the countries studied should make greater efforts to improve timely initiation of breast-feeding and EBF for 6 months. Measures should be taken to reduce high bottle-feeding rate in the Philippines, Mongolia, Indonesia and Vietnam, and improve complementary-feeding rate in Lao PDR, Myanmar, DPR Korea and Philippines.

Inappropriate Feeding Behavior: One of the Important Causes of Malnutrition in 6- to 36-Month-Old Children in Myanmar

PubMed Central

Zhao, Ai; Gao, Hongchong; Li, Bo; Zhang, Jun; Win, Naing Naing; Wang, Peiyu; Li, Jiayin; Zhang, Yumei

2016-01-01

The complementary feeding period is an important time for children's growth and development. This study was conducted to 1) determine the feeding behaviors of 6- to 36-month-old children in Myanmar, 2) explore health effects of feeding behaviors, and 3) determine factors associated with feeding behaviors. A total of 807 children and their mothers (N = 642) were recruited from nine villages in Kachin, Shan, and Kokang, Myanmar. Feeding behaviors and sociodemographic characteristics were investigated using a validated questionnaire. Hemoglobin and anthropometric indicators were measured during the fieldwork. In our sample, 18.6%, 72.7%, and 9.8% of children were introduced to complementary foods (CFs) earlier than 4 months of age, between 4 and 8 months of age, and later than 8 months of age, respectively. For different types of CFs, up to the age of 24.1–36 months, there were still 6.5% and 4.1% of the children who had never been introduced to eggs and meat. Introduction of CFs earlier than 4 months of age was a risk factor for being underweight (age-adjusted odds ratio (ORadjust-age) = 1.7, 95% confidence interval (CI) = 1.2–2.5) and for stunting (ORadjust-age = 1.6, 95% CI = 1.1–2.3), whereas introduction of CFs later than 8 months of age was a risk factor for anemia (ORadjust-age = 3.5, 95% CI = 1.7–7.2). Mothers who had anemia (OR = 3.7, 95% CI = 2.0–6.9) tended toward early introduction of CFs. Women with a lower family income tended toward later introduction of CFs (OR = 2.0, 95% CI = 1.3–3.3). This study demonstrated that inappropriate feeding behavior was one of the important causes of malnutrition. PMID:27481057

Child feeding style is associated with food intake and linear growth in rural Ethiopia.

PubMed

Abebe, Zeweter; Haki, Gulelat Desse; Baye, Kaleab

2017-09-01

Little is known about mother-child feeding interactions and how this is associated with food intake and linear growth. To characterize mother-child feeding styles and investigate their associations with accepted mouthful and linear growth in west Gojam, rural Ethiopia. Two, in-home, meal observations of children aged 12-23 months (n = 100) were video-taped. The number of mouthful accepted was counted and the caregiver/child feeding styles were coded into positive/negative categories of self-feeding, responsive-feeding, active-feeding, social-behavior and distraction. Data on socio-demographic characteristics, child feeding practices, perception about child's overall appetite, and strategies adopted to overcome food refusal were collected through questionnaire-based interviews. Child and mothers' anthropometric measurements were also taken. Stunting was highly prevalent (48%) and the number of mouthful accepted was very low. Offering breastmilk and threatening to harm were the main strategies adopted to overcome food refusal. Although all forms of feeding style were present, active positive feeding style was dominant (90%) and was positively associated with mouthful accepted. Talking with non-feeding partner (64%), and domestic animals (24%) surrounding the feeding place were common distractions of feeding. Feeding was mostly terminated by caregivers (75%), often prematurely. Overall, caregivers of stunted children had poorer complementary- and breast-feeding practices and were less responsive to child's hunger and satiation cues (P < 0.05). Positive responsive feeding behaviors were associated with child's number of mouthful accepted (r = 0.27; P = 0.007) and stunting (r = 0.4; P < 0.001). Low complementary food intake in this setting is associated with caregivers' feeding style and stunting. Nutrition interventions that reinforce messages of optimal infant and young child feeding and integrate the promotion of responsive feeding behaviors are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Non-governmental organization facilitation of a community-based nutrition and health program: Effect on program exposure and associated infant feeding practices in rural India.

PubMed

Singh, Veena; Ahmed, Saifuddin; Dreyfuss, Michele L; Kiran, Usha; Chaudhery, Deepika N; Srivastava, Vinod K; Ahuja, Ramesh C; Baqui, Abdullah H; Darmstadt, Gary L; Santosham, Mathuram; West, Keith P

2017-01-01

Integrated nutrition and health programs seek to reduce undernutrition by educating child caregivers about infant feeding and care. Data on the quality of program implementation and consequent effects on infant feeding practices are limited. This study evaluated the effectiveness of enhancing a nutrition and health program on breastfeeding and complementary-feeding practices in rural India. Utilizing a quasi-experimental design, one of the implementing districts of a Cooperative for Assistance and Relief Everywhere (CARE) nutrition and health program was randomly selected for enhanced services and compared with a district receiving the Government of India's standard nutrition and health package alone. A cohort of 942 mother-child dyads was longitudinally followed from birth to 18 months. In both districts, the evaluation focused on responses to services delivered by community-based nutrition and health care providers [anganwadi workers (AWWs) and auxiliary nurse midwives (ANMs)]. The CARE enhanced program district showed an improvement in program coverage indicators (e.g., contacts, advice) through outreach visits by both AWWs (28.8-59.8% vs. 0.7-12.4%; all p<0.05) and ANMs (8.6-46.2% vs. 6.1-44.2%; <0.05 for ages ≥6 months). A significantly higher percentage of child caregivers reported being contacted by the AWWs in the CARE program district (20.5-45.6% vs. 0.3-21.6%; p<0.05 for all ages except at 6months). No differences in ANM household contacts were reported. Overall, coverage remained low in both areas. Less than a quarter of women received any infant feeding advice in the intervention district. Earlier and exclusive breastfeeding improved with increasing number or quality of visits by either level of health care provider (OR: 2.04-3.08, p = <0.001), after adjusting for potentially confounding factors. Socio-demographic indicators were the major determinants of exclusive breastfeeding up to 6 month and age-appropriate complementary-feeding practices thereafter in the program-enhanced but not comparison district. An enhanced nutrition and health intervention package improved program exposure and associated breastfeeding but not complementary-feeding practices, compared to standard government package. ClinicalTrials.gov NCT00198835.

Breastfeeding and Complementary Feeding Practices among HIV-Exposed Infants in Coastal Tanzania.

PubMed

Williams, Anne M; Chantry, Caroline; Geubbels, Eveline L; Ramaiya, Astha K; Shemdoe, Aloisia I; Tancredi, Daniel J; Young, Sera L

2016-02-01

Appropriate infant feeding is a persistent challenge for human immunodeficiency virus (HIV)-infected mothers in sub-Saharan Africa. This study aimed to describe correlates of infant feeding among HIV-infected mothers in coastal Tanzania. HIV-infected women (n = 400) with infants younger than 18 months were enrolled from June to November 2011 from 3 public health facilities in Pwani, Tanzania: Tumbi Regional Hospital (TRH), Chalinze Health Center (CHC), and Bagamoyo District Hospital (BDH). Participants were surveyed about sociodemographics and infant feeding behavior at enrollment; infant feeding data were collected prospectively and retrospectively in the month of study follow-up. Statistically significant correlates of exclusive breastfeeding (EBF) were infant age (months) (adjusted odds ratio [AOR] = 0.6; 95% confidence interval [CI], 0.5-0.9), enrollment facility (TRH: reference; CHC: AOR = 5.0, 95% CI, 1.2-20.8; BDH: AOR = 11.6, 95% CI, 2.3-59.9), and HIV disclosure to one's mother (AOR = 0.2; 95% CI, 0.1-0.6). Exclusive breastfeeding prevalence among infants younger than 6 months was 77%, but 50% of infants older than 6 months no longer receiving breast milk did not receive animal source foods (ASF) daily. Enrollment facility (TRH: reference; CHC: AOR = 0.2, 95% CI, 0.1-1.0; BDH: AOR = 0.1, 95% CI, 0.01-0.4) and HIV disclosure (to mother-in-law: AOR = 0.2, 95% CI, 0.1-0.8; to brother: AOR = 0.3, 95% CI, 0.1-0.8) were negatively associated with ASF provision. High prevalence of EBF suggests that it is an attainable behavior, whereas low prevalence of daily ASF provision suggests that adequate diets are difficult to achieve after breastfeeding cessation. These findings support current recommendations for HIV-infected mothers in resource-poor regions to continue breastfeeding for at least 1 year and suggest the need for greater support with complementary feeding. Associations between HIV disclosure and infant feeding merit further exploration, and correlations between enrollment facility and infant feeding highlight the potential influence of clinics on achieving infant feeding recommendations. © The Author(s) 2015.

Feeding Practices and Infant Growth: Quantifying the Effects of Breastfeeding Termination and Complementary Food Introduction on BMI z-Score Growth Velocity through Growth Curve Models.

PubMed

Horodynski, Mildred A; Pierce, Steven J; Reyes-Gastelum, David; Olson, Beth; Shattuck, Mackenzie

2017-12-01

Infant feeding practices are a focus of early obesity prevention. We tested whether infant growth velocity increased after breastfeeding termination and complementary food introduction. Our secondary analysis included a sample of 547 mother-infant dyads from a longitudinal randomized controlled trial conducted in Michigan and Colorado. Infant anthropometrics at birth, baseline, and 6- and 12-month follow-up were standardized to BMI-for-age z-score (ZBMI) according to World Health Organization (WHO) growth charts. We used growth curve models with time-varying predictors to quantify effects of breastfeeding termination and timing of complementary food introduction on growth velocity. Median breastfeeding duration was 2.0 months [confidence interval (CI) = 2.0-2.5]; median introduction of complementary foods occurred at 3.0 months (CI = 2.8-3.2). Breastfed infants not yet introduced to complementary foods had an average ZBMI growth velocity of 0.050 (CI = -0.013 to 0.113) z-score units per month [zpm], not significantly faster than WHO growth trajectory (p = 0.118) defined as 0 zpm. Breastfeeding termination had negligible effect on ZBMI growth velocity (γ 11  = 0.001, CI = -0.027 to 0.030, p = 0.927). Introduction of complementary foods increased ZBMI growth velocity relative to an average child in the sample, but not significantly (γ 12  = 0.033, CI = -0.034 to 0.100, p = 0.334). Growth velocities for infants receiving complementary foods both before and after breastfeeding termination were significantly faster than the WHO growth trajectory (0.083 zpm, CI = 0.052-0.114, and 0.084 zpm, CI = 0.064-0.105, respectively, p's < 0.001). Average postcomplementary food introduction growth velocity was significantly higher than WHO growth trajectory, but did not differ from the sample's initial average trajectory. Growth curve models can accurately estimate effects of feeding practices on infant growth to direct obesity prevention efforts.

Nutrients and neurodevelopment: lipids.

PubMed

González, Horacio F; Visentin, Silvana

2016-10-01

Nutrients, lipids in particular, make up the central nervous system structure and play major functional roles: they stimulate development, migration, and nerve cell differentiation. They are part of gray matter, white matter, nerve nuclei, and synaptogenesis. Breast milk contains lipids which are crucial for infant brain development. The lipid profile of breast milk was used as a guideline for the development of breast milk substitutes. However, to date, no substitute has matched it. Complementary feeding should include docosahexaenoic acid, arachidonic acid, other polyunsaturated fatty acids, saturated fatty acids, and complex lipids found in milk fat. The lipid composition of breast milk depends on maternal intake and nutritional status during pregnancy and breast-feeding. It has a great impact on development. Our goal is to review scientific literature regarding the role of lipids on infant brain development and the importance of breast milk lipid composition, maternal diet, and complementary feeding. Sociedad Argentina de Pediatría.

Knowledge about food classification systems and value attributes provides insight for understanding complementary food choices in Mexican working mothers.

PubMed

Rodriguez-Oliveros, Maria Guadalupe; Bisogni, Carole A; Frongillo, Edward A

2014-12-01

Knowledge about mothers' perceptions of food classification and values about complementary feeding is necessary for designing educational and food supply interventions targeted to young children. To determine classification, attributes, and consumption/preparation routines of key complementary foods, 44 mothers of children < 2 y of age in 14 manufacturing businesses were studied. Using 31 key foods, we conducted free-listings, pile-sort, and food attributes exercises. Hierarchical clustering showed that mothers identified nine classes of key foods, including milk derivatives, complements, junk food, infant products, chicken parts, and other meats. From multidimensional scaling, mothers used three primary classification systems: food groups, food introduction stages, and food processing. Secondary classification systems were healthy-junk, heavy-light, hot-cold, good-bad fat, and main dish-complement. Child health and nutrition, particularly vitamin content, were salient attributes. Fruits and vegetables were preferred for initiating complementary feeding on the second month of age. Consumption of guava, mango, and legumes, however, was associated with digestive problems (empacho). Red meats were viewed as cold-type, heavy, and hard, not suitable for young children, but right for toddlers. Chicken liver was considered nutritious but dirty and bitter. Egg and fish were viewed as a vitamin source but potentially allergenic. Mothers valued vitamin content, flavor, and convenience of processed foods, but some were suspicious about expiration date, chemical and excessive sugar content and overall safety of these foods. Mothers' perceptions and values may differ from those of nutritionists and program designers, and should be addressed when promoting opportune introduction of complementary foods in social programs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Infant feeding practices in Bombay slums.

PubMed

Bavdekar, S B; Bavdekar, M S; Kasla, R R; Raghunandana, K J; Joshi, S Y; Hathi, G S

1994-09-01

A study was conducted in two slum areas in a Bombay suburb covering a total population of 4879. One hundred and fifty-three mothers having children below two years were interviewed. Ninety six per cent infants below the age of 4 months received breast milk, though exclusive breastfeeding was practised only in 37% infants. Timely complementary feeding rate was only 0.48. Twenty three per cent of mothers used bottle for administration of supplementary food or water. Only 15.7% of mothers used commercial milk formula and 8.5% used commercial weaning food.

A Food Transfer Program without a Formal Education Component Modifies Complementary Feeding Practices in Poor Rural Mexican Communities.

PubMed

Ramírez-Luzuriaga, María J; Unar-Munguía, Mishel; Rodríguez-Ramírez, Sonia; Rivera, Juan A; González de Cosío, Teresa

2016-01-01

Inadequate complementary feeding partially explains micronutrient deficiencies in the first 2 y of life. To prevent malnutrition, the Mexican government implemented the Programa de Apoyo Alimentario (PAL), which transferred either food baskets containing micronutrient-fortified milk and animal food products or cash to beneficiary families along with educational sessions. This study evaluated the impact of PAL on 2 indicators of complementary feeding: minimum dietary diversity and consumption of iron-rich or iron-fortified foods in children aged 6-23 mo. A secondary analysis of the original PAL evaluation design was conducted through a randomized community trial implemented with 3 intervention groups (food basket with education, food basket without education, and cash transfer with education) and a control. The impact of PAL after 14 mo of exposure was estimated in 2 cross-sectional groups of children aged 6-23 mo at baseline and at follow-up in a panel of 145 communities by using difference-in-difference models. Only children who lived in households and communities that were similar between treatment groups at baseline were included in the analysis. These children were identified by using a propensity score. Of the 3 intervention groups, when compared with the control, only the food basket without education group component increased the consumption of iron-rich or iron-fortified foods by 31.2 percentage points (PP) (P < 0.01) and the prevalence of minimum dietary diversity by 21.6 PP (P < 0.01). These findings suggest that in order to improve dietary quality in children, food baskets that include fortified complementary foods may be more effective than cash transfers. The fact that the 2 food basket groups differed in the observed impact does not allow for more convincing conclusions to be made about the education component of the program. This trial was registered at clinicaltrials.gov as NCT01304888. © 2016 American Society for Nutrition.

Nutrient Content And Acceptability Of Snakehead-Fish (Ophiocephalus Striatus) And Pumpkin (Cucurbita Moschata) Based Complementary Foods

NASA Astrophysics Data System (ADS)

Ratna Noer, Etika; Candra, Aryu; Panunggal, Binar

2017-02-01

Poor nutrient-dense complementary foods is one of the common factors contributed for decline growth pattern in children. Snakehead-fish and Pumpkin Complementary Feeding (SPCF) base on locally food can help to reduce child malnutrition. Specifically, high protein and vitamin A in SPCF may improve immunity and nutrition status of malnutrition children. This study aimed to formulate low-cost, nutritive value and acceptable of SPCF on malnutrition children in coastal area. Carbohydrate content was determined by difference, protein by Kjeldahl, betacaroten by spectofotometri and sensory evaluation using a five point hedonic scale. Fe and zinc was determined by AAS. There is an effect of the substitution of snake-head fish flour and yellow pumpkin flour toward the nutrient content and the acceptability

Cadmium, lead, mercury and arsenic in animal feed and feed materials - trend analysis of monitoring results.

PubMed

Adamse, Paulien; Van der Fels-Klerx, H J Ine; de Jong, Jacob

2017-08-01

This study aimed to obtain insights into the presence of cadmium, lead, mercury and arsenic in feed materials and feed over time for the purpose of guiding national monitoring. Data from the Dutch feed monitoring programme and from representatives of the feed industry during the period 2007-13 were used. Data covered a variety of feed materials and compound feeds in the Netherlands. Trends in the percentage of samples that exceeded the maximum limit (ML) set by the European Commission, and trends in average, median and 90th percentile concentrations of each of these elements were investigated. Based on the results, monitoring should focus on feed material of mineral origin, feed material of marine origin, especially fish meal, seaweed and algae, as well as feed additives belonging to the functional groups of (1) trace elements (notably cupric sulphate, zinc oxide and manganese oxide for arsenic) and (2) binders and anti-caking agents. Mycotoxin binders are a new group of feed additives that also need attention. For complementary feed it is important to make a proper distinction between mineral and non-mineral feed (lower ML). Forage crops in general do not need high priority in monitoring programmes, although for arsenic grass meal still needs attention.

The effect of early feeding practices on growth indices and obesity at preschool children from four European countries and UK schoolchildren and adolescents.

PubMed

Moschonis, George; de Lauzon-Guillain, Blandine; Jones, Louise; Oliveira, Andreia; Lambrinou, Christina-Paulina; Damianidi, Louiza; Lioret, Sandrine; Moreira, Pedro; Lopes, Carla; Emmett, Pauline; Charles, Marie Aline; Manios, Yannis

2017-09-01

Not only healthy growth but also childhood obesity partly originate from early life. The current work aimed to examine the association of feeding practices during infancy with growth and adiposity indices in preschool children from four European countries and in UK schoolchildren and adolescents. Existing data from four European birth cohorts (ALSPAC-UK, EDEN-France, EuroPrevall-Greece and Generation XXI-Portugal) were used. Anthropometrics and body composition indices were collected. Parallel multivariate regression analyses were performed to examine the research hypothesis. Overall, the analyses showed that breastfeeding and timing of complementary feeding were not consistently associated with height z-score, overweight/obesity, and body fat mass in children or adolescents. However, breastfeeding duration for less than 6 months was associated with lower height z-scores in 5-year-old French children (P < 0.001) but with higher height z-scores in 4-year-old UK children (P = 0.006). Furthermore, introduction of complementary foods earlier than 4 months of age was positively associated with fat mass levels in 5-year-old French children (P = 0.026). Early feeding practices, i.e., any breastfeeding duration and age of introduction of complementary foods, do not appear to be consistently associated with height z-score, overweight/obesity, and body fat mass in preschool children from four European countries and in UK schoolchildren and adolescents. What is known? • Healthy growth and childhood obesity partly originate from early life. What is new? • Breastfeeding duration less than 6 months was associated with lower height z-scores in 5-year-old French children, while the opposite was observed in 4-year-old British children. • Introduction of complementary foods earlier than 4 months was positively associated with fat mass levels in 5-year-old French children, but not in the other three countries. • Early feeding practices did not appear to be consistently associated with growth and adiposity indices, and as such, no clear influence can be observed.

Effect of in-home fortification of complementary feeding on intellectual development of Chinese children.

PubMed

Chen, Chun-Ming; Wang, Yu-Ying; Chang, Su-Ying

2010-04-01

To explore the effect of in-home fortification of complementary feeding on intellectual development of Chinese children aged below 24 months. One thousand and four hundred seventy eight children aged 4-12 months were recruited and divided into study groups (formula 1 group and formula 2 group) and control group. In two study groups, in addition to the usual complementary food, children were fed with a sachet of fortified food supplement each day. Protein and micronutrients were provided in formula 1 group. Formula 2 group had the same energy intake as the formula 1 group . In addition to measurement of physical growth and detection of hemoglobin level, Development Quotient (DQ) or Intelligence Quotient (IQ) was assessed. The DQ of children aged below 24 months was 97.2, 95.5, and 93.8 in formula 1 group, formula 2 group and control group, respectively, and the differences were statistically significant (P < 0.05). The DQ of children in formula 1 group, formula 2 group, and control group was 92.7, 90.4, and 88.3 respectively in the first follow up showing statistically significant differences (P < 0.05). And, DQ of children in formula 1 group, formula 2 group and control group were 96.7, 94.5, and 93.7 respectively in the second follow up, showing statistically significant differences (P < 0.05). Full-IQ of children in the formula 1 group was 3.1 and 4.5 points higher than that in formula 2 group and in control group respectively. Verbal IQ of children in the formula 1 group was 2.1 and 5 points higher than that in formula 2 group and control group respectively. Performance IQ was 2.5 and 3.1 points higher than that in formula 2 group and control group respectively. All above mentioned comparisons were statistically significant. Fortification of complementary feeding showed persistent effect on intelligence development of young children which could persist to 6 years of age. The critical time for correction of anemia could be under 18 months.

Breast-feeding initiation and exclusive breast-feeding in rural Vietnam.

PubMed

Duong, Dat V; Binns, Colin W; Lee, Andy H

2004-09-01

To investigate the initiation of breast-feeding and exclusive breast-feeding within the first week after delivery for women in rural Vietnam. An interviewer-administered survey was conducted on a sample of rural women who gave birth during August-October 2002. Quang Xuong District, Thanh Hoa Province of Vietnam. Four hundred and sixty-three women participated in the study, of whom 181 delivered at the district hospital (39.1%), 229 at a commune health centre (49.5%) and 53 at home attended by a traditional birth attendant (11.4%). Although the initiation and exclusive breast-feeding rates were relatively high at 98.3% and 83.6% respectively, the premature introduction of complementary food was a great concern. Logistic regression analysis showed that, together with socio-cultural determinants such as feeding preferences of the husband and maternal grandmother, feeding practices of friends, factors relating to delivery methods, delivery locations and health problems could influence the initiation rate and breast-feeding patterns. To promote breast-feeding practices of rural mothers, health education on breast-feeding should take into account local socio-cultural features in addition to improving the counselling skills of health workers.

Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition.

PubMed

Fewtrell, Mary; Bronsky, Jiri; Campoy, Cristina; Domellöf, Magnus; Embleton, Nicholas; Fidler Mis, Nataša; Hojsak, Iva; Hulst, Jessie M; Indrio, Flavia; Lapillonne, Alexandre; Molgaard, Christian

2017-01-01

This position paper considers different aspects of complementary feeding (CF), focussing on healthy term infants in Europe. After reviewing current knowledge and practices, we have formulated these recommendations: Timing: Exclusive or full breast-feeding should be promoted for at least 4 months (17 weeks, beginning of the 5th month of life) and exclusive or predominant breast-feeding for approximately 6 months (26 weeks, beginning of the 7th month) is a desirable goal. Complementary foods (solids and liquids other than breast milk or infant formula) should not be introduced before 4 months but should not be delayed beyond 6 months. Infants should be offered foods with a variety of flavours and textures including bitter tasting green vegetables. Continued breast-feeding is recommended alongside CF. Whole cows' milk should not be used as the main drink before 12 months of age. Allergenic foods may be introduced when CF is commenced any time after 4 months. Infants at high risk of peanut allergy (those with severe eczema, egg allergy, or both) should have peanut introduced between 4 and 11 months, following evaluation by an appropriately trained specialist. Gluten may be introduced between 4 and 12 months, but consumption of large quantities should be avoided during the first weeks after gluten introduction and later during infancy. All infants should receive iron-rich CF including meat products and/or iron-fortified foods. No sugar or salt should be added to CF and fruit juices or sugar-sweetened beverages should be avoided. Vegan diets should only be used under appropriate medical or dietetic supervision and parents should understand the serious consequences of failing to follow advice regarding supplementation of the diet. Parents should be encouraged to respond to their infant's hunger and satiety queues and to avoid feeding to comfort or as a reward.

[Effects of infant feeding practice on eczema during early childhood in Shanghai, Hohhot, and Fuzhou].

PubMed

Zheng, X Q; Zhu, G W; Zheng, Z Q; Yang, Y; Gong, C D; Deng, S S; Wu, Q L; Peng, Y M

2016-12-02

Objective: To estimate the prevalence of eczema in early childhood and effect of infant feeding practice on eczema by different regions of China with diverse climate and dietary patterns. Method: A questionnaire survey was conducted from June 2012 to October 2012 in Shanghai, Hohhot, and Fuzhou. The parent or guardian of the children aged between 2.5 to 3.5 years attending routine health visit in the chosen communities were invited to complete a modified questionnaire of the International Study of Asthma and Allergy in Childhood (ISAAC). Logistic regression model was used to analyze of the family history of allergy, duration of breastfeeding, timing of introduction of complementary foods and other potential confounders. Result: A total of 2 242 children were interviewed, 750 from Shanghai, 716 from Hohhot, and 776 from Fuzhou. The prevalence of eczema in early childhood was significantly different among Shanghai (16.9%, 95% CI 16.87-16.93), Hohhot (34.5%, 95% CI 34.46-34.54)and Fuzhou (44.3%, 95% CI 44.26-44.34). The difference was statistically significant between 3 groups (χ 2 =72.05, P <0.05). Introducing complementary food after the age of 6 months was associated with a decreased risk for eczema when compared to introduction between 4 to 6 months(odds ratio (OR) 0.58, 95% CI 0.41-0.81) in Fuzhou, while there was no significant association between timing of introduction of complementary foods and eczema in Shanghai and Hohhot. Conclusion: The prevalence of eczema during early childhood is various among three cities. The relationship between timing of introduction of complementary foods and eczema in Fuzhou is different from that in Shanghai and Hohhot. The role of climate and dietary patterns on prevalence of eczema needs further studies.

Effects of complementary and excess diet supplementation with selected minerals on their metabolism and distribution in the body: a model study.

PubMed

Friedrich, Mariola; Podlaszewska, Grażyna; Pokorska-Niewiada, Kamila

2015-01-01

n. The study was aimed at determining, on an animal model, effects of supplementing a diet, modified by substituting whole wheat and corn grains with white flour and sucrose, with calcium, magnesium, zinc, and chromium on metabolism of the minerals and their distribution in the body. The study involved 4 groups of Wistar rat females (n = 11) fed: a standard feed (group I) containing, i.a., whole wheat and corn grains; modified feed (84% and 50% of whole wheat and corn grains, respectively, in the standard feed substituted with Type 500 wheat flour and sucrose, respectively) (group II); modified feed with complementary supplementation (elimination of Ca, Mg, Zn, and Cr deficiencies resulting from diet modification) (group III); and modified feed with excess supplementation (the same minerals applied in excess, i.e., amounts from 0.5 to 3 times higher than the deficiencies produced by diet modification) (group IV). The replacement of whole grains with white flour and sucrose, as well as the mineral  supplementation could, to some extent, imitate the contemporary eating habits and supplementation applied in food technology. The excess supplementation is, on the other hand, typical of current behaviours of various social groups. Both types of supplementation resulted in a significant increase in the perivisceral adipose tissue content, but did not affect the fat tissue content in muscles. The supplementation applied did not change the content of calcium, magnesium, and zinc in muscles, nor did it significantly change calcium and magnesium excretion with urine. However, changes in the ALP activity and calcitonin concentration did not suggest the deposition of the minerals in bones. Analysis of the results allowed to conclude that: 1) except for chromium, contents of the selected minerals in the tissues examined and urea, as well as concentrations of calcitonin and alkaline phosphatase (ALP) activities did not point to any significant effect of the supplementation applied on the body contents of those minerals; 2) effects observed as the accumulation of perivisceral, epicardial and intramuscular adipose tissue, as well as increased body weight increments could have been related to disturbed proportions of the minerals supplemented, their synergy and antagonism and, consequently, a potential generation of secondary deficiencies and excesses which could significantly affect individual metabolic pathways; 3) the intensity of changes observed was generally higher in the females receiving complementary supplementation, although their uptake of minerals studied was similar to that shown by the females kept on the standard diet.

The challenge of meeting nutrient needs of infants and young children during the period of complementary feeding: an evolutionary perspective.

PubMed

Dewey, Kathryn G

2013-12-01

Breast-fed infants and young children need complementary foods with a very high nutrient density (particularly for iron and zinc), especially at ages 6-12 mo. However, in low-income countries, their diet is usually dominated by cereal-based porridges with low nutrient density and poor mineral bioavailability. Complementary feeding diets typically fall short in iron and zinc and sometimes in other nutrients. These gaps in nutritional adequacy of infant diets have likely been a characteristic of human diets since the agricultural revolution ~10,000 y ago. Estimates of nutrient intakes before then, based on hypothetical diets of preagricultural humans, suggest that infants had much higher intakes of key nutrients than is true today and would have been able to meet their nutrient needs from the combination of breast milk and premasticated foods provided by their mothers. Strategies for achieving adequate nutrition for infants and young children in modern times must address the challenge of meeting nutrient needs from largely cereal-based diets.

Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6-23 months in poor areas of Qinghai Province, China: a controlled interventional study.

PubMed

Zhang, Yanfeng; Wu, Qiong; Wang, Wei; van Velthoven, Michelle Helena; Chang, Suying; Han, Huijun; Xing, Min; Chen, Li; Scherpbier, Robert W

2016-10-31

To assess the effectiveness of dietary counselling and complementary food supplements on anaemia and stunting prevalence in children aged 6-23 months. A controlled intervention study with measurements of height and haemoglobin levels, and cross-sectional surveys in August 2012 (baseline), 2013 (mid-term) and 2014 (end-line). One intervention county and one control county in rural Qinghai Province, China. Complementary food supplements (containing protein, fat, carbohydrate, vitamin A, B 1 , B 2 , B 12 , D 3 , folic acid, iron, zinc and calcium) and complementary feeding counselling were given in the intervention county. Caregivers and their children aged 6-23 months. Effect of the interventions on the prevalence of anaemia (haemoglobin <110 g/L) and stunting (z-score of height-for-age <-2.0) (controlled for differences between the counties), and on infant feeding practices. The surveys were conducted on 1804, 2187 and 2186 children aged 6-23 months in the intervention county in August 2012, 2013 and 2014, respectively, and 804, 680 and 790 children in the control county, respectively. Between the baseline and end-line surveys, anaemia prevalence decreased more in the intervention county than in the control county (71.1% to 47.8% vs 86.3% to 75.3%, respectively; p<0.0001). There was no difference in the decrease in stunting prevalence between the counties (9.7% to 7.1% vs 17.0% to 15.0%; p=0.7954). The proportions of children given iron-rich or iron-fortified food, introduced to (semi-) solid food at 6-8 months, and given food with minimum dietary diversity increased from 43.2% to 88.8% (p<0.0001), 81.4% to 96% (p=0.0470) and 53.0% to 59.8% (p<0.0001), respectively in the intervention county. We found much higher anaemia prevalence in poor rural areas of Qinghai Province compared with the national data. Community-based complementary food supplements combined with dietary counselling can improve feeding practices and reduce anaemia prevalence. Future studies should use longer follow-up to assess the effects on stunting. We included a large number of participants and assessed a combined complementary food supplements and dietary counselling intervention in a poor rural area in China with high anaemia prevalence. Although the study took place in only one intervention county and one control county, we conducted an analysis that controlled for differences between the two counties. Also, although we made significant efforts to train village doctors, their education was not systematically assessed after training and thus their delivery of the interventions may have been variable. ChiCTRPRC12002444; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effectiveness of complementary food supplements and dietary counselling on anaemia and stunting in children aged 6–23 months in poor areas of Qinghai Province, China: a controlled interventional study

PubMed Central

Zhang, Yanfeng; Wu, Qiong; Wang, Wei; van Velthoven, Michelle Helena; Chang, Suying; Han, Huijun; Xing, Min; Chen, Li; Scherpbier, Robert W.

2016-01-01

Objective To assess the effectiveness of dietary counselling and complementary food supplements on anaemia and stunting prevalence in children aged 6–23 months. Design A controlled intervention study with measurements of height and haemoglobin levels, and cross-sectional surveys in August 2012 (baseline), 2013 (mid-term) and 2014 (end-line). Setting One intervention county and one control county in rural Qinghai Province, China. Intervention Complementary food supplements (containing protein, fat, carbohydrate, vitamin A, B1, B2, B12, D3, folic acid, iron, zinc and calcium) and complementary feeding counselling were given in the intervention county. Participants Caregivers and their children aged 6–23 months. Primary and secondary outcome measures Effect of the interventions on the prevalence of anaemia (haemoglobin <110 g/L) and stunting (z-score of height-for-age <−2.0) (controlled for differences between the counties), and on infant feeding practices. Results The surveys were conducted on 1804, 2187 and 2186 children aged 6–23 months in the intervention county in August 2012, 2013 and 2014, respectively, and 804, 680 and 790 children in the control county, respectively. Between the baseline and end-line surveys, anaemia prevalence decreased more in the intervention county than in the control county (71.1% to 47.8% vs 86.3% to 75.3%, respectively; p<0.0001). There was no difference in the decrease in stunting prevalence between the counties (9.7% to 7.1% vs 17.0% to 15.0%; p=0.7954). The proportions of children given iron-rich or iron-fortified food, introduced to (semi-) solid food at 6–8 months, and given food with minimum dietary diversity increased from 43.2% to 88.8% (p<0.0001), 81.4% to 96% (p=0.0470) and 53.0% to 59.8% (p<0.0001), respectively in the intervention county. Conclusions We found much higher anaemia prevalence in poor rural areas of Qinghai Province compared with the national data. Community-based complementary food supplements combined with dietary counselling can improve feeding practices and reduce anaemia prevalence. Future studies should use longer follow-up to assess the effects on stunting. Strengths and limitations We included a large number of participants and assessed a combined complementary food supplements and dietary counselling intervention in a poor rural area in China with high anaemia prevalence. Although the study took place in only one intervention county and one control county, we conducted an analysis that controlled for differences between the two counties. Also, although we made significant efforts to train village doctors, their education was not systematically assessed after training and thus their delivery of the interventions may have been variable. Trial registration number ChiCTRPRC12002444; Pre-results. PMID:27799239

Association between breast-feeding practices and sucking habits: a cross-sectional study of children in their first year of life.

PubMed

Moimaz, Suzely A S; Zina, Lívia G; Saliba, Nemre A; Saliba, Orlando

2008-09-01

In addition to providing nutrition and immunological protection, breast-feeding has positive effects on the development of the infant's oral cavity. The aim of the present study is to assess breast-feeding patterns and to analyze the influence of breast-feeding practices and maternal sociodemographic variables on the prevalence of non-nutritive sucking habits in a sample of Brazilian infants. This cross-sectional study was carried out in Southern Brazil. A random sample of 100 mothers of infants up to 12 months of age was interviewed during the National Vaccination Campaign Day. The prevalence and median duration of breast-feeding were assessed. Breast-feeding practice, the exposure factor, was categorized as exclusive breast-feeding, predominant breast-feeding, complementary breast-feeding, or weaning. Maternal sociodemographic variables included age, race, marital status, educational level, profession, and family income. The outcome investigated was the prevalence of sucking habits (pacifier use and thumb sucking). We used two-sample tests, the chi-square test and FISHER'S EXACT TEST for statistical analyses of the data. The study revealed that 75% of infants were being breast-fed. Pacifier use and thumb sucking were common in 55%. Bottle-feeding was prevalent in 74% of infants. Breast-feeding was negatively correlated with pacifier use and thumb sucking (OR=0.11; 95% CI: 0.03 to 0.4). Bottle-feeding was strongly associated with weaning (p=0.0003). Among the sociodemographic variables, only marital status showed a statistical association with sucking habits (p=0.04). These findings suggest that breast-feeding can prevent the occurrence of sucking habits. Although we could not evaluate causality assessment, malocclusion prevention seems to be yet one more reason for promoting breast-feeding practices.

Who's feeding baby? Non-maternal involvement in feeding and its association with dietary intakes among infants and toddlers.

PubMed

Wasser, Heather M; Thompson, Amanda L; Siega-Riz, Anna Maria; Adair, Linda S; Hodges, Eric A; Bentley, Margaret E

2013-12-01

This study examined non-maternal involvement in feeding during the first 2 years of life and its association with breastfeeding duration, early introduction of complementary foods, and dietary intakes of selected foods and beverages. Data were from the Infant Care, Feeding and Risk of Obesity Study, a cohort of 217 low-income, African-American mother-infant dyads, followed from 3 to 18 months postpartum. Non-maternal caregivers (NMCs) were defined as persons involved in feeding an infant/toddler 50% or more of the total daily feedings. Use of any NMC and the type of NMC was tabulated for each study visit (3, 6, 9, 12, and 18 months). At each time point, more than half of all households reported a NMC. Fathers, grandmothers, and licensed childcare providers were the most common types of NMCs. In longitudinal models adjusted for confounding variables, NMC use was associated with a decreased likelihood of continued breastfeeding, and an increased likelihood of infants and toddlers consuming juice or whole fruit. Given the high prevalence of non-maternal involvement in feeding, interventions targeting multiple family members are warranted as they are likely to be more effective than those targeting the mother alone. Copyright © 2013 Elsevier Ltd. All rights reserved.

Who’s feeding baby? Non-maternal involvement in feeding and its association with dietary intakes among infants and toddlers

PubMed Central

Wasser, Heather M.; Thompson, Amanda L.; Siega-Riz, Anna Maria; Adair, Linda S.; Hodges, Eric A.; Bentley, Margaret E.

2013-01-01

This study examined non-maternal involvement in feeding during the first two years of life and its association with breastfeeding duration, early introduction of complementary foods, and dietary intakes of selected foods and beverages. Data were from the Infant Care, Feeding and Risk of Obesity Study, a cohort of 217 low-income, African-American mother-infant dyads, followed from 3-18 months postpartum. Non-maternal caregivers (NMCs) were defined as persons involved in feeding an infant/toddler 50% or more of the total daily feedings. Use of any NMC and the type of NMC was tabulated for each study visit (3, 6, 9, 12, and 18 months). At each time point, more than half of all households reported a NMC. Fathers, grandmothers, and licensed childcare providers were the most common types of NMCs. In longitudinal models adjusted for confounding variables, NMC use was associated with a decreased likelihood of continued breastfeeding, and an increased likelihood of infants and toddlers consuming juice or whole fruit. Given the high prevalence of non-maternal involvement in feeding, interventions targeting multiple family members are warranted as they are likely to be more effective than those targeting the mother alone. PMID:23856432

Breastfeeding and complementary feeding in relation to body mass index and overweight at ages 7 and 11 y: a path analysis within the Danish National Birth Cohort.

PubMed

Morgen, Camilla Schmidt; Ängquist, Lars; Baker, Jennifer L; Andersen, Anne-Marie Nybo; Sørensen, Thorkild I A; Michaelsen, Kim F

2018-03-01

Infant feeding may play an important role in the development of childhood overweight and obesity. The objective of this study was to examine whether duration of breastfeeding (BF), timing of introduction of complementary food, and protein intake at age 18 mo are associated with body mass index [BMI (measured in kg/m2)] and overweight at ages 7 and 11 y, independent of BMI during infancy. Children participating in the Danish National Birth Cohort were followed up at ages 7 and 11 y. Information on infant feeding, protein intake at age 18 mo, Ponderal Index at birth, child BMI (at ages 5 mo, 12 mo, 7 y, and 11 y), and several parental factors was available. Path analysis was used to assess the direct and indirect effects of infant feeding on BMI z scores (BMIz) at ages 7 (n = 36,481) and 11 y (n = 22,047). Logistic regression analyses were used to examine associations with overweight. Duration of BF was not associated with childhood BMIz at ages 7 and 11 y. Earlier introduction of complementary food (<4 mo old) was not associated with BMIz at age 7 y, but with a 0.069 (95% CI: 0.021, 0.117, P = 0.005) higher BMIz at age 11 y and increased risk of overweight at age 11 y (OR 1.44; 95% CI: 1.04, 2.00; P = 0.03). Protein intake from dairy products (per 5 g/d) was associated with higher BMIz only at age 7 y (OR: 0.012; 95% CI: 0.003, 0.021; P = 0.007). Protein intake from meat and fish (per 2 g/d) was associated with a 0.010 (95% CI: 0.004, 0.017; P = 0.003) higher BMIz at age 7 y, a 0.013 (95% CI: 0.005, 0.020; P = 0.002) higher BMIz at age 11 y and increased odds of overweight at age 7 y (OR: 1.07; 95% CI: 1.03, 1.10; P < 0.001), but not at age 11 y. Intake of protein from meat and fish at age 18 mo was associated with higher BMIz and risk of overweight in childhood. However, the effect sizes were small. Early introduction of complementary food may be associated with child BMIz and child overweight. This study was registered at www.clinicaltrials.gov as NCT03334760.

Postintervention growth of Malawian children who received 12-mo dietary complementation with a lipid-based nutrient supplement or maize-soy flour

USDA-ARS?s Scientific Manuscript database

Therapeutic feeding with micronutrient-fortified lipid-based nutrient supplements (LNSs) has proven useful in the rehabilitation of severely malnourished children. We recently reported that complementary feeding of 6 to 18-mo-old infants with LNS known as FS50, was associated with improved linear gr...

A situational review of infant and young child feeding practices and interventions in Viet Nam.

PubMed

Nguyen, Phuong Hong; Menon, Purnima; Ruel, Mariel; Hajeebhoy, Nemat

2011-01-01

Sub-optimal infant and young child feeding (IYCF) practices are likely a significant contributor to high undernutrition rates in Viet Nam. To date, however, there has been no comprehensive review of IYCF practices in Viet Nam. The objectives of this paper were to review: 1) patterns/trends in IYCF in Viet Nam; 2) the barriers and facilitators to IYCF practices; and 3) interventions and policies and their effectiveness. Methods used include reviewing and analyzing existing data, summarizing and organizing the evidence into broad themes based on a pre-defined conceptual framework. Findings show that the proportion of children ever breastfed is almost universal and the median duration of breastfeeding is 13-18 months. However, exclusive breastfeeding for the first six months is low (8-17%) and appears to be declining over time. Information on complementary feeding is limited, but two key challenges are: early introduction, and low nutrient quality of complementary foods. Facilitators of optimal IYCF were support from 1) government progressive policies, 2) non-profit organizations and 3) family members. Barriers to optimal IYCF included 1) the lack of enforcement of, and compliance with the code of marketing breast milk substitutes, 2) inadequate knowledge among health care providers; and 3) maternal poor knowledge. These findings indicate that the evidence base on complementary feeding is weak in Viet Nam and needs to be strengthened. The review also reinforces that program and policy actions to improve IYCF in Viet Nam must target multiple stakeholders at different levels: the family, the health system and the private sector.

Exploring barriers and enablers for scaling up a community-based grain bank intervention for improved infant and young child feeding in Ethiopia: A qualitative process evaluation.

PubMed

Sako, Binta; Leerlooijer, Joanne N; Lelisa, Azeb; Hailemariam, Abebe; Brouwer, Inge D; Tucker Brown, Amal; Osendarp, Saskia J M

2018-04-01

Child malnutrition remains high in Ethiopia, and inadequate complementary feeding is a contributing factor. In this context, a community-based intervention was designed to provide locally made complementary food for children 6-23 months, using a bartering system, in four Ethiopian regions. After a pilot phase, the intervention was scaled up from 8 to 180 localities. We conducted a process evaluation to determine enablers and barriers for the scaling up of this intervention. Eight study sites were selected to perform 52 key informant interviews and 31 focus group discussions with purposely selected informants. For analysis, we used a framework describing six elements of successful scaling up: socio-political context, attributes of the intervention, attributes of the implementers, appropriate delivery strategy, the adopting community, and use of research to inform the scale-up process. A strong political will, alignment of the intervention with national priorities, and integration with the health care system were instrumental in the scaling up. The participatory approach in decision-making reinforced ownership at community level, and training about complementary feeding motivated mothers and women's groups to participate. However, the management of the complex intervention, limited human resources, and lack of incentives for female volunteers proved challenging. In the bartering model, the barter rate was accepted, but the bartering was hindered by unavailability of cereals and limited financial and material resources to contribute, threatening the project's sustainability. Scaling up strategies for nutrition interventions require sufficient time, thorough planning, and assessment of the community's capacity to contribute human, financial, and material resources. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Exploring barriers and enablers for scaling up a community‐based grain bank intervention for improved infant and young child feeding in Ethiopia: A qualitative process evaluation

PubMed Central

Sako, Binta; Leerlooijer, Joanne N.; Lelisa, Azeb; Hailemariam, Abebe; Brouwer, Inge D.; Tucker Brown, Amal

2017-01-01

Abstract Child malnutrition remains high in Ethiopia, and inadequate complementary feeding is a contributing factor. In this context, a community‐based intervention was designed to provide locally made complementary food for children 6–23 months, using a bartering system, in four Ethiopian regions. After a pilot phase, the intervention was scaled up from 8 to 180 localities. We conducted a process evaluation to determine enablers and barriers for the scaling up of this intervention. Eight study sites were selected to perform 52 key informant interviews and 31 focus group discussions with purposely selected informants. For analysis, we used a framework describing six elements of successful scaling up: socio‐political context, attributes of the intervention, attributes of the implementers, appropriate delivery strategy, the adopting community, and use of research to inform the scale‐up process. A strong political will, alignment of the intervention with national priorities, and integration with the health care system were instrumental in the scaling up. The participatory approach in decision‐making reinforced ownership at community level, and training about complementary feeding motivated mothers and women's groups to participate. However, the management of the complex intervention, limited human resources, and lack of incentives for female volunteers proved challenging. In the bartering model, the barter rate was accepted, but the bartering was hindered by unavailability of cereals and limited financial and material resources to contribute, threatening the project's sustainability. Scaling up strategies for nutrition interventions require sufficient time, thorough planning, and assessment of the community's capacity to contribute human, financial, and material resources. PMID:29063698

Feeding styles of caregivers of children 6-23 months of age in Derashe special district, Southern Ethiopia.

PubMed

Wondafrash, Mekitie; Amsalu, Tseganeh; Woldie, Mirkuzie

2012-03-23

Apart from basic determinants, appropriate child care practices are important in prevention of growth faltering and undernutrition. Providing safe and appropriate quality complementary foods is crucial to child growth and development. However, some children in low-income communities grow normally mainly due to proper caregiver feeding behaviors. Hence, the objective of this study was to determine caregivers' feeding styles as well as to indentify predictors in Derashe special district, Southern Ethiopia. A community based cross-sectional study design was employed in the seven randomly selected Kebeles (smallest administrative unit) of Derashe special district. A total of 826 caregivers provided data pertaining to socio-demographic variables. However, 764 caregivers had complete data for the outcome variable (caregiver feeding style). A multistage stratified sampling technique was used to identify study subjects. An adapted Caregiver's Feeding Styles Questionnaire (CFSQ) was used to gather information about caregivers' feeding styles. Multivariate multinomial logistic regression was employed to identify predictors of caregivers' feeding style. The majority (80.6%) of caregivers were biological mothers. Nearly seventy-six percent of the caregivers practiced a responsive feeding style. Caregivers other than the biological mother favoured a laissez-faire feeding style, while caregivers residing in rural Kebeles were more responsive. Caregivers with a breastfeeding frequency of more than eight times predicted both laissez-faire (RRR = 1.88; 95% CI = 1.03-3.41) and controlling (RRR = 1.7; 95% CI = 1.02-2.85) feeding styles as compared to responsive feeding. Responsive feeding was the commonest style practiced by the caregivers. Many of the caregivers who were rural residents and birth parents have been responsive in child feeding. The instruments needed to be validated in the Ethiopian context and an additional prospective study based on direct observation of caregiver-child interactions is recommended.

Complementary feeding with fortified spread and incidence of severe stunting in 6- to 18-month-old rural Malawians

USDA-ARS?s Scientific Manuscript database

The objective of this study was to compare growth and incidence of malnutrition in infants receiving long-term dietary supplementation with ready-to-use fortified spread (FS) or micronutrient-fortified maize-soy flour (likuni phala [LP]). A total of 182 6-month-old infants in rural Malawi were rando...

Understanding and measuring parent use of food to soothe infant and toddler distress: A longitudinal study from 6 to 18 months of age.

PubMed

Stifter, Cynthia A; Moding, Kameron J

2015-12-01

The present study examined the development of parent use of food to soothe infant distress by examining this feeding practice longitudinally when infants were 6, 12 and 18 months of age. Two measures of feeding to soothe were obtained: parent self-report and observations of food to soothe during each laboratory visit. Demographic and maternal predictors of food to soothe were examined as well as the outcome, infant weight gain. The findings showed that the two measures of food to soothe were unrelated but did reveal similar and unique relations with predictor variables such as parent feeding style and maternal self-efficacy. Only observations of the use of food to soothe were related to infant weight gain. The findings indicate that the two measures of food to soothe may be complementary and that observations of this feeding practice may capture certain relations that are not obtained through the use of self-report. Copyright © 2015 Elsevier Ltd. All rights reserved.

Deterioration in the nutritional status of young children and their mothers in Brazzaville, Congo, following the 1994 devaluation of the CFA franc.

PubMed Central

Martin-Prével, Y.; Delpeuch, F.; Traissac, P.; Massamba, J. P.; Adoua-Oyila, G.; Coudert, K.; Trèche, S.

2000-01-01

The effects of the January 1994 devaluation of the African Financial Community (CFA) franc on the nutritional situation of the populations concerned has been little documented. We report in this article on two nutritional cross-sectional surveys that were conducted before and after this devaluation (1993 and 1996) in two districts of Brazzaville, Congo. The surveys involved a representative sample of 4206 households with a child aged 4-23 months. Complementary feeding practices and the anthropometric indices of the children and their mothers were compared, adjusting for changes in household socioeconomic characteristics. The results show a decline in the quality of the first complementary foods offered to the infants, i.e. less frequent use of special transitional foods and imported complementary flours (of higher nutritional quality), and preparation of less nutritious local gruels. Overall, the nutritional situation had deteriorated, with greater levels of stunting and wasting among children, mothers with lower body mass index, and infants with reduced birth weights. Increased food prices would appear to be the direct cause of the decreased quality in complementary feeding, but factors other than the devaluation have also had an impact on household welfare. The influence of these factors on nutritional-status is discussed. PMID:10686745

Harnessing private sector expertise to improve complementary feeding within a regulatory framework: Where is the evidence?

PubMed

van Liere, Marti J; Tarlton, Dessie; Menon, Ravi; Yellamanda, M; Reerink, Ietje

2017-10-01

Global recognition that the complex and multicausal problems of malnutrition require all players to collaborate and to invest towards the same objective has led to increased private sector engagement as exemplified through the Scaling Up Nutrition Business Network and mechanisms for blended financing and matched funding, such as the Global Nutrition for Growth Compact. The careful steps made over the past 5 to 10 years have however not taken away or reduced the hesitation and scepticism of the public sector actors towards commercial or even social businesses. Evidence of impact or even a positive contribution of a private sector approach to intermediate nutrition outcomes is still lacking. This commentary aims to discuss the multiple ways in which private sector can leverage its expertise to improve nutrition in general, and complementary feeding in particular. It draws on specific lessons learned in Bangladesh, Côte d'Ivoire, India, Indonesia, and Madagascar on how private sector expertise has contributed, within the boundaries of a regulatory framework, to improve availability, accessibility, affordability, and adequate use of nutritious foods. It concludes that a solid evidence base regarding the contribution of private sector to complementary feeding is still lacking and that the development of a systematic learning agenda is essential to make progress in the area of private sector engagement in nutrition. © 2017 John Wiley & Sons Ltd.

Nutritional status of infants and young children and characteristics of their diets.

PubMed

Lutter, Chessa K; Rivera, Juan A

2003-09-01

Adoption of the recommended breast-feeding and complementary feeding behaviors and access to the appropriate quality and quantity of foods are essential components of optimal nutrition for infants and young children between ages 6 and 24 mo. Iron, zinc and vitamin B-6 are deficient in complementary food diets in Bangladesh, Ghana, Guatemala, Mexico and Peru. Low intakes of iron are consistent with a high prevalence of anemia seen in this age group. The adequacy of observed intakes for calcium, vitamin A, thiamin, folate and vitamin C depends on the age range in question and the set of requirements used in the assessment. The lipid content of many complementary food diets is low. In addition to providing essential fatty acids, lipids are needed for the absorption of fat-soluble vitamins and also enhance the texture, flavor and aroma of foods, which may lead to increased intake. The relative roles of palatability, micronutrient deficiency and morbidity-induced anorexia in the appetite of infants and young children are not known. However, even among children who were growth retarded and had a total energy deficit compared with requirements, up to 25% of food offered was not consumed. This indicates that dietary quality rather than quantity is the key aspect of complementary food diets that needs to be improved. Targeted fortification or the production of complementary foods fortified with micronutrients and of an adequate macro- and micronutrient composition is one approach to help meet nutritional requirements during the vulnerable period of 6-24 mo.

BMI, body fat and waist-to-height ratio of stunted v. non-stunted Indian children: a case-control study.

PubMed

Savanur, Mitravinda S; Ghugre, Padmini S

2016-06-01

To compare the BMI, body fat and waist-to-height ratio (WHtR) of stunted and non-stunted children following different growth trajectories from low socio-economic strata in Mumbai, India. Cross-sectional, case-control study. Weight, height, skinfold thicknesses and waist circumference were measured. Information regarding the duration of breast-feeding, age at initiation of complementary feeding and income was obtained. Birth weight was obtained from records. BMI, body fat, WHtR and change in weight sd were calculated. Children who were beneficiaries of anganwadis, Mumbai city, India. Three hundred and thirty children aged 2-4 years were selected in each of the stunted and non-stunted groups after matching for age and sex. After adjusting for birth weight, change in weight sd, duration of breast-feeding, age at complementary feeding initiation and income, stunted children had significantly higher body fat, WHtR and BMI than the non-stunted (P<0·01). The stunted and non-stunted children were classified based on their change in weight sd. Stunted children with no change in weight sd had higher mean body fat, BMI (P<0·01) and WHtR (P<0·05) than their non-stunted counterparts. In the catch-up growth group, stunted children had higher BMI and WHtR than the non-stunted (both P<0·001). In the catch-down growth group, stunted children had higher BMI than the non-stunted (P<0·001). Stunting was seen to increase the tendency of conserving body fat in young children. Such a tendency, if continued during later childhood and adolescence, can increase the risk of obesity and non-communicable diseases.

Distinct Mechanisms Produce Functionally Complementary Actions of Neuropeptides that are Structurally Related but Derived from Different Precursors

PubMed Central

Vilim, F.S.; Sasaki, K.; Rybak, J.; Alexeeva, V.; Cropper, E.; Jing, J.; Orekhova, I.V.; Brezina, V.; Price, D.; Romanova, E.V.; Rubakhin, S.S.; Hatcher, N.; Sweedler, J.V.; Weiss, K.R.

2010-01-01

Many bioactive neuropeptides containing RFamide at their C-terminus have been described in both invertebrates and vertebrates. To obtain insight into the functional logic of RFamide signaling, we investigate it here in the feeding system of Aplysia. We focus on the expression, localization, and actions of two families of RFamide peptides, the FRFamides and FMRFamide, in the central neuronal circuitry and the peripheral musculature that generate the feeding movements. We describe the cloning of the FRFamide precursor protein and show that the FRFamides and FMRFamide are derived from different precursors. We map the expression of the FRFamide and FMRFamide precursors in the feeding circuitry using in-situ hybridization and immunostaining, and confirm proteolytic processing of the FRFamide precursor by mass spectrometry. We show that the two precursors are expressed in different populations of sensory neurons in the feeding system. In a representative feeding muscle, we demonstrate the presence of both FRFamides and FMRFamide and their release, probably from the processes of the sensory neurons in the muscle. Both centrally and in the periphery, the FRFamides and FMRFamide act in distinct ways, apparently through distinct mechanisms, that nevertheless, from an overall functional perspective, their actions are complementary. Together, the FRFamides and FMRFamide convert feeding motor programs from ingestive to egestive, and depress feeding muscle contractions. We conclude that these structurally related peptides, even though derived from different precursors, expressed in different neurons, and acting through different mechanisms, remain related to each other in the functional roles that they play in the system. PMID:20053896

The effect of qat chewing and other factors on breast-feeding and child survival in a Yemeni society

PubMed Central

Mansoub, Mohammed Al; Omer, Rahab; Omer, Rasha; Shadli, Muna; Williams, Rachael

2011-01-01

In a survey conducted in Dammar, Republic of Yemen, 755 mothers were interviewed to investigate the patterns and factors affecting childhood feeding practices. It was found that full breast-feeding rate (41.8%) and timely introduction of complementary feeding rate (57.4%) were low, bottle-feeding rate (25.1%) was high and timely first suckling rate was zero. It was also found that the more educated and older mothers tended to wean their children earlier than illiterate and younger mothers. A significant association between regular frequent qat chewing and history of child death was observed. The implications of these findings were discussed. PMID:27493314

The effect of qat chewing and other factors on breast-feeding and child survival in a Yemeni society.

PubMed

Ibrahim Ali Omer, Mohammed; Mansoub, Mohammed Al; Omer, Rahab; Omer, Rasha; Shadli, Muna; Williams, Rachael

2011-01-01

In a survey conducted in Dammar, Republic of Yemen, 755 mothers were interviewed to investigate the patterns and factors affecting childhood feeding practices. It was found that full breast-feeding rate (41.8%) and timely introduction of complementary feeding rate (57.4%) were low, bottle-feeding rate (25.1%) was high and timely first suckling rate was zero. It was also found that the more educated and older mothers tended to wean their children earlier than illiterate and younger mothers. A significant association between regular frequent qat chewing and history of child death was observed. The implications of these findings were discussed.

Using formative research to design a context-specific behaviour change strategy to improve infant and young child feeding practices and nutrition in Nepal.

PubMed

Locks, Lindsey M; Pandey, Pooja R; Osei, Akoto K; Spiro, David S; Adhikari, Debendra P; Haselow, Nancy J; Quinn, Victoria J; Nielsen, Jennifer N

2015-10-01

Global recommendations on strategies to improve infant feeding, care and nutrition are clear; however, there is limited literature that explains methods for tailoring these recommendations to the local context where programmes are implemented. This paper aims to: (1) highlight the individual, cultural and environmental factors revealed by formative research to affect infant and young child feeding and care practices in Baitadi district of Far Western Nepal; and (2) outline how both quantitative and qualitative research methods were used to design a context-specific behaviour change strategy to improve child nutrition. Quantitative data on 750 children aged 12-23 months and their families were collected via surveys administered to mothers. The participants were selected using a multistage cluster sampling technique. The survey asked about knowledge, attitude and behaviours relating to infant and young child feeding. Qualitative data on breastfeeding and complementary feeding beliefs and practices were also collected from a separate sample via focus group discussions with mothers, and key informant interviews with mothers-in-law and husbands. Key findings revealed gaps in knowledge among many informants resulting in suboptimal infant and young child feeding practices - particularly with relation to duration of exclusive breastfeeding and dietary diversity of complementary foods. The findings from this research were then incorporated into a context-specific nutrition behaviour change communication strategy. © 2013 Helen Keller International © 2013 John Wiley & Sons, Ltd.

Household Food Insecurity, Mother's Feeding Practices, and the Early Childhood's Iron Status.

PubMed

Salarkia, Nahid; Neyestani, Tirang R; Omidvar, Nasrin; Zayeri, Farid

2015-01-01

Health consequences of food insecurity among infants and toddlers have not been fully examined. The purpose of this study was to assess the relationship between household food insecurity, mother's infant feeding practices and iron status of 6-24 months children. In this cross-sectional study, 423 mother-child pairs were randomly selected by multistage sampling method. Children blood samples were analyzed for hemoglobin and serum ferritin concentrations. Household food security was evaluated using a validated Household Food Insecurity Access Scale. The mother's feeding practices were evaluated using Infant and Young Child Feeding practice variables including: The duration of breastfeeding and the time of introducing of complementary feeding. Based on the results, of the studied households only 47.7% were food secure. Mild and moderate-severe household food insecurity was 39.5% and 12.8%, respectively. Anemia, iron deficiency (ID), and iron deficiency anemia were seen in 29.1%, 12.2%, and 4.8% of children, respectively. There was no significant association between household food insecurity; mother's feeding practices and child ID with or without anemia. We found no association between household food insecurity and the occurrence of anemia in the 6-24 months children. However, these findings do not rule out the possibility of other micronutrient deficiencies among the food-insecure household children.

Intensive nutrition education with or without supplementary feeding improves the nutritional status of moderately-malnourished children in Bangladesh.

PubMed

Roy, S K; Fuchs, G J; Mahmud, Zeba; Ara, Gulshan; Islam, Sumaya; Shafique, Sohana; Akter, Syeda Sharmin; Chakraborty, Barnali

2005-12-01

This prospective randomized trial was carried out to test the efficacy of a specific intervention for reducing the extent of their malnutrition and to change behaviour of mothers relating to child-feeding practices, care-giving, and health-seeking practices under the Bangladesh Integrated Nutrition Project (BINP). The study was conducted in rural Bangladesh among 282 moderately-malnourished (weight-for-age between 61% and 75% of median of the National Center for Health Statistics standard) children aged 6-24 months. Mothers of the first intervention group received intensive nutrition education (INE group) twice a week for three months. The second intervention group received the same nutrition education, and their children received additional supplementary feeding (INE+SF group). The comparison group received nutrition education from the community nutrition promoters twice a month according to the standard routine service of BINP. The children were observed for a further six months. After three months of interventions, a significantly higher proportion of children in the INE and INE+SF groups improved (37% and 47% respectively) from moderate to mild or normal nutrition compared to the comparison group (18%) (p < 0.001). At the end of six months of observation, the nutritional status of children in the intervention groups improved further from moderate to mild or normal nutrition compared to the comparison group (59% and 86% vs 30%, p < 0.0001). As the intensive nutrition education and supplementation given were highly effective, more children improved from moderate malnutrition to mild or normal nutritional status despite a higher incidence of morbidity. The frequency of child feeding and home-based complementary feeding improved significantly (p < 0.001) in both the intervention groups after three months of interventions and six months of observation. Body-weight gain was positively associated with age, length-for-age, weight-for-length, frequency of feeding of khichuri, egg, and potato (p < 0.05). Ability of mothers to identify malnutrition improved from 15% to 99% in the INE group and from 15% to 100% in the INE+SF group, but reduced from 24% to 21% in the comparison group. Use of separate feed pots, frequency of feeding, and cooking of additional complementary feeds improved significantly in the INE and INE+SF groups compared to the comparison group after three months of interventions and six months of observation. It can be concluded from the findings of the study that intensive nutrition education significantly improves the status of moderately-malnourished children with or without supplementary feeding.

Feeding infants and toddlers study: Improvements needed in meeting infant feeding recommendations.

PubMed

Briefel, Ronette R; Reidy, Kathleen; Karwe, Vatsala; Devaney, Barbara

2004-01-01

To assess adherence to infant feeding recommendations among a sample of infants and toddlers four to 24 months of age in the United States. Descriptive analysis of data collected in the 2002 Feeding Infants and Toddlers Study (FITS) based on telephone interviews and 24-hour dietary recalls collected with the Nutrition Data System for Research of the University of Minnesota. A national random sample of 3,022 infants and toddlers age four to 24 months, including 2,024 infants age four to 11 months. Breastfeeding, timing of introduction of complementary foods, and adherence to infant feeding recommendations. Means and standard errors, percentile distributions, and percentages by age group (four to six months, seven to eight months, and nine to 11 months). About 76% of infants and toddlers were fully or partly breastfed at birth. This percentage declined to 30% at six months and 16% at 12 months-short of Healthy People 2010 goals of 50% and 25%, respectively. The average duration of breastfeeding was 5.5 months for all who initiated breastfeeding. About two-thirds of infants had been introduced to complementary foods between four and six months-the period recommended by the American Academy of Pediatrics (AAP); 17% consumed juice before the AAP recommended age of six months or later. Twenty-two percent of infants nine to 11 months consumed cow's milk on a daily basis before the recommended age of 12 months or later, and one in 10 consumed french fries and/or sweetened beverages on any given day. More parents and caregivers can benefit from guidance about the introduction of developmentally appropriate, micronutrient-rich first solid foods such as iron-rich infant cereals, iron-fortified grain products, meats, soft fruits, and cooked vegetables and the importance of breastfeeding through the first year of life. A smaller proportion of parents and caregivers require guidance on delaying the introduction of juices until six months of age and cow's milk other than formula until one year of age.

Weaning practices among pastoralists: New evidence of infant feeding patterns from Bronze Age Eurasia.

PubMed

Ventresca Miller, Alicia; Hanks, Bryan K; Judd, Margaret; Epimakhov, Andrey; Razhev, Dmitry

2017-03-01

This paper investigates infant feeding practices through stable carbon (δ 13 C) and nitrogen (δ 15 N) isotopic analyses of human bone collagen from Kamennyi Ambar 5, a Middle Bronze Age cemetery located in central Eurasia. The results presented are unique for the time period and region, as few cemeteries have been excavated to reveal a demographic cross-section of the population. Studies of weaning among pastoral societies are infrequent and this research adds to our knowledge of the timing, potential supplementary foods, and cessation of breastfeeding practices. Samples were collected from 41 subadults (<15 years) and 27 adults (15+ years). Isotopic reference sets from adult humans as well as faunal remains were utilized as these form the primary and complementary foods fed to infants. Slight shifts in δ 13 C and δ 15 N values revealed that weaning was a multi-stage process (breastfeeding, weaning, and complete cessation of nursing) that began at 6 months of age, occurred over several years of early childhood, and was completed by 4 years of age. Our results indicate that weaning was a multi-stage process that was unique among late prehistoric pastoralist groups in Eurasia that were dependent on milk products as a supplementary food. Our discussion centers on supporting this hypothesis with modern information on central and east Eurasian herding societies including the age at which complementary foods are introduced, the types of complementary foods, and the timing of the cessation of breastfeeding. Integral to this work is the nature of pastoral economies and their dependence on animal products, the impact of complementary foods on nutrition and health, and how milk processing may have affected nutrition content and digestibility of foods. This research on Eurasian pastoralists provides insights into the complexities of weaning among prehistoric pastoral societies as well as the potential for different complementary foods to be incorporated into infant diets in the past. © 2016 Wiley Periodicals, Inc.

Age of Complementary Foods Introduction and Risk of Anemia in Children Aged 4-6 years: A Prospective Birth Cohort in China.

PubMed

Wang, Fenglei; Liu, Huijuan; Wan, Yi; Li, Jing; Chen, Yu; Zheng, Jusheng; Huang, Tao; Li, Duo

2017-03-23

Age of complementary foods introduction is associated with childhood anemia, but the ideal age for the introduction of complementary foods to infants is a continuing topic of debate. We examined the longitudinal association between complementary foods introduction age and risk of anemia in 18,446 children from the Jiaxing Birth Cohort, who had detailed complementary feeding records at 3 and 6 months of age and had hemoglobin concentrations measured at 4-6 years. Early introduction of complementary foods at 3-6 months of age was significantly associated with a higher risk of anemia (odds ratio = 1.14; 95% confidence interval: 1.01-1.28) and a lower hemoglobin concentration of -0.84 g/L (95% confidence interval: -1.33 to -0.35) in children aged 4-6 years, compared with those fed complementary foods starting at 6 months of age. When it comes to the specific type of complementary foods, early introduction of all plant-based foods was associated with increased anemia risks and lower hemoglobin concentrations, while early introduction of most animal-based foods was not. These findings may be informative regarding the appropriate time to introduce complementary foods in infants.

The effectiveness of nutrition education: Applying the Health Belief Model in child-feeding practices to use pulses for complementary feeding in Southern Ethiopia.

PubMed

Mulualem, Demmelash; Henry, Carol J; Berhanu, Getenesh; Whiting, Susan J

2016-01-01

Complementary foods (CFs) in Ethiopia are cereal based and adding locally grown pulses (legumes) to CF would provide needed nutrients. To assess the effects of nutrition education (NEd) using Health Belief Model (HBM) in promoting pulses for CF, a 6-month quasi-experimental study was conducted in 160 mother-child pairs. Knowledge, attitude, and practice (KAP) questions were given to mothers at baseline, midline, and endline, along with anthropometric measurements of children. NEd involving discussions and recipe demonstrations was given twice monthly for 6 months to the intervention group (n = 80) while control mothers received usual education. At baseline, mothers' KAP scores were low at both sites; at 3 and 6 months of NEd, mean KAP scores of mothers increased (p < 0.05) compared to the control site. Significant improvements in children's mean weight, weight for height, and weight for age occurred in the intervention site only. Nutritional status of children improved after providing mothers with pulse-based NEd.

The Influence of Maternal Psychosocial Characteristics on Infant Feeding Styles

PubMed Central

Barrett, Katherine J.; Thompson, Amanda L.; Bentley, Margaret E.

2017-01-01

Maternal feeding styles in infancy and early childhood are associated with children’s later risk for overweight and obesity. Maternal psychosocial factors that influence feeding styles during the complementary feeding period, the time during which infants transition from a milk-based diet to one that includes solid foods and other non-milk products, have received less attention. The present study explores how maternal psychosocial factors—specifically self-esteem, parenting self-efficacy, parenting satisfaction, and depression symptoms—influence mothers’ infant feeding styles at nine months of age, a time during which solid foods eating habits are being established. Participants included 160 low-income, African-American mother-infant pairs in central North Carolina who were enrolled in the Infant Care and Risk of Obesity Study. Regression models tested for associations between maternal psychosocial characteristics and pressuring and restrictive feeding styles. Models were first adjusted for maternal age, education, marital status and obesity status. To account for infant characteristics, models were then adjusted for infant weight-for-length, distress to limitations and activity level scores. Maternal self-esteem was negatively associated with pressuring to soothe. Maternal parenting self-efficacy was positively associated with restriction-diet quality. Maternal parenting satisfaction and depression symptoms were not associated with feeding styles in the final models. Focusing on strengthening maternal self-esteem and parenting self-efficacy may help to prevent the development of less desirable infant feeding styles. PMID:27174251

Complementary feeding with cowpea reduces growth faltering in rural Malawian infants: a blind, randomized controlled clinical trial.

PubMed

Stephenson, Kevin B; Agapova, Sophia E; Divala, Oscar; Kaimila, Yankho; Maleta, Kenneth M; Thakwalakwa, Chrissie; Ordiz, M Isabel; Trehan, Indi; Manary, Mark J

2017-12-01

Background: Growth faltering is common in rural African children and is attributed to inadequate dietary intake and environmental enteric dysfunction (EED). Objective: We tested the hypothesis that complementary feeding with cowpea or common bean flour would reduce growth faltering and EED in 6-mo-old rural Malawians compared with the control group receiving a corn-soy blend. Design: A prospective, double-blind, randomized controlled clinical trial was conducted in which children received daily feeding for 6 mo (200 kcal/d when 6-9 mo old and 300 kcal/d when 10-12 mo old). The primary outcomes were change in length-for-age z score (LAZ) and improvements in EED, as measured by percentage of lactulose excretion (%L). %L <0.2% was considered normal. Anthropometric measurements and %L through urine were compared between each legume group and the control group with Student's t test. Results: Of the 355 infants enrolled, 291 infants completed the trial, and 288 were breastfed throughout the duration of the study. Cowpea and common bean added 4.6-5.2 g protein/d and 4-5 g indigestible carbohydrate/d to the diet. LAZ and weight-for-height z score were reduced in all 3 groups from 6 to 12 mo of age. The changes in LAZ [mean (95% CI)] for the cowpea, common bean, and control groups from 6 to 9 mo were -0.14 (-0.24, -0.04), -0.27 (-0.38, -0.16), and -0.27 (-0.35, -0.19), respectively. LAZ was reduced less in infants receiving cowpea than in those receiving control food from 6 to 9 mo ( P = 0.048). The absolute value of %L did not differ between the dietary groups at 9 mo of age (mean ± SD: 0.30 ± 0.43, 0.23 ± 0.21, and 0.26 ± 0.31 for cowpea, common bean, and control, respectively), nor did the change in %L from 6 to 9 mo. Conclusion: Addition of cowpea to complementary feeding in Malawian infants resulted in less linear growth faltering. This trial was registered at clinicaltrials.gov as NCT02472262. © 2017 American Society for Nutrition.

Exposure to Large-Scale Social and Behavior Change Communication Interventions Is Associated with Improvements in Infant and Young Child Feeding Practices in Ethiopia

PubMed Central

Rawat, Rahul; Mwangi, Edina M.; Tesfaye, Roman; Abebe, Yewelsew; Baker, Jean; Frongillo, Edward A.; Ruel, Marie T.; Menon, Purnima

2016-01-01

Optimal breastfeeding (BF) practices in Ethiopia are far below the government’s targets, and complementary feeding practices are poor. The Alive & Thrive initiative aimed to improve infant and young child feeding (IYCF) practices through large-scale implementation of social and behavior change communication interventions in four regions of Ethiopia. The study assessed the effects of the interventions on IYCF practices and anthropometry over time in two regions–Southern Nations, Nationalities and Peoples Region and Tigray. A pre- and post-intervention adequacy evaluation design was used; repeated cross-sectional surveys of households with children aged 0–23.9 mo (n = 1481 and n = 1494) and with children aged 24–59.9 mo (n = 1481 and n = 1475) were conducted at baseline (2010) and endline (2014), respectively. Differences in outcomes over time were estimated using regression models, accounting for clustering and covariates. Plausibility analyses included tracing recall of key messages and promoted foods and dose-response analyses. We observed improvements in most WHO-recommended IYCF indicators. Early BF initiation and exclusive BF increased by 13.7 and 9.4 percentage points (pp), respectively. Differences for timely introduction of complementary foods, minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), and consumption of iron-rich foods were 22.2, 3.3, 26.2, 3.5, and 2.7 pp, respectively. Timely introduction and intake of foods promoted by the interventions improved significantly, but anthropometric outcomes did not. We also observed a dose-response association between health post visits and early initiation of BF (OR: 1.8); higher numbers of home visits by community volunteers and key messages recalled were associated with 1.8–4.4 times greater odds of achieving MDD, MMF, and MAD, and higher numbers of radio spots heard were associated with 3 times greater odds of achieving MDD and MAD. The interventions were associated with plausible improvements in IYCF practices, but large gaps in improving children’s diets in Ethiopia remain, particularly during complementary feeding. PMID:27755586

Effect of peer counselling by mother support groups on infant and young child feeding practices: the Lalitpur experience.

PubMed

Kushwaha, Komal P; Sankar, Jhuma; Sankar, M Jeeva; Gupta, Arun; Dadhich, J P; Gupta, Y P; Bhatt, Girish C; Ansari, Dilshad A; Sharma, B

2014-01-01

Our primary objective was to evaluate the effect of peer counselling by mother support groups (MSG's) in improving the infant and young child feeding (IYCF) practices in the community. We conducted this repeated-measure before and after study in the Lalitpur district of Uttar Pradesh, India between 2006 and 2011. We assessed the IYCF practices before and after creating MSG's within the community. The feeding practices were reassessed at two time points-2 (T1) and 5 years (T2) after the intervention and compared with that of the pre-intervention phase (T0). The total population covered by the project from the time of its initiation was 105000. A total of 425 (T0), 480 (T1) and 521 (T2) mother infant pairs were selected from this population. There was significant improvement in the following IYCF practices in the community (represented as %; adjOR (95% CI, p) such as initiation of breast feeding within 1 hour at both T1 (71% vs. 11%); 19.6 (13.6, 28.2, p =  <0.0001)and T2 (62% vs. 11%); 13.3 (9.4, 18.9, p =  <0.0001); use of prelacteal feeds at both T1 (67% vs. 15%); 12.6 (CI: 9.0, 17.6, p<0.0001) and T2 (67% vs. 5%); 44.4 (28.8, 68.4, p = <0.0001); rates of exclusive breast feeding for 6 months at both T1 (50% vs. 7%); 13.6 (7.6, 25.0, p =  <0.0001) and T2 (60% vs. 7%); 20.5 (11.3, 37.2, p =  <0.0001); initiation of complementary feeding at T1 (85% vs. 54%); 5.6 (3.6, 8.7, p =  <0.0001) and T2 (96% vs. 54%); 22.9 (11.8, 44.1, p =  <0.0001) and complementary feeding along with continued breast feeding at both T1 (36% vs. 4.5%); 6 (1.15, 31.4, p = 0.033) and T2 (42% vs. 4.5%); 8.06 (1.96, 49.1, p = 0.005) as compared to pre-intervention period (T0) after adjusting for important social and demographic variables. Peer counseling by MSG's improved the IYCF practices in the district and could be sustained.

Effect of Peer Counselling by Mother Support Groups on Infant and Young Child Feeding Practices: The Lalitpur Experience

PubMed Central

Kushwaha, Komal P.; Sankar, Jhuma; Sankar, M. Jeeva; Gupta, Arun; Dadhich, J. P.; Gupta, Y. P.; Bhatt, Girish C.; Ansari, Dilshad A.; Sharma, B.

2014-01-01

Objective Our primary objective was to evaluate the effect of peer counselling by mother support groups (MSG's) in improving the infant and young child feeding (IYCF) practices in the community. Methods We conducted this repeated-measure before and after study in the Lalitpur district of Uttar Pradesh, India between 2006 and 2011. We assessed the IYCF practices before and after creating MSG's within the community. The feeding practices were reassessed at two time points–2 (T1) and 5 years (T2) after the intervention and compared with that of the pre-intervention phase (T0). Results The total population covered by the project from the time of its initiation was 105000. A total of 425 (T0), 480 (T1) and 521 (T2) mother infant pairs were selected from this population. There was significant improvement in the following IYCF practices in the community (represented as %; adjOR (95% CI, p) such as initiation of breast feeding within 1 hour at both T1 (71% vs. 11%); 19.6 (13.6, 28.2, p = <0.0001)and T2 (62% vs. 11%); 13.3 (9.4, 18.9, p = <0.0001); use of prelacteal feeds at both T1 (67% vs. 15%); 12.6 (CI: 9.0, 17.6, p<0.0001) and T2 (67% vs. 5%); 44.4 (28.8, 68.4, p = <0.0001); rates of exclusive breast feeding for 6 months at both T1 (50% vs. 7%); 13.6 (7.6, 25.0, p = <0.0001) and T2 (60% vs. 7%); 20.5 (11.3, 37.2, p = <0.0001); initiation of complementary feeding at T1 (85% vs. 54%); 5.6 (3.6, 8.7, p = <0.0001) and T2 (96% vs. 54%); 22.9 (11.8, 44.1, p = <0.0001) and complementary feeding along with continued breast feeding at both T1 (36% vs. 4.5%); 6 (1.15, 31.4, p = 0.033) and T2 (42% vs. 4.5%); 8.06 (1.96, 49.1, p = 0.005) as compared to pre-intervention period (T0) after adjusting for important social and demographic variables. Conclusions Peer counseling by MSG's improved the IYCF practices in the district and could be sustained. PMID:25369452

Acceptability and utility of an innovative feeding toolkit to improve maternal and child dietary practices in Bihar, India.

PubMed

Collison, Deborah Kortso; Kekre, Priya; Verma, Pankaj; Melgen, Sarah; Kram, Nidal; Colton, Jonathan; Blount, Wendy; Girard, Amy Webb

2015-03-01

Dietary practices in India often fail to provide adequate nutrition during the first 1,000 days of life. To explore the acceptability and utility of a low-cost and simple-to-use feeding toolkit consisting of a bowl with marks to indicate meal volume and frequency, a slotted spoon, and an illustrated counseling card to cue optimal dietary practices during the first 1,000 days. In Samastipur District, Bihar, India, we conducted 16 focus group discussions and 8 key informant interviews to determine community acceptability and obtain feedback on design and delivery of the feeding toolkit. We conducted 14 days of user testing with 20 pregnant women, 20 breastfeeding women 0 to 6 months postpartum, and 20 mothers with infants 6 to 18 months of age. The toolkit, which is made of plastic, was well accepted by the community, although the communities recommended manufacturing the bowl and spoon in steel. The proportion of pregnant and breast-feeding women taking an extra portion of food per day increased from 0% to 100%, and the number of meals taken per day increased from two or three to three or four. For children 6 to 18 months of age, meal frequency, quantity of food consumed during meals, and thickness of the foods increased for all age groups. Children 6 to 8 months of age who had not yet initiated complementary feeding all initiated complementary feeding during the testing period. Simple feeding tools are culturally acceptable and can be appropriately used by families in Bihar, India, to improve dietary practices during the first 1,000 days of life. Research is needed to assess whether the tools promote dietary and nutritional improvements over and above counseling alone.

Legislation should support optimal breastfeeding practices and access to low-cost, high-quality complementary foods: Indonesia provides a case study.

PubMed

Soekarjo, Damayanti; Zehner, Elizabeth

2011-10-01

It is important to support women to exclusively breastfeed for 6 months and continue breastfeeding for 24 months and beyond. It is also necessary to provide the poor with access to affordable ways to improve the quality of complementary foods. Currently, many countries do not have the legal and policy environment necessary to support exclusive and continued breastfeeding. Legislative and policy changes are also necessary for introducing complementary food supplements, allowing them to be marketed to those who need them, and ensuring that marketing remains appropriate and in full compliance with the International Code of Marketing of Breastmilk Substitutes. This paper aims to illustrate the above with examples from Indonesia and to identify legislative requirements for supporting breastfeeding and enabling appropriate access to high-quality complementary food supplements for children 6-24 months of age. Requirements include improved information, training, monitoring and enforcement systems for the International Code of Marketing of Breastmilk Substitutes; implementation and monitoring of the Baby-Friendly Hospital Initiative; establishment of a registration category for complementary food supplements to enhance availability of high-quality, low-cost fortified products to help improve young child feeding; clear identification and marketing of these products as complementary food supplements for 6-24-month-olds so as to promote proper use and not interfere with breastfeeding. © 2011 Blackwell Publishing Ltd.

Feeding styles of caregivers of children 6-23 months of age in Derashe special district, Southern Ethiopia

PubMed Central

2012-01-01

Background Apart from basic determinants, appropriate child care practices are important in prevention of growth faltering and undernutrition. Providing safe and appropriate quality complementary foods is crucial to child growth and development. However, some children in low-income communities grow normally mainly due to proper caregiver feeding behaviors. Hence, the objective of this study was to determine caregivers' feeding styles as well as to indentify predictors in Derashe special district, Southern Ethiopia. Methods A community based cross-sectional study design was employed in the seven randomly selected Kebeles (smallest administrative unit) of Derashe special district. A total of 826 caregivers provided data pertaining to socio-demographic variables. However, 764 caregivers had complete data for the outcome variable (caregiver feeding style). A multistage stratified sampling technique was used to identify study subjects. An adapted Caregiver's Feeding Styles Questionnaire (CFSQ) was used to gather information about caregivers' feeding styles. Multivariate multinomial logistic regression was employed to identify predictors of caregivers' feeding style. Results The majority (80.6%) of caregivers were biological mothers. Nearly seventy-six percent of the caregivers practiced a responsive feeding style. Caregivers other than the biological mother favoured a laissez-faire feeding style, while caregivers residing in rural Kebeles were more responsive. Caregivers with a breastfeeding frequency of more than eight times predicted both laissez-faire (RRR = 1.88; 95% CI = 1.03-3.41) and controlling (RRR = 1.7; 95% CI = 1.02-2.85) feeding styles as compared to responsive feeding. Conclusion Responsive feeding was the commonest style practiced by the caregivers. Many of the caregivers who were rural residents and birth parents have been responsive in child feeding. The instruments needed to be validated in the Ethiopian context and an additional prospective study based on direct observation of caregiver-child interactions is recommended. PMID:22439749

[Interventions to prevent the development of overweight and obesity in children younger than five years].

PubMed

Bonilla, Catherine; Híjar, Gisely; Márquez, Delia; Aramburú, Adolfo; Aparco, Juan Pablo; Gutiérrez, Ericson L

2017-01-01

Childhood obesity is one of the most severe public health problems worldwide. The present study describes the interventions used to prevent overweight and obesity in children younger than 5 years. The objective of the interventions was to stimulate breastfeeding, monitor the child's growth, and promote adequate complementary feeding by means of nutritional counseling using a responsive feeding approach in different settings, including health centers and residences. The interventions included physical activity and nutritional counseling, with the active participation of the parents. The quality of evidence from most studies was high because the evidence was derived from controlled clinical trials, systematic reviews, and meta-analyses. All interventions were conducted or could be replicated in Peru by adequate contextualization.

Timing of Introduction of Complementary Foods to US Infants, National Health and Nutrition Examination Survey 2009-2014.

PubMed

Barrera, Chloe M; Hamner, Heather C; Perrine, Cria G; Scanlon, Kelley S

2018-03-01

Although there has been inconsistency in recommendations regarding the optimal time for introducing complementary foods, most experts agree that introduction should not occur before 4 months. Despite recommendations, studies suggest that 20% to 40% of US infants are introduced to foods at younger than 4 months. Previous studies focused on the introduction of solid foods and are not nationally representative. Our aims were to provide a nationally representative estimate of the timing of introduction of complementary foods and to describe predictors of early (<4 months) introduction. We conducted a cross-sectional analysis of 2009-2014 National Health and Nutrition Examination Survey data. The study included 1,482 children aged 6 to 36 months. Timing of first introduction to complementary foods (anything other than breast milk or formula) was analyzed. Prevalence estimates of first introduction to complementary foods are presented by month. Logistic regression was used to assess characteristics associated with early (<4 months) introduction. In this sample, 16.3% of US infants were introduced to complementary foods at <4 months, 38.3% between 4 and <6 months, 32.5% between 6 and <7 months, and 12.9% at ≥7 months of age. In unadjusted analyses, early introduction varied by breastfeeding status; race/Hispanic origin; Special Supplemental Nutrition Program for Women, Infants, and Children participation; and maternal age. In adjusted analyses, only breastfeeding status remained significant; infants who never breastfed or stopped at <4 months were more likely (odds ratio 2.27; 95% CI 1.62 to 3.18) to be introduced to complementary foods early than infants who breastfed ≥4 months. Despite using a broader definition of complementary foods, this analysis found a lower prevalence of early introduction in this nationally representative sample than previous studies that included only solids. However, many young children were still introduced to complementary foods earlier than recommended. Strategies to support caregivers to adhere to infant feeding guidelines may be needed. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A Case–Control Study on the Origin of Atypical Scrapie in Sheep, France

PubMed Central

Morignat, Eric; Ducrot, Christian; Calavas, Didier

2009-01-01

A matched case–control study (95 cases and 220 controls) was designed to study risk factors for atypical scrapie in sheep in France. We analyzed contacts with animals from other flocks, lambing and feeding practices, and exposure to toxic substances. Data on the prnp genotype were collected for some case and control animals and included in a complementary analysis. Sheep dairy farms had a higher risk for scrapie (odds ratio [OR] 15.1, 95% confidence interval [CI] 3.3–69.7). Lower risk was associated with organic farms (OR 0.15, 95% CI 0.02–1.26), feeding corn silage (OR 0.16, 95% CI 0.05–0.53), and feeding vitamin and mineral supplements (OR 0.6, 95% CI 0.32–1.14). Genetic effects were quantitatively important but only marginally changed estimates of other variables. We did not find any risk factor associated with an infectious origin of scrapie. Atypical scrapie could be a spontaneous disease influenced by genetic and metabolic factors. PMID:19402956

Transfer of arsenic from poultry feed to poultry litter: A mass balance study.

PubMed

Gupta, Sanjay K; Le, X Chris; Kachanosky, Gary; Zuidhof, Martin J; Siddique, Tariq

2018-07-15

Roxarsone (rox), an arsenic (As) containing organic compound, is a common feed additive used in poultry production. To determine if As present in rox is excreted into the poultry litter without any retention in chicken meat for safe human consumption, the transference of As from the feed to poultry excreta was assessed using two commercial chicken strains fed with and without dietary rox. The results revealed that both the strains had similar behaviour in growth (chicken weight; 2.17-2.25kg), feed consumption (282-300kgpen -1 initially containing 102 chicken) and poultry litter production (73-81kgpen -1 ) during the growth phase of 35days. Our mass balance calculations showed that chickens ingested 2669-2730mg As with the feed and excreted out 2362-2896mg As in poultry litter during the growth period of 28days when As containing feed was used, yielding As recovery between 86 and 108%. Though our complementary studies show that residual arsenic species in rox-fed chicken meat may have relevance to human exposure, insignificant retention of total As in the chicken meat substantiates our mass balance results. The results are important in evaluating the fate of feed additive used in poultry production and its potential environmental implications if As containing poultry litter is applied to soil for crop production. Copyright © 2018 Elsevier B.V. All rights reserved.

Household Food Insecurity, Mother's Feeding Practices, and the Early Childhood's Iron Status

PubMed Central

Salarkia, Nahid; Neyestani, Tirang R.; Omidvar, Nasrin; Zayeri, Farid

2015-01-01

Background: Health consequences of food insecurity among infants and toddlers have not been fully examined. The purpose of this study was to assess the relationship between household food insecurity, mother's infant feeding practices and iron status of 6–24 months children. Methods: In this cross-sectional study, 423 mother-child pairs were randomly selected by multistage sampling method. Children blood samples were analyzed for hemoglobin and serum ferritin concentrations. Household food security was evaluated using a validated Household Food Insecurity Access Scale. The mother's feeding practices were evaluated using Infant and Young Child Feeding practice variables including: The duration of breastfeeding and the time of introducing of complementary feeding. Results: Based on the results, of the studied households only 47.7% were food secure. Mild and moderate-severe household food insecurity was 39.5% and 12.8%, respectively. Anemia, iron deficiency (ID), and iron deficiency anemia were seen in 29.1%, 12.2%, and 4.8% of children, respectively. There was no significant association between household food insecurity; mother's feeding practices and child ID with or without anemia. Conclusions: We found no association between household food insecurity and the occurrence of anemia in the 6–24 months children. However, these findings do not rule out the possibility of other micronutrient deficiencies among the food-insecure household children. PMID:26445633

Social inequalities in infant feeding during the first year of life. The Longitudinal Study of Child Development in Québec (LSCDQ 1998-2002).

PubMed

Dubois, Lise; Girard, Manon

2003-12-01

The aim of this paper is to describe the source and the scope of social inequalities in infant feeding practices. It examines the extent to which different recommendations are followed in different social groups and highlights the main factors influencing the total adherence to three recommendations at the population level. The study follows a representative sample (n=2103) of the children born in 1998 in the province of Québec (Canada). Detailed information on breast-feeding and complementary feeding was collected at 5 and 17 months by face-to-face interviews with the mother. The independent variables were mother's age, mother's education level, poverty level, family type, socio-economic status (SES) and living area. Odds ratios (adjusted for baby's rank in the family, birth weight and premature birth) are presented for breast-feeding, and for formula and cows' milk consumption, at different ages. The adherence to a combined indicator cumulating three recommendations (breast-fed at birth, complementary food at 4 months or later and cows' milk at 9 months or later) is also presented. The analysis indicates that adherence to the recommendations is low in Québec. Breast-feeding initiation, duration and its exclusivity improved with mother's age and education level and SES. Adherence to the different recommendations was interrelated, indicating an accumulation of bad nutritional circumstances for children in low-SES families. The odds of being fed in accordance with the three studied recommendations, when living in a family with the highest SES, was 2.3 times higher than when living in a family with the lowest SES. When living with a highly educated mother, the odds ratio was 2.7 times higher than when living with a low-educated mother. For mother's age, the odds ratio reached 3.7 for children from mothers aged > or =35 years, in comparison with children from mothers < or =24 years old. When SES or mother's education level was combined with mother's age, the children in the best situation were >8 more times likely than the least privileged children to be fed in accordance with these recommendations. Living area was not related with infant feeding during the first year of life. Breast-feeding and nutrition could be related with different health and cognitive outcomes in childhood and later in life. Consequently, social disparities in diet during infancy could play a role in the development of social and health inequalities more broadly observed at the population level. Intervention to improve adherence to breast-feeding and nutrition recommendations in infancy should be prioritised and evaluated for its impact on the reduction on infant diet inequalities over time.

Duration of exclusive breast-feeding: introduction of complementary feeding may be necessary before 6 months of age.

PubMed

Reilly, John J; Wells, Jonathan C K

2005-12-01

The WHO recommends exclusive breast-feeding for the first 6 months of life. At present, <2 % of mothers who breast-feed in the UK do so exclusively for 6 months. We propose the testable hypothesis that this is because many mothers do not provide sufficient breast milk to feed a 6-month-old baby adequately. We review recent evidence on energy requirements during infancy, and energy transfer from mother to baby, and consider the adequacy of exclusive breast-feeding to age 6 months for mothers and babies in the developed world. Evidence from our recent systematic review suggests that mean metabolisable energy intake in exclusively breast-fed infants at 6 months is 2.2-2.4 MJ/d (525-574 kcal/d), and mean energy requirement approximately 2.6-2.7 MJ/d (632-649 kcal/d), leading to a gap between the energy provided by milk and energy needs by 6 months for many babies. Our hypothesis is consistent with other evidence, and with evolutionary considerations, and we briefly review this other evidence. The hypothesis would be testable in a longitudinal study of infant energy balance using stable-isotope techniques, which are both practical and valid.

Role reversal method for treatment of food refusal associated with infantile feeding disorders.

PubMed

Segal, Idit; Tirosh, Anat; Sinai, Tali; Alony, Sari; Levi, Anat; Korenfeld, Lia; Zangen, Tsili; Mizrachi, Avi; Boaz, Mona; Levine, Arie

2014-06-01

Infantile feeding disorders (IFDs) are common causes of food refusal and failure to thrive, and are frequently encountered by primary care physicians and specialists. We have published the Wolfson criteria for IFD, which have eased the approach to the diagnosis of IFDs. Along with and complementary to the Wolfson criteria, we have also developed the role reversal treatment method for IFD, which has been briefly described earlier. The aim of this study was to validate the role reversal treatment method on a cohort of infants diagnosed as having IFD and to present a detailed description of this method for the first time. Parents of infants and children diagnosed as having IFD were invited to participate in the study; they were handed over a questionnaire comprising 6 categories of questions related to patient and parents behaviors, attitudes, and perceptions, which was completed at initiation and at the end of treatment. Full response was defined as improved normative feeding, cessation of abnormal parental feeding, and improved or normal growth patterns. A partial response was defined as success with two-third categories. We enrolled 38 patients, and 32 patients completed the study. Improved feeding occurred in 78%, full recovery was documented in 53% of infants by 6 months, and partial response was observed in another 25%. All forms of pathological feeding improved significantly (mechanistic, nocturnal, persecutory, forced feeding, and distraction). The role reversal treatment method is a simple and effective approach to the treatment of food refusal associated with IFD.

Provision versus promotion to develop a handwashing station: the effect on desired handwashing behavior.

PubMed

Biswas, Debashish; Nizame, Fosiul Alam; Sanghvi, Tina; Roy, Sumitro; Luby, Stephen P; Unicomb, Leanne E

2017-05-05

Diarrhea prevalence increases from around the time that complementary foods are introduced. Improving caregiver's hand hygiene during food preparation could reduce complementary food contamination and enteric pathogen transmission. Washing hands with soap is more common when water and soap are together at a convenient location. We conducted a three-month pilot intervention to evaluate two options for setting up handwashing stations: i) provide a handwashing station, or ii) help the family to make their own from available materials. Additionally, we assessed the feasibility of this intervention to be integrated with a child feeding program. We conducted the intervention among two groups; 40 households received a free of cost handwashing station and another 40 households were motivated to place their own soap/soapy-water and water vessel near the food preparation and child feeding area. Community health workers encouraged caregivers to wash hands with soap/soapy-water before food preparation and feeding a child. They either assisted study participants to install the study-provided handwashing station at the recommended place or encouraged caregivers to develop their own. Field researchers assessed placement and composition of handwashing stations and the feasibility of integrating handwashing and nutrition messages. By end of the trial, 39/40 households developed their own handwashing station, comprising a bucket, mug and bar soap/soapy-water of which 60% (6/10) households were observed with a functional and complete handwashing station set. Observed handwashing with soap was detected among 8/10 households from the study-provided handwashing station group and 5/10 among households who had made their own handwashing station. Sixty-seven of the 76 caregivers recalled integrated intervention messages on social and health benefits of infant and young child feeding correctly; and all recalled key handwashing with soap times, before food preparation and feeding a child. Encouraging households to develop their own handwashing station with soap and water to place at a food preparation/child feeding location is feasible over the short term. In the absence of large-scale provision of handwashing stations, caregivers can be encouraged to create and use their own. Integrating handwashing with soap into a nutrition intervention was feasible and acceptable and should be considered by policy makers.

The influence of maternal psychosocial characteristics on infant feeding styles.

PubMed

Barrett, Katherine J; Thompson, Amanda L; Bentley, Margaret E

2016-08-01

Maternal feeding styles in infancy and early childhood are associated with children's later risk for overweight and obesity. Maternal psychosocial factors that influence feeding styles during the complementary feeding period, the time during which infants transition from a milk-based diet to one that includes solid foods and other non-milk products, have received less attention. The present study explores how maternal psychosocial factors-specifically self-esteem, parenting self-efficacy, parenting satisfaction, and depression symptoms-influence mothers' infant feeding styles at nine months of age, a time during which solid foods eating habits are being established. Participants included 160 low-income, African-American mother-infant pairs in central North Carolina who were enrolled in the Infant Care and Risk of Obesity Study. Regression models tested for associations between maternal psychosocial characteristics and pressuring and restrictive feeding styles. Models were first adjusted for maternal age, education, marital status and obesity status. To account for infant characteristics, models were then adjusted for infant weight-for-length, distress to limitations and activity level scores. Maternal self-esteem was negatively associated with pressuring to soothe. Maternal parenting self-efficacy was positively associated with restriction-diet quality. Maternal parenting satisfaction and depression symptoms were not associated with feeding styles in the final models. Focusing on strengthening maternal self-esteem and parenting self-efficacy may help to prevent the development of less desirable infant feeding styles. Copyright © 2016 Elsevier Ltd. All rights reserved.

Role of Protein and Amino Acids in Infant and Young Child Nutrition: Considerations for the Development and Delivery of High Quality Complementary Food Supplements.

PubMed

Ghosh, Shibani; Kurpad, Anura; Tano-Debrah, Kwaku; Otoo, Gloria E; Aaron, Grant A; Toride, Yasuhiko; Uauy, Ricardo

2015-01-01

Prevention of malnutrition in infants and children is multifaceted and requires the following: access to and intake of nutritious food starting at birth with exclusive breastfeeding for the first 6 mo of life, continued breastfeeding in combination with complementary foods from 6-24 mo of age, access to clean drinking water and sanitation, and access to preventive and curative health care (including prenatal). Nutrient-dense complementary foods can improve nutritional status and have long-term benefits; however, in a review of plant-based complementary foods in developing countries, most of them failed to meet many micronutrient requirements. There is need to provide other cost-effective alternatives to increase the quality of the diet during the complementary feeding stage of the lifecycle. This paper provides an overview of the development, testing, efficacy and effectiveness of the delivery of KOKO Plus on the growth and nutritional status of infants 6-24 mo of age.

Outcomes of an early feeding practices intervention to prevent childhood obesity.

PubMed

Daniels, Lynne Allison; Mallan, Kimberley Margaret; Nicholson, Jan Maree; Battistutta, Diana; Magarey, Anthea

2013-07-01

The goal of this study was to evaluate outcomes of a universal intervention to promote protective feeding practices that commenced in infancy and aimed to prevent childhood obesity. The NOURISH randomized controlled trial enrolled 698 first-time mothers (mean ± SD age: 30.1 ± 5.3 years) with healthy term infants (51% female) aged 4.3 ± 1.0 months at baseline. Mothers were randomly allocated to self-directed access to usual care or to attend two 6-session interactive group education modules that provided anticipatory guidance on early feeding practices. Outcomes were assessed 6 months after completion of the second information module, 20 months from baseline and when the children were 2 years old. Maternal feeding practices were self-reported by using validated questionnaires and study-developed items. Study-measured child height and weight were used to calculate BMI z scores. Retention at follow-up was 78%. Mothers in the intervention group reported using responsive feeding more frequently on 6 of 9 subscales and 8 of 8 items (all, P ≤ .03) and overall less controlling feeding practices (P < .001). They also more frequently used feeding practices (3 of 4 items; all, P < .01) likely to enhance food acceptance. No statistically significant differences were noted in anthropometric outcomes (BMI z score: P = .10) nor in prevalence of overweight/obesity (control 17.9% vs intervention 13.8%; P = .23). Evaluation of NOURISH data at child age 2 years found that anticipatory guidance on complementary feeding, tailored to developmental stage, increased use by first-time mothers of "protective" feeding practices that potentially support the development of healthy eating and growth patterns in young children.

Mothers' restrictive eating and food neophobia and fathers' dietary quality are associated with breast-feeding duration and introduction of solid foods: the STEPS study.

PubMed

Vaarno, Jenni; Niinikoski, Harri; Kaljonen, Anne; Aromaa, Minna; Lagström, Hanna

2015-08-01

The purpose of the present study was to examine the association between parental eating behaviours and dietary patterns and feeding practices of infants and young children. Data on infant-feeding practices were collected from each infant's birth via parentally self-administered follow-up diaries. Three questionnaires, the Three-Factor Eating Questionnaire, the Food Neophobia Scale and the Index of Diet Quality, were administered when the children were aged 4 and 13 months. South-western Finland. Families participating in the STEPS longitudinal cohort study (n 1797). Mean duration of exclusive breast-feeding was 2.4 months and total duration of breast-feeding averaged 8.1 months. The first solid food was introduced into children's diets at the age of 3.9 months, on average. Mothers with highly restrictive eating were more likely to introduce solid foods sooner than mothers who ranked lower in these behaviours (3.8 months v. 4.0 months, P = 0.012). Neophobic mothers breast-fed exclusively (2.0 v. 2.6 months, P = 0.038) and in total (7.2 v. 8.5 months, P = 0.039) for shorter times than average mothers, even after adjusting for various demographic characteristics. Fathers' diet quality was associated with total breast-feeding duration and with introduction of complementary foods in unadjusted analyses and with total breast-feeding duration also after adjusting for confounding factors. Mothers' and fathers' eating patterns and practices are associated with the feeding practices of infants and young children. Health promotion interventions seeking to improve parents' eating patterns might lead to more favourable feeding practices for infants and young children.

Capacity of frontline ICDS functionaries to support caregivers on infant and young child feeding (IYCF) practices in Gujarat, India.

PubMed

Chaturvedi, Anuraag; Nakkeeran, N; Doshi, Minal; Patel, Ruchi; Bhagwat, Sadhana

2014-01-01

Improved infant and young child feeding practices have the potential to improve child growth and development outcomes in India. Anganwadi Workers, the frontline government functionaries of the national nutrition supplementation programme in India, play a vital role in promoting infant and young child feeding practices in the community. The present study assessed the Anganwadi Workers' knowledge of infant and young child feeding practices, and their ability to counsel and influence caregivers regarding these practices. Eighty Anganwadi Workers from four districts of Gujarat participated in assessment centres designed to evaluate a range of competencies considered necessary for the successful promotion of infant and young child feeding practices. The results of the evaluation showed the Anganwadi Workers possessing more knowledge about infant and young child feeding practices like initiation of breastfeeding, pre-lacteal feeding and colostrum, age of introduction of complementary foods, portion size and feeding frequency than about domains which appear to have a direct bearing on practices. A huge contrast existed between the Anganwadi Workers' knowledge and their ability to apply this in formal counselling sessions with caregivers. Inability to empathetically engage with caregivers, disregard for taking the feeding history of children, poor active listening skills and inability to provide need-based advice were pervasive during counselling. In conclusion, to ensure enhanced interaction between the Anganwadi Workers and caregivers on infant and young child feeding practices, a paradigm shift in training is required, making communication processes and counselling skills central to the training.

An Early Feeding Practices Intervention for Obesity Prevention.

PubMed

Daniels, Lynne Allison; Mallan, Kimberley Margaret; Nicholson, Jan Maree; Thorpe, Karen; Nambiar, Smita; Mauch, Chelsea Emma; Magarey, Anthea

2015-07-01

Report long-term outcomes of the NOURISH randomized controlled trial (RCT), which evaluated a universal intervention commencing in infancy to provide anticipatory guidance to first-time mothers on "protective" complementary feeding practices that were hypothesized to reduce childhood obesity risk. The NOURISH RCT enrolled 698 mothers (mean age 30.1 years, SD = 5.3) with healthy term infants (51% female). Mothers were randomly allocated to usual care or to attend two 6-session, 12-week group education modules. Outcomes were assessed 5 times: baseline (infants 4.3 months); 6 months after module 1 (infants 14 months); 6 months after module 2 (infants 2 years) and at 3.5 and 5 years of age. Maternal feeding practices were self-reported using validated questionnaires. BMI Z-score was calculated from measured child height and weight. Linear mixed models evaluated intervention (group) effect across time. Retention at age 5 years was 61%. Across ages 2 to 5 years, intervention mothers reported less frequent use of nonresponsive feeding practices on 6 of 9 scales. At 5 years, they also reported more appropriate responses to food refusal on 7 of 12 items (Ps ≤ .05). No statistically significant group effect was noted for anthropometric outcomes (BMI Z-score: P = .06) or the prevalence of overweight/obesity (control 13.3% vs intervention 11.4%, P = .66). Anticipatory guidance on complementary feeding resulted in first-time mothers reporting increased use of protective feeding practices. These intervention effects were sustained up to 5 years of age and were paralleled by a nonsignificant trend for lower child BMI Z-scores at all postintervention assessment points. Copyright © 2015 by the American Academy of Pediatrics.

Feeding practices for infants and young children during and after common illness. Evidence from South Asia

PubMed Central

Aguayo, Víctor M.

2016-01-01

Abstract Global evidence shows that children's growth deteriorates rapidly during/after illness if foods and feeding practices do not meet the additional nutrient requirements associated with illness/convalescence. To inform policies and programmes, we conducted a review of the literature published from 1990 to 2014 to document how children 0–23 months old are fed during/after common childhood illnesses. The review indicates that infant and young child feeding (IYCF) during common childhood illnesses is far from optimal. When sick, most children continue to be breastfed, but few are breastfed more frequently, as recommended. Restriction/withdrawal of complementary foods during illness is frequent because of children's anorexia (perceived/real), poor awareness of caregivers' about the feeding needs of sick children, traditional beliefs/behaviours and/or suboptimal counselling and support by health workers. As a result, many children are fed lower quantities of complementary foods and/or are fed less frequently when they are sick. Mothers/caregivers often turn to family/community elders and traditional/non‐qualified practitioners to seek advice on how to feed their sick children. Thus, traditional beliefs and behaviours guide the use of ‘special’ feeding practices, foods and diets for sick children. A significant proportion of mothers/caregivers turn to the primary health care system for support but receive little or no advice. Building the knowledge, skills and capacity of community health workers and primary health care practitioners to provide mothers/caregivers with accurate and timely information, counselling and support on IYCF during and after common childhood illnesses, combined with large‐scale communication programmes to address traditional beliefs and norms that may be harmful, is an urgent priority to reduce the high burden of child stunting in South Asia. PMID:26840205

Knowledge of pregnant women on transmission of HIV infection through breast feeding.

PubMed

Kasinga, F; Mogotlane, S M; van Rensburg, G H

2008-09-01

Although breast-feeding is nature's way of providing nutrition to the baby, in HIV positive mothers this has been identified as one of the means through which HIV infection is transmitted from the mother to the child. In Africa where children under the age of 5 are killed by preventable diseases like diarrhoea, the issue of HIV transmission through breast feeding poses an added huge problem. Research has, however shown that exclusive infant feeding, be it breast or formula, reduces the risk substantially. It is imperative that mothers be informed about safer methods of infant feeding so that HIV infection is kept to a minimum. The objective of the study was to explore and describe the knowledge that pregnant women had about mother to child transmission of HIV infection through breast-feeding. A non-experimental quantitative exploratory and descriptive research design was used to explore the knowledge women had on mother to child transmission of HIV infection through breast-feeding. From the data collected, it showed that although women were aware of the susceptibility of children to HIV infection if fed on breast and formula feeds simultaneously by HIV positive mothers, exclusive feeding was a problem as people associated the practise with a positive HIV status. Women who had not disclosed their HIV status and were HIV positive, found it difficult to comply with the requirement to exclusively feed their infants. These either continued with complementary feeds or did not collect the free formula milk supply preferring instead to buy the formula feeds privately. In this study it was recommended that information on transmission of HIV infection from mother to child through breast -feeding including the benefits of exclusive infant feeding, be it breast or formula, for the first three to six months be provided to the community so that relatives can support the mother on infant feeding method of choice.

Exclusive and any breast-feeding rates of Pacific infants in Auckland: data from the Pacific Islands Families First Two Years of Life Study.

PubMed

Schluter, Philip J; Carter, Sarnia; Percival, Teuila

2006-09-01

To present current breast-feeding rates for Pacific infants resident in New Zealand. Reasons for the introduction of complementary liquid foods were also explored. A longitudinal study using hospital discharge summary records and maternal home interviews undertaken at 6 weeks, 12 and 24 months postpartum. Turnbull's non-parametric survival analysis was used to model exclusive breast-feeding rates. Auckland, New Zealand. The cohort comprised 1376 infants at 6 weeks, 1223 infants at 12 months and 1142 infants at 24 months. Exclusive breast-feeding rates at hospital discharge, 6 weeks, 3 and 6 months postpartum were 84% (95% confidence interval (CI): 80-88%), 49% (95% CI: 43-55%), 37% (95% CI: 32-42%) and 9% (95% CI: 7-11%), respectively. Significant ethnic difference existed, with Samoan mothers having higher exclusive breast-feeding rates than Tongan mothers (P = 0.002). The percentage of infants receiving any breast milk at hospital discharge, 6 weeks, 12 and 24 months was 96% (95% CI: 94-97%), 95% (95% CI: 94-96%), 31% (95% CI: 28-34%) and 15% (95% CI: 13-17%), respectively. Again ethnic differences emerged. Common reasons cited for discontinuation of exclusive breast-feeding included uncertainty of breast milk supply (56%), problems with breasts (30%) and difficulties breast-feeding in work or educational environments (26%). However, 691 (50%) mothers sought no advice about their breast-feeding concerns within the first six weeks of life. Exclusive breast-feeding rates for Pacific infants are ethnically heterogeneous, have declined since the 1990s and fall short of the World Health Organization recommendations. The principal reasons cited for exclusive breast-feeding discontinuation echo those reported over a decade ago.

Infant and young child feeding counseling: an intervention study.

PubMed

Bassichetto, Katia Cristina; Réa, Marina Ferreira

2008-01-01

To evaluate the effectiveness of an integrated infant and young child feeding counseling course for transforming the knowledge, attitudes and practices of pediatricians and nutritionists working for the municipal health system of São Paulo, Brazil. A randomized intervention study enrolling 29 professionals in the intervention group and 27 in the control group. Interviewers were trained in advance to collect data on the professionals working at health centers, before and 2 months after the intervention. Three research instruments were used, the first was to assess the profile of each professional, the second assessed their knowledge and the third was a clinical observation protocol. Analysis was performed using the Kruskal-Wallis test for independent samples and the Tukey method. The results for the knowledge questionnaire showed improvements in the intervention group (p < 0.001) for the whole questionnaire and for questions on breastfeeding (p = 0.004); HIV and infant and young child feeding (p = 0.049); complementary feeding (p = 0.012); and counseling in infant and young child feeding (p = 0.004). In terms of performance, it was observed that the intervention group had significantly improved their dietary anamnesis after the intervention (p < 0.001). This course effectively promoted an increase in knowledge and improvements in dietary anamnesis performance, but the same was not true of counseling skills.

Breast feeding among Brazilian adolescents: practice and needs.

PubMed

Monteiro, J C S; Dias, F A; Stefanello, J; Reis, M C G; Nakano, A M S; Gomes-Sponholz, F A

2014-03-01

to characterise breast feeding practices among Brazilian adolescents and identify their breast feeding needs. the study was undertaken in Ribeirão Preto, Brazil in two stages. The first stage analysed data from the Second National Survey of Breast-feeding Prevalence, held in August 2008, which included 229 adolescent mothers. The second stage was a qualitative approach, and involved interviews with 10 adolescent mothers in a primary care unit. The data from the first stage were analysed in June 2010 based on descriptive statistics. The data obtained from the interviews were transcribed and organised using thematic content analysis. breast feeding was reported by 75% of the adolescent mothers. Of the 144 mothers with infants aged <180 days, 84% reported that they were breast feeding: 19% were breast feeding exclusively, 17% were breast feeding predominantly, 49% were providing complementary feeding, and 16% had weaned their infants. Analysis of the interviews led to the identification of three thematic units: concern for the child's health; breast feeding difficulties; and health team and family support. the majority of the adolescent mothers presented conditions that were favourable to breast feeding (e.g. did not work outside the home, only had one child, breast fed in the first hour post partum). However, the practice of breast feeding still failed to meet the recommendations of the World Health Organization. The interviews led to identification of the breast feeding needs and demands of adolescent mothers, many of which were related to the needs of their infants. It is important to know what adolescent mothers think about breast feeding, in order to encourage the establishment of practices to keep breastfeeding as longer as possible in a satisfactory way for both mothers and infants. Copyright © 2013 Elsevier Ltd. All rights reserved.

The potential effectiveness of the nutrition improvement program on infant and young child feeding and nutritional status in the Northwest and Southwest regions of Cameroon, Central Africa.

PubMed

Reinsma, Kate; Nkuoh, Godlove; Nshom, Emmanuel

2016-11-15

Despite the recent international focus on maternal and child nutrition, little attention is paid to nutrition capacity development. Although infant feeding counselling by health workers increases caregivers' knowledge, and improves breastfeeding, complementary feeding, and children's linear growth, most of the counselling in sub-Saharan Africa is primarily conducted by nurses or volunteers, and little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. The Cameroon Baptist Convention Health Services Nutrition Improvement Program (NIP) has integrated a cadre of nutrition counselors into prevention of mother-to-child transmission of HIV programs, infant welfare clinics, and antenatal clinics to improve infant and young child feeding practices (IYCF). The study objective was to evaluate the effects of NIP's infant feeding counselors on exclusive breastfeeding (EBF), complementary feeding (CF), and children's linear growth. A cross-sectional evaluation design was used. Using systematic random sampling, caregivers were recruited from NIP sites (n = 359) and non-NIP sites (n = 415) from Infant Welfare Clinics (IWCs) in the Northwest (NWR) and Southwest Regions (SWR) of Cameroon between October 2014 and April 2015. Differences in EBF and CF practices and children's linear growth between NIP and non-NIP sites were determined using chi-square and multiple logistic regression. After adjusting for differences in religion, occupation, and number of months planning to breastfeed, children were almost seven times (Odds Ratio [OR]: 6.9; 95% Confidence Interval [CI]: 2.30, 21.09; β = 1.94) more likely to be exclusively breastfed at NIP sites compared to non-NIP sites. After adjusting for differences in occupation, religion, number of months planning to breastfeed, rural environment, economic status, attending other Infant Welfare Clinics, and non-biological caregiver, children were five times more likely to be stunted at non-NIP sites compared to NIP sites. Training a cadre of nutrition counselors is one approach towards increasing nutrition human resources to implement nutrition interventions to improve maternal and child nutrition. In this research project, the study design did not allow for conclusive results, but rather suggest IYCF counseling provided by nutrition counselors was effective in increasing EBF and reduced the risk of stunting in children 6-8 months.

Undernutrition, poor feeding practices, and low coverage of key nutrition interventions.

PubMed

Lutter, Chessa K; Daelmans, Bernadette M E G; de Onis, Mercedes; Kothari, Monica T; Ruel, Marie T; Arimond, Mary; Deitchler, Megan; Dewey, Kathryn G; Blössner, Monika; Borghi, Elaine

2011-12-01

To estimate the global burden of malnutrition and highlight data on child feeding practices and coverage of key nutrition interventions. Linear mixed-effects modeling was used to estimate prevalence rates and numbers of underweight and stunted children according to United Nations region from 1990 to 2010 by using surveys from 147 countries. Indicators of infant and young child feeding practices and intervention coverage were calculated from Demographic and Health Survey data from 46 developing countries between 2002 and 2008. In 2010, globally, an estimated 27% (171 million) of children younger than 5 years were stunted and 16% (104 million) were underweight. Africa and Asia have more severe burdens of undernutrition, but the problem persists in some Latin American countries. Few children in the developing world benefit from optimal breastfeeding and complementary feeding practices. Fewer than half of infants were put to the breast within 1 hour of birth, and 36% of infants younger than 6 months were exclusively breastfed. Fewer than one-third of 6- to 23-month-old children met the minimum criteria for dietary diversity, and only ∼50% received the minimum number of meals. Although effective health-sector-based interventions for tackling childhood undernutrition are known, intervention-coverage data are available for only a small proportion of them and reveal mostly low coverage. Undernutrition continues to be high and progress toward reaching Millennium Development Goal 1 has been slow. Previously unrecognized extremely poor breastfeeding and complementary feeding practices and lack of comprehensive data on intervention coverage require urgent action to improve child nutrition.

FEEDING DIFFICULTIES IN PRESCHOOL CHILDREN, PREVIOUS FEEDING PRACTICES, AND NUTRITIONAL STATUS.

PubMed

Maranhão, Hélcio de Sousa; Aguiar, Renata Cunha de; Lira, Débora Teixeira Jales de; Sales, Mônica Úrsula Figuerêdo; Nóbrega, Nathalia Ávila do Nascimento

2018-01-01

To identify the prevalence of feeding difficulties in preschoolers, its association with epidemiological factors and previous eating habits, and repercussion on nutritional status. Cross-sectional study with a questionnaire given to the mothers of 301 children aged 2-6 years enrolled in public and private kindergartens in Natal, Northeast Brazil, conducted in 2014-2015. Feeding difficulty was assessed according to Kerzner's criteria, resulting in the profiles "highly selective intake", "active child with small appetite", "fear of feeding", and "child with psychological disorder or neglected". Association with the following independent variables was analyzed by logistic regression: breastfeeding time, age of cows' milk and complementary feeding introduction, age range, family income, type of school, mothers' profile (responsive or nonresponsive), and body mass index (BMI). Feeding difficulty was found in 37.2% of cases, with predominance of "highly selective intake" (25.4%). It was not associated with infancy feeding practices, family income or type of school. There were no differences between the BMI Z score means for the groups with and without feeding difficulty (1.0±1.5 SD and 1.1±1.4 SD, respectively). The five-to-six age range had more occurrences (OR 1.8; 95%CI 1.1-2.9). Children of responsive mothers were less likely to have feeding difficulties (OR 0.4; 95%CI 0.2-0.8). Feeding difficulties were very frequent. Nutritional status was not impacted by it, and infancy eating habits were not associated with it. Responsive mothers' profile is a protective factor against eating difficulties and reinforces the importance of behavioral factors and mother-child interaction.

Continuous countercurrent membrane column for the separation of solute/solvent and solvent/solvent systems

DOEpatents

Nerad, Bruce A.; Krantz, William B.

1988-01-01

A reverse osmosis membrane process or hybrid membrane - complementary separator process for producing enriched product or waste streams from concentrated and dilute feed streams for both solvent/solvent and solute/solvent systems is described.

Feeding bottles usage and the prevalence of childhood allergy and asthma.

PubMed

Hsu, Nai-Yun; Wu, Pei-Chih; Bornehag, Carl-Gustaf; Sundell, Jan; Su, Huey-Jen

2012-01-01

This study aimed to examine the association between the length of use of feeding bottles or pacifiers during childhood and the prevalence of respiratory and allergic morbidities. A large-scale questionnaire survey was performed in day care centers and kindergartens (with children's ages ranging from 2 to 7 years) in southern Taiwan, and a total of 14,862 questionnaires completed by parents were finally recruited for data analysis. Effects of using feeding bottles on children's wheezing/asthma (adjusted OR: 1.05, 95% CI 1.00-1.09), allergic rhinitis (adjusted OR: 1.04, 95% CI 1.00-1.08), and eczema (adjusted OR: 1.07, 95% CI 1.01-1.2) were found. Moreover, significant dose-dependent relationships were further established after an adjustment for confounders was performed that included children's ages, gender, gestational age, birth weight, length of breastfeeding, the age when first given infant formula or complementary foods, family history, parental educational levels, and smoking status, as well as the problem of indoor water damage. This study was the first to reveal the potential risk of using plastic consumer products such as feeding bottles on the reported health status of preschool children in Asian countries.

Feeding Bottles Usage and the Prevalence of Childhood Allergy and Asthma

PubMed Central

Hsu, Nai-Yun; Wu, Pei-Chih; Bornehag, Carl-Gustaf; Sundell, Jan; Su, Huey-Jen

2012-01-01

This study aimed to examine the association between the length of use of feeding bottles or pacifiers during childhood and the prevalence of respiratory and allergic morbidities. A large-scale questionnaire survey was performed in day care centers and kindergartens (with children's ages ranging from 2 to 7 years) in southern Taiwan, and a total of 14,862 questionnaires completed by parents were finally recruited for data analysis. Effects of using feeding bottles on children's wheezing/asthma (adjusted OR: 1.05, 95% CI 1.00–1.09), allergic rhinitis (adjusted OR: 1.04, 95% CI 1.00–1.08), and eczema (adjusted OR: 1.07, 95% CI 1.01–1.2) were found. Moreover, significant dose-dependent relationships were further established after an adjustment for confounders was performed that included children's ages, gender, gestational age, birth weight, length of breastfeeding, the age when first given infant formula or complementary foods, family history, parental educational levels, and smoking status, as well as the problem of indoor water damage. This study was the first to reveal the potential risk of using plastic consumer products such as feeding bottles on the reported health status of preschool children in Asian countries. PMID:22291844

Infant feeding counselling of HIV-infected women in two areas in Kenya in 2008.

PubMed

Israel-Ballard, Kiersten; Waithaka, Margaret; Greiner, Ted

2014-11-01

While WHO no longer recommends individual infant feeding counselling to HIV-positive women, it may still be practised in some settings and for specific cases. In any case, lessons can be learned by examining how well front line health workers are able to take on counselling tasks. This qualitative study was designed to assess how counsellors deal with challenges they face in two Kenyan provinces. It consisted of brief post-counselling exit interviews with 80 mothers, observations of 21 counselling sessions and 11 key informant interviews. Much infant feeding counselling was of reasonable quality, better than often reported elsewhere. However, nutrition and infant feeding were given low priority, counsellors' training was inadequate, individual postnatal counselling as well as growth monitoring and promotion were rarely done and complementary feeding was inadequately covered. Acceptable, feasible, affordable, sustainable and safe (AFASS) assessments were not of satisfactory quality. Breast milk expression was mentioned only to a minority and the possibility of heat treatment during the transition to cessation was not mentioned. Counsellors were often biased in discussing risks of breastfeeding and replacement feeding. Implementing the new WHO guidance will reduce the need for AFASS assessments, greatly simplifying both the government's and counsellors' tasks. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Determinants of infant feeding choices by Zambian mothers: a mixed quantitative and qualitative study.

PubMed

Chisenga, Molly; Siame, Joshua; Baisley, Kathy; Kasonka, Lackson; Filteau, Suzanne

2011-04-01

Choosing an infant feeding mode is complex for human immunodeficiency virus (HIV)-infected African women. We documented infant feeding choices by 811 mothers of infants aged less than 18 months enrolled in the Chilenje Infant Growth, Nutrition and Infection Study of fortified complementary or replacement foods. We also conducted 20 interviews and 4 focus group discussions among women and nurses to explore the issues in depth. Practices of most HIV-infected women did not closely follow national or international guidelines: 26% never initiated breastfeeding, and 55% were not breastfeeding by 6 months post partum. Women of lower socio-economic status and those not meeting criteria for safe replacement feeding were more likely to initiate breastfeeding, to continue longer and to stop at 6 months when provided with free food within the trial. Most HIV-negative women and women of unknown HIV status continued breastfeeding into the infant's second year, indicating limited 'spillover' of infant feeding messages designed for HIV-infected women into the uninfected population. Qualitative work indicated that the main factors affecting HIV-infected women's infant feeding decisions were the cost of formula, the advice of health workers, influence of relatives, stigma and difficulties with using an exclusive feeding mode. Rapidly changing international recommendations confused both mothers and nurses. Many HIV-infected women chose replacement feeding without meeting criteria to do this safely. Women were influenced by health workers but, for several reasons, found it difficult to follow their advice. The recently revised international HIV and infant feeding recommendations may make the counselling process simpler for health workers and makes following their advice easier for HIV-infected women. © 2010 Blackwell Publishing Ltd.

Breast-feeding and weaning practices in the DONALD study: age and time trends.

PubMed

Foterek, Kristina; Hilbig, Annett; Alexy, Ute

2014-03-01

Besides influencing short- and long-term health status, infant feeding practices are known to have an effect on later food preferences. This study aimed to identify present trends in breast-feeding duration and weaning practices with special focus on preparation methods of complementary food (CF), that is, homemade and commercial CF. In total, 1419 three-day weighed diet records collected between 2004 and 2012 from 366 children of the German DOrtmund Nutritional and Anthropometric Longitudinally Designed study ages 6 to 24 months were analysed. Full (n = 339) and total breast-feeding duration (n = 344) was collected by questionnaire. To investigate age and time trends, logistic regression and polynomial mixed regression models were used. Infants born between 2008 and 2012 were 3.3-fold less likely to be fully breast-fed for ≥4 months than those born before 2004 (P < 0.0001). Overall, 59.3% commercial, 21.1% homemade, and 19.6% combined CF was consumed by the study sample. Subjects with high commercial CF consumption (percentage of commercial CF > median 62%) were significantly older (P < 0.0001), showed shorter full and total breast-feeding duration (P < 0.0001), and were more likely to have mothers with a lower educational status (P = 0.01). Both commercial and homemade CF showed opposing, nonlinear age trends. No time trends could be found. Decreasing duration of full breast-feeding should encourage health care providers to further promote longer breast-feeding duration. With the constantly high consumption of commercial CF at all ages, nutritional adequacy of both homemade and commercial CF needs to be investigated closer, as does their long-term influence on health and dietary habits, for example, fruit and vegetable intake.

Infant feeding practices among HIV-positive women in Dar es Salaam, Tanzania, indicate a need for more intensive infant feeding counselling.

PubMed

Young, Sera L; Israel-Ballard, Kiersten A; Dantzer, Emily A; Ngonyani, Monica M; Nyambo, Margaret T; Ash, Deborah M; Chantry, Caroline J

2010-12-01

To assess feeding practices of infants born to HIV-positive women in Dar es Salaam, Tanzania. These data then served as a proxy to evaluate the adequacy of current infant feeding counselling. A cross-sectional survey of infant feeding behaviours. Four clinics in greater Dar es Salaam in early 2008. A total of 196 HIV-positive mothers of children aged 6-10 months recruited from HIV clinics. Initiation of breast-feeding was reported by 95·4 % of survey participants. In the entire sample, 80·1 %, 34·2 % and 13·3 % of women reported exclusive breast-feeding (EBF) up to 2, 4 and 6 months, respectively. Median duration of EBF among women who ever breast-fed was 3 (interquartile range (IQR): 2·1, 4·0) months. Most non-breast-milk foods fed to infants were low in nutrient density. Complete cessation of breast-feeding occurred within 14 d of the introduction of non-breast-milk foods among 138 of the 187 children (73·8 %) who had ever received any breast milk. Of the 187 infants in the study who ever received breast milk, 19·4 % received neither human milk nor any replacement milks for 1 week or more (median duration of no milk was 14 (IQR: 7, 152) d). Infant feeding practices among these HIV-positive mothers resulted in infants receiving far less breast milk and more mixed complementary feeds than recommended, thus placing them at greater risk of both malnutrition and HIV infection. An environment that better enables mothers to follow national guidelines is urgently needed. More intensive infant feeding counselling programmes would very likely increase rates of optimal infant feeding.

Impact of Maternal Education about Complementary Feeding on Their Infants' Nutritional Outcomes in Low- and Middle-income Households: A Community-based Randomized Interventional Study in Karachi, Pakistan

PubMed Central

Saleem, Ali Faisal; Mahmud, Sadia; Baig-Ansari, Naila

2014-01-01

ABSTRACT This cluster-randomized interventional trial at peri-urban settings of Karachi was conducted to evaluate the impact of maternal educational messages regarding appropriate complementary feeding (CF) on the nutritional status of their infants after 30 weeks of educational interventions delivered by trained community health workers. Mothers in the intervention group received three education modules about breastfeeding (BF) and appropriate CF at a baseline visit and two subsequent visits 10 weeks apart. The control group received advice about BF according to national guidelines. Infants' growth [weight, length, and mid-upper arm-circumference (MUAC), stunting, wasting, and underweight] were measured at four time points. At the end of the study, infants in the intervention group had a higher mean weight of 350 g (p=0.001); length of 0.66 cm (p=0.001), and MUAC of 0.46 cm (p=0.002) compared to the controls; proportionate reduction of stunting and underweight were 10% (84% vs 74%; ORadj 8.36 (5.6-12.42) and 5% (25% vs 20%; ORadj 0.75 (0.4-1.79) in the intervention compared to the control group. For relatively food-secure populations, educational interventions about appropriate CF to mothers had a direct positive impact on linear growth of their infants. PMID:25895196

Giardia intestinalis and nutritional status in children participating in the complementary nutrition program, Antioquia, Colombia, May to October 2006.

PubMed

Botero-Garcés, Jorge H; García-Montoya, Gisela M; Grisales-Patiño, Dayvin; Aguirre-Acevedo, Daniel C; Alvarez-Uribe, Martha C

2009-01-01

Giardia intestinalis infection is prevalent throughout the world and widely distributed in developing countries. In general, children display serious consequences to their state of health, including slow height-weight development; therefore, the main aim of this study was to determine the association between Giardia infection and the nutritional status of children who participate in the program of complementary feeding (Mejoramiento Alimentario y Nutricional de Antioquia (MANA) - Instituto Colombiano de Bienestar Familiar (ICBF)). A cross-sectional study examining the association of giardiasis with nutritional status was conducted. A total of 2035 children aged eight months to six years-old were studied. Data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and stool samples. Analysis of the results showed that 27.6% of children were infected with G. intestinalis, while 8.1% and 1.9% were mildly and significantly underweight, respectively, and 14.1% presented stunting. Giardiasis was statistically identified as a strong predictor of stunting in this study population.

Associations of land, cattle and food security with infant feeding practices among a rural population living in Manyara, Tanzania.

PubMed

Hanselman, Bailey; Ambikapathi, Ramya; Mduma, Estomih; Svensen, Erling; Caulfield, Laura E; Patil, Crystal L

2018-01-19

Livelihoods strategies and food security experiences can positively and negatively affect infant and young child feeding (IYCF) practices. This study contributes to this literature by exploring how variation in household economics among rural farmers in Tanzania relates to IYCF patterns over the first 8 months of an infant's life. These data were produced from a longitudinal study in which a cohort of mother-infant dyads was followed from birth to 24 months. In addition to baseline maternal, infant, and household characteristics, mothers were queried twice weekly and monthly about infant feeding practices and diet. Weekly and monthly datasets were merged and analyzed to assess infant feeding patterns through the first 8 months. Standard statistical methods including survival and logistic regression analyses were used. Aside from breastfeeding initiation, all other IYCF practices were suboptimal in this cohort. Land and cattle ownership were associated with the early introduction of non-breastmilk food items. Food insecurity also played a role in patterning and inadequate complementary feeding was commonplace. Health promotion programs are needed to delay the introduction of animal milks and grain-based porridge, and to achieve a minimum acceptable diet after 6 months of age among smallholder farmers in rural Tanzania. Results highlight that livelihoods-based health promotion interventions, built from a flexible and integrated design, may be an important strategy to address community-level variation in infant feeding practices and promote optimal IYCF practices.

Excessive weight gain during full breast-feeding.

PubMed

Grunewald, Maria; Hellmuth, Christian; Demmelmair, Hans; Koletzko, Berthold

2014-01-01

Breast-feeding is considered to offer optimal nutrition for healthy infant growth and development. Observational studies have linked breast-feeding to reduced obesity. CASE OBSERVATION: We observed an infant who was born macrosomic (4.56 kg) and showed excessive weight gain markedly exceeding the 97th percentile of weight during full breast-feeding. At the age of 4 months, the weight was greater than 11 kg. Clinical evaluation did not reveal any underlying pathology. After the introduction of complementary feeding and hence reduction of the breast milk intake, the excessive weight gain was attenuated and the slope of the percentile curve paralleled upper percentiles. Since this pattern suggested full breast-feeding as the driver of excessive weight gain, we analyzed the human milk composition at the infant age of 1 year and compared the results with published data on composition at this stage of lactation. The milk contents of lactose, fat, fatty acids, polar lipids, carnitine species, and insulin were similar to the reference data. The adiponectin content was increased. The most remarkable alteration was a high milk protein content (mean 1.25 g/dl, reference 0.8 g/dl). A very high protein supply in infancy has been previously shown to increase plasma concentrations of the growth factors insulin and IGF-1, weight gain, and later obesity. We speculate that interindividual variations in human milk adiponectin and protein contents may contribute to modulation of the growth of fully breast-fed infants and in this case may have contributed to excessive weight gain during full breast-feeding. This hypothesis merits being tested in future cohort studies. © 2014 S. Karger AG, Basel.

Docosahexaenoic acid (DHA): from the maternal-foetal dyad to the complementary feeding period.

PubMed

Agostoni, Carlo

2010-07-01

The docosahexaenoic acid (DHA, C22:6n-3) status of infants at birth and maternal DHA intake during pregnancy are interconnected and associated with infants' developmental performance. High-dosage supplementation of long-chain polyunsaturated fatty acids (LCPUFAs; particularly DHA) in mothers, started at mid-pregnancy, has been associated with long-term positive effects on intelligence quotient scores of neurodevelopment. Poor maternal and infant DHA status could partly contribute to the observed association between certain conditions and impaired developmental outcome. The dietary DHA enrichment of human milk seems to be functionally effective in breastfed infants only when lactating mothers start supplementation during pregnancy. Results from trials in artificially fed infants are dissimilar and could be related in part to uninvestigated covariates such as infant DHA status at birth and the individual genetic background. Nevertheless, DHA supplementation during the complementary feeding period seems to be effective in improving neurofunctional and visual performance. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Complementary roles of two resilient neotropical mammalian seed dispersers

NASA Astrophysics Data System (ADS)

de Almeida, Adriana; Morris, Rebecca J.; Lewis, Owen T.; Mikich, Sandra B.

2018-04-01

Capuchin monkeys (Cebus spp. and Sapajus spp.) and coatis (Nasua spp.) coexist in most neotropical forests, including small forest remnants. Both capuchins and coatis eat fruit and disperse seeds, but little is known about whether their roles in seed dispersal are redundant or complementary. We compiled 49 studies from the literature on feeding by capuchins and/or coatis, of which 19 were comprehensive enough for our analyses. We determined the relative importance of fruit eating to each species and compared their diets. Additionally, we analysed the structure of three fruit-frugivore networks built with both animal groups and the fruits they eat and evaluated whether fruit traits influenced the network topology. Fruits represented the largest part of capuchin and coati diets, even though coatis have been known for their opportunistic and generalist diets. Capuchins and coatis also exhibited similar general diet parameters (niche breadth and trophic diversity). The three networks exhibited high connectance values and variable niche overlap. A Multiple Correspondence Analysis, failed to detect any trait or trait combination related to food use. In conclusion, capuchins and coatis both have generalist diets; they feed on many different species of fruits and exhibit important complementarity as seed dispersers. Both are likely to be particularly important seed dispersers in disturbed and fragmented forests.

Postnatal Prevention of Childhood Obesity in Offspring Prenatally Exposed to Gestational Diabetes mellitus: Where Are We Now?

PubMed Central

Dugas, Camille; Perron, Julie; Kearney, Michèle; Mercier, Roxanne; Tchernof, André; Marc, Isabelle; Weisnagel, S. John; Robitaille, Julie

2017-01-01

Children exposed to gestational diabetes mellitus (GDM) in utero are at high risk of developing many health problems such as obesity. There is an urgent need to find new strategies to prevent obesity development among high-risk populations such as those children. Accordingly, the aim of this review was to summarize current knowledge on the postnatal prevention of childhood obesity in offspring born from mothers with GDM. Specifically, this review addresses the impact of breastfeeding, complementary feeding practices as well as dietary intake and physical activity during childhood on obesity risk of children exposed to GDM in utero. Furthermore, breast milk composition of diabetic mothers and its potential impact on growth is discussed. According to the available literature, breastfeeding may reduce obesity risk in children exposed to GDM in utero but a longer duration seems necessary to achieve its protective effect against obesity. Detailed analysis of breast milk composition of mothers with GDM will be necessary to fully understand the relationship between breastfeeding and obesity in this specific population. This review highlights the need for more studies addressing the impact of complementary feeding practices and lifestyle habits during childhood on obesity risk of children exposed to GDM in utero. PMID:28848122

Postnatal Prevention of Childhood Obesity in Offspring Prenatally Exposed to Gestational Diabetes mellitus: Where Are We Now?

PubMed

Dugas, Camille; Perron, Julie; Kearney, Michèle; Mercier, Roxanne; Tchernof, André; Marc, Isabelle; Weisnagel, S John; Robitaille, Julie

2017-01-01

Children exposed to gestational diabetes mellitus (GDM) in utero are at high risk of developing many health problems such as obesity. There is an urgent need to find new strategies to prevent obesity development among high-risk populations such as those children. Accordingly, the aim of this review was to summarize current knowledge on the postnatal prevention of childhood obesity in offspring born from mothers with GDM. Specifically, this review addresses the impact of breastfeeding, complementary feeding practices as well as dietary intake and physical activity during childhood on obesity risk of children exposed to GDM in utero. Furthermore, breast milk composition of diabetic mothers and its potential impact on growth is discussed. According to the available literature, breastfeeding may reduce obesity risk in children exposed to GDM in utero but a longer duration seems necessary to achieve its protective effect against obesity. Detailed analysis of breast milk composition of mothers with GDM will be necessary to fully understand the relationship between breastfeeding and obesity in this specific population. This review highlights the need for more studies addressing the impact of complementary feeding practices and lifestyle habits during childhood on obesity risk of children exposed to GDM in utero. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

The critical period of infant feeding for the development of early disparities in obesity

PubMed Central

Thompson, Amanda L.; Bentley, Margaret E.

2013-01-01

Childhood obesity is an increasing public health problem, particularly among minority infants and young children. Disparities in overweight prevalence persist and widen with age, highlighting the need to identify factors contributing to early excess weight gain. We review the behavioral, social and macro-environmental factors contributing to the development of obesogenic early feeding practices among African-American infants and young children. We then examine the sociodemographic, household factors, feeding beliefs and infant characteristics associated with age-inappropriate feeding of liquids and solids (inappropriate feeding) among mothers and infants participating the U.S. Infant Care and Risk of Obesity Study, a cohort study of 217 low-income, first-time mothers and infants followed from 3 to 18 months of age. Maternal and infant anthropometry, infant diet, and maternal and household characteristics were collected at home visits at 3, 6, 9, 12 and 18 months of age. Mixed logistic regression was used to estimate the association between maternal and infant characteristics and inappropriate feeding. Rates of age-inappropriate feeding are high; over 75% of infants received solids or juice by 3 months of age. The odds of age-inappropriate feeding were higher among mothers who were single, depressed or believed that their infant is a “greedy” baby. Inappropriate feeding was associated with higher daily energy intake in infants (β = 109.28 calories, p = 0.01) and with increased odds of high infant weight-for-length (WFL; OR = 1.74, 95%CI: 1.01–3.01). Our findings suggest that age-inappropriate complementary feeding influences current energy intakes and infant WFL, factors that may increase long-term obesity risk by shaping infant appetite, food preferences, and metabolism. Given the intractability of pediatric obesity, understanding the role of early feeding in shaping long-term health disparities is critical for developing prevention strategies to stem obesity in early childhood. PMID:23312304

Breast-feeding in a complex emergency: four linked cross-sectional studies during the Bosnian conflict.

PubMed

Andersson, Neil; Paredes-Solís, Sergio; Legorreta-Soberanis, José; Cockcroft, Anne; Sherr, Lorraine

2010-12-01

To examine changes in breast-feeding and impacts on child health during the Bosnian conflict. Four linked representative cross-sectional household surveys, 1994 to 1997. The countries of former Yugoslavia largely missed the international wave of enthusiasm for breast-feeding of the 1980s and early 1990s. The concern is that breast-feeding deteriorates during humanitarian emergencies, when children need it most. The four surveys visited a random sample of clusters from population registers in the Federation of Bosnia and Herzegovina (BiH) and the Republica Srpska (RS). Interviewers asked about breast-feeding and other factors related to child health, and measured mid upper-arm circumference in 1123 infants aged 1-12 months. One-fifth of infants were not breast-fed at all (220/1087). Muslim and displaced children were less likely to breast-feed; 59 % of Muslim displaced children never breast-fed. Among infants in sites visited by all four surveys, there was no change in the proportion ever breast-fed and a significant increase in duration of breast-feeding and exclusive breast-feeding between 1994 and 1997. Children were breast-fed for shorter durations in male absent households, in frontline communities, the RS, and households that did not receive remittances from abroad. Non-breast-fed children and those who breast-fed for less than 4 months were more likely to be malnourished, as were those with complementary foods added either before or after their sixth month of life. If relief agencies had promoted and supported breast-feeding, this might have avoided some of the increased malnutrition that occurred during the conflict.

Key principles to improve programmes and interventions in complementary feeding.

PubMed

Lutter, Chessa K; Iannotti, Lora; Creed-Kanashiro, Hilary; Guyon, Agnes; Daelmans, Bernadette; Robert, Rebecca; Haider, Rukhsana

2013-09-01

Although there are some examples of successful complementary feeding programmes to promote healthy growth and prevent stunting at the community level, to date there are few, if any, examples of successful programmes at scale. A lack of systematic process and impact evaluations on pilot projects to generate lessons learned has precluded scaling up of effective programmes. Programmes to effect positive change in nutrition rarely follow systematic planning, implementation, and evaluation (PIE) processes to enhance effectiveness over the long term. As a result a set of programme-oriented key principles to promote healthy growth remains elusive. The purpose of this paper is to fill this gap by proposing a set of principles to improve programmes and interventions to promote healthy growth and development. Identifying such principles for programme success has three requirements: rethinking traditional paradigms used to promote improved infant and young child feeding; ensuring better linkages to delivery platforms; and, improving programming. Following the PIE model for programmes and learning from experiences from four relatively large-scale programmes described in this paper, 10 key principles are identified in the areas of programme planning, programme implementation, programme evaluation, and dissemination, replication, and scaling up. Nonetheless, numerous operational research questions remain, some of which are highlighted in this paper. © 2013 John Wiley & Sons Ltd.

Identification of specific bovine blood biomarkers with a non-targeted approach using HPLC ESI tandem mass spectrometry.

PubMed

Lecrenier, M C; Marbaix, H; Dieu, M; Veys, P; Saegerman, C; Raes, M; Baeten, V

2016-12-15

Animal by-products are valuable protein sources in animal nutrition. Among them are blood products and blood meal, which are used as high-quality material for their beneficial effects on growth and health. Within the framework of the feed ban relaxation, the development of complementary methods in order to refine the identification of processed animal proteins remains challenging. The aim of this study was to identify specific biomarkers that would allow the detection of bovine blood products and processed animal proteins using tandem mass spectrometry. Seventeen biomarkers were identified: nine peptides for bovine plasma powder; seven peptides for bovine haemoglobin powder, including six peptides for bovine blood meal; and one peptide for porcine blood. They were not detected in several commercial compound feed or feed materials, such as blood by-products of other animal origins, milk-derived products and fish meal. These biomarkers could be used for developing a species-specific and blood-specific detection method. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ambient and Cryogenic, Decade Bandwidth, Low Noise Receiving System for Radio Astronomy Using Sinuous Antenna

NASA Astrophysics Data System (ADS)

Gawande, Rohit Sudhir

Traditionally, radio astronomy receivers have been limited to bandwidths less than an octave, and as a result multiple feeds and receivers are necessary to observe over a wide bandwidth. Next generation of instruments for radio astronomy will benefit greatly from reflector antenna feeds that demonstrate very wide instantaneous bandwidth, and exhibit low noise behavior. There is an increasing interest in wideband systems from both the cost and science point of view. A wideband feed will allow simultaneous observations or sweeps over a decade or more bandwidth. Instantaneous wide bandwidth is necessary for detection of short duration pulses. Future telescopes like square kilometer array (SKA), consisting of 2000 to 3000 coherently connected antennas and covering a frequency range of 70 MHz to 30 GHz, will need decade bandwidth single pixel feeds (SPFs) along with integrated LNAs to achieve the scientific objectives in a cost effective way. This dissertation focuses on the design and measurement of a novel decade bandwidth sinuous-type, dual linear polarized, fixed phase center, low loss feed with an integrated LNA. A decade bandwidth, low noise amplifier is specially designed for noise match to the higher terminal impedance encountered by this antenna yielding an improved sensitivity over what is possible with conventional 50 O amplifiers. The self-complementary, frequency independent nature of the planar sinuous geometry results in a nearly constant beam pattern and fixed phase center over more than a 10:1 operating frequency range. In order to eliminate the back-lobe response over such a wide frequency range, we have projected the sinuous pattern onto a cone, and a ground plane is placed directly behind the cone's apex. This inverted, conical geometry assures wide bandwidth operation by locating each sinuous resonator a quarter wavelength above the ground plane. The presence of a ground plane near a self complementary antenna destroys the self complementary nature of the composite structure resulting in frequency dependent impedance variations. We demonstrate, using simulations and measurements, how the return loss can be improved by modifying the sinuous geometry. The feed-LNA combination is characterized for important properties such as return loss, system noise, far field beam patterns including cross-polarization over a wide frequency range. The system is developed as a feed for a parabolic reflector. The overall system performance is calculated in terms of the A/Tsys ratio. A cryogenic version would have a direct impact on specialized observing applications requiring large instantaneous bandwidths with high sensitivity. A novel cryogenic implementation of this system is demonstrated using a Stirling cycle, one-stage refrigerator. The cryocooler offers advantages like low cost, light weight, small size, low power consumption, and does not require routine maintenance. The higher antenna input impedance and a balanced feeding method for the sinuous antenna offers a unique set of challenges when developing a cryogenic system.

Contrasting diets reveal the metabolic plasticity of the tree-killing beetle, Anoplophora glabripennis (Cerambycidae: Lamiinae)

USDA-ARS?s Scientific Manuscript database

Wood-feeding insects encounter challenging diets with low quantities of protein, recalcitrant sources of carbohydrates, and high levels of defensive compounds. These insects have multiple, complementary mechanisms to contend with these digestive challenges. The Asian longhorned beetle (Anoplophora g...

Breast-feeding: A commentary by the ESPGHAN Committee on Nutrition.

PubMed

Agostoni, Carlo; Braegger, Christian; Decsi, Tamas; Kolacek, Sanja; Koletzko, Berthold; Michaelsen, Kim Fleischer; Mihatsch, Walter; Moreno, Luis A; Puntis, John; Shamir, Raanan; Szajewska, Hania; Turck, Dominique; van Goudoever, Johannes

2009-07-01

This medical position article by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition summarises the current status of breast-feeding practice, the present knowledge on the composition of human milk, advisable duration of exclusive and partial breast-feeding, growth of the breast-fed infant, health benefits associated with breast-feeding, nutritional supplementation for breast-fed infants, and contraindications to breast-feeding. This article emphasises the important role of paediatricians in the implementation of health policies devised to promote breast-feeding.The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition recognises breast-feeding as the natural and advisable way of supporting the healthy growth and development of young children. This article delineates the health benefits of breast-feeding, reduced risk of infectious diarrhoea and acute otitis media being the best documented. Exclusive breast-feeding for around 6 months is a desirable goal, but partial breast-feeding as well as breast-feeding for shorter periods of time are also valuable. Continuation of breast-feeding after the introduction of complementary feeding is encouraged as long as mutually desired by mother and child.The role of health care workers, including paediatricians, is to protect, promote, and support breast-feeding. Health care workers should be trained in breast-feeding issues and counselling, and they should encourage practices that do not undermine breast-feeding. Societal standards and legal regulations that facilitate breast-feeding should be promoted, such as providing maternity leave for at least 6 months and protecting working mothers.

Infant and young child feeding practices among children under 2 years of age and maternal exposure to infant and young child feeding messages and promotions in Dar es Salaam, Tanzania.

PubMed

Vitta, Bineti S; Benjamin, Margaret; Pries, Alissa M; Champeny, Mary; Zehner, Elizabeth; Huffman, Sandra L

2016-04-01

There are limited data describing infant and young child feeding practices (IYCF) in urban Tanzania. This study assessed the types of foods consumed by children under 2 years of age and maternal exposure to promotions of these foods in Dar es Salaam, Tanzania. A cross-sectional survey was conducted among 305 mothers of children less than 24 months of age who attended child health services in October and November, 2014. Among infants less than 6 months of age, rates of exclusive breastfeeding were low (40.8%) and a high proportion (38.2%) received semi-solid foods. Continued breastfeeding among 20-23-month-olds was only 33.3%. Consumption of breastmilk substitutes was not prevalent, and only 3.9% of infants less than 6 months of age and 4.8% of 6-23 month-olds were fed formula. Among 6-23-month-olds, only 38.4% consumed a minimum acceptable diet (using a modified definition). The homemade complementary foods consumed by the majority of 6-23-month-olds (85.2%) were cereal-dominated and infrequently contained micronutrient-rich ingredients. Only 3.1% of 6-23-month-olds consumed commercially produced infant cereal on the day preceding the interview. In contrast, commercially produced snack foods were consumed by 23.1% of 6-23-month-olds. Maternal exposure to commercial promotions of breastmilk substitutes and commercially produced complementary foods was low (10.5% and 1.0%, respectively), while exposure to promotions of commercially produced snack foods was high (45.9%). Strategies are needed to improve IYCF practices, particularly with regard to exclusive and continued breastfeeding, increased dietary diversity and consumption of micronutrient-rich foods, and avoidance of feeding commercially produced snack foods. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Implementation of a programme to market a complementary food supplement (Ying Yang Bao) and impacts on anaemia and feeding practices in Shanxi, China.

PubMed

Sun, Jing; Dai, Yaohua; Zhang, Shuaiming; Huang, Jian; Yang, Zhenyu; Huo, Junsheng; Chen, Chunming

2011-10-01

In China, a full fat soy powder mixed with multiple micronutrient powders (Ying Yang Bao (YYB)) was developed, and the efficacy of YYB was shown in controlling anaemia and improving child growth and development. However, prior to 2008, there was no sustainable way to provide YYB to vulnerable populations, except through free distribution by the government. This study was to test the concept of public-private partnership (PPP) to deliver YYB and to evaluate the effectiveness of marketing YYB through PPP. Programme activities included development of a complementary food supplement (CFS) national standard, product concept test, product development and marketing, behavior change communication, monitoring and evaluation. Baseline and end-line surveys were used to evaluate product awareness, purchasing and the impacts of the project on anaemia and feeding practices. A Chinese CFS standard was approved. Caregivers and their 6- to-24-month-old children participated in the baseline (n=226) and the end-line survey (n=221). A concept test at the baseline survey showed that 78% of caregivers were willing to buy YYB at 0.1 USD. After developing the product and implementing the intervention for 8 months, 59.6% of surveyed caregivers purchased YYB. While not significant, the prevalence of anaemia was marginally lower at the end line (28.8%) than at the baseline (36.2%). For those purchasing YYB, the risk of anaemia was significantly reduced by 87% of odds (P<0.009). The end-line survey found that feeding practices had improved significantly following the intervention. An enabling policy and regulatory environment in which CFSs are defined and parameters for appropriate marketing are identified as a prerequisite for marketing YYB or other nutritious CFS. Public and private advocacy and marketing could successfully increase awareness of YYB and access and use through market channels. The YYB project may be effective for reducing anaemia and improving feeding practices. © 2011 Blackwell Publishing Ltd.

Diets and Feeding Practices during the First 1000 Days Window in the Phnom Penh and North Eastern Districts of Cambodia.

PubMed

Som, Somphos Vicheth; Prak, Sophonneary; Laillou, Arnaud; Gauthier, Ludovic; Berger, Jacques; Poirot, Etienne; Wieringa, Frank T

2018-04-18

Although several health and development indicators have improved significantly in Cambodia, inadequate breastfeeding and inappropriate complementary feeding practices leave many children at high risk of malnutrition during the early stages of life. In 2014, the prevalence of wasting and stunting among Cambodian children under 5 were 10% and 32%, respectively. Thus, a strong focus on improving feeding practices within the first 1000 days window to reduce child malnutrition prevalence in Cambodia is needed. This cross-sectional study assessed the current feeding practices among of women of reproductive age, pregnant women, lactating women and children less than 24 months living in six districts from Phnom Penh and two rural provinces in the North East of Cambodia. The nutritional status of pregnant women was poor, with 21.4% having a Middle Upper arm circumference below 23 cm. While breastfeeding was predominant within the first 6 months of age in every district, feeding practices of pregnant women and children were a concern, as >70% of the children were not meeting the minimum acceptable diet, and most of the women did not improve their diet during pregnancy. Inadequate nutrition during the first 1000 days is highly prevalent in Cambodia. A comprehensive national Mother, Infant and Young Child Nutrition strategy needs to be developed and operationalized to improve feeding practices of Cambodian women and children.

Diets and Feeding Practices during the First 1000 Days Window in the Phnom Penh and North Eastern Districts of Cambodia

PubMed Central

Som, Somphos Vicheth; Prak, Sophonneary; Laillou, Arnaud; Gauthier, Ludovic; Berger, Jacques; Poirot, Etienne; Wieringa, Frank T.

2018-01-01

Although several health and development indicators have improved significantly in Cambodia, inadequate breastfeeding and inappropriate complementary feeding practices leave many children at high risk of malnutrition during the early stages of life. In 2014, the prevalence of wasting and stunting among Cambodian children under 5 were 10% and 32%, respectively. Thus, a strong focus on improving feeding practices within the first 1000 days window to reduce child malnutrition prevalence in Cambodia is needed. This cross-sectional study assessed the current feeding practices among of women of reproductive age, pregnant women, lactating women and children less than 24 months living in six districts from Phnom Penh and two rural provinces in the North East of Cambodia. The nutritional status of pregnant women was poor, with 21.4% having a Middle Upper arm circumference below 23 cm. While breastfeeding was predominant within the first 6 months of age in every district, feeding practices of pregnant women and children were a concern, as >70% of the children were not meeting the minimum acceptable diet, and most of the women did not improve their diet during pregnancy. Inadequate nutrition during the first 1000 days is highly prevalent in Cambodia. A comprehensive national Mother, Infant and Young Child Nutrition strategy needs to be developed and operationalized to improve feeding practices of Cambodian women and children. PMID:29670006

FEEDING DIFFICULTIES IN PRESCHOOL CHILDREN, PREVIOUS FEEDING PRACTICES, AND NUTRITIONAL STATUS

PubMed Central

Maranhão, Hélcio de Sousa; de Aguiar, Renata Cunha; de Lira, Débora Teixeira Jales; Sales, Mônica Úrsula Figuerêdo; Nóbrega, Nathalia Ávila do Nascimento

2017-01-01

ABSTRACT Objective: To identify the prevalence of feeding difficulties in preschoolers, its association with epidemiological factors and previous eating habits, and repercussion on nutritional status. Methods: Cross-sectional study with a questionnaire given to the mothers of 301 children aged 2-6 years enrolled in public and private kindergartens in Natal, Northeast Brazil, conducted in 2014-2015. Feeding difficulty was assessed according to Kerzner’s criteria, resulting in the profiles “highly selective intake”, “active child with small appetite”, “fear of feeding”, and “child with psychological disorder or neglected”. Association with the following independent variables was analyzed by logistic regression: breastfeeding time, age of cows’ milk and complementary feeding introduction, age range, family income, type of school, mothers’ profile (responsive or nonresponsive), and body mass index (BMI). Results: Feeding difficulty was found in 37.2% of cases, with predominance of “highly selective intake” (25.4%). It was not associated with infancy feeding practices, family income or type of school. There were no differences between the BMI Z score means for the groups with and without feeding difficulty (1.0±1.5 SD and 1.1±1.4 SD, respectively). The five-to-six age range had more occurrences (OR 1.8; 95%CI 1.1-2.9). Children of responsive mothers were less likely to have feeding difficulties (OR 0.4; 95%CI 0.2-0.8). Conclusions: Feeding difficulties were very frequent. Nutritional status was not impacted by it, and infancy eating habits were not associated with it. Responsive mothers’ profile is a protective factor against eating difficulties and reinforces the importance of behavioral factors and mother-child interaction. PMID:29091129

A Multifaceted Mass Spectrometric Method to Probe Feeding Related Neuropeptide Changes in Callinectes sapidus and Carcinus maenas

NASA Astrophysics Data System (ADS)

Zhang, Yuzhuo; DeLaney, Kellen; Hui, Limei; Wang, Junhua; Sturm, Robert M.; Li, Lingjun

2018-02-01

Food intake is regulated by various neuromodulators, including numerous neuropeptides. However, it remains elusive at the molecular and cellular level as to how these important chemicals regulate internal processes and which regions of the neuronal organs are responsible for regulating the behavior. Here we report a comparative neuropeptidomic analysis of the brain and pericardial organ (PO) in response to feeding in two well-studied crustacean physiology model organisms, Callinectes sapidus and Carcinus maenas, using mass spectrometry (MS) techniques. A multifaceted MS-based approach has been developed to obtain complementary information on the expression changes of a large array of neuropeptides in the brain and PO. The method employs stable isotope labeling of brain and PO extracts for relative MS quantitation, capillary electrophoresis (CE)-MS for fractionation and high-specificity analysis, and mass spectrometric imaging (MSI) for in-situ molecular mapping of peptides. A number of neuropeptides, including RFamides, B-type allatostatins (AST-B), RYamides, and orcokinins exhibit significant changes in abundance after feeding in this investigation. Peptides from the AST-B family found in PO tissue were shown to have both altered expression and localization changes after feeding, indicating that they may be a class of vital neuropeptide regulators involved in feeding behavior. [Figure not available: see fulltext.

A Multifaceted Mass Spectrometric Method to Probe Feeding Related Neuropeptide Changes in Callinectes sapidus and Carcinus maenas

NASA Astrophysics Data System (ADS)

Zhang, Yuzhuo; DeLaney, Kellen; Hui, Limei; Wang, Junhua; Sturm, Robert M.; Li, Lingjun

2018-05-01

Food intake is regulated by various neuromodulators, including numerous neuropeptides. However, it remains elusive at the molecular and cellular level as to how these important chemicals regulate internal processes and which regions of the neuronal organs are responsible for regulating the behavior. Here we report a comparative neuropeptidomic analysis of the brain and pericardial organ (PO) in response to feeding in two well-studied crustacean physiology model organisms, Callinectes sapidus and Carcinus maenas, using mass spectrometry (MS) techniques. A multifaceted MS-based approach has been developed to obtain complementary information on the expression changes of a large array of neuropeptides in the brain and PO. The method employs stable isotope labeling of brain and PO extracts for relative MS quantitation, capillary electrophoresis (CE)-MS for fractionation and high-specificity analysis, and mass spectrometric imaging (MSI) for in-situ molecular mapping of peptides. A number of neuropeptides, including RFamides, B-type allatostatins (AST-B), RYamides, and orcokinins exhibit significant changes in abundance after feeding in this investigation. Peptides from the AST-B family found in PO tissue were shown to have both altered expression and localization changes after feeding, indicating that they may be a class of vital neuropeptide regulators involved in feeding behavior. [Figure not available: see fulltext.

A Multifaceted Mass Spectrometric Method to Probe Feeding Related Neuropeptide Changes in Callinectes sapidus and Carcinus maenas.

PubMed

Zhang, Yuzhuo; DeLaney, Kellen; Hui, Limei; Wang, Junhua; Sturm, Robert M; Li, Lingjun

2018-05-01

Food intake is regulated by various neuromodulators, including numerous neuropeptides. However, it remains elusive at the molecular and cellular level as to how these important chemicals regulate internal processes and which regions of the neuronal organs are responsible for regulating the behavior. Here we report a comparative neuropeptidomic analysis of the brain and pericardial organ (PO) in response to feeding in two well-studied crustacean physiology model organisms, Callinectes sapidus and Carcinus maenas, using mass spectrometry (MS) techniques. A multifaceted MS-based approach has been developed to obtain complementary information on the expression changes of a large array of neuropeptides in the brain and PO. The method employs stable isotope labeling of brain and PO extracts for relative MS quantitation, capillary electrophoresis (CE)-MS for fractionation and high-specificity analysis, and mass spectrometric imaging (MSI) for in-situ molecular mapping of peptides. A number of neuropeptides, including RFamides, B-type allatostatins (AST-B), RYamides, and orcokinins exhibit significant changes in abundance after feeding in this investigation. Peptides from the AST-B family found in PO tissue were shown to have both altered expression and localization changes after feeding, indicating that they may be a class of vital neuropeptide regulators involved in feeding behavior. Graphical Abstract ᅟ.

Determinants of infant and young child feeding practices in Bangladesh: secondary data analysis of Demographic and Health Survey 2004.

PubMed

Mihrshahi, Seema; Kabir, Iqbal; Roy, S K; Agho, Kingsley E; Senarath, Upul; Dibley, Michael J

2010-06-01

In Bangladesh, poor infant and young child feeding practices are contributing to the burden of infectious diseases and malnutrition. Objective. To estimate the determinants of selected feeding practices and key indicators of breastfeeding and complementary feeding in Bangladesh. The sample included 2482 children aged 0 to 23 months from the Bangladesh Demographic and Health Survey of 2004. The World Health Organization (WHO)-recommended infant and young child feeding indicators were estimated, and selected feeding indicators were examined against a set of individual-, household-, and community-level variables using univariate and multivariate analyses. Only 27.5% of mothers initiated breastfeeding within the first hour after birth, 99.9% had ever breastfed their infants, 97.3% were currently breastfeeding, and 22.4% were currently bottle-feeding. Among infants under 6 months of age, 42.5% were exclusively breastfed, and among those aged 6 to 9 months, 62.3% received complementary foods in addition to breastmilk. Among the risk factors for an infant not being exclusively breastfed were higher socioeconomic status, higher maternal education, and living in the Dhaka region. Higher birth order and female sex were associated with increased rates of exclusive breastfeeding of infants under 6 months of age. The risk factors for bottle-feeding were similar and included having a partner with a higher educational level (OR = 2.17), older maternal age (OR for age > or = 35 years = 2.32), and being in the upper wealth quintiles (OR for the richest = 3.43). Urban mothers were at higher risk for not initiating breastfeeding within the first hour after birth (OR = 1.61). Those who made three to six visits to the antenatal clinic were at lower risk for not initiating breastfeeding within the first hour (OR = 0.61). The rate of initiating breastfeeding within the first hour was higher in mothers from richer households (OR = 0.37). Most breastfeeding indicators in Bangladesh were below acceptable levels. Breastfeeding promotion programs in Bangladesh need nationwide application because of the low rates of appropriate infant feeding indicators, but they should also target women who have the main risk factors, i.e., working mothers living in urban areas (particularly in Dhaka).

COMPLEMENTARY APPROACHES TO THE DETERMINATION OF ARSENIC SPECIES RELEVANT TO CONCENTRATED ANIMAL FEEDING OPERATIONS

EPA Science Inventory

Ion-exchange chromatography is the most often used analytical approach for arsenic

speciation, due to the weak-acid nature of several of its species. However, no single

technique can determine all potentially occurring arsenic species, especially in complex

e...

Microbiological quality of complementary foods and its association with diarrhoeal morbidity and nutritional status of Bangladeshi children.

PubMed

Islam, M A; Ahmed, T; Faruque, A S G; Rahman, S; Das, S K; Ahmed, D; Fattori, V; Clarke, R; Endtz, H P; Cravioto, A

2012-11-01

To examine the bacteriological quality of complementary foods (CF) and to correlate the results with diarrhoeal morbidity and nutritional status of Bangladeshi children aged 6-24 months. A total of 212 CF samples were tested, of which 72 were collected immediately before the first time of feeding (≤ 1 h of food preparation) and 140 were collected at second/third time of feeding from 140 households located in urban and rural areas of Bangladesh. Anthropometry, food frequency data and demographic information of the children were collected. Of the first time feeding samples, 3% from each of urban and rural areas were found to be contaminated with faecal coliforms (FC) at ≥ 100 CFU/g. E. coli was isolated from 11% and 6% of samples, and B. cereus from 8% and 6% of samples from urban and rural areas, respectively. In contrast, 33% of the second/third time feeding samples from urban areas and 19% from rural areas were contaminated with FC at ≥ 100 CFU/g (P<0.05). E. coli was isolated from 40% and 39% of samples, and B. cereus from 33% and 26% of samples from urban and rural areas, respectively. Significantly high numbers of wasted rural children had CF with a high aerobic plate count, which was also significantly associated with diarrhoeal morbidity in children. Around 40% of CF samples were contaminated with E. coli, which was mainly attributable to food preparation practices. Consumption of contaminated CF appeared to be associated with a higher frequency of diarrhoea and malnutrition in children.

Modelling Pasture-based Automatic Milking System Herds: System Fitness of Grazeable Home-grown Forages, Land Areas and Walking Distances

PubMed Central

Islam, M. R.; Garcia, S. C.; Clark, C. E. F.; Kerrisk, K. L.

2015-01-01

To maintain a predominantly pasture-based system, the large herd milked by automatic milking rotary would be required to walk significant distances. Walking distances of greater than 1-km are associated with an increased incidence of undesirably long milking intervals and reduced milk yield. Complementary forages can be incorporated into pasture-based systems to lift total home grown feed in a given area, thus potentially ‘concentrating’ feed closer to the dairy. The aim of this modelling study was to investigate the total land area required and associated walking distance for large automatic milking system (AMS) herds when incorporating complementary forage rotations (CFR) into the system. Thirty-six scenarios consisting of 3 AMS herds (400, 600, 800 cows), 2 levels of pasture utilisation (current AMS utilisation of 15.0 t dry matter [DM]/ha, termed as moderate; optimum pasture utilisation of 19.7 t DM/ha, termed as high) and 6 rates of replacement of each of these pastures by grazeable CFR (0%, 10%, 20%, 30%, 40%, 50%) were investigated. Results showed that AMS cows were required to walk greater than 1-km when the farm area was greater than 86 ha. Insufficient pasture could be produced within a 1 km distance (i.e. 86 ha land) with home-grown feed (HGF) providing 43%, 29%, and 22% of the metabolisable energy (ME) required by 400, 600, and 800 cows, respectively from pastures. Introduction of pasture (moderate): CFR in AMS at a ratio of 80:20 can feed a 400 cow AMS herd, and can supply 42% and 31% of the ME requirements for 600 and 800 cows, respectively with pasture (moderate): CFR at 50:50 levels. In contrast to moderate pasture, 400 cows can be managed on high pasture utilisation (provided 57% of the total ME requirements). However, similar to the scenarios conducted with moderate pasture, there was insufficient feed produced within 1-km distance of the dairy for 600 or 800 cows. An 800 cow herd required 140 and 130 ha on moderate and high pasture-based AMS system, respectively with the introduction of pasture: CFR at a ratio of 50:50. Given the impact of increasing land area past 86 ha on walking distance, cow numbers could be increased by purchasing feed from off the milking platform and/or using the land outside 1-km distance for conserved feed. However, this warrants further investigations into risk analyses of different management options including development of an innovative system to manage large herds in an AMS farming system. PMID:25925068

Does breast-feeding affect severity of familial Mediterranean fever?

PubMed

Makay, Balahan; Unsal, Erbil

2009-12-01

Familial Mediterranean fever (FMF) is the most common inherited autoinflammatory disease, which is caused by an inborn error in innate immune system. It was shown that disease severity of patients of the same ethnic origin differed according to different country of residence, suggesting an influence of environment on phenotype of FMF. Different microbial milieus of the countries were accused. Breast-feeding has an important role on innate immunity and protects the infant from infections. The aim of this study is to investigate whether being breast-fed and duration of breast-feeding has an impact on disease severity of FMF. The mothers of patients were asked to fill a questionnaire about the feeding type in infancy. Mode of delivery, gestational age, and age at onset of FMF symptoms were also asked. The disease severity score of each patient was calculated according to the scoring system suggested by Pras et al. (Am J Med Genet 75:216-219, 1998). MEFV mutations were noted. The mothers of 81 FMF patients completed the questionnaire. Fifteen patients (18.5%) had mild, 49 (60.5%) had moderate, and 17 (21%) had severe disease. All the patients except four were breast-fed for some period. The duration of breast-feeding was similar between three severity groups. Time to introduce cow's milk and complementary foods also did not differ between groups. Longer duration of breast-feeding did not delay the onset of FMF symptoms. Mode of delivery and gestational age had no effect on disease severity. Patients homozygous for M694V had higher severity scores. This preliminary study suggests that breast-feeding is not an exogenous factor having an influence on phenotype of FMF. M694V genotype seems to cause more severe disease.

Specific Infant Feeding Practices Do Not Consistently Explain Variation in Anthropometry at Age 1 Year in Urban United States, Mexico, and China Cohorts12

PubMed Central

Woo, Jessica G.; Guerrero, M. Lourdes; Ruiz-Palacios, Guillermo M.; Peng, Yong-mei; Herbers, Patricia M.; Yao, Wen; Ortega, Hilda; Davidson, Barbara S.; McMahon, Robert J.; Morrow, Ardythe L.

2013-01-01

Infant feeding practices generally influence infant growth, but it is unclear how introduction of specific foods affects growth across global populations. We studied 3 urban populations in the Global Exploration of Human Milk study to determine the association between infant feeding and anthropometry at 1 y of age. Three hundred sixty-five breastfeeding mother-infant pairs (120 US, 120 China, and 125 Mexico) were recruited soon after the infant’s birth. Enrollment required agreement to breastfeed ≥75% for at least 3 mo. Weekly, 24-h, food frequency data were conducted on infants for 1 y and exclusive breastfeeding (EBF) duration and timing of specific complementary food introduction were calculated. Weight and length were measured at age 1 y and anthropometry Z-scores calculated using WHO standards. Cohorts in the 3 urban populations (Shanghai, China; Cincinnati, USA; and Mexico City, Mexico) differed by median EBF duration (5, 14, and 7 wk, respectively; P < 0.001), timing of introduction of meat/eggs/legumes (4.8, 9.3, and 7.0 mo, respectively; P < 0.0001), and other feeding practices. By age 1 y, infants in Shanghai were heavier and longer than Cincinnati and Mexico City infants (P < 0.001). Adjusting for nonfeeding covariates, the only feeding variable associated with anthropometry was EBF duration, which was modestly inversely associated with weight-for-age but not length-for-age or BMI Z-scores at 1 y. Although feeding variables differed by cohort, their impact on anthropometry differences was not consistent among cohorts. Overall, across these urban, international, breast-fed cohorts, differences in specific feeding practices did not explain the significant variation in anthropometry. PMID:23236024

Formative research to explore the acceptability and use of infant food grinders for the promotion of animal source foods and micronutrient powders in rural Peru.

PubMed

Creed-Kanashiro, Hilary; Wasser, Heather M; Bartolini, Rosario; Goya, Cecilia; Bentley, Margaret E

2018-04-02

According to global recommendations, quality diets for complementary feeding (CF) should include a diversity of foods including vitamin A-rich fruits and vegetables and sources of high-quality proteins and essential nutrients, particularly animal-source foods (ASF). A key barrier to feeding ASF surrounds beliefs that the preparation of foods of a thicker consistency may cause problems of digestion, "heaviness" or stomach problems, swallowing, and choking. The objective of this study was to explore, through systematic formative research, the acceptability, use, and feasibility of a simple technology, commercial infant food grinders, in two rural Peruvian settings where there is delayed and low consumption of complementary foods of a thick consistency, including ASF. Phase I explored the barriers, constraints, and opportunities related to the provision of foods of a thicker consistency with a focus on ASF. Phase II encompassed household behavioural trials with mothers and infants to assess the acceptability and use of the grinders in the home setting, using key concepts and messages developed from the information obtained during Phase I. The technology was highly acceptable, used by the majority of mothers (87.8%), and led to changes in cultural perceptions, facilitating increased feeding of appropriate textures (thick purees), ASF, and multimicronutrient powders. Energy, protein, and micronutrient intakes were all significantly greater after the household behavioural trials. This simple technology, paired with systematic formative research to appropriately promote its use across cultures, may have a significant effect on improving CF practices globally, particularly for young infants beginning CF at 6 months. © 2018 John Wiley & Sons Ltd.

Development of food-based complementary feeding recommendations for 9- to 11-month-old peri-urban Indonesian infants using linear programming.

PubMed

Santika, Otte; Fahmida, Umi; Ferguson, Elaine L

2009-01-01

Effective population-specific, food-based complementary feeding recommendations (CFR) are required to combat micronutrient deficiencies. To facilitate their formulation, a modeling approach was recently developed. However, it has not yet been used in practice. This study therefore aimed to use this approach to develop CFR for 9- to 11-mo-old Indonesian infants and to identify nutrients that will likely remain low in their diets. The CFR were developed using a 4-phase approach based on linear and goal programming. Model parameters were defined using dietary data collected in a cross-sectional survey of 9- to 11-mo-old infants (n = 100) living in the Bogor District, West-Java, Indonesia and a market survey of 3 local markets. Results showed theoretical iron requirements could not be achieved using local food sources (highest level achievable, 63% of recommendations) and adequate levels of iron, niacin, zinc, and calcium were difficult to achieve. Fortified foods, meatballs, chicken liver, eggs, tempe-tofu, banana, and spinach were the best local food sources to improve dietary quality. The final CFR were: breast-feed on demand, provide 3 meals/d, of which 1 is a fortified infant cereal; > or = 5 servings/wk of tempe/tofu; > or = 3 servings/wk of animal-source foods, of which 2 servings/wk are chicken liver; vegetables, daily; snacks, 2 times/d, including > or = 2 servings/wk of banana; and > or = 4 servings/wk of fortified-biscuits. Results showed that the approach can be used to objectively formulate population-specific CFR and identify key problem nutrients to strengthen nutrition program planning and policy decisions. Before recommending these CFR, their long-term acceptability, affordability, and effectiveness should be assessed.

Introduction of Complementary Foods to Infants.

PubMed

West, Christina

2017-01-01

While earlier food allergy prevention strategies implemented avoidance of allergenic foods in infancy, the current paradigm is shifting from avoidance to controlled exposure. This review focuses on the outcome of recent randomized controlled trials, which have examined the early introduction of allergenic foods for allergy prevention, and discusses the implementation of results in clinical practice. In infants at high risk of allergic disease, there is now direct evidence that regular early peanut consumption will reduce the prevalence of peanut allergy, compared to avoidance. Many international infant feeding guidelines already recommend complementary foods, including allergenic foods, to be introduced from 4 to 6 months of age irrespective of family history risk. Interim guidelines from 10 International Pediatric Allergy Associations state that healthcare providers should recommend the introduction of peanut-containing products into the diets of infants at high risk of allergic disease in countries where peanut allergy is prevalent. Direct translation of the results obtained from a cohort of high-risk infants to the general population has proved difficult, and issues regarding feasibility, safety, and cost-effectiveness have been raised. Five randomized placebo-controlled trials have assessed the effects of early egg exposure in infancy with varying results. In a recent comprehensive meta-analysis, there was moderate-certainty evidence that early versus late introduction of egg was associated with a reduced egg allergy risk. Although promising, optimal timing, doses, and if the feeding regimen should be stratified according to infant allergy risk remain to be determined. The single study that assessed introduction of multiple foods from 3 months whilst breastfeeding compared with exclusive breastfeeding until 6 months of age showed no reduction in food allergy prevalence. Future research should aim at optimizing infant feeding regimens and support a tolerogenic gastrointestinal microenvironment during the period of food allergen introduction. © 2017 S. Karger AG, Basel.

Determinants of severe acute malnutrition among children under 5 years of age in Nepal: a community-based case-control study.

PubMed

Pravana, Nilesh Kumar; Piryani, Suneel; Chaurasiya, Surendra Prasad; Kawan, Rasmila; Thapa, Ram Krishna; Shrestha, Sumina

2017-08-28

Malnutrition is one of the leading causes of morbidity and mortality among children under the age of 5 years in low and middle income countries like Nepal. Children with severe acute malnutrition (SAM) are nine times more likely to die than children without malnutrition. The prevalence of SAM has increased in Nepal over the past 15 years; however, the determinants of SAM have not been clearly assessed in the country. To assess the determinants of SAM among children aged 6-59 months in the Bara district of Nepal. A community-based case-control study was conducted in 12 randomly selected Village Development Committees (VDCs) of the Bara district of Nepal. A random sample of 292 children aged 6-59 months (146 as cases and 146 as controls) from 12 VDCs were included in this study. The prevalence of SAM among children under the age of 5 years was 4.14%. The following factors were significantly associated with SAM: low socioeconomic status (adjusted odds ratio (AOR) 17.13, 95% CI 5.85 to 50.13); mother's age at birth <20 or >35 years (AOR 3.21, 95% CI 1.30 to 7.94); birth interval <24 months (AOR 4.09, 95% CI 1.87 to 8.97); illiterate father (AOR 3.65, 95% CI 1.62 to 8.20); bottle feeding (AOR 2.19, 95% CI 1.73 to 12.03); and not initiating complementary feeding at the age of 6 months (AOR 2.91, 95% CI 1.73 to 12.03). Mother's educational level, initiation of breastfeeding, colostrum feeding, and exclusive breastfeeding were not significantly associated with SAM. The mother's age at birth, birth interval, socioeconomic status, father's educational level and initiation of complementary feeding at the age of 6 months were important determinants of SAM among children. A multi-sector approach is essential to address SAM. There is a need for further studies not only focusing on SAM but also moderate acute malnutrition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study.

PubMed

Lim, Shan-Xuan; Toh, Jia-Ying; van Lee, Linde; Han, Wee-Meng; Shek, Lynette Pei-Chi; Tan, Kok-Hian; Yap, Fabian; Godfrey, Keith M; Chong, Yap-Seng; Chong, Mary Foong-Fong

2018-03-10

Adequate nutrition during complementary feeding is important for the growth, development and well-being of children. We aim to examine the energy and macronutrient intake composition and their main food sources in a mother-offspring cohort study in Singapore. The diets of infants were assessed by 24 h dietary recalls or food diaries collected from mothers when their offspring were 6 (n = 760), 9 (n = 893) and 12 (n = 907) months of age. Food sources of energy and macronutrients were determined using the population proportion methodology. Energy intakes per day (kcal; mean (standard deviation, SD)) of these infants were 640 (158) at 6 months, 675 (173) at 9 months, and 761 (208) at 12 months. Infant formula, breastmilk and infant cereals were the top three food sources of energy and macronutrient intakes in infants through the period 6 to 12 months. Other main energy and carbohydrate sources at 9 and 12 months of age were rice porridge, infant biscuits and fresh fruits, while fish, red meat and eggs were the other main protein and total fat sources. Breast-fed and mixed-fed infants had a more varied diet as compared to formula-fed infants. Formula-fed infants had consistently higher protein and lower total fat consumption compared to those who were breastfed. An understanding of these main food sources during complementary feeding can inform local dietary recommendations and policies.

Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study

PubMed Central

Lim, Shan-Xuan; Toh, Jia-Ying; Han, Wee-Meng; Shek, Lynette Pei-Chi; Yap, Fabian; Chong, Yap-Seng; Chong, Mary Foong-Fong

2018-01-01

Adequate nutrition during complementary feeding is important for the growth, development and well-being of children. We aim to examine the energy and macronutrient intake composition and their main food sources in a mother–offspring cohort study in Singapore. The diets of infants were assessed by 24 h dietary recalls or food diaries collected from mothers when their offspring were 6 (n = 760), 9 (n = 893) and 12 (n = 907) months of age. Food sources of energy and macronutrients were determined using the population proportion methodology. Energy intakes per day (kcal; mean (standard deviation, SD)) of these infants were 640 (158) at 6 months, 675 (173) at 9 months, and 761 (208) at 12 months. Infant formula, breastmilk and infant cereals were the top three food sources of energy and macronutrient intakes in infants through the period 6 to 12 months. Other main energy and carbohydrate sources at 9 and 12 months of age were rice porridge, infant biscuits and fresh fruits, while fish, red meat and eggs were the other main protein and total fat sources. Breast-fed and mixed-fed infants had a more varied diet as compared to formula-fed infants. Formula-fed infants had consistently higher protein and lower total fat consumption compared to those who were breastfed. An understanding of these main food sources during complementary feeding can inform local dietary recommendations and policies. PMID:29534442

Exploring why junk foods are 'essential' foods and how culturally tailored recommendations improved feeding in Egyptian children.

PubMed

Kavle, Justine A; Mehanna, Sohair; Saleh, Gulsen; Fouad, Mervat A; Ramzy, Magda; Hamed, Doaa; Hassan, Mohamed; Khan, Ghada; Galloway, Rae

2015-07-01

In Egypt, the double burden of malnutrition and rising overweight and obesity in adults mirrors the transition to westernized diets and a growing reliance on energy-dense, low-nutrient foods. This study utilized the trials of improved practices (TIPs) methodology to gain an understanding of the cultural beliefs and perceptions related to feeding practices of infants and young children 0-23 months of age and used this information to work in tandem with 150 mothers to implement feasible solutions to feeding problems in Lower and Upper Egypt. The study triangulated in-depth interviews (IDIs) with mothers participating in TIPs, with IDIs with 40 health providers, 40 fathers and 40 grandmothers to gain an understanding of the influence and importance of the role of other caretakers and health providers in supporting these feeding practices. Study findings reveal high consumption of junk foods among toddlers, increasing in age and peaking at 12-23 months of age. Sponge cakes and sugary biscuits are not perceived as harmful and considered 'ideal' common complementary foods. Junk foods and beverages often compensate for trivial amounts of food given. Mothers are cautious about introducing nutritious foods to young children because of fears of illness and inability to digest food. Although challenges in feeding nutritious foods exist, mothers were able to substitute junk foods with locally available and affordable foods. Future programming should build upon cultural considerations learned in TIPs to address sustainable, meaningful changes in infant and young child feeding to reduce junk foods and increase dietary quality, quantity and frequency. © 2014 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Association of Exposure to Formula in the Hospital and Subsequent Infant Feeding Practices With Gut Microbiota and Risk of Overweight in the First Year of Life.

PubMed

Forbes, Jessica D; Azad, Meghan B; Vehling, Lorena; Tun, Hein M; Konya, Theodore B; Guttman, David S; Field, Catherine J; Lefebvre, Diana; Sears, Malcolm R; Becker, Allan B; Mandhane, Piushkumar J; Turvey, Stuart E; Moraes, Theo J; Subbarao, Padmaja; Scott, James A; Kozyrskyj, Anita L

2018-06-04

The effect of neonatal and infant feeding practices on childhood obesity is unclear. The gut microbiome is strongly influenced by feeding practices and has been linked to obesity. To characterize the association between breastfeeding, microbiota, and risk of overweight during infancy, accounting for the type and timing of supplementary feeding. In this study of a subset of 1087 infants from the prospective CHILD pregnancy cohort, mothers were recruited between January 1, 2009, and December 31, 2012. Statistical analysis was performed from February 1 to December 20, 2017. Feeding was reported by mothers and documented from hospital records. Fecal microbiota at 3 to 4 months (from 996 infants) and/or 12 months (from 821 infants) were characterized by 16S ribosomal RNA sequencing. Infants with a weight for length exceeding the 85th percentile were considered to be at risk for overweight. There were 1087 infants in the study (507 girls and 580 boys); at 3 months, 579 of 1077 (53.8%) were exclusively breastfed according to maternal report. Infants who were exclusively formula fed at 3 months had an increased risk of overweight in covariate-adjusted models (53 of 159 [33.3%] vs 74 of 386 [19.2%]; adjusted odds ratio, 2.04; 95% CI, 1.25-3.32). This association was attenuated (adjusted odds ratio, 1.33; 95% CI, 0.79-2.24) after further adjustment for microbiota features characteristic of formula feeding at 3 to 4 months, including higher overall richness and enrichment of Lachnospiraceae. A total of 179 of 579 infants who were exclusively breastfed (30.9%) received formula as neonates; this brief supplementation was associated with lower relative abundance of Bifidobacteriaceae and higher relative abundance of Enterobacteriaceae at 3 to 4 months but did not influence the risk of overweight. At 12 months, microbiota profiles differed significantly according to feeding practices at 6 months; among partially breastfed infants, formula supplementation was associated with a profile similar to that of nonbreastfed infants (higher diversity and enrichment of Bacteroidaceae), whereas the introduction of complementary foods without formula was associated with a profile more similar to that of exclusively breastfed infants (lower diversity and enrichment of Bifidobacteriaceae and Veillonellaceae). Microbiota profiles at 3 months were more strongly associated with risk of overweight than were microbiota profiles at 12 months. Breastfeeding may be protective against overweight, and gut microbiota may contribute to this effect. Formula feeding appears to stimulate changes in microbiota that are associated with overweight, whereas other complementary foods do not. Subtle microbiota differences emerge after brief exposure to formula in the hospital. These results identify important areas for future research and distinguish early infancy as a critical period when transient gut dysbiosis may lead to increased risk of overweight.

Improving complementary feeding in Ghana: reaching the vulnerable through innovative business--the case of KOKO Plus.

PubMed

Ghosh, Shibani; Tano-Debrah, Kwaku; Aaron, Grant J; Otoo, Gloria; Strutt, Nicholas; Bomfeh, Kennedy; Kitamura, Satoshi; Suri, Devika J; Murakami, Hitoshi; Furuta, Chie; Sarpong, Daniel; Saalia, F; Nakao, Youzou; Amonoo-Kuofi, Harold; Uauy, Ricardo; Toride, Yasuhiko

2014-12-01

Reaching vulnerable populations in low-resource settings with effective business solutions is critical, given the global nature of food and nutrition security. Over a third of deaths of children under 5 years of age are directly or indirectly caused by undernutrition. The Lancet series on malnutrition (2013) estimates that over 220,000 lives of children under 5 years of age can be saved through the implementation of an infant and young child feeding and care package. A unique project being undertaken in Ghana aims to bring in two elements of innovation in infant and young child feeding. The first involves a public-private partnership (PPP) to develop and test the efficacy and effectiveness of the delivery of a low-cost complementary food supplement in Ghana called KOKO Plus™. The second involves the testing of the concepts of social entrepreneurship and social business models in the distribution and delivery of the product. This paper shares information on the ongoing activities in the testing of concepts of PPPs, social business, social marketing, and demand creation using different delivery platforms to achieve optimal nutrition in Ghanaian infants and young children in the first 2 years of life. It also focuses on outlining the concept of using PPP and base-of-the-pyramid approaches toward achieving nutrition objectives. © 2014 New York Academy of Sciences.

Comparison of two modes of vitamin B12 supplementation on neuroconduction and cognitive function among older people living in Santiago, Chile: a cluster randomized controlled trial. a study protocol [ISRCTN 02694183

PubMed Central

2011-01-01

Background Older people have a high risk of vitamin B12 deficiency; this can lead to varying degrees of cognitive and neurological impairment. CBL deficiency may present as macrocytic anemia, subacute combined degeneration of the spinal cord, or as neuropathy, but is often asymptomatic in older people. Less is known about subclinical vitamin B12 deficiency and concurrent neuroconduction and cognitive impairment. A Programme of Complementary Feeding for the Older Population (PACAM) in Chile delivers 2 complementary fortified foods that provide approximately 1.4 μg/day of vitamin B12 (2.4 μg/day elderly RDA). The aim of the present study is to assess whether supplementation with vitamin B12 will improve neuroconduction and cognitive function in older people who have biochemical evidence of vitamin B12 insufficiency in the absence of clinical deficiency. Methods We designed a cluster double-blind placebo-controlled trial involving community dwelling people aged 70-79 living in Santiago, Chile. We randomized 15 clusters (health centers) involving 300 people (20 per cluster). Each cluster will be randomly assigned to one of three arms: a) a 1 mg vitamin B12 pill taken daily and a routine PACAM food; b) a placebo pill and the milk-PACAM food fortified to provide 1 mg of vitamin B12; c) the routine PACAM food and a placebo pill. The study has been designed as an 18 month follow up period. The primary outcomes assessed at baseline, 4, 9 and 18 months will be: serum levels of vitamin B12, neuroconduction and cognitive function. Conclusions In view of the high prevalence of vitamin B12 deficiency in later life, the present study has potential public health interest because since it will measure the impact of the existing program of complementary feeding as compared to two options that provide higher vitamin B12 intakes that might potentially may contribute in preserving neurophysiologic and cognitive function and thus improve quality of life for older people in Chile. Trial registration ISRCTN: ISRCTN02694183 PMID:21952034

[Breastfeeding from the perspective of teenage mothers in Bogotá].

PubMed

Forero, Yibby; Rodríguez, Sandra Milena; Isaács, María Alexandra; Hernández, Jenny Alexandra

2013-01-01

In Colombia, breastfeeding is inadequate and -especially in teenage girls- short. Given that adolescents are a social group with their own lifestyles, we need to know what meanings they have regarding breastfeeding, and also what the characteristics of their breastfeeding experience are, in order to identify issues that limit or facilitate this practice, which will produce the knowledge to improve breastfeeding promotion strategies. To characterize the experience of breastfeeding in nursing adolescents and identify strengths, limitations and perceived needs from their own perspective. This was a phenomenological qualitative study. We conducted 24 interviews and had three focal groups with female adolescents in different postpartum periods. Data collection was carried out in Bogotá, with women participating in a program of the Secretaría Distrital de Integración Social. The systematic process was developed in parallel with the analysis process. It involved the relationships between categories and the networks that form among them. Teenagers do not breastfeed exclusively, identifying several difficulties in the act of breastfeeding. Complementary feeding includes unnatural foods. Maternity and breastfeeding are not consistent with the perception of being a teenager. Adolescents recognize the benefits of breastfeeding for their children and for them; however, their breastfeeding experience differs from the recommendations to achieve exclusive breastfeeding and a healthy complementary feeding. Among the identified causes, we highlight the lack of accurate backing and timely support.

Intestinal blood loss as an aggravating factor of iron deficiency in infants aged 9 to 12 months fed whole cow's milk.

PubMed

Fernandes, Sandra Maria Rodrigues; de Morais, Mauro Batista; Amancio, Olga Maria Silverio

2008-02-01

To verify the occurrence of occult intestinal blood loss and iron deficiency in infants aged 9 to 12 months. A consecutive sample of 98 infants of the Pediatric Public Health Primary Care Unit in the town of Arapongas, Parana State, Brazil was involved in this cross-sectional study. Dietary history, hemoglobin, serum iron, transferrin saturation, ferritin, and an occult fecal blood loss investigation, by the immune chromatographic method specific for human hemoglobin were performed. Presence of occult intestinal blood occurred in 8/23 of the breast-fed (plus complementary feed) infants and in 30/64 of the infants who were fed with cow's milk (plus complementary feed) (P=0.449). The comparison of body iron indicators in accordance to positive or negative occult fecal blood, did not show any significant difference in the 23 breast-fed infants. Serum ferritin (median=4.2 ng/mL) was significantly lower (P=0.004) in infants who received whole cow's milk and had positive occult fecal blood, than in those infants who received whole cow's milk but were without occult fecal blood (median=12.1 ng/mL). In breast-fed infants with negative occult fecal blood, iron deficiency severity is not greater than in those with positive results. In infants fed whole cow's milk, occult fecal blood loss is an aggravating factor of iron deficiency.

Australian lungfish (Neoceratodus forsteri): a missing link in the evolution of complementary side biases for predator avoidance and prey capture.

PubMed

Lippolis, G; Joss, J M P; Rogers, Lesley J

2009-01-01

Side biases in behavior, reflecting lateral specializations of the brain, are widespread amongst vertebrates. We studied laterality in the Australian lungfish (Neoceratodus forsteri) to gain insight into the evolution of the complementary specializations of predator avoidance (right hemisphere) and foraging behavior (left hemisphere). Because N. forsteri is the closest extant ancestor of the first land-dwelling vertebrates, knowledge of laterality in this species should provide a missing link in the transition from fish to tetrapods. Predator escape responses were elicited by generating pressure waves and a significant bias for C-start responses to the left side was found. This bias was unaffected by activity levels that change according to a diurnal cycle: activity is higher in the dark phase than the light phase. A complementary bias to turn to the right side was found during feeding behavior. This pattern of opposite-side specializations matches that known for fish, anurans, reptiles, birds and, as some evidence indicates, also mammals. Hence, we conclude that it is a homologous pattern of lateralization that evolved in early aquatic vertebrates and was retained as they made the transition to land-dwelling tetrapods. Copyright 2009 S. Karger AG, Basel.

The duration of diarrhea and fever is associated with growth faltering in rural Malawian children aged 6-18 months

USDA-ARS?s Scientific Manuscript database

Nutrition support programs that only focus upon better complementary feeding remain an insufficient means of limiting growth faltering in vulnerable populations of children. To determine if symptoms of acute infections correlate with the incidence of growth faltering in rural Malawian children, the ...

Additional common bean in the diet of Malawian children does not affect linear growth, but reduces intestinal permeability

USDA-ARS?s Scientific Manuscript database

Chronic malnutrition, as manifested by linear growth faltering, is pervasive among rural African children. Improvements in complementary feeding may decrease the burden of environmental enteric dysfunction (EED) and thus improve growth in children during the critical first 1000 d of development. We...

Stiff upper lip: Labrum deformity and functionality in bees (Hymenoptera: Apoidea)

USDA-ARS?s Scientific Manuscript database

In hyper-diverse groups such as Hymenoptera, a variety of structures with different, complementary functions are used for feeding. Although the function of the parts such as the mandibles is obvious, the use of others, like the labrum, is more difficult to discern. Here, we discuss the labrum’s func...

Genome of the Asian longhorned beetle (Anoplophora glabripennis), a globally significant invasive species, reveals key functional and evolutionary innovations at the beetle-plant interface.

PubMed

McKenna, Duane D; Scully, Erin D; Pauchet, Yannick; Hoover, Kelli; Kirsch, Roy; Geib, Scott M; Mitchell, Robert F; Waterhouse, Robert M; Ahn, Seung-Joon; Arsala, Deanna; Benoit, Joshua B; Blackmon, Heath; Bledsoe, Tiffany; Bowsher, Julia H; Busch, André; Calla, Bernarda; Chao, Hsu; Childers, Anna K; Childers, Christopher; Clarke, Dave J; Cohen, Lorna; Demuth, Jeffery P; Dinh, Huyen; Doddapaneni, HarshaVardhan; Dolan, Amanda; Duan, Jian J; Dugan, Shannon; Friedrich, Markus; Glastad, Karl M; Goodisman, Michael A D; Haddad, Stephanie; Han, Yi; Hughes, Daniel S T; Ioannidis, Panagiotis; Johnston, J Spencer; Jones, Jeffery W; Kuhn, Leslie A; Lance, David R; Lee, Chien-Yueh; Lee, Sandra L; Lin, Han; Lynch, Jeremy A; Moczek, Armin P; Murali, Shwetha C; Muzny, Donna M; Nelson, David R; Palli, Subba R; Panfilio, Kristen A; Pers, Dan; Poelchau, Monica F; Quan, Honghu; Qu, Jiaxin; Ray, Ann M; Rinehart, Joseph P; Robertson, Hugh M; Roehrdanz, Richard; Rosendale, Andrew J; Shin, Seunggwan; Silva, Christian; Torson, Alex S; Jentzsch, Iris M Vargas; Werren, John H; Worley, Kim C; Yocum, George; Zdobnov, Evgeny M; Gibbs, Richard A; Richards, Stephen

2016-11-11

Relatively little is known about the genomic basis and evolution of wood-feeding in beetles. We undertook genome sequencing and annotation, gene expression assays, studies of plant cell wall degrading enzymes, and other functional and comparative studies of the Asian longhorned beetle, Anoplophora glabripennis, a globally significant invasive species capable of inflicting severe feeding damage on many important tree species. Complementary studies of genes encoding enzymes involved in digestion of woody plant tissues or detoxification of plant allelochemicals were undertaken with the genomes of 14 additional insects, including the newly sequenced emerald ash borer and bull-headed dung beetle. The Asian longhorned beetle genome encodes a uniquely diverse arsenal of enzymes that can degrade the main polysaccharide networks in plant cell walls, detoxify plant allelochemicals, and otherwise facilitate feeding on woody plants. It has the metabolic plasticity needed to feed on diverse plant species, contributing to its highly invasive nature. Large expansions of chemosensory genes involved in the reception of pheromones and plant kairomones are consistent with the complexity of chemical cues it uses to find host plants and mates. Amplification and functional divergence of genes associated with specialized feeding on plants, including genes originally obtained via horizontal gene transfer from fungi and bacteria, contributed to the addition, expansion, and enhancement of the metabolic repertoire of the Asian longhorned beetle, certain other phytophagous beetles, and to a lesser degree, other phytophagous insects. Our results thus begin to establish a genomic basis for the evolutionary success of beetles on plants.

Nutrition in pregnancy and early childhood and associations with obesity in developing countries.

PubMed

Yang, Zhenyu; Huffman, Sandra L

2013-01-01

Concerns about the increasing rates of obesity in developing countries have led many policy makers to question the impacts of maternal and early child nutrition on risk of later obesity. The purposes of the review are to summarise the studies on the associations between nutrition during pregnancy and infant feeding practices with later obesity from childhood through adulthood and to identify potential ways for preventing obesity in developing countries. As few studies were identified in developing countries, key studies in developed countries were included in the review. Poor prenatal dietary intakes of energy, protein and micronutrients were shown to be associated with increased risk of adult obesity in offspring. Female offspring seem to be more vulnerable than male offspring when their mothers receive insufficient energy during pregnancy. By influencing birthweight, optimal prenatal nutrition might reduce the risk of obesity in adults. While normal birthweights (2500-3999 g) were associated with higher body mass index (BMI) as adults, they generally were associated with higher fat-free mass and lower fat mass compared with low birthweights (<2500 g). Low birthweight was associated with higher risk of metabolic syndrome and central obesity in adults. Breastfeeding and timely introduction of complementary foods were shown to protect against obesity later in life in observational studies. High-protein intake during early childhood however was associated with higher body fat mass and obesity in adulthood. In developed countries, increased weight gain during the first 2 years of life was associated with a higher BMI in adulthood. However, recent studies in developing countries showed that higher BMI was more related to greater lean body mass than fat mass. It appears that increased length at 2 years of age was positively associated with height, weight and fat-free mass, and was only weakly associated with fat mass. The protective associations between breastfeeding and obesity may differ in developing countries compared to developed countries because many studies in developed countries used formula feeding as a control. Future research on the relationship between breastfeeding, timely introduction of complementary feeding or rapid weight gain and obesity are warranted in developing countries. The focus of interventions to reduce risk of obesity in later life in developing countries could include: improving maternal nutritional status during pregnancy to reduce low birthweight; enhancing breastfeeding (including durations of exclusive and total breastfeeding); timely introduction of high-quality complementary foods (containing micronutrients and essential fats) but not excessive in protein; further evidence is needed to understand the extent of weight gain and length gain during early childhood are related to body composition in later life. © 2012 Blackwell Publishing Ltd.

Weaning Time in Preterm Infants: An Audit of Italian Primary Care Paediatricians.

PubMed

Baldassarre, Maria Elisabetta; Di Mauro, Antonio; Pedico, Annarita; Rizzo, Valentina; Capozza, Manuela; Meneghin, Fabio; Lista, Gianluca; Laforgia, Nicola

2018-05-15

According to the 2016 Italian National Institute of Statistics (Istat) data in Italy, about 6.7% of all newborns are born prematurely. Due to the lack of data on current complementary feeding in preterm infants in Italy, the aim of the survey was to evaluate individual attitudes of primary care paediatricians, concerning the introduction of complementary foods in preterm infants. An internet-based survey was conducted among primary care paediatricians, working in Italy, regarding (1) timing of the introduction of complementary foods to preterm newborns; (2) type of complementary foods introduced; (3) vitamin D and iron supplementations. A total of 347 primary care Italian paediatricians answered the questionnaire; 44% of responders based the timing of the introduction of solid food exclusively on an infant's age, 18% on an infant's neurodevelopmental status and 4% on the body weight; the remaining 34% based the timing on two or more of these aspects. The type of complementary foods did not comply with an evidence-based sequence; 98% of participants promoted vitamin D supplementation and 89% promoted iron supplementation with great diversity in timing and doses. Due to limited evidence, there is a great heterogeneity in the attitudes of primary care paediatricians concerning the introduction of complementary foods to preterm newborns. Further research is needed to provide evidence-based guidelines regarding weaning preterm newborns.

Infant and Young Child Feeding Behaviors among Working Mothers in India: Implications for Global Health Policy and Practice

PubMed Central

Kumar, Vinay; Arora, Gunjan; Midha, Ish Kumar; Gupta, Yogender Pal

2015-01-01

Background: The National Guidelines on Infant and Young Child Feeding introduced in 2006 recommended the initiation of breastfeeding immediately after birth, preferably within one hour; exclusive breastfeeding for the first six months; appropriate and adequate complementary feeding from six months of age while continuing breastfeeding; and continued breastfeeding up to the age of two years or beyond. Working women in India constitute a dominant and expanding pool of mothers. There is paucity of research focused on feeding behavior within this group. Method: One hundred and fifty working women answered a structured questionnaire about their demographics, birth history, levels of awareness and practice of feeding guidelines, and perceptions about breastfeeding and counseling. Data analysis was carried out using Microsoft Excel and the Statistical Package for the Social Sciences. Results: Majority of participants belonged to 21-39 years age group, had nuclear families, received college education, and delivered in institutional setups. Gaps were observed between the mother’s levels of awareness and practice for different tenets of national guidelines. Higher education, longer maternity leave, higher income, and utilization of counseling services facilitated adoption of optimal feeding behavior. Most women perceived breast milk to be superior to any alternative and favored provision of counseling during last trimester. Conclusions and Global Health Implications: Counseling women on optimal feeding behavior is a potential intervention to convert its awareness into actual practice. The lessons learned from this study can help refine both national and global Mother and Child Health policies and programs. PMID:27621981

Women's autonomy and social support and their associations with infant and young child feeding and nutritional status: community-based survey in rural Nicaragua.

PubMed

Ziaei, Shirin; Contreras, Mariela; Zelaya Blandón, Elmer; Persson, Lars-Åke; Hjern, Anders; Ekström, Eva-Charlotte

2015-08-01

To evaluate the associations of women's autonomy and social support with infant and young child feeding practices (including consumption of highly processed snacks and sugar-sweetened beverages) and nutritional status in rural Nicaragua. Cross-sectional study. Feeding practices and children's nutritional status were evaluated according to the WHO guidelines complemented with information on highly processed snacks and sugar-sweetened beverages. Women's autonomy was assessed by a seventeen-item questionnaire covering dimensions of financial independence, household-, child-, reproductive and health-related decision making and freedom of movement. Women's social support was determined using the Duke-UNC Functional Social Support Questionnaire. The scores attained were categorized into tertiles. Los Cuatro Santos area, rural Nicaragua. A total of 1371 children 0-35 months of age. Children of women with the lowest autonomy were more likely to be exclusively breast-fed and continue to be breast-fed, while children of women with middle level of autonomy had better complementary feeding practices. Children of women with the lowest social support were more likely to consume highly processed snacks and/or sugar-sweetened beverages but also be taller. While lower levels of autonomy and social support were independently associated with some favourable feeding and nutrition outcomes, this may not indicate a causal relationship but rather that these factors reflect other matters of importance for child care.

Litmus tests for verification of feeding tube location in infants: evaluation of their clinical use.

PubMed

Nyqvist, Kerstin Hedberg; Sorell, Annette; Ewald, Uwe

2005-04-01

To examine the clinical use of litmus paper tests for the assessment of aspirates in infants. In connection with establishing a programme for home care of infants with requirement of tube feeding with parents as the infants' carers, the need for a research-based method for verification of feeding tube position was identified by nurses as a complement to other methods. In adult care the litmus paper test is commonly used when visual inspection is not sufficient for assessment of aspirates obtained from feeding tubes. Observational study. Nurses performed litmus tests for verification of feeding tube location in a convenience sample of 60 infants born at a gestational age (GA) of 24-42 weeks. Presence/absence and volumes of aspirates were recorded as well as positive/negative litmus test reactions. Analyses on the association between test results and the infants' GA and postmenstrual and postnatal age at the time of the tests were conducted. Data were obtained from 2970 tube feeds. Aspirates were present on 1840 occasions (62%). A higher proportion of infants with absence of aspirates were born at a GA below 32 weeks. A positive reaction occurred in 97% of the tests in volumes between 0.01 and 22 ml. Birth at a GA below 32 weeks and respiratory problems were associated with negative tests. The high ratio of positive litmus reactions at all maturational levels supports the bedside use of analysis of pH in gastric aspirates for verification of feeding tube location. Application of pH indicator paper is recommended as a complementary method for assessment of aspirates from feeding tubes.

Determinants of infant nutritional status in Dabat district, North Gondar, Ethiopia: A case control study.

PubMed

Wubante, Amarech Asratie

2017-01-01

Malnutrition is the top cause of global burden of disease, disability and mortality among infants. Over two-thirds of deaths of children globally occur during the first year of life (infancy). Malnutrition among infants is substantially high in Ethiopia. Therefore, this study is aimed to assess determinants of infant nutritional status. A community based nested case-control study was conducted from February to June 2013 in Dabat district. A total of 80 cases and 320 controls (1:4 ratios) were studied. Relevant data was extracted from the community based survey data set. Anthroplus software was used to identify cases and controls. Determinants of infant nutritional status were identified using multivariate analysis. Among the total of 80 cases and 320 controls, more than half (52.5%) of the cases and the controls (53.8%) were males and females, respectively. Breast Feeding (BF) was started immediately after birth in only 43.8% of the cases. Nearly 94% of the mothers of the cases had no breast feeding information as part of Ante Natal Care (ANC) follow up. Maternal age (AOR: 0.29; 95% CI: 0.11-0.76), having radio (AOR: 0.43; 95% CI: 0.22-0.82), lack of toilet facility (AOR: 2.24; 95% CI: 1.16-4.33), deprivation of colostrum (AOR: 1.76; 95% CI: 1.01-1.06) and method of complementary feeding (AOR: 2.82; 95% CI: 1.33-5.99) were associated with wasting. This study has found that inappropriate infant feeding; nutritional information gap and lack of toilet facility as significant predictors of malnutrition. Hence, joint interventions, including counseling of mothers about benefits of colostrum feeding and use of appropriate feeding method, toilet utilization and mass media such as radio possession, are needed to address the problem in Dabat district.

Infant feeding practices and reported food allergies at 6 years of age.

PubMed

Luccioli, Stefano; Zhang, Yuanting; Verrill, Linda; Ramos-Valle, Moraima; Kwegyir-Afful, Ernest

2014-09-01

The goal of this study was to identify the frequency of physician-diagnosed food allergies among 6-year-old US children and study the impact of exclusive breastfeeding and complementary food introduction on this frequency. Data were analyzed from children who participated in the Infant Feeding Practices Study II Year 6 Follow-Up Study (Y6FU). Children with probable food allergy (pFA) were defined as children with report of physician-diagnosed food allergy at age 6 years. Subgroups of pFA included children who were not diagnosed before 1 year of age (new pFA) and those with atopic risk factors (high risk). Prevalence of total pFA in the Y6FU was 6.34%. The majority of these children had new pFA and high-risk factors. Higher maternal education, higher family income, family history of food allergy, and reported eczema before 1 year of age were significantly associated with higher odds of total or new pFA. Exclusive breastfeeding duration and timing of complementary food introduction were not significantly associated with total pFA. However, exclusive breastfeeding of ≥4 months compared with no breastfeeding was marginally associated with lower odds of new pFA (adjusted odds ratio: 0.51; P = .07); this effect was not observed with high-risk children. Analysis of infant and maternal variables in the Y6FU cohort of US children revealed that socioeconomic and atopic factors were the main predictors of pFA at age 6 years. Exclusive breastfeeding of ≥4 months may have a preventive effect on development of pFA after 1 year of age in non high-risk children. Copyright © 2014 by the American Academy of Pediatrics.

The influence of maternal psychosocial circumstances and physical environment on the risk of severe wasting in rural Gambian infants: a mixed methods approach.

PubMed

Nabwera, Helen M; Moore, Sophie E; Mwangome, Martha K; Molyneux, Sassy C; Darboe, Momodou K; Camara-Trawally, Nyima; Sonko, Bakary; Darboe, Alhagie; Singhateh, Seedy; Fulford, Anthony J; Prentice, Andrew M

2018-01-06

Severe wasting affects 16 million under 5's and carries an immediate risk of death. Prevalence remains unacceptably high in sub-Saharan Africa and early infancy is a high-risk period. We aimed to explore risk factors for severe wasting in rural Gambian infants. We undertook a case-control study from November 2014 to June 2015, in rural Gambia. Cases had WHO standard weight-for-length z-scores (WLZ) < -3 on at least 1 occasion in infancy. Controls with a WLZ > -3 in the same interval, matched on age, gender, village size and distance from the clinic were selected. Standard questionnaires were used to assess maternal socioeconomic status, water sanitation and hygiene and maternal mental health. Conditional logistic regression using a multivariable model was used to determine the risk factors for severe wasting. Qualitative in depth interviews were conducted with mothers and fathers who were purposively sampled. A thematic framework was used to analyse the in-depth interviews. Two hundred and eighty (77 cases and 203 controls) children were recruited. In-depth interviews were conducted with 16 mothers, 3 fathers and 4 research staff members. The mean age of introduction of complementary feeds was similar between cases and controls (5.2 [SD 1.2] vs 5.1 [SD 1.3] months). Increased odds of severe wasting were associated with increased frequency of complementary feeds (range 1-8) [adjusted OR 2.06 (95%: 1.17-3.62), p = 0.01]. Maternal adherence to the recommended infant care practices was influenced by her social support networks, most importantly her husband, by infant feeding difficulties and maternal psychosocial stressors that include death of a child or spouse, recurrent ill health of child and lack of autonomy in child spacing. In rural Gambia, inappropriate infant feeding practices were associated with severe wasting in infants. Additionally, adverse psychosocial circumstances and infant feeding difficulties constrain mothers from practising the recommended child care practices. Interventions that promote maternal resilience through gender empowerment, prioritising maternal psychosocial support and encouraging the involvement of fathers in infant and child care promotion strategies, would help prevent severe wasting in these infants.

Nutrition: Basis for Healthy Children and Mothers in Bangladesh

PubMed Central

Faruque, A.S.G.; Ahmed, A.M. Shamsir; Ahmed, Tahmeed; Islam, M. Munirul; Hossain, Md. Iqbal; Roy, S.K.; Alam, Nurul; Kabir, Iqbal; Sack, David A.

2008-01-01

Recent data from the World Health Organization showed that about 60% of all deaths, occurring among children aged less than five years (under-five children) in developing countries, could be attributed to malnutrition. It has been estimated that nearly 50.6 million under-five children are malnourished, and almost 90% of these children are from developing countries. Bangladesh is one of the countries with the highest rate of malnutrition. The recent baseline survey by the National Nutrition Programme (NNP) showed high rates of stunting, underweight, and wasting. However, data from the nutrition surveillance at the ICDDR, B hospital showed that the proportion of children with stunting, underweight, and wasting has actually reduced during 1984–2005. Inappropriate infant and young child-feeding practices (breastfeeding and complementary feeding) have been identified as a major cause of malnutrition. In Bangladesh, although the median duration of breastfeeding is about 30 months, the rate of exclusive breastfeeding until the first six months of life is low, and practice of appropriate complementary feeding is not satisfactory. Different surveys done by the Bangladesh Demographic and Health Survey, United Nations Children's Fund (UNICEF), and Bangladesh Breastfeeding Foundation (BBF) showed a rate of exclusive breastfeeding to be around 32-52%, which have actually remained same or declined over time. The NNP baseline survey using a strict definition of exclusive breastfeeding showed a rate of exclusive breastfeeding (12.8%) until six months of age. Another study from the Abhoynagar field site of ICDDR, B reported the prevalence of exclusive breastfeeding to be 15% only. Considerable efforts have been made to improve the rates of exclusive breastfeeding. Nationally, initiation of breastfeeding within one hour of birth, feeding colostrum, and exclusive breastfeeding have been promoted through the Baby-Friendly Hospital Initiative (BFHI) implemented and supported by BBF and UNICEF respectively. Since most (87-91%) deliveries take place in home, the BFHI has a limited impact on the breastfeeding practices. Results of a few studies done at ICDDR, B and elsewhere in developing countries showed that the breastfeeding peer-counselling method could substantially increase the rates of exclusive breastfeeding. Results of a study in urban Dhaka showed that the rate of exclusive breastfeeding was 70% among mothers who were counselled compared to only 6% who were not counselled. Results of another study in rural Bangladesh showed that peer-counselling given either individually or in a group improved the rate of exclusive breastfeeding from 89% to 81% compared to those mothers who received regular health messages only. This implies that scaling up peer-counselling methods and incorporation of breastfeeding counselling in the existing maternal and child heath programme is needed to achieve the Millennium Development Goal of improving child survival. The recent data showed that the prevalence of starting complementary food among infants aged 6-9 months had increased substantially with 76% in the current dataset. However, the adequacy, frequency, and energy density of the complementary food are in question. Remarkable advances have been made in the hospital management of severely-malnourished children. The protocolized management of severe protein-energy malnutrition at the Dhaka hospital of ICDDR, B has reduced the rate of hospital mortality by 50%. A recent study at ICDDR, B has also documented that home-based management of severe protein-energy malnutrition without follow-up was comparable with a hospital-based protocolized management. Although the community nutrition centres of the NNP have been providing food supplementation and performing growth monitoring of children with protein-energy malnutrition, the referral system and management of complicated severely-malnourished children are still not in place. PMID:18831228

Sheep Feed and Scrapie, France

PubMed Central

Philippe, Sandrine; Ducrot, Christian; Roy, Pascal; Remontet, Laurent; Jarrige, Nathalie

2005-01-01

Scrapie is a small ruminant, transmissible spongiform encephalopathy (TSE). Although in the past scrapie has not been considered a zoonosis, the emergence of bovine spongiform encephalopathy, transmissible to humans and experimentally to sheep, indicates that risk exists for small ruminant TSEs in humans. To identify the risk factors for introducing scrapie into sheep flocks, a case-control study was conducted in France from 1999 to 2000. Ninety-four case and 350 control flocks were matched by location and main breed. Three main hypotheses were tested: direct contact between flocks, indirect environmental contact, and foodborne risk. Statistical analysis was performed by using adjusted generalized linear models with the complementary log-log link function, considering flock size as an offset. A notable effect of using proprietary concentrates and milk replacers was observed. The risk was heterogeneous among feed factories. Contacts between flocks were not shown to be a risk factor. PMID:16102318

Feeding habits of the deep-snouted pipefish Syngnathus typhle in a temperate coastal lagoon

NASA Astrophysics Data System (ADS)

Oliveira, Frederico; Erzini, Karim; Gonçalves, Jorge M. S.

2007-03-01

Feeding habits of Syngnathus typhle were determined based on monthly sampling during experimental fishing in a coastal lagoon (Ria Formosa, South Portugal) from April 2001 to May 2002. The gut contents of 856 individuals were analysed and quantified with numerical and gravimetric methods, as well as with some complementary indices and measures (vacuity, fullness and relative importance). In this study, this species fed mainly on Copepoda, Mysidacea, small caridean grass shrimps (Hippolytidae and Palaemonidae) and small fishes (Gobiidae) and to a lesser degree on other small invertebrates. No significant differences were found between the diets of males and females. However, significant differences in the fullness indexes of both sexes were observed during the reproductive period. Significant differences in the diet among seasons were also verified but no seasonal trends were discovered. Snout length showed a linear increase with growth while mouth area and total length displayed an allometric relation. Mouth shape varied between an ellipse and an almost perfect circle. The increase in mouth area and snout length as S. typhle grows contributed to the observed ontogenic diet shift with specimens smaller than 10 cm feeding almost exclusively on Copepoda, medium sized specimens feeding mainly on Hippolytidae and Mysidacea, while larger specimens preyed on Hippolytidae, Palaemonidae and Gobiidae. Prey size generally increased with size of S. typhle.

Community-based grain banks using local foods for improved infant and young child feeding in Ethiopia.

PubMed

Roche, Marion L; Sako, Binta; Osendarp, Saskia J M; Adish, Abdul A; Tolossa, Azeb L

2017-04-01

The first thousand days of a child's life are critical for ensuring adequate nutrition to enable optimal health, development and growth. Inadequate infant and young child feeding (IYCF) practices likely contribute to Ethiopia's concerning malnutrition situation. Development partners in four regions of Ethiopia implemented community production of complementary food with women's groups processing local grains and legumes at grain banks to improve availability, accessibility, dietary diversity and timely introduction of complementary foods. The objective of this study was to establish the acceptability, perceived impact, feasibility and required inputs to sustain local grain bank interventions to improve IYCF. A subsidized barter system was used by mothers in the rural communities, and flour was sold in the semi-urban context. Purposive sampling guided the qualitative study design and selection of project stakeholders. A total of 51 key informant interviews and 33 focus group discussions (n = 237) were conducted. The grain bank flour was valued for its perceived diverse local ingredients; while the project was perceived as creating labour savings for women. The grain bank flour offered the potential to contribute to improved IYCF; however, further dietary modification or fortification is needed to improve the micronutrient content. Dependence upon external inputs to subsidize the barter model and the reliance on volunteer labour from women's groups in the rural context are the greatest risks to sustainability. This intervention illustrates how integrated agricultural and health interventions leveraging local production can appeal to diverse stakeholders as an acceptable approach to improve IYCF. © 2015 John Wiley & Sons Ltd.

Adaptation of New Colombian Food-based Complementary Feeding Recommendations Using Linear Programming.

PubMed

Tharrey, Marion; Olaya, Gilma A; Fewtrell, Mary; Ferguson, Elaine

2017-12-01

The aim of the study was to use linear programming (LP) analyses to adapt New Complementary Feeding Guidelines (NCFg) designed for infants aged 6 to 12 months living in poor socioeconomic circumstances in Bogota to ensure dietary adequacy for young children aged 12 to 23 months. A secondary data analysis was performed using dietary and anthropometric data collected from 12-month-old infants (n = 72) participating in a randomized controlled trial. LP analyses were performed to identify nutrients whose requirements were difficult to achieve using local foods as consumed; and to test and compare the NCFg and alternative food-based recommendations (FBRs) on the basis of dietary adequacy, for 11 micronutrients, at the population level. Thiamine recommended nutrient intakes for these young children could not be achieved given local foods as consumed. NCFg focusing only on meat, fruits, vegetables, and breast milk ensured dietary adequacy at the population level for only 4 micronutrients, increasing to 8 of 11 modelled micronutrients when the FBRs promoted legumes, dairy, vitamin A-rich vegetables, and chicken giblets. None of the FBRs tested ensured population-level dietary adequacy for thiamine, niacin, and iron unless a fortified infant food was recommended. The present study demonstrated the value of using LP to adapt NCFg for a different age group than the one for which they were designed. Our analyses suggest that to ensure dietary adequacy for 12- to 23-month olds these adaptations should include legumes, dairy products, vitamin A-rich vegetables, organ meat, and a fortified food.

Healthcare professionals' and mothers' perceptions of factors that influence decisions to breastfeed or formula feed infants: a comparative study.

PubMed

Brown, Amy; Raynor, Peter; Lee, Michelle

2011-09-01

This article is a report of a study comparing healthcare professionals' and mothers' perceptions of factors that influence the decision to breastfeed or formula feed an infant. The World Health Organisation recommends that mothers should breastfeed exclusively for the first 6 months of age and then continue to do so alongside complementary foods for the first 2 years and beyond. However, levels of breastfeeding in the United Kingdom are below the recommended targets. Low levels of actual or perceived professional support and understanding are associated with formula use. Twenty professionals working closely with mothers of young infants completed a semi-structured interview exploring the reasons they believed mothers chose to use formula milk. Twenty-three mothers with an infant aged 6-12 months also reflected on their experiences of milk feeding. The data were collected during 2007-2008. Professionals described a range of influences on maternal decisions to breastfeed or formula feed including lack of knowledge, support and help with difficulties. These were strongly echoed in the reasons mothers gave for formula use, suggesting clear professional understanding of the challenges relating to breastfeeding. Although keen to give further support, professionals raised issues of lack of time and resources to support mothers. Contrary to maternal beliefs of poor professional understanding, professionals had a clear perception of influences affecting early milk feeding choice. Further resources and recognition are needed for healthcare professionals working with new mothers to enable them to offer increased support, with the aim of increasing breastfeeding duration. © 2011 Blackwell Publishing Ltd.

High Awareness but Low Coverage of a Locally Produced Fortified Complementary Food in Abidjan, Côte d'Ivoire: Findings from a Cross-Sectional Survey.

PubMed

Leyvraz, Magali; Rohner, Fabian; Konan, Amoin G; Esso, Lasme J C E; Woodruff, Bradley A; Norte, Augusto; Adiko, Adiko F; Bonfoh, Bassirou; Aaron, Grant J

2016-01-01

Poor complementary feeding practices among infants and young children in Côte d'Ivoire are major contributing factors to the country's high burden of malnutrition. As part of a broad effort to address this issue, an affordable, nutritious, and locally produced fortified complementary food product was launched in the Côte d'Ivoire in 2011. The objective of the current research was to assess various levels of coverage of the program and to identify coverage barriers. A cross-sectional household survey was conducted among caregivers of children less than 2-years of age living in Abidjan, Côte d'Ivoire. Four measures of coverage were assessed: "message coverage" (i.e., has the caregiver ever heard of the product?), "contact coverage" (i.e., has the caregiver ever fed the child the product?), "partial coverage" (i.e., has the caregiver fed the child the product in the previous month?), and "effective coverage" (i.e., has the caregiver fed the child the product in the previous 7 days?). A total of 1,113 caregivers with children between 0 and 23 months of age were interviewed. Results showed high message coverage (85.0%), moderate contact coverage (37.8%), and poor partial and effective coverages (8.8% and 4.6%, respectively). Product awareness was lower among caregivers from poorer households, but partial and effective coverages were comparable in both poor and non-poor groups. Infant and young child feeding (IYCF) practices were generally poor and did not appear to have improved since previous assessments. In conclusion, the results from the present study indicate that availability on the market and high awareness among the target population is not sufficient to achieve high and effective coverage. With market-based delivery models, significant efforts are needed to improve demand. Moreover, given the high prevalence of malnutrition and poor IYCF practices, additional modes of delivering IYCF interventions and improving IYCF practices should be considered.

Effect of community level intervention on nutritional status and feeding practices of under five children in Ile Ife, Nigeria.

PubMed

Ogundele, Olorunfemi Akinbode; Ogundele, Tolulope

2015-01-01

Childhood malnutrition remains a widespread problem in developing world like Nigeria. The country ranks second among the ten countries contributing to sixty percent of the world's wasted under-five children. Community Integrated Management of Childhood illness (CIMCI) is a programme that employs the use of community based counsellors to address child health and nutritional challenges of the under-five and has the potential to reduce the morbidity and mortality resulting from poor nutritional and feeding practices. The study assessed the effect of community level intervention on nutritional status and feeding practices of children in Ile-Ife, Nigeria. A cross-sectional comparative study that employed the use of multi stage cluster sampling techniques in selecting 722 mothers of index under five children. The study was done in two Local Government Areas of Osun State, Nigeria. Quantitative techniques were used in data collection. Data analysis was done using SPSS version 20.0. Descriptive and bivariate analyses was performed. The two Local Government Area (LGA) did not differ significantly in their wealth index (p = 0.344). However, more children in the non-implementing LGA (16.1%) had low weight for age compared with 3.6% in the CIMCI implementing LGA (p = 0.000). A statistically significant difference exist in the MUAC measurement of children 12-23 months between the CIMCI implementing and non-implementing communities (p = 0.007). A higher percentage of caregivers (19.3%) introduced complementary feeding earlier than 6 months in the non-implementing area (p < 0.001). Using community level nutritional counseling can greatly improve nutritional status and feeding practices of under five children.

Relationships between species feeding traits and environmental conditions in fish communities: a three-matrix approach.

PubMed

Brind'Amour, Anik; Boisclair, Daniel; Dray, Stéphane; Legendre, Pierre

2011-03-01

Understanding the relationships between species biological traits and the environment is crucial to predicting the effect of habitat perturbations on fish communities. It is also an essential step in the assessment of the functional diversity. Using two complementary three-matrix approaches (fourth-corner and RLQ analyses), we tested the hypothesis that feeding-oriented traits determine the spatial distributions of littoral fish species by assessing the relationship between fish spatial distributions, fish species traits, and habitat characteristics in two Laurentian Shield lakes. Significant associations between the feeding-oriented traits and the environmental characteristics suggested that fish communities in small lakes (displaying low species richness) can be spatially structured. Three groups of traits, mainly categorized by the species spatial and temporal feeding activity, were identified. The water column may be divided in two sections, each of them corresponding to a group of traits related to the vertical distribution of the prey coupled with the position of the mouth. Lake areas of low structural complexity were inhabited by functional assemblages dominated by surface feeders while structurally more complex areas were occupied by mid-water and benthic feeders. A third group referring to the time of feeding activity was observed. Our work could serve as a guideline study to evaluate species traits x environment associations at multiple spatial scales. Our results indicate that three-matrix statistical approaches are powerful tools that can be used to study such relationships. These recent statistical approaches open up new research directions such as the study of spatially based biological functions in lakes. They also provide new analytical tools for determining, for example, the potential size of freshwater protected areas.

Impact of nutritional education on nutritional status of under-five children in two rural communities of south-west Nigeria.

PubMed

Sule, S S; Onayade, A A; Abiona, T C; Fatusi, A O; Ojofeitimi, E O; Esimai, O A; Ijadunola, K T

2009-06-01

This study evaluated the impact of nutritional education on knowledge, attitude and practices (KAP) of mothers concerning infants and young children feeding and their children's nutritional status in two semi-urban communities of south-west Nigeria. This is a community intervention study. We recruited 150 mothers of children aged 0-18 months independently from the intervention and control communities through a multi-stage sampling technique. We collected data with the aid of an interviewer-administered questionnaire at baseline and at six months after intervention from both communities to obtain information on feeding of infants and young children. In addition, we measured weights and heights of recruited children. Intervention involved group counselling of mothers and food demonstrations at designated health facilities. Data analysis for quantitative data was done using Epi-Info software, and for qualitative data, content analysis of major themes was used. Before intervention, recruited mothers and their children from the two communities were comparable in terms of all the parameters assessed (P>0.05 in all cases). After six months of intervention, mothers who had nutritional education demonstrated better knowledge and attitudes to key infant and young children feeding recommendations. There was also limited improvement in feeding practices. Mothers from the intervention community exclusively breastfed their infants longer with mean age at introduction of complementary foods at 5.3 months compared to 4.5 months in the control community (P<0.05), breastfed their children longer (P<0.05). However, there was no statistically significant improvement in the weight of their children. In this study, nutritional education of mothers only had positive impact on their level of KAP on infant and young children feeding.

Daily patterns of synchrony in lying and feeding of cows: Quasi-natural state and (anti-) synchrony factors.

PubMed

Flury, Rebekka; Gygax, Lorenz

2016-12-01

Synchrony is thought to provide fitness advantages to group-living animals, but little is known how animals maintain synchrony. We investigated intensity of synchrony factors (milking, feed-provision) in cattle herds. Intensity decreased from dairy cows milked in a parlour to cows milked by a robot to suckler cows raising calves. On 30 farms, 10 of each type, we recorded synchrony in lying and feeding. Peaks in lying synchronously were visible in the early morning, around noon, and late at night. These peaks decreased from the suckler cows to the cows milked in a parlour and to the cows milked by a robot. Complementary peaks were found for synchronous feeding. The asynchronous milking times with the milking robot decreased synchrony. Unexpectedly, the suckler cows with the weakest synchrony factors also showed a high level of synchrony. These results indicate that internal motivations for synchrony may be present in addition to external synchrony factors. Copyright © 2016 Elsevier B.V. All rights reserved.

Increased expressions of genes and proteins involved in mitochondrial oxidation and antioxidant pathway in adipose tissue of pigs selected for a low residual feed intake.

PubMed

Louveau, I; Vincent, A; Tacher, S; Gilbert, H; Gondret, F

2016-12-01

Adipose tissue is a primary sensor for nutrient availability and regulates many functions including feed intake and energy homeostasis. This study was undertaken to determine the molecular responses of adipose tissue to differences in feed intake and feed efficiency. Subcutaneous adipose tissue was collected from two lines of pigs divergently selected for residual feed intake (RFI), a measure of feed efficiency defined as the difference between actual and expected feed intake, and from a subset of high-RFI pigs that were feed-restricted at the level of the voluntary feed intake of low-RFI pigs during the growing-finishing period. Transcriptomics analyses indicated that the number of genes that were differentially expressed ( < 0.01) between low- and high-RFI pigs ( = 8 per group at each stage) in adipose tissue was much lower when pigs were considered at 19 kg (postweaning) than at 115 kg BW (market weight). Extended investigations were performed at 115 kg BW to compare low-RFI ( = 8), high-RFI ( = 8), and feed-restricted high-RFI ( = 8) pigs. They included in silico pathway analyses of the differentially expressed (DE) genes ( < 0.01) and a complementary proteomic investigation to list adipose proteins with a differential abundance ( < 0.10). Only 23% of the DE genes were affected by both RFI and feed restriction. This indicates that the responses of adipose tissue to RFI difference shared only some common mechanisms with feed intake modulation, notably the regulation of cell cycle (including ) and transferase activity pathway. Two carboxylesterase genes (, ) involved in lipolysis, were among the most overexpressed genes in the low-RFI pigs; they were also affected by feed restriction within the high-RFI line. About 60% of the molecular changes between low- and high-RFI pigs were specific to genetic divergence in feed efficiency, independently of feed intake. Different genes and proteins known to be associated with mitochondrial oxidative metabolism were overexpressed in adipose tissue of low-RFI pigs compared with high-RFI pigs; other proteins participating in the generation of energy were also affected by feed restriction within the high-RFI line. Finally, mitochondrial antioxidant genes were upregulated in low-RFI pigs vs. high-RFI pigs. Altogether, increased oxidative and antioxidant processes in adipose tissue might be associated with improved feed efficiency.

Measuring Food Intake and Nutrient Absorption in Caenorhabditis elegans.

PubMed

Gomez-Amaro, Rafael L; Valentine, Elizabeth R; Carretero, Maria; LeBoeuf, Sarah E; Rangaraju, Sunitha; Broaddus, Caroline D; Solis, Gregory M; Williamson, James R; Petrascheck, Michael

2015-06-01

Caenorhabditis elegans has emerged as a powerful model to study the genetics of feeding, food-related behaviors, and metabolism. Despite the many advantages of C. elegans as a model organism, direct measurement of its bacterial food intake remains challenging. Here, we describe two complementary methods that measure the food intake of C. elegans. The first method is a microtiter plate-based bacterial clearing assay that measures food intake by quantifying the change in the optical density of bacteria over time. The second method, termed pulse feeding, measures the absorption of food by tracking de novo protein synthesis using a novel metabolic pulse-labeling strategy. Using the bacterial clearance assay, we compare the bacterial food intake of various C. elegans strains and show that long-lived eat mutants eat substantially more than previous estimates. To demonstrate the applicability of the pulse-feeding assay, we compare the assimilation of food for two C. elegans strains in response to serotonin. We show that serotonin-increased feeding leads to increased protein synthesis in a SER-7-dependent manner, including proteins known to promote aging. Protein content in the food has recently emerged as critical factor in determining how food composition affects aging and health. The pulse-feeding assay, by measuring de novo protein synthesis, represents an ideal method to unequivocally establish how the composition of food dictates protein synthesis. In combination, these two assays provide new and powerful tools for C. elegans research to investigate feeding and how food intake affects the proteome and thus the physiology and health of an organism. Copyright © 2015 by the Genetics Society of America.

Measuring Food Intake and Nutrient Absorption in Caenorhabditis elegans

PubMed Central

Gomez-Amaro, Rafael L.; Valentine, Elizabeth R.; Carretero, Maria; LeBoeuf, Sarah E.; Rangaraju, Sunitha; Broaddus, Caroline D.; Solis, Gregory M.; Williamson, James R.; Petrascheck, Michael

2015-01-01

Caenorhabditis elegans has emerged as a powerful model to study the genetics of feeding, food-related behaviors, and metabolism. Despite the many advantages of C. elegans as a model organism, direct measurement of its bacterial food intake remains challenging. Here, we describe two complementary methods that measure the food intake of C. elegans. The first method is a microtiter plate-based bacterial clearing assay that measures food intake by quantifying the change in the optical density of bacteria over time. The second method, termed pulse feeding, measures the absorption of food by tracking de novo protein synthesis using a novel metabolic pulse-labeling strategy. Using the bacterial clearance assay, we compare the bacterial food intake of various C. elegans strains and show that long-lived eat mutants eat substantially more than previous estimates. To demonstrate the applicability of the pulse-feeding assay, we compare the assimilation of food for two C. elegans strains in response to serotonin. We show that serotonin-increased feeding leads to increased protein synthesis in a SER-7-dependent manner, including proteins known to promote aging. Protein content in the food has recently emerged as critical factor in determining how food composition affects aging and health. The pulse-feeding assay, by measuring de novo protein synthesis, represents an ideal method to unequivocally establish how the composition of food dictates protein synthesis. In combination, these two assays provide new and powerful tools for C. elegans research to investigate feeding and how food intake affects the proteome and thus the physiology and health of an organism. PMID:25903497

Historical Overview of Transitional Feeding Recommendations and Vegetable Feeding Practices for Infants and Young Children

PubMed Central

Kleinman, Ronald E.; Coletta, Frances A.

2016-01-01

Although recommendations for introducing solid foods to infants and young children have changed significantly since the beginning of the 20th century, vegetable consumption recommendations have always been an important part of the child-feeding repertoire. In 1958, the first report of the American Academy of Pediatrics (AAP) Committee on Nutrition stated that developmental maturity of the gut and neuromuscular system, growth rate, and activity level were good indicators for determining when to introduce solid foods to infants than age. All 7 editions of the AAP Pediatric Nutrition Handbook use an evidence-based model for recommendations concerning the complementary feeding of infants and young children. The model includes developmental readiness principles, feeding practices, and age-appropriate nutrient requirements. Dietary patterns and nutrient consumption among infants and young children have been analyzed using data from the 2002 and 2008 Feeding Infants and Toddlers Study (FITS). The 2008 FITS also collected information concerning participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Since 1972, WIC has been a cost-effective means of improving the diets and health of infants and young children from low-income families. Data from the 2008 FITS showed that many young children did not consume recommended amounts of fiber or potassium, and vegetable and fruit intakes continued to be lower than recommended. Low vegetable consumption and limited variety were also seen among WIC participants and nonparticipants aged 6 months to 4 years prior to changes in the WIC food package. Increasing children’s consumption of all vegetables should continue to be a focus going forward. PMID:27003950

Factors associated with nutritional status of infants and young children in Somali Region, Ethiopia: a cross- sectional study.

PubMed

Fekadu, Yirgu; Mesfin, Addisalem; Haile, Demewoz; Stoecker, Barbara J

2015-09-02

Inadequate nutrition during the first two years of life may lead to childhood morbidity and mortality, as well as inadequate brain development. Infants are at increased risk of malnutrition by six months, when breast milk alone is no longer sufficient to meet their nutritional requirements. However the factors associated with nutritional status of infants after 6 months of age have received little attention in pastoralist communities of Ethiopia. Therefore this study aimed to identify the factors associated with nutritional status of infants and young children (6-23 months) in Filtu town, Somali Region, Ethiopia. A cross-sectional community-based study was conducted. Simple random sampling was employed to select 214 infants for the study. Univariable and multivariable logistic regressions models were used in the statistical analysis. The strength of association was measured by odds ratios with 95% confidence intervals. Both the crude (COR) and adjusted odds ratios (AOR) are reported. The prevalence of wasting, stunting and underweight among infants and young children were 17.5% (95% CI: 12.91-23.22), 22.9% (95% CI: 17.6-28.9) and 19.5% (95% CI: 14.58-25.3) respectively. The multivariable logistic regression model showed that breastfeeding was independently associated with reduced odds of wasting (AOR = 0.38(95% CI: 0.14-0.99)). Diarrhea in the past 15 days (AOR = 2.13 (95% CI: 1.55-4.69)) was also associated with increased odds for wasting. The independent predictors of reduced odds for stunting were dietary diversity score ≥ 4 (AOR = 0.45(95% CI: 0.21-0.95)) and introduction of complementary feeding at 6 months (AOR = 0.25 (95% CI: 0.09-0.66)). Bottle feeding was associated with increased odds of stunting (AOR = 3.83 (95% CI: 1.69-8.67)). Breastfeeding was associated with reduced odds of underweight (AOR = 0.24 (95% CI: 0.1-0.59)), while diarrheal disease in the past 15 days was associated with increased odds of underweight (AOR = 3.54 (95% CI: 1.17-7.72)). Under nutrition is a public health problem among infants and young children in Filtu town, Somali region Ethiopia. Breastfeeding was associated with lower odds of wasting and underweight while diarrheal disease was associated with higher odds of wasting and underweight. Low dietary diversity scores, inappropriate age of complementary feeding initiation and bottle feeding were identified to be significant predictors of stunting. Those factors should be considered for any intervention aimed to reduce under nutrition among infants and young children in Filitu town, Somali region, Ethiopia.

Beyond an Assumed Mother-Child Symbiosis in Nutritional Guidelines: The Everyday Reasoning behind Complementary Feeding Decisions

ERIC Educational Resources Information Center

Nielsen, Annemette; Michaelsen, Kim F.; Holm, Lotte

2014-01-01

Researchers question the implications of the way in which "motherhood" is constructed in public health discourse. Current nutritional guidelines for Danish parents of young children are part of this discourse. They are shaped by an assumed symbiotic relationship between the nutritional needs of the child and the interest and focus of the…

Child feeding knowledge and practices among women participating in growth monitoring and promotion in Accra, Ghana

PubMed Central

2014-01-01

Background Child undernutrition and poor feeding practices remain a concern in Ghana. The Growth Monitoring and Promotion (GMP) programme seeks to empower mothers to provide appropriate child care. Although the program has been implemented in Ghana for over four decades, little is known about its impact on child feeding outcomes. The current study assessed the association between GMP exposure and mothers' child feeding knowledge and practices in the Accra Metropolitan Area (AMA), Ghana. Methods A cross-sectional survey of 199 mother-child pairs accessing child welfare services in six public health facilities in the AMA was conducted. A structured questionnaire was used to collect data on respondent characteristics and child feeding knowledge; a 24-hour dietary recall tool was used to record child feeding practices. Linear regression analysis was used to determine the association between mothers' exposure to GMP and their knowledge and practices on child feeding. Results Seventy four percent of mothers had not missed any scheduled child welfare clinic sessions. Over 60% of mothers knew the appropriate age of introduction of foods; 86% also gave correct response regarding minimum number of times their child should be fed daily. About 81% of children less than 6 months were exclusively breastfed in the preceding 24 hours, although 36% had received water since birth. Forty two percent of children 6–23 months received dietary diverse meals while 64% were fed the required number of times in a day. Overall, only 32% of children 6–23 months received a minimum acceptable diet in the preceding 24 hours. A higher GMP exposure was positively associated with feeding knowledge scores among mothers with children below 6 months (p < 0.05). Conclusion Although most mothers were knowledgeable about recommendations, feeding practices were suboptimal, especially complementary feeding. GMP exposure was associated with feeding knowledge only among mothers with children less than 6 months. Strengthening of feeding counselling focused on children above 6 months is recommended. PMID:24886576

Food variety in commercial and homemade complementary meals for infants in Germany. Market survey and dietary practice.

PubMed

Mesch, Christina M; Stimming, Madlen; Foterek, Kristina; Hilbig, Annett; Alexy, Ute; Kersting, Mathilde; Libuda, Lars

2014-05-01

Already infants do not meet the recommendations for fruit and vegetable intake although the complementary feeding period offers the possibility to expose the infant to a variety of flavours from fruits and vegetables. The objective of the present analysis was to identify differences in the vegetable variety in commercial vs. homemade complementary meals and to describe fish and meat variety in these meals in dietary practice in Germany. A further objective was to provide an overview of the food variety in commercial complementary vegetable-potato-meat/fish meals available on the German baby food market in 2012. 3-day weighed dietary records from the German DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were used to describe the fish and meat variety and to compare the vegetable variety in commercial and homemade meals using a vegetable variety score (VegVS). The online data base 'Nutrichild' served to describe the food variety on the market. The vegetable variety was low in homemade as well as in commercial meals without any differences in total variety at 6 and 9months of age. At 12months of age infants fed with commercial meals got a higher vegetable variety than those fed with homemade meals. In homemade and commercial meals most often carrot was used, whereas other vegetables were far below this frequency. In both meals, poultry and beef were most often used whereas fish meals were rarely offered. The market survey showed the same low vegetable variety and low fish offer as the results of the DONALD study. The data show that it is necessary to promote the advantages of a vegetable variety and fish consumption in Germany, already in early infancy. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Content Analysis of Infant and Toddler Food Advertisements in Taiwanese Popular Pregnancy and Early Parenting Magazines.

PubMed

Chen, Yi-Chun; Chang, Jung-Su; Gong, Yu-Tang

2015-08-01

Mothers who are exposed to formula advertisements (ads) are less likely to initiate breastfeeding and more likely to breastfeed for a shorter duration than other mothers. The purpose of this study was to examine infant and toddler food ads in pregnancy and early parenting magazines. A content analysis of infant and toddler food ads printed in 12 issues of 4 magazines published in 2011 was performed. Coding categories of ads included product category, advertisement category, marketing information, and advertising appeal. The target age and health-related message of each product were coded. The researchers identified 756 infant and toddler food ads in the magazines. Compared with complementary food ads, formula product ads used more marketing strategies such as antenatal classes and baby contests to influence consumers and promote products. Nutritional quality and child health benefits were the two most frequently used advertising appeals. In addition, this study identified 794 formula products and 400 complementary food products; 42.8% of the complementary food products were intended for 4-month-old infants. Furthermore, 91.9% of the ads for formula products and 81% of the ads for complementary food products contained claims concerning health function or nutrient content. Taiwanese pregnancy and early parenting magazines contain numerous infant and toddler food ads. These ads generally use health-related claims regarding specific nutrient content and health functions to promote infant and toddler foods. Health professionals should provide more information to parents on the differences between breast milk and formula milk, and they should be aware of the potential effect of infant and toddler food ads on parents' infant feeding decisions. © The Author(s) 2015.

Bibliographic analysis of scientific research on selected topics in public health nutrition in West Africa: Review of articles published from 1998 to 2008.

PubMed

Aaron, Grant J; Wilson, Shelby E; Brown, Kenneth H

2010-01-01

Few countries in West Africa have the capacity for carrying out advanced training in nutrition and public health. To provide additional information on current regional applied nutrition research capacity and productivity, we analysed peer-reviewed articles on key public health nutrition topics that were published from 1998 to 2008. Using MEDLINE/PubMed, the following terms were searched: 'breast feeding', 'infant nutrition physiology' (comprising complementary feeding and weaning), 'protein energy malnutrition', 'nutrition and infection', 'vitamin A', 'iodine', 'zinc' and 'overweight', each linked with the term 'Western Africa'. In total, 412 unique articles (37±6 articles per year) were identified. Most research focused on infant and young child feeding practices, selected micronutrient deficiencies, and the emerging problem of overweight and obesity. The primary author of nearly half (46%) the publications was located in an institution outside of West Africa. Most articles were published in English (90%), and nearly half of all articles (41%) were cross-sectional studies. Our findings indicate that few peer-reviewed research studies are being published on key public health topics in the West African region, considering the magnitude of nutrition problems in this region. New approaches are needed to encourage and support research capacity and output in West Africa.

Need for Early Interventions in the Prevention of Pediatric Overweight: A Review and Upcoming Directions

PubMed Central

Dattilo, Anne M.; Birch, Leann; Krebs, Nancy F.; Lake, Alan; Taveras, Elsie M.; Saavedra, Jose M.

2012-01-01

Childhood obesity is currently one of the most prevailing and challenging public health issues among industrialized countries and of international priority. The global prevalence of obesity poses such a serious concern that the World Health Organization (WHO) has described it as a “global epidemic.” Recent literature suggests that the genesis of the problem occurs in the first years of life as feeding patterns, dietary habits, and parental feeding practices are established. Obesity prevention evidence points to specific dietary factors, such as the promotion of breastfeeding and appropriate introduction of nutritious complementary foods, but also calls for attention to parental feeding practices, awareness of appropriate responses to infant hunger and satiety cues, physical activity/inactivity behaviors, infant sleep duration, and family meals. Interventions that begin at birth, targeting multiple factors related to healthy growth, have not been adequately studied. Due to the overwhelming importance and global significance of excess weight within pediatric populations, this narrative review was undertaken to summarize factors associated with overweight and obesity among infants and toddlers, with focus on potentially modifiable risk factors beginning at birth, and to address the need for early intervention prevention. PMID:22675610

An overview of the legislation and light microscopy for detection of processed animal proteins in feeds.

PubMed

Liu, Xian; Han, Lujia; Veys, Pascal; Baeten, Vincent; Jiang, Xunpeng; Dardenne, Pierre

2011-08-01

From the first cases of bovine spongiform encephalopathy (BSE) among cattle in the United Kingdom in 1986, the route of infection of BSE is generally believed by means of feeds containing low level of processed animal proteins (PAPs). Therefore, many feed bans and alternative and complementary techniques were resulted for the BSE safeguards in the world. Now the feed bans are expected to develop into a "species to species" ban, which requires the corresponding species-specific identification methods. Currently, banned PAPs can be detected by various methods as light microscopy, polymerase chain reaction, enzyme-linked immunosorbent assay, near infrared spectroscopy, and near infrared microscopy. Light microscopy as described in the recent Commission Regulation EC/152/2009 is the only official method for the detection and characterization of PAPs in feed in the European Union. It is able to detect the presence of constituents of animal origin in feed at the level of 1 g/kg with hardly any false negative. Nevertheless, light microscopy has the limitation of lack of species specificity. This article presents a review of legislations on the use of PAPs in feedstuff, the detection details of animal proteins by light microscopy, and also presents and discusses the analysis procedure and expected development of the technique. Copyright © 2010 Wiley-Liss, Inc.

Canadian infants' nutrient intakes from complementary foods during the first year of life

PubMed Central

2010-01-01

Background Complementary feeding is currently recommended after six months of age, when the nutrients in breast milk alone are no longer adequate to support growth. Few studies have examined macro- and micro-nutrient intakes from complementary foods (CF) only. Our purpose was to assess the sources and nutritional contribution of CF over the first year of life. Methods In July 2003, a cross-sectional survey was conducted on a nationally representative sample of mothers with infants aged three to 12 months. The survey was administered evenly across all regions of the country and included a four-day dietary record to assess infants' CF intakes in household (tablespoon) measures (breast milk and formula intakes excluded). Records from 2,663 infants were analyzed for nutrient and CF food intake according to 12 categories. Mean daily intakes for infants at each month of age from CF were pooled and compared to the Dietary Reference Intakes for the respective age range. Results At three months of age, 83% of infants were already consuming infant cereals. Fruits and vegetables were among the most common foods consumed by infants at all ages, while meats were least common at all ages except 12 months. Macro- and micro-nutrient intakes from CF generally increased with age. All mean nutrient intakes, except vitamin D and iron, met CF recommendations at seven to 12 months. Conclusions Complementary foods were introduced earlier than recommended. Although mean nutrient intakes from CF at six to 12 months appear to be adequate among Canadian infants, further attention to iron and vitamin D intakes and sources may be warranted. PMID:20565759

Maternal and Child Health Handbook use for maternal and child care: a cluster randomized controlled study in rural Java, Indonesia.

PubMed

Osaki, Keiko; Hattori, Tomoko; Toda, Akemi; Mulati, Erna; Hermawan, Lukas; Pritasari, Kirana; Bardosono, Saptawati; Kosen, Soewarta

2018-01-09

Effectiveness of the Maternal and Child Health Handbook (MCHHB), a home-based booklet for pregnancy, delivery and postnatal/child health, was evaluated on care acquisition and home care in rural Java, a low service-coverage area. We conducted a health centre-based randomized trial, with a 2-year follow-up. Intervention included (i) MCHHB provision at antenatal care visits; (ii) records and guides by health personnel on and with the MCHHB; and (iii) sensitization of care by volunteers using the MCHHB. The follow-up rate was 70.2% (183, intervention area; 271, control area). Respondents in the intervention area received consecutive MCH services including two doses of tetanus toxoid injections and antenatal care four times or more during pregnancy, professional assistance during child delivery and vitamin A supplements administration to their children, after adjustment for confounding variables and cluster effects (OR = 2.03, 95% CI: 1.19-3.47). In the intervention area, home care (continued breastfeeding; introducing complementary feeding; proper feeding order; varied foods feeding; self-feeding training; and care for cough), perceived support by husbands, and lower underweight rates and stunting rates among children were observed. MCHHB use promoted continuous care acquisition and care at home from pregnancy to early child-rearing stages in rural Java. © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health.

Consumption of highly processed snacks, sugar-sweetened beverages and child feeding practices in a rural area of Nicaragua.

PubMed

Contreras, Mariela; Zelaya Blandón, Elmer; Persson, Lars-Åke; Ekström, Eva-Charlotte

2016-01-01

Appropriate feeding behaviours are important for child growth and development. In societies undergoing nutrition transition, new food items are introduced that may be unfavourable for child health. Set in rural Nicaragua, the aim of this study was to describe the infant and young child feeding (IYCF) practices as well as the consumption of highly processed snack foods (HP snacks) and sugar-sweetened beverages (SSBs). All households with at least one child 0- to 35-month-old (n = 1371) were visited to collect information on current IYCF practices in the youngest child as well as consumption of SSBs and HP snacks. Breastfeeding was dominant (98%) among 0- to 1-month-olds and continued to be prevalent (60%) in the second year, while only 34% of the 0- to 5-month-olds were exclusively breastfed. Complementary feeding practices were deemed acceptable for only 59% of the 6- to 11-month-old infants, with low dietary diversity reported for 50% and inadequate meal frequency reported for 30%. Consumption of HP snacks and SSBs was frequent and started early; among 6- to 8-month-olds, 42% and 32% had consumed HP snacks and SSBs, respectively. The difference between the observed IYCF behaviours and World Health Organization recommendations raises concern of increased risk of infections and insufficient intake of micronutrients that may impair linear growth. The concurrent high consumption of SSBs and HP snacks may increase the risk of displacing the recommended feeding behaviours. To promote immediate and long-term health, growth and development, there is a need to both promote recommended IYCF practices as well as discourage unfavourable feeding behaviours. © 2014 John Wiley & Sons Ltd.

Effectiveness of a comprehensive integrated module using interactive lectures and workshops in understanding and knowledge retention about infant feeding practice in fifth year medical students: a quasi-experimental study.

PubMed

Sjarif, Damayanti Rusli; Yuliarti, Klara; Wahyuni, Luh Karunia; Wiguna, Tjhin; Prawitasari, Titis; Devaera, Yoga; Triyuniati, Henni Wahyu; Afriansyah, Andika

2016-08-18

Sixty percent of the 10.9 million under-5 deaths every year are related to malnutrition. More than two thirds of malnutrition is caused by inappropriate infant feeding practice. Only 35 % of mothers worldwide provide 4 months of exclusive breast-feeding, while complementary feeding is often untimely, nutritionally inadequate, hygienically poor, and improperly delivered. The existing pediatric nutrition module in our institution does not include proper delivery of food that involves oral-motor skills and feeding behavior. To scale up the knowledge and skill of medical students regarding evidence-based infant feeding practice, we designed a new module composed of comprehensive and integrated lectures with additional multidisciplinary lectures on oral-motor skill development and feeding behavior. A quasi-experimental study was conducted to evaluate the efficacy of the new module compared to the previous module. Fifth year medical students of Universitas Indonesia were divided into intervention and control groups. The control group received lectures and a paper-based workshop. The intervention group received comprehensive and integrated interactive lectures with additional multidisciplinary lectures on oral-motor skill development and behavioral approaches to feeding problems. A hands-on workshop using real cases shown on recorded video and role-play sessions was also presented to the intervention group. A pre-/post-test, 3-month retention test, and Observed Structured Clinical Examination (OSCE) were performed to evaluate understanding, knowledge retention, and counseling skills. A linear mixed effect model with a random intercept analysis for pre-test, post-test, and retention test scores showed significant higher result for intervention group compared to control group (p < 0.001). Comprehensive knowledge and counselling skills were better in the intervention group than in the control group as shown by the OSCE score (68.6 vs 59.3, p < 0.001). Our comprehensive integrated infant feeding practice module, which incorporates multidisciplinary learning processes and an interactive hands-on workshop with a role-play session yields better knowledge understanding and counseling skills compared with the existing module. Comprehensive knowledge and good counseling skills of medical students as future doctors are a pre-requisite to provide effective education to parents to support successful infant feeding practices.

Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study.

PubMed

Huang, Xiao-Na; Wang, Hui-Shan; Chang, Jen-Jen; Wang, Lin-Hong; Liu, Xi-Cheng; Jiang, Jing-Xiong; An, Lin

2016-02-01

Findings from prior research into the effect of feeding methods on infant sleep are inconsistent. The objectives of this study were to examine infants' sleep patterns by feeding methods and sleep arrangement from birth to eight months old. This longitudinal cohort study enrolled 524 pregnant women at 34-41 weeks of gestation and their infants after delivery in 2006 and followed up until eight months postpartum. The study subjects were recruited from nine women and children hospitals in nine cities in China (Beijing, Chongqing, Wuhan, Changsha, Nanning, Xiamen, Xi'an, Jinan, and Hailin). Participating infants were followed up weekly during the first month and monthly from the second to the eighth month after birth. Twenty-four hour sleep diaries recording infants' sleeping and feeding methods were administered based on caregiver's self-report. Multivariable mixed growth curve models were fitted to estimate the effects of feeding methods and sleep arrangement on infants' sleep patterns over time, controlling for maternal and paternal age, maternal and paternal education level, household income, supplementation of complementary food, and infant birth weight and length. Exclusively formula fed infants had the greatest sleep percentage/24 h, followed by exclusively breast milk fed infants and partially breast milk fed infants (P<0.01). Night waking followed a similar pattern. However, the differences in sleep percentage and night waking frequency between exclusively formula and exclusively breast milk fed infants weakened over time as infants developed. In addition, compared to infants with bed-sharing sleep arrangement, those with room sharing sleep arrangement had greater daytime and 24-hour infant sleep percentage, whereas those with sleeping alone sleep arrangement had greater nighttime sleep percentage. Our data based on caregiver's self-report suggested that partial breastfeeding and bed-sharing may be associated with less sleep in infants. Health care professionals need to work with parents of newborns to develop coping strategies that will help prevent early weaning of breastfeeding.

SystEmatic review and meta-aNAlysis of infanT and young child feeding Practices (ENAT-P) in Ethiopia: protocol

PubMed Central

Islam, Md. Atiqul; Sharew, Nigussie Tadesse; Birhanu, Mulugeta Molla; Tegegne, Balewgizie Sileshi

2017-01-01

Introduction Infant and young child feeding (IYCF) is the cornerstone of infant and child survival, healthy growth and development, healthy future generations and national development. In spite of the importance of optimal nutrition in low- and middle-income countries, there has been no review conducted in Ethiopia. Thus, the aim of this systematic review and meta-analysis is to estimate the national coverage and identify the associated factors of IYCF practices in Ethiopia. Methods PubMed, Scopus, EMBASE, CINHAL, EBSCO, Web of Science and WHO Global Health Library databases will be searched for all available publications from 1 January 2000 to 30 September 2017. All published studies on the timely initiation of breast feeding, exclusive breast feeding and timely initiation of complementary feeding practice in Ethiopia will be screened, selected and reviewed. Bibliographies of identified articles and grey literature will be hand-searched as well. Heterogeneity of studies will be quantified using Higgins’s method where I2 statistic >80% indicates substantial heterogeneity. Funnel plots and Egger’s regression test will be used to assess potential publication bias. The Newcastle–Ottawa Scale (NOS) will be used to assess the quality of evidence and risk of bias. Meta-analysis and meta-regression will be carried out to estimate the pooled national prevalence rate and an OR of each associated factor of IYCF practices. Narrative synthesis will be performed if meta-analysis is not feasible due to the substantial heterogeneity of studies. Ethics and dissemination Ethical clearance is not required for this study because primary data will not be collected. The results of this systematic review and meta-analysis will be published in a peer-reviewed journal and presented at an (inter)national research symposium. Systematic review registration This systematic review and meta-analysis has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017056768. PMID:28775196

Detection of banned meat and bone meal in feedstuffs by near-infrared microscopic analysis of the dense sediment fraction.

PubMed

Baeten, Vincent; von Holst, Christoph; Garrido, Ana; Vancutsem, Jeroen; Michotte Renier, Antoine; Dardenne, Pierre

2005-05-01

In this paper we present an alternative method for detection of meat and bone meal (MBM) in feedstuffs by near-infrared microscopic (NIRM) analysis of the particles in the sediment fraction (dense fraction (d >1.62) from dichloroethylene) of compound feeds. To apply this method the particles of the sediment fraction are spread on a sample holder and presented to the NIR microscope. By using the pointer of the microscope the infrared beam is focussed on each particle and the NIR spectrum (1112-2500 nm) is collected. This method can be used to detect the presence of MBM at concentrations as low as 0.05% mass fraction. When results from the NIRM method were compared with the classical microscopic method, a coefficient of determination (R2) of 0.87 was obtained. The results of this study demonstrated that this method could be proposed as a complementary tool for the detection of banned MBM in feedstuffs by reinforcement of the monitoring of feeds.

Many Infants and Young Children Are Not Compliant with Mexican and International Complementary Feeding Recommendations for Milk and Other Beverages

PubMed Central

Afeiche, Myriam C.; Villalpando-Carrión, Salvador; Reidy, Kathleen C.; Eldridge, Alison L.

2018-01-01

Mexican and international authorities provide guidelines for milk and beverage consumption for young children. This study classifies beverages as appropriate or inappropriate by age (0–5.9, 6–11.9, and 12–23.9 months) and details consumption patterns, amounts consumed, and the associated socio-demographic characteristics. Analysis of the Mexican National Nutrition and Health Survey (ENSANUT 2012) was conducted (n = 949). Among 0–5.9 month olds, 66.7% consumed either breast milk, infant formula, or a combination with no other beverages, whereas 29.3% consumed breast milk and/or infant formula with water (mean = 58 g/day) and/or other beverages (mean = 115 g/day), such as 100% fruit juice, milk, and sugar-sweetened beverages (SSBs). For infants 6–11.9 months, appropriate beverages include breast milk, infant formula, and water; only 40.2% met these recommendations. Many 6–11.9 month olds consumed age-inappropriate beverages, including milk (31%) and SSBs (35%). After 12 months of age, appropriate beverages include water, milk, and a limited amount of 100% fruit juice and SSBs; 32.4% complied fully, 18.3% consumed appropriate and inappropriate beverages, and 49.3% consumed only inappropriate beverages. Among 12–23.9 month olds, 58% consumed milk, 18% juice, and 42% water while 63% consumed SSBs. Many infants and young children are not compliant with Mexican and international breastfeeding and complementary feeding guidelines for beverages. Communication and guidance about age-appropriate beverages should be improved. PMID:29642599

Infant feeding patterns over the first year of life: influence of family characteristics

PubMed Central

Betoko, Aisha; Charles, Marie-Aline; Hankard, Régis; Forhan, Anne; Bonet, Mercedes; Saurel-Cubizolles, Marie-Josephe; Heude, Barbara; De Lauzon-Guillain, Blandine

2013-01-01

Background/Objectives Early eating patterns and behaviors can determine later eating habits and food preferences and they have been related to the development of childhood overweight and obesity. We aimed to identify patterns of feeding in the first year of life and to examine their associations with family characteristics. Subjects/Methods Our analysis included 1004 infants from the EDEN mother-child cohort. Feeding practices were assessed through maternal self-report at birth, 4, 8 and 12 months. Principal component analysis was applied to derive patterns from breastfeeding duration, age at complementary food (CF) introduction and type of food used at 1y. Associations between patterns and family characteristics were analyzed by linear regressions. Results The main source of variability in infant feeding was characterized by a pattern labeled ‘Late CF introduction and use of ready-prepared baby foods’. Older, more educated, primiparous women with high monthly income ranked high on this pattern. The second pattern, labeled ‘Longer breastfeeding, late CF introduction and use of home-made foods’ was the closest to infant feeding guidelines. Mothers ranking high on this pattern were older and more educated. The third pattern, labeled ‘Use of adults’ foods’ suggests a less age-specific diet for the infants. Mothers ranking high on this pattern were often younger and multiparous. Recruitment center was related to all patterns. Conclusion Not only maternal education level and age but also parity and region are important contributors to the variability in patterns. Further studies are needed to describe associations between these patterns and infant growth and later food preferences. PMID:23299715

Infant feeding patterns over the first year of life: influence of family characteristics.

PubMed

Betoko, A; Charles, M-A; Hankard, R; Forhan, A; Bonet, M; Saurel-Cubizolles, M-J; Heude, B; de Lauzon-Guillain, B

2013-06-01

Early eating patterns and behaviors can determine later eating habits and food preferences and they have been related to the development of childhood overweight and obesity. We aimed to identify patterns of feeding in the first year of life and to examine their associations with family characteristics. Our analysis included 1004 infants from the EDEN mother-child cohort. Feeding practices were assessed through maternal self-report at birth, 4, 8 and 12 months. Principal component analysis was applied to derive patterns from breastfeeding duration, age at complementary food (CF) introduction and type of food used at 1 year. Associations between patterns and family characteristics were analyzed by linear regressions. The main source of variability in infant feeding was characterized by a pattern labeled 'late CF introduction and use of ready-prepared baby foods'. Older, more educated, primiparous women with high monthly income ranked high on this pattern. The second pattern, labeled 'longer breastfeeding, late CF introduction and use of home-made foods' was the closest to infant feeding guidelines. Mothers ranking high on this pattern were older and more educated. The third pattern, labeled 'use of adults' foods' suggests a less age-specific diet for the infants. Mothers ranking high on this pattern were often younger and multiparous. Recruitment center was related to all patterns. Not only maternal education level and age, but also parity and region are important contributors to the variability in patterns. Further studies are needed to describe associations between these patterns and infant growth and later food preferences.

Preferred delivery method and acceptability of Wheat-Soy Blend (WSB++) as a daily complementary food supplement in northwest Bangladesh.

PubMed

Shamim, Abu Ahmed; Hanif, Abu A M; Merrill, Rebecca D; Campbell, Rebecca K; Kumkum, Mehnaz Alam; Shaikh, Saijuddin; de Pee, Saskia; Ahmed, Tahmeed; Parveen, Monira; Mehra, Sucheta; Klemm, Rolf D W; Labrique, Alain B; West, Keith P; Christian, Parul

2015-01-01

Fortified blended foods (FBFs) are widely used to prevent undernutrition in early childhood in food-insecure settings. We field tested enhanced Wheat Soy Blend (WSB++)-a FBF fortified with micronutrients, milk powder, sugar, and oil-in preparation for a complementary food supplement (CFS) trial in rural northwestern Bangladesh. Formative work was conducted to determine the optimal delivery method (cooked vs. not) for this CFS, to examine mothers' child feeding practices with and acceptance of the WSB++, and to identify potential barriers to adherence. Our results suggest WSB++ is an acceptable CFS in rural Bangladesh and the requirement for mothers to cook WSB++ at home is unlikely to be a barrier to its daily use as a CFS in this population.

The Role of Avocados in Complementary and Transitional Feeding.

PubMed

Comerford, Kevin B; Ayoob, Keith T; Murray, Robert D; Atkinson, Stephanie A

2016-05-21

Infant dietary patterns tend to be insufficient sources of fruits, vegetables, and fiber, as well as excessive in salt, added sugars, and overall energy. Despite the serious long-term health risks associated with suboptimal fruit and vegetable intake, a large percentage of infants and toddlers in the U.S. do not consume any fruits or vegetables on a daily basis. Since not all fruits and vegetables are nutritionally similar, guidance on the optimal selection of fruits and vegetables should emphasize those with the greatest potential for nutrition and health benefits. A challenge is that the most popularly consumed fruits for this age group (i.e., apples, pears, bananas, grapes, strawberries) do not closely fit the current general recommendations since they tend to be overly sweet and/or high in sugar. Unsaturated oil-containing fruits such as avocados are nutritionally unique among fruits in that they are lower in sugar and higher in fiber and monounsaturated fatty acids than most other fruits, and they also have the proper consistency and texture for first foods with a neutral flavor spectrum. Taken together, avocados show promise for helping to meet the dietary needs of infants and toddlers, and should be considered for inclusion in future dietary recommendations for complementary and transitional feeding.

A qualitative Kaupapa Māori approach to understanding infant and young child feeding practices of Māori and Pacific grandparents in Auckland, New Zealand.

PubMed

Tapera, Rachel; Harwood, Matire; Anderson, Anneka

2017-04-01

The present research sought to better understand the barriers, facilitators, attitudes and beliefs that influence the way Māori and Samoan grandparents feed their grandchildren in a deprived urban neighbourhood in New Zealand. The research adopted a qualitative methodology that was consistent with a Kaupapa Māori research approach. Seven semi-structured interviews were conducted with grandparents to collect narrative data. Sampling occurred in one Auckland suburb. The suburb was selected because of its high level of socio-economic deprivation and ethnic diversity. Seven grandparents participated in the study (five Māori and two Samoan). Each participant met the inclusion criteria (i.e. they had provided at least five meals per week over the previous three months to grandchildren aged less than 24 months). Marae (i.e. meeting houses and areas used by local Māori tribes/sub-tribes) and community organisations were used to recruit participants. A general inductive thematic analysis identified four key themes: (i) grandparents' understanding of optimal feeding practices; (ii) economic and material factors; (iii) previous experiences and customary norms; and (iv) social support and societal pressure. The study showed that grandparents' complementary feeding practices in caring for infant grandchildren were influenced by upstream structural elements such as government policies related to welfare and pensions, employment, income and cultural knowledge. Frameworks that seek to achieve social justice and support cultural practices should be employed and promoted in the development of future policy and research in this area.

Utilizing direct skin feeding assays for development of vaccines that interrupt malaria transmission: A systematic review of methods and case study.

PubMed

Brickley, Elizabeth B; Coulibaly, Mamadou; Gabriel, Erin E; Healy, Sara A; Hume, Jen C C; Sagara, Issaka; Traore, Sekou F; Doumbo, Ogobara; Duffy, Patrick E

2016-11-21

Shifting the malaria priorities from a paradigm of control and elimination to a goal of global eradication calls for renewed attention to the interruption of malaria transmission. Sustained progress toward eradication will require both improved understanding of infectious reservoirs and efficient development of novel transmission-blocking interventions, such as rapidly acting and highly efficacious therapeutics and vaccines. Here, we review the direct skin feeding assay (DSF), which has been proposed as a valuable tool for measuring the in natura transmission of malaria parasites from human hosts to mosquito vectors across heterogeneous populations. To capture the methodological breadth of this assay's use, we first systematically review and qualitatively synthesize previously published investigations using DSFs to study malaria transmission in humans. Then, using a recent Phase 1 trial in Mali of the Pfs25H-EPA/Alhydrogel® vaccine candidate (NCT01867463) designed to interrupt Plasmodium falciparum transmission as a case study, we describe the potential opportunities and current limitations of utilizing the endpoints measured by DSF in making early clinical decisions for individually randomized transmission-interrupting intervention candidates. Using simulations based on the data collected in the clinical trial, we demonstrate that the capacity of the DSF to serve as an evaluative tool is limited by the statistical power constraints of the "effective sample size" (i.e. the number of subjects that are capable of transmitting at the time of feeding). Altogether, our findings suggest DSFs have great potential utility for assessing the public health impacts of emerging antimalarial tools, but additional research is needed to address issues of scalability and to establish correlation with community-wide clinical endpoints as well as complementary in vitro measures, such as standard membrane feeding assays. Published by Elsevier Ltd.

First- and second-trimester WIC participation is associated with lower rates of breastfeeding and early introduction of cow's milk during infancy.

PubMed

Ziol-Guest, Kathleen M; Hernandez, Daphne C

2010-05-01

Existing literature suggests prenatal participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) may reduce breastfeeding among low-income mothers. However, little is known about whether the timing of WIC entrance during pregnancy influences infant feeding decisions. This study assesses the association between the timing of prenatal participation in WIC and various infant feeding practices, including breastfeeding initiation, breastfeeding for at least 4 months, exclusive breastfeeding, formula feeding, and early introduction of cow's milk and solid food. Cross-sectional survey matching of birth certificate data to mothers' interviews 9 months after the child's birth. Mothers provided information on participation in the WIC program, infant feeding practices, and sociodemographic characteristics. A nationally representative sample of 4,450 births in 2001 from the Early Childhood Longitudinal Survey-Birth Cohort. Multivariate logistic regression techniques (using STATA 9.0 SE, Stata Company, College Station, TX) estimated the relationship between the timing of prenatal WIC participation and infant feeding practices. Entry into the WIC program during the first or second trimester of pregnancy is associated with reduced likelihood of initiation of breastfeeding and early cow's milk introduction; and entry during the first trimester is associated with reduced duration of breastfeeding. WIC participation at any trimester is positively related to formula feeding. Prenatal WIC participation is associated with a greater likelihood of providing babies infant formula rather than breastmilk after birth. Findings also indicate that there are critical prenatal periods for educating women about the health risks of early cow's milk introduction. Given the health implications of feeding infants cow's milk too early, WIC may be successful in educating women on the health risks of introducing complementary foods early, even if direct counseling on cow's milk is not provided. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

The development of an ivermectin-based attractive toxic sugar bait (ATSB) to target Anopheles arabiensis.

PubMed

Tenywa, Frank Chelestino; Kambagha, Athumani; Saddler, Adam; Maia, Marta Ferreira

2017-08-15

An increasing number of countries in sub-Saharan Africa are moving towards malaria-elimination, mostly thanks to successful vector control campaigns. However, elimination has proven challenging, resulting in the persistence of malaria transmission. It is now accepted that in order to eliminate malaria, new complementary vector control approaches must be developed. This study describes the development of a sugar-baited resting place containing a toxic dose of ivermectin for the control of Anopheles arabiensis. Dose response experiments were performed in insectary conditions to determine the LD90 of ivermectin against An. arabiensis. Over 95% of An. arabiensis were knocked down 48 h post-sugar feeding on 10% sucrose solutions containing 0.01% ivermectin. When investigating different juices as attractants, it was observed that An. arabiensis preferred orange, watermelon and commercial guava juice over pawpaw, tomato, mango or banana, but were most likely to feed on simple 10% sugar solution. Using recycled materials, different bait prototypes were tested to determine the best design to maximize sugar feeding. Baits that offered a resting place for the mosquito rather than just a surface to sugar feed were more likely to attract An. arabiensis to sugar feed. The optimized prototype was then placed in different locations within a screen-house, colour-coded with different food dyes, containing competing vegetation (Ricinus communis) and experimental huts where humans slept under bed nets. Around half of all the released An. arabiensis sugar fed on the sugar baits, and approximately 50% of all sugar fed mosquitoes chose the baits close to outdoor vegetation before entering the huts. Ivermectin is an effective insecticide for use in sugar baits. The design of the sugar bait can influence feeding rates and, therefore, efficacy. Sugar baits that offer a resting surface are more efficient and sugar feeding on the baits is maximized when these are placed close to peri-domestic vegetation. Attractive toxic sugar baited resting places may provide an additional vector control method to complement with existing strategies.

Strategies to reduce exposure of fumonisins from complementary foods in rural Tanzania.

PubMed

Kimanya, Martin E; De Meulenaer, Bruno; Van Camp, John; Baert, Katleen; Kolsteren, Patrick

2012-10-01

Feeding infants with maize can expose them to fumonisin mycotoxins. We assessed fumonisin exposure from complementary foods in rural Tanzania and determined strategies to reduce the exposure. We conducted a cross-sectional study in four villages of Tarakea division, Northern Tanzania. We used a repeat 24-hour dietary recall to collect data of maize consumption as complementary food for 254 infants aged 6-8 months. Fumonisin concentrations in the maize were also estimated. Fumonisin exposure was assessed using @risk analysis software. With the software, several maximum fumonisin contamination and maize consumption patterns were combined in order to determine effective strategies for minimizing fumonisin exposure. Of the infants, 89% consumed maize at amounts up to 158g/person/day (mean; 43g/person/day±28). The maize was contaminated with fumonisins at levels up to 3201µgkg(-1) . Risk of fumonisin intake above the provisional maximum tolerable daily limit of 2µgkg(-1) body weight was 15% (95% confidence interval; 10-19). The risk was minimized when the maximum contamination was set at 150µgkg(-1) . The risk was also minimized when the maximum consumption was set at 20g/child/day while keeping the maximum contamination at the European Union (EU) maximum tolerated limit (MTL) of 1000µgkg(-1) . Considering the economical and technological limitations of adopting good agricultural practices in rural Tanzania, it is practically difficult to reduce contamination in maize to 150µgkg(-1) . We suggest adoption of the EU MTL of 1000µgkg(-1) for fumonisins in maize and reduction, by replacement with another cereal, of the maize component in complementary foods to a maximum intake of 20g/child/day. © 2011 Blackwell Publishing Ltd.

Modernization is Associated with Intensive Breastfeeding Patterns in the Bolivian Amazon

PubMed Central

Veile, Amanda; Martin, Melanie; McAllister, Lisa

2014-01-01

For many traditional, non-industrialized populations, intensive and prolonged breastfeeding buffers infant health against poverty, poor sanitation, and limited health care. Due to novel influences on local economies, values, and beliefs, the traditional and largely beneficial breastfeeding patterns of such populations may be changing to the detriment of infant health. To assess if and why such changes are occurring in a traditional breastfeeding population, we document breastfeeding patterns in the Bolivian Tsimane, a forager-horticulturalist population in the early stages of modernization. Three predictions are developed and tested to evaluate the general hypothesis that modernizing influences encourage less intensive breastfeeding in the Tsimane: 1) Tsimane mothers in regions of higher infant mortality will practice more intensive BF; 2) Tsimane mothers who are located closer to a local market town will practice more intensive BF; and 3) Older Tsimane mothers will practice more intensive BF. Predictions were tested using a series of maternal interviews (from 2003-2011, n=215) and observations of mother-infant dyads (from 2002-2007, n=133). Tsimane breastfeeding patterns were generally intensive: 72% of mothers reported initiating BF within a few hours of birth, mean (± SD) age of CF introduction was 4.1±2.0 months, and mean (± SD) weaning age was 19.2±7.3 months. There was, however, intra-population variation in several dimensions of breastfeeding (initiation, frequency, duration, and complementary feeding). Contrary to our predictions, breastfeeding was most intensive in the most modernized Tsimane villages, and maternal age was not a significant predictor of breastfeeding patterns. Regional differences accounted for variation in most dimensions of breastfeeding (initiation, frequency, and complementary feeding). Future research should therefore identify constraints on breastfeeding in the less modernized Tsimane regions, and examine the formation of maternal beliefs regarding infant feeding. PMID:24444850

Measuring Infant and Young Child Complementary Feeding Practices: Indicators, Current Practice, and Research Gaps.

PubMed

Ruel, Marie T

2017-01-01

The publication of the WHO Infant and Young Child Feeding (IYCF) indicators in 2008 equipped the nutrition and broader development community with an invaluable tool for measuring, documenting, and advocating for faster progress in improving these practices in low- and middle-income countries (LMICs). The indicators, with 5 of them focusing on complementary feeding (CF) practices, were originally designed for population level assessment, targeting, monitoring, and evaluation. This chapter takes stock of where we are with the existing CF indicators: it reviews how the indicators have been used, what we have learned, and what their strengths and limitations are, and it suggests a way forward. We find that the indicators have been used extensively for population level assessments and country comparisons, and to track progress. They have also been adopted by researchers in program impact evaluations and in research seeking to understand the determinants and consequences of poor CF practices for child growth and development outcomes. In addition to generating a wealth of knowledge and unveiling the severity of the global problem of poor CF practices in LMICs, the indicators have been an invaluable tool to raise awareness and call for urgent action on improving CF practices at scale. The indicators have strengths and limitations, which are summarized in this chapter. Although enormous progress has been achieved since the indicators were released in 2008, we feel it is time to reflect and revisit the CF indicators, improve them, develop new ones, and promote their appropriate use. Better indicators are critically important to stimulate action and investments in improving CF practices at scale. © 2017 Nestec Ltd., Vevey/S. Karger AG, Basel.

Complementary Feeding and Diarrhea and Respiratory Infection Among HIV-exposed Tanzanian Infants

PubMed Central

Kamenju, P; Liu, E; Hertzmark, E; Spiegelman, D; Kisenge, R.R.; Kupka, R; Aboud, S; Manji, K.P.; Duggan, C; Fawzi, W.W.

2016-01-01

Objective To examine the association between complementary feeding (CF) and risks of diarrhea and acute respiratory infection (ARI) among HIV-exposed infants aged 6–24 months. Design We prospectively employed an Infant and Child Feeding Index (ICFI) to measure CF practices (breastfeeding status, food consistency, dietary diversity, food group frequency and meal frequency). We determined the association of ICFI and each of its components with the risk of diarrhea and ARI. Generalized estimating equations (GEE) were used to estimate the relative risks for morbidity episodes. Setting Dar es Salaam, Tanzania. Subjects 2092 HIV-exposed infants followed from 6 months of age to 24 months of age. Results The ICFI score ranged from 0 to 9; the median score was 6 (Inter-Quartile Range; IQR=4, 7). Low ICFI scores were likely associated with increased risk of dysentery (low vs. high tertile Risk Ratio, RR: 1.40; 95% CI: 0.93, 2.10; P for trend=0.02) and respiratory infection (low vs. high tertile RR: 1.16; 95% CI: 0.96, 1.41; P for trend=0.01). Low dietary diversity scores were likely associated with higher risk of dysentery (low vs. high tertile RR: 1.47; 95% CI: 0.92, 2.35; P for trend=0.03) and respiratory infection (low vs. high tertile RR: 1.41; 95% CI: 1.13, 1.76; P for trend=0.01). Low food consistency scores were associated with higher risk of respiratory infection (RR: 1.77; 95% CI: 1.40, 2.26; P<0.01). Conclusions In this setting, low ICFI, dietary diversity and food consistency scores were likely associated with increased risk of diarrhea and acute respiratory infection among HIV-exposed infants. PMID:27861238

Community Based Maternal and Child Health Nutrition Project, Uttar Pradesh: An Innovative Strategy Focusing on “At Risk” Families

PubMed Central

Vir, Sheila C

2013-01-01

Research Question: Use of community based volunteers, frequently reaching and counseling a selected group of prioritized families, can make a substantial difference in improving maternal and child care practices and in reducing child undernutrition. Setting: Program Rural Uttar Pradesh, India. Study Design: A comparison of baseline and endline surveys following 4 years of community based project intervention Participants: “At risk” undernutrition families comprising mothers of under twos, newlyweds, and severely undernourished children below 6 years. Intervention: Mapping and counseling of “at risk” families. Measuring impact on maternal-child care practices, underweight status. Results: Trained community mobilizers identified and counseled selected “at risk” families. Following 4 years of implementation in 907 villages of 8 blocks of four districts, significant improvement was noted in practices of early initiation of breastfeeding, feeding colostrum, timely introduction of complementary feeding, and washing the hands after defecation. Percentage of mothers exclusively breastfeeding at 6 months was only 2.1% with 78% receiving prelacteal feeds. A small increase in normal and mild malnutrition and a significant reduction of 43% in severe malnutrition was noted. Conclusion: Frequently counseling by accredited social health activists by focusing on selected defined “at risk” families of under twos and those with severe malnourished children could result in increasing acceptability of correct child health, feeding, and care practices and in contributing to improving nutritional status scenario. PMID:24302825

Kinetics of Cold-Cap Reactions for Vitrification of Nuclear Waste Glass Based on Simultaneous Differential Scanning Calorimetry - Thermogravimetry (DSC-TGA) and Evolved Gas Analysis (EGA)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rodriguez, Carmen P.; Pierce, David A.; Schweiger, Michael J.

2013-12-03

For vitrifying nuclear waste glass, the feed, a mixture of waste with glass-forming and modifying additives, is charged onto the cold cap that covers 90-100% of the melt surface. The cold cap consists of a layer of reacting molten glass floating on the surface of the melt in an all-electric, continuous glass melter. As the feed moves through the cold cap, it undergoes chemical reactions and phase transitions through which it is converted to molten glass that moves from the cold cap into the melt pool. The process involves a series of reactions that generate multiple gases and subsequent massmore » loss and foaming significantly influence the mass and heat transfers. The rate of glass melting, which is greatly influenced by mass and heat transfers, affects the vitrification process and the efficiency of the immobilization of nuclear waste. We studied the cold-cap reactions of a representative waste glass feed using both the simultaneous differential scanning calorimetry thermogravimetry (DSC-TGA) and the thermogravimetry coupled with gas chromatography-mass spectrometer (TGA-GC-MS) as complementary tools to perform evolved gas analysis (EGA). Analyses from DSC-TGA and EGA on the cold-cap reactions provide a key element for the development of an advanced cold-cap model. It also helps to formulate melter feeds for higher production rate.« less

A Month of Breastfeeding Associated with Greater Adherence to Pediatric Nutrition Guidelines.

PubMed

Khalessi, Ali; Reich, Stephanie M

2013-07-01

Research has shown that both breastfeeding and delaying the introduction of solids or liquids other than breast milk protect against obesity later in early childhood. To compare whether breastfeeding mothers adhere to more of the American Academy of Pediatrics (AAP) feeding recommendations for infants. This longitudinal study compared the breastfeeding knowledge, intentions, and practices as well as complementary feeding choices of 163 ethnically diverse, primiparous women over the first 18 months of motherhood. Although almost all women knew about the health benefits of (98%) breastfeeding and intended to (98%) breastfeed, only 85% initiated and 51% continued beyond 4 weeks. Breastfeeding for longer durations was associated with better feeding choices. Mothers who breastfed for more weeks were more likely to adhere to AAP guidelines on liquids other than breast milk at 4, 6, and 12 months, and introduce solids, liquids other than breast milk, and other complimentary foods at later ages. Furthermore, mothers who breastfed for less than 1 month were more likely to introduce solids by 2 months in comparison to mothers who breastfed for 1 month or more (OR=3.22). Knowledge and intentions do not explain breastfeeding initiation or continuation. However, when women committed to more weeks of breastfeeding, especially more than 4 weeks, they made better nutrition choices for their infants.

Cluster-randomized trial of infant nutrition training for caries prevention.

PubMed

Chaffee, B W; Feldens, C A; Vítolo, M R

2013-07-01

The objective of this study was to estimate the caries impact of providing training in infant feeding guidelines to workers at Brazilian public primary care clinics. In a cluster-randomized controlled trial (n = 20 clinics), health care workers either were trained in guidelines for infant nutrition, stressing healthful complementary feeding, or were assigned to a 'usual practices' control, which allowed for maternal counseling at practitioner discretion. Training occurred once; the amount of counseling provided to mothers was not assessed. Eligible pregnant women were enrolled to follow health outcomes in their children. Early childhood caries (ECC) was measured at age three years (n = 458 children). The overall reductions in ECC (relative risk, 0.92; 95%CI, 0.75, 1.12) and severe ECC (RR, 0.87; 95%CI, 0.64, 1.19) were not statistically significant. There was a protective effect among mothers who remained exclusively at the same health center (S-ECC RR, 0.68; 95%CI, 0.47, 0.99) and among those naming the health center as their principal source of feeding advice (S-ECC RR, 0.53; 95%CI, 0.29, 0.97). Health care worker training did not yield a statistically significant reduction in caries overall, although caries was reduced among children of mothers more connected to their health centers.

The importance of iodine nutrition during pregnancy.

PubMed

Glinoer, Daniel

2007-12-01

To examine the importance of iodine nutrition during pregnancy. Review of existing literature of iodine in pregnancy. Population surveys and metabolic studies. Pregnant women. The main changes in thyroid function associated with pregnancy are due to an increase in hormone requirements that begin in the first trimester of gestation. This increase can only be met by a proportional increase in hormone production, something that depends directly upon the availability of iodine. When dietary iodine is lacking, an adequate physiological adaptation is difficult to achieve and is progressively replaced by pathological alterations that occur in parallel with the degree and duration of iodine deprivation. Iodine prophylaxis should be given systematically to women during pregnancy. In most public health programmes dealing with the correction of iodine deficiency disorders, iodised salt has been used as the preferred means to deliver iodine to households. Iodised salt, however, is not the ideal means of delivering iodine in the specific instances of pregnancy, breast-feeding and complementary feeding because of the need to limit salt intake during these periods. In European countries, presently it is proposed that iodine is given to pregnant women and breast-feeding mothers by systematically administering multivitamin tablets containing iodine in order to reach the recommended dietary allowance of 250 microg iodine day-1.

Chemical Composition and Nutritive Benefits of Chicory (Cichorium intybus) as an Ideal Complementary and/or Alternative Livestock Feed Supplement

PubMed Central

Shale, Karabo

2017-01-01

Chicory is a perennial plant grown in different parts of the world, used as forage for livestock, as folklore remedies, or as a vegetable addition in human diets. There are several varieties of the chicory plant, known differently globally due to its numerous medicinal, culinary, and nutritional qualities. Most parts of the plant contain a potpourri of nutrients ranging within carbohydrates, proteins, vitamins, minerals, soluble fiber, trace elements, and bioactive phenolic compounds, which are responsible for the various nutritive, prophylactic, and therapeutic qualities of chicory. Inulin, coumarins, tannins, monomeric flavonoids, and sesquiterpene lactones are some of the major phytocompounds mostly found in chicory plants. The health-promoting activities attributed to chicory comprise, among others, anti-inflammatory, anticarcinogenic, antiviral, antibacterial, antimutagenic, antifungal, anthelmintic, immune-stimulating, and antihepatotoxic and its antioxidative qualities. As a versatile plant, chicory's chemical composition and use as a suitable livestock feed supplement or as an alternative feed ingredient (AFI) are thus reviewed. PMID:29387778

Feeding ecology of two demersal opportunistic predators coexisting in the northwestern Mediterranean Sea

NASA Astrophysics Data System (ADS)

López, Nieves; Navarro, Joan; Barría, Claudio; Albo-Puigserver, Marta; Coll, Marta; Palomera, Isabel

2016-06-01

The study of the feeding ecology of marine organisms is crucial to understanding their ecological roles and advancing our knowledge of marine ecosystem functioning. The aim of this study was to analyse the trophic ecology of two demersal predator species, black anglerfish (Lophius budegassa) and white anglerfish (L. piscatorius), in the northwestern Mediterranean Sea. Both species are important in the study area due to their high abundance and economic value, but information about their feeding behaviour is scarce. Here, we described the diet composition and ecological role of these two species, investigating whether trophic segregation exists between them and amongst fish of different sizes. In addition, by using experimental survey data we described the spatial distribution of both species to help us interpret trophic behaviour patterns. We gathered samples of two different sizes (small individuals of a total length <30 cm and large individuals ≥30 cm) of both species and combined stomach content analyses (SCA) and stable isotope analyses (SIA) of nitrogen and carbon with isotopic mixing models. Our results revealed that both anglerfish species are opportunistic predators, showing a diet composed mainly of fishes and, to a lesser extent, of crustaceans, with a small proportion of cephalopods, gastropods, bivalves and echinoderms. We found trophic segregation between the two species and the two sizes, indicating that they feed on different prey, in line with differences in their spatial distribution within the study area. This partial partition of food resources could also be explained by the differences in rhythms of activity that were reported in previous studies. In addition, although both species occupied a high position within the food web, our results showed that white anglerfish individuals and the large-sized fish of both species held higher trophic positions. This study demonstrates the usefulness of complementary approaches for trophic studies and confirms that both anglerfish species play an important role as predators in the northwestern Mediterranean Sea food web.

Systematic review of the design, implementation and effectiveness of mass media and nutrition education interventions for infant and young child feeding.

PubMed

Graziose, Matthew M; Downs, Shauna M; O'Brien, Quentin; Fanzo, Jessica

2018-02-01

To systematically review the design, implementation and effectiveness of mass media and nutrition education interventions for improving infant and young child feeding (IYCF) practices and related psychosocial factors. A search of PubMed, Embase and PsycINFO databases, a Google search, and a consultation with experts in the field of IYCF performed in July 2016. Low- and middle-income countries, as defined by the World Bank Group. Eligible studies: included a mass media component (with or without nutrition education); conducted a pre-post evaluation (with or without a control group); assessed IYCF knowledge, attitudes, beliefs and/or practices; and were published in English between 2000 and present. Eighteen unique studies were identified that examined the effect of mass media (types included: television; print; voice and/or SMS (text) messages; radio; megaphones/loudspeakers; videos; social media; songs/dramas) and nutrition education interventions on IYCF practices within thirteen countries. Of these, fifteen studies reported improvements in breast- and/or complementary feeding practices, using indicators recommended by the WHO, and six studies reported improvements in related psychosocial factors. However, little detail was provided on the use of formative research, a formal behaviour change theory and behaviour change techniques. Few studies reported both dose delivered and participants' exposure to the intervention. Despite evidence of effectiveness, few common elements in the design of interventions were identified. Future research should consistently report these details to open the 'black box' of IYCF interventions, identify effective design components and ensure replicability.

Complementary and alternative approaches used by parents of children with epilepsy on epilepsy management.

PubMed

Işler, Ayşegül; Turan, Fatma Dilek; Gözüm, Sebahat; Oncel, Selma

2014-03-01

The aim of this study was to determine the complementary and alternative approaches used by parents of children with epilepsy on epilepsy management. This descriptive study included a total of 304 parents of children with epilepsy aged between 0 and 18years evaluated at the Pediatric Neurology Clinic of Akdeniz University Hospital in Turkey between January and May 2013. Data were collected by using a questionnaire developed by the researchers. It was determined that all the parents use complementary and alternative approaches for their children with epilepsy, and the most common approaches are praying (99.3%); keeping their children away from the effects of smoking (79.8%); feeding their children walnuts (79.6%), butter (59.2%), and bone marrow (58.6%); providing their children with good quality sleep (58.6%); and enabling their children to play games (51%). The approaches commonly applied during seizures include praying (96.2%), comforting their children in their arms and showing affection (55.6%), waiting for seizures to finish at home (45.7%), and laying children on their side (41.1%). Of parents, 98% stated that alternative approaches enable them to control their child's seizures, 100% said that alternative approaches have no adverse effect, and 98.4% stated that they will continue to use these approaches. The children's approaches to cope with epilepsy included looking after pets (72.7%), listening to music (70.1%), watching television (64.5%), playing games (55.3%), praying (51%), and spending time with friends (48.7%). Most of the approaches used by parents and children with epilepsy for the management of illness are determined to consist of complementary approaches that may contribute to management of epilepsy. Knowing the approaches of parents and children with epilepsy that could adversely affect disease management is important for educating parents and children to avoid these potentially harmful interventions. Copyright © 2013 Elsevier Inc. All rights reserved.

Results with Complementary Food Using Local Food Ingredients.

PubMed

Ahmed, Tahmeed; Islam, Munirul; Choudhury, Nuzhat; Hossain, Iqbal; Huq, Sayeeda; Mahfuz, Mustafa; Sarker, Shafiqul Alam

2017-01-01

Appropriate complementary food is a must for optimum growth of infants and children. The food should be diverse and be given in sufficient quantities 2-4 times a day depending upon age. Poverty, food insecurity, and lack of awareness regarding the choice of nutritious food ingredients are deterrents to optimum complementary feeding. In Bangladesh, 77% of children do not receive appropriate complementary food and, hence, the high prevalence of childhood malnutrition. We developed ready-to-use complementary foods (RUCFs) using locally available food ingredients, rice/lentil and chickpea, which conform to standard specifications. These foods were found to be acceptable by children and their mothers compared to the Pushti packet, the cereal-based supplement used in the erstwhile National Nutrition Program of Bangladesh. In a cluster-randomized community-based trial in rural Bangladesh among more than 5,000 children, the efficacy of rice/lentil- and chickpea-based RUCFs was compared with another commonly used supplementary food called wheat-soy blend++ (WSB++) and a commercial product called Plumpy'doz. Deceleration in length for age was significantly lower (by 0.02-0.04/month) in the rice/lentil, Plumpy'doz, and chickpea groups compared to the control group at 18 months of age. Weight-for-length z-score decline was lower only in Plumpy'doz and chickpea groups. WSB++ was not different from the control group. In children who received chickpea RUCF or Plumpy'doz, the prevalence of stunting was 5-6% lower at 18 months. These foods can be used to prevent or treat malnutrition among children, particularly those from food-insecure households. © 2017 Nestec Ltd., Vevey/S. Karger AG, Basel.

Feeding practices and nutritional status of HIV-exposed and HIV-unexposed infants in the Western Cape

PubMed Central

Cornell, Morna; Cotton, Mark F.; Esser, Monika M.

2016-01-01

Background Optimal infant- and young child–feeding practices are crucial for nutritional status, growth, development, health and, ultimately, survival. Human breast milk is optimal nutrition for all infants. Complementary food introduced at the correct age is part of optimal feeding practices. In South Africa, widespread access to antiretrovirals and a programme to prevent mother-to-child transmission of HIV have reduced HIV infection in infants and increased the number of HIV-exposed uninfected (HEU) infants. However, little is known about the feeding practices and nutritional status of HEU and HIV-unexposed (HU) infants. Objective To assess the feeding practices and nutritional status of HIV-exposed and HIV-unexposed (HU) infants in the Western Cape. Design Prospective substudy on feeding practices nested in a pilot study investigating the innate immune abnormalities in HEU infants compared to HU infants. The main study commenced at week 2 of life with the nutrition component added from 6 months. Information on children’s dietary intake was obtained at each visit from the caregiver, mainly the mother. Head circumference, weight and length were recorded at each visit. Data were obtained from 6-, 12- and 18-month visits. World Health Organization feeding practice indicators and nutrition indicators were utilised. Setting Tygerberg Academic Hospital, Western Cape. Mothers were recruited from the postnatal wards. Subjects Forty-seven mother–infant pairs, 25 HEU and 22 HU infants, participated in this nutritional substudy. Eight (17%) infants, one HU and seven HEU, were lost to follow-up over the next 12 months. The HEU children were mainly Xhosa (76%) and HU were mainly mixed race (77%). Results The participants were from poor socio-economic backgrounds. In both groups, adherence to breastfeeding recommendations was low with suboptimal dietary diversity. We noted a high rate of sugar- and salt-containing snacks given from a young age. The HU group had poorer anthropometric and nutritional indicators not explained by nutritional factors alone. However, alcohol and tobacco use was much higher amongst the HU mothers. Conclusion Adherence to breastfeeding recommendations was low. Ethnicity and cultural milieu may have influenced feeding choices and growth. Further research is needed to understand possible reasons for the poorer nutritional and anthropometric indicators in the HU group. PMID:29568600

A step-by-step introduction to vegetables at the beginning of complementary feeding. The effects of early and repeated exposure.

PubMed

Hetherington, Marion M; Schwartz, C; Madrelle, J; Croden, F; Nekitsing, C; Vereijken, C M J L; Weenen, H

2015-01-01

Breastfeeding (BF) is associated with willingness to accept vegetables. This may be due to the variety of flavours delivered via breast milk. Some mothers add vegetables to milk during complementary feeding (CF) to enhance acceptance. The present study tested a step-by-step exposure to vegetables in milk then rice during CF, on intake and liking of vegetables. Just before CF, enrolled mothers were randomised to an intervention (IG, n = 18; 6 BF) or control group (CG, n = 18; 6 BF). IG infants received 12 daily exposures to vegetable puree added to milk (days 1-12), then 12 × 2 daily exposures to vegetable puree added to rice at home (days 13-24). Plain milk and rice were given to CG. Then both received 11 daily exposures to vegetable puree. Intake was weighed and liking rated on days 25-26 and 33-35 after the start of CF in the laboratory, supplemented by the same data recorded at home. Vegetables were rotated daily (carrots, green beans, spinach, broccoli). Intake, liking and pace of eating were greater for IG than CG infants. Intake and liking of carrots were greater than green beans. However, at 6m then 18m follow up, vegetable (carrot > green beans) but not group differences were observed. Mothers reported appreciation of the structure and guidance of this systematic approach. Early exposure to vegetables in a step-by-step method could be included in CF guidelines and longer term benefits assessed by extending the exposure period. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effectiveness in improving knowledge, practices, and intakes of "key problem nutrients" of a complementary feeding intervention developed by using linear programming: experience in Lombok, Indonesia.

PubMed

Fahmida, Umi; Kolopaking, Risatianti; Santika, Otte; Sriani, Sriani; Umar, Jahja; Htet, Min Kyaw; Ferguson, Elaine

2015-03-01

Complementary feeding recommendations (CFRs) with the use of locally available foods can be developed by using linear programming (LP). Although its potential has been shown for planning phases of food-based interventions, the effectiveness in the community setting has not been tested to our knowledge. We aimed to assess effectiveness of promoting optimized CFRs for improving maternal knowledge, feeding practices, and child intakes of key problem nutrients (calcium, iron, niacin, and zinc). A community-intervention trial with a quasi-experimental design was conducted in East Lombok, West Nusa Tenggara Province, Indonesia, on children aged 9-16 mo at baseline. A CFR group (n = 240) was compared with a non-CFR group (n = 215). The CFRs, which were developed using LP, were promoted in an intervention that included monthly cooking sessions and weekly home visits. The mother's nutrition knowledge and her child's feeding practices and the child's nutrient intakes were measured before and after the 6-mo intervention by using a structured interview, 24-h recall, and 1-wk food-frequency questionnaire. The CFR intervention improved mothers' knowledge and children's feeding practices and improved children's intakes of calcium, iron, and zinc. At the end line, median (IQR) nutrient densities were significantly higher in the CFR group than in the non-CFR group for iron [i.e., 0.6 mg/100 kcal (0.4-0.8 mg/100 kcal) compared with 0.5 mg/100 kcal (0.4-0.7 mg/100 kcal)] and niacin [i.e., 0.8 mg/100 kcal (0.5-1.0 mg/100 kcal) compared with 0.6 mg/100 kcal (0.4-0.8 mg/100 kcal)]. However, median nutrient densities for calcium, iron, niacin, and zinc in the CFR group (23, 0.6, 0.7, and 0.5 mg/100 kcal, respectively) were still below desired densities (63, 1.0, 0.9, and 0.6 mg/100 kcal, respectively). The CFRs significantly increased intakes of calcium, iron, niacin, and zinc, but nutrient densities were still below desired nutrient densities. When the adoption of optimized CFRs is constrained by economic access for or acceptability of nutrient-dense foods, other strategies need to be incorporated into interventions to ensure adequate intakes of these nutrients. © 2015 American Society for Nutrition.

Species and tissues specific differentiation of processed animal proteins in aquafeeds using proteomics tools.

PubMed

Rasinger, J D; Marbaix, H; Dieu, M; Fumière, O; Mauro, S; Palmblad, M; Raes, M; Berntssen, M H G

2016-09-16

The rapidly growing aquaculture industry drives the search for sustainable protein sources in fish feed. In the European Union (EU) since 2013 non-ruminant processed animal proteins (PAP) are again permitted to be used in aquafeeds. To ensure that commercial fish feeds do not contain PAP from prohibited species, EU reference methods were established. However, due to the heterogeneous and complex nature of PAP complementary methods are required to guarantee the safe use of this fish feed ingredient. In addition, there is a need for tissue specific PAP detection to identify the sources (i.e. bovine carcass, blood, or meat) of illegal PAP use. In the present study, we investigated and compared different protein extraction, solubilisation and digestion protocols on different proteomics platforms for the detection and differentiation of prohibited PAP. In addition, we assessed if tissue specific PAP detection was feasible using proteomics tools. All work was performed independently in two different laboratories. We found that irrespective of sample preparation gel-based proteomics tools were inappropriate when working with PAP. Gel-free shotgun proteomics approaches in combination with direct spectral comparison were able to provide quality species and tissue specific data to complement and refine current methods of PAP detection and identification. To guarantee the safe use of processed animal protein (PAP) in aquafeeds efficient PAP detection and monitoring tools are required. The present study investigated and compared various proteomics workflows and shows that the application of shotgun proteomics in combination with direct comparison of spectral libraries provides for the desired species and tissue specific classification of this heat sterilized and pressure treated (≥133°C, at 3bar for 20min) protein feed ingredient. Copyright © 2016 Elsevier B.V. All rights reserved.

Growing normally in an urban environment: positive deviance among slum children of Vadodara, India.

PubMed

Kanani, Shubhada; Popat, Kamal

2012-05-01

To assess factors contributing to positive deviance among the urban poor of Vadodara city. Mothers of sixty 6-18 mo old children- 30 each in positive deviant (PD: normal by weight-age) and negative deviant (ND: grade II by weight-age) groups-were interviewed through home visits using semi-structured questionnaires. Factors contributing significantly to PD (p < 0.01): PD children (vs. ND), were older (12-18 mo vs. 6-11 mo); families were smaller (5-7 vs. >7 members), of lower parity (1-2 vs. 3-4), greater birth interval (>3 y vs. 1-2 y); received colostrum (96% vs. 26%), breastfed at least 8-9 times/d (86% vs. 20%); were started on complementary feeds (CF) at 6-8 mo (53% vs. 23%); given thicker consistency CF (73% vs. 36%); fed actively (40% vs. 23%), fewer had diarrhea episodes in past 15 d (26% vs. 83%). Mean calorie intake (% RDA) from CF among PD was significantly higher than in ND (68% vs.42%). Factors contributing to PD in urban poor families are similar to those reported in rural India; which implies that ICDS-Health services for both urban and rural poor need to ensure that national IYCF guidelines-healthcare recommendations are followed by communities. Further research relating PD to desirable complementary feeding and hygiene-healthcare practices in rural and urban areas is required.

Influence of infant feeding patterns over the first year of life on growth from birth to 5 years.

PubMed

Betoko, A; Lioret, S; Heude, B; Hankard, R; Carles, S; Forhan, A; Regnault, N; Botton, J; Charles, M A; de Lauzon-Guillain, B

2017-08-01

As early-life feeding experiences may influence later health, we aimed to examine relations between feeding patterns over the first year of life and child's growth in the first 5 years of life. Our analysis included 1022 children from the EDEN mother-child cohort. Three feeding patterns were previously identified, i.e. 'Later dairy products introduction and use of ready-prepared baby foods' (pattern-1), 'Long breastfeeding, later main meal food introduction and use of home-made foods' (pattern-2) and 'Use of ready-prepared adult foods' (pattern-3). Associations between the feeding patterns and growth [weight, height and body mass index {BMI}] were analysed by multivariable linear regressions. Anthropometric changes were assessed by the final value adjusted for the initial value. Even though infant feeding patterns were not related to anthropometric measurements at 1, 3 and 5 years, high scores on pattern-1 were associated with higher 1-3 years weight and height changes. High scores on pattern-2 were related to lower 0-1 year weight and height changes, higher 1-5 years weight and height changes but not to BMI changes, after controlling for a wide range of potential confounding variables including parental BMI. Scores on pattern-3 were not significantly related to growth. Additional adjustment for breastfeeding duration reduced the strength of the associations between pattern-2 and growth but not those between pattern-1 and height growth. Our findings emphasize the relevance of considering infant feeding patterns including breastfeeding duration, age of complementary foods introduction as well as type of foods used when examining effects of early infant feeding practices on later health. © 2017 World Obesity Federation. © 2017 World Obesity Federation.

Promotion of breastfeeding in Poland: the current situation.

PubMed

Królak-Olejnik, Barbara; Błasiak, Ilona; Szczygieł, Anna

2017-12-01

Objective Exclusive breastfeeding is safe and beneficial for healthy infants; it is the optimal feeding method during the first 6 months of life. Infants should be complementary fed in conjunction with breastfeeding until 12 months of age or longer. The aim of the present study was to analyse the duration of breastfeeding through 12 months of age. Methods Participants were 1679 women from 42 randomly selected hospitals in Poland. The data were obtained from surveys, including a paper and pencil interview that was conducted after mothers delivered in the hospital and before discharge. Computer aided telephone interviews were administered at 2, 4, 6 and 12 months. Results There was a high rate of initiating breastfeeding after birth (97%), a rapid abandonment of exclusive breastfeeding (43.5% at 2 months, 28.9% at 4 months and 4% at 6 months) and an onset of formula feeding during the first days of life, which is contrary to current recommendations. Conclusions It is necessary re-educate mothers, medical staff who care for mothers and children during the perinatal period, and other specialists.

Large-Scale Behavior-Change Initiative for Infant and Young Child Feeding Advanced Language and Motor Development in a Cluster-Randomized Program Evaluation in Bangladesh.

PubMed

Frongillo, Edward A; Nguyen, Phuong H; Saha, Kuntal K; Sanghvi, Tina; Afsana, Kaosar; Haque, Raisul; Baker, Jean; Ruel, Marie T; Rawat, Rahul; Menon, Purnima

2017-02-01

Promoting adequate nutrition through interventions to improve infant and young child feeding (IYCF) has the potential to contribute to child development. We examined whether an intensive intervention package that was aimed at improving IYCF at scale through the Alive & Thrive initiative in Bangladesh also advanced language and gross motor development, and whether advancements in language and gross motor development were explained through improved complementary feeding. A cluster-randomized design compared 2 intervention packages: intensive interpersonal counseling on IYCF, mass media campaign, and community mobilization (intensive) compared with usual nutrition counseling and mass media campaign (nonintensive). Twenty subdistricts were randomly assigned to receive either the intensive or the nonintensive intervention. Household surveys were conducted at baseline (2010) and at endline (2014) in the same communities (n = ∼4000 children aged 0-47.9 mo for each round). Child development was measured by asking mothers if their child had reached each of multiple milestones, with some observed. Linear regression accounting for clustering was used to derive difference-in-differences (DID) impact estimates, and path analysis was used to examine developmental advancement through indicators of improved IYCF and other factors. The DID in language development between intensive and nonintensive groups was 1.05 milestones (P = 0.001) among children aged 6-23.9 mo and 0.76 milestones (P = 0.038) among children aged 24-47.9 mo. For gross motor development, the DID was 0.85 milestones (P = 0.035) among children aged 6-23.9 mo. The differences observed corresponded to age- and sex-adjusted effect sizes of 0.35 for language and 0.23 for gross motor development. Developmental advancement at 6-23.9 mo was partially explained through improved minimum dietary diversity and the consumption of iron-rich food. Intensive IYCF intervention differentially advanced language and gross motor development, which was partially explained through improved complementary feeding. Measuring a diverse set of child outcomes, including functional outcomes such as child development, is important when evaluating integrated nutrition programs. This trial was registered at clinicaltrials.gov as NCT01678716. © 2017 American Society for Nutrition.

Sensitive detection of porcine DNA in processed animal proteins using a TaqMan real-time PCR assay.

PubMed

Pegels, N; González, I; Fernández, S; García, T; Martín, R

2012-01-01

A TaqMan real-time PCR method was developed for specific detection of porcine-prohibited material in industrial feeds. The assay combines the use of a porcine-specific primer pair, which amplifies a 79 bp fragment of the mitochondrial (mt) 12 S rRNA gene, and a locked nucleic acid (LNA) TaqMan probe complementary to a target sequence lying between the porcine-specific primers. The nuclear 18 S rRNA gene system, yielding a 77 bp amplicon, was employed as a positive amplification control to monitor the total content of amplifiable DNA in the samples. The specificity of the porcine primers-probe system was verified against different animal and plant species, including mammals, birds and fish. The applicability of the real-time PCR protocol to detect the presence of porcine mt DNA in feeds was determined through the analysis of 190 industrial feeds (19 known reference and 171 blind samples) subjected to stringent processing treatments. The performance of the method allows qualitative and highly sensitive detection of short fragments from porcine DNA in all the industrial feeds declared to contain porcine material. Although the method has quantitative potential, the real quantitative capability of the assay is limited by the existing variability in terms of composition and processing conditions of the feeds, which affect the amount and quality of amplifiable DNA.

Breastfeeding, Childhood Asthma, and Allergic Disease.

PubMed

Oddy, Wendy H

2017-01-01

The worldwide prevalence of childhood asthma has been increasing considerably, and the protection afforded by breastfeeding in its development has been the subject of controversy for more than 80 years. Previous systematic reviews have generally found a protective effect of breastfeeding on allergic outcomes, although many studies have methodological limitations. Although breastfeeding is protective against lower respiratory tract infection during infancy, such protection has not been demonstrated for asthma in all studies. Breastfeeding has health benefits for the mother and child. Exclusive breastfeeding for the first 6 months of an infant's life, with continued breastfeeding for up to 2 years or longer, is recognized as the "gold" standard for infant feeding because human milk is uniquely suited to the human infant, and its nutritional content and bioactivity promote a healthy development. There is increasing concern that the practice of delaying complementary foods until 6 months may exacerbate the risk of allergic disease. Breast milk contains immunological components that protect against infections and allergic disease in infancy. The composition of human breast milk is complex, containing factors that interact with the infant immune system and intestinal milieu including allergens, cytokines, immunoglobulins, polyunsaturated fatty acids, and chemokines. Transforming growth factor β is a cytokine in human milk involved in maintaining intestinal homeostasis, inflammation regulation, and oral tolerance development. Modern day society, with increased standards of hygiene, has changed the gut flora of Western infants, potentially impacting the risk of developing immune-mediated diseases including allergic disease and asthma. Microbial diversity is intrinsic to healthy immune maturation and function. Compared to breastfed infants, formula-fed infants had lower bacterial diversity and an altered intestinal microbiota in the first few weeks of life associated with an increased risk of eczema and asthma. Favorable gut colonization through continued breastfeeding may promote tolerance as well as protection when complementary feeding is initiated. © 2017 S. Karger AG, Basel.

Can gossip change nutrition behaviour? Results of a mass media and community-based intervention trial in East Java, Indonesia.

PubMed

White, Sian; Schmidt, Wolf; Sahanggamu, Daniel; Fatmaningrum, Dewi; van Liere, Marti; Curtis, Val

2016-03-01

It is unclear how best to go about improving child feeding practices. We studied the effect of a novel behaviour change intervention, Gerakan Rumpi Sehat (the Healthy Gossip Movement), on infant and young child feeding practices in peri-urban Indonesia. The pilot intervention was designed based on the principles of a new behaviour change theory, Behaviour Centred Design (BCD). It avoided educational messaging in favour of employing emotional drivers of behaviour change, such as affiliation, nurture and disgust and used television commercials, community activations and house-to-house visits as delivery channels. The evaluation took the form of a 2-arm cluster randomised trial with a non-randomised control arm. One intervention arm received TV only, while the other received TV plus community activations. The intervention components were delivered over a 3-month period in 12 villages in each arm, each containing an average of 1300 households. There were two primary outcomes: dietary diversity of complementary food and the provision of unhealthy snacks to children aged 6-24 months. Dietary diversity scores increased by 0.8 points in the arm exposed to TV adverts only (95% CI: 0.4-1.2) and a further 0.2 points in the arm that received both intervention components (95% CI: 0.6-1.4). In both intervention arms, there were increases in the frequency of vegetable and fruit intake. We found inconsistent evidence of an effect on unhealthy snacking. The study suggests that novel theory-driven approaches which employ emotional motivators are capable of having an effect on improving dietary diversity and the regularity of vegetable and fruit intake among children aged 6-24 months. Mass media can have a measurable effect on nutrition-related behaviour, but these effects are likely to be enhanced through complementary community activations. Changing several behaviours at once remains a challenge. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Introduction of complementary foods in infancy and atopic sensitization at the age of 5 years: timing and food diversity in a Finnish birth cohort.

PubMed

Nwaru, B I; Takkinen, H-M; Niemelä, O; Kaila, M; Erkkola, M; Ahonen, S; Tuomi, H; Haapala, A-M; Kenward, M G; Pekkanen, J; Lahesmaa, R; Kere, J; Simell, O; Veijola, R; Ilonen, J; Hyöty, H; Knip, M; Virtanen, S M

2013-04-01

To study the associations between timing and diversity of introduction of complementary foods during infancy and atopic sensitization in 5-year-old children. In the Finnish DIPP (type 1 diabetes prediction and prevention) birth cohort (n = 3781), data on the timing of infant feeding were collected up to the age of 2 years and serum IgE antibodies toward four food and four inhalant allergens measured at the age of 5 years. Logistic regression was used for the analyses. Median duration of exclusive and total breastfeeding was 1.4 (interquartile range: 0.2-3.5) and 7.0 (4.0-11.0) months, respectively. When all the foods were studied together and adjusted for confounders, short duration of breastfeeding decreased the risk of sensitization to birch allergen; introduction of oats <5.1 months and barley <5.5 months decreased the risk of sensitization to wheat and egg allergens, and oats additionally associated with milk, timothy grass, and birch allergens. Introduction of rye <7.0 months decreased the risk of sensitization to birch allergen. Introduction of fish <6 months and egg ≤11 months decreased the risk of sensitization to all the specific allergens studied. The introduction of <3 food items at 3 months was associated with sensitization to wheat, timothy grass, and birch allergens; the introduction of 1-2 food items at 4 months and ≤4 food items at 6 months was associated with all endpoints, but house dust mite. These results were particularly evident among high-risk children when the results were stratified by atopic history, indicating the potential for reverse causality. The introduction of complementary foods was consecutively done, and with respect to the timing of each food, early introduction of complementary foods may protect against atopic sensitization in childhood, particularly among high-risk children. Less food diversity as already at 3 months of age may increase the risk of atopic sensitization. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

In Situ Estuarine and Marine Toxicity Testing: A Review, Including Recommendations for Future Use in Ecological Risk Assessment

DTIC Science & Technology

2009-09-01

testing may be a preferable or complementary strategy in certain situations utilizing a weight of evidence approach (Baird et al. 2007). One of the most...embryonic development, or post-exposure feeding rate are discussed. It is acknowledged that a plethora of additional endpoints have utility for use in situ...example, may have proven utility , it is generally preferable to evaluate toxicity using ecologically relevant species and life stages (i.e., those

A Month of Breastfeeding Associated with Greater Adherence to Pediatric Nutrition Guidelines

PubMed Central

Khalessi, Ali; Reich, Stephanie M.

2013-01-01

Background Research has shown that both breastfeeding and delaying the introduction of solids or liquids other than breast milk protect against obesity later in early childhood. Objectives To compare whether breastfeeding mothers adhere to more of the American Academy of Pediatrics (AAP) feeding recommendations for infants. Method This longitudinal study compared the breastfeeding knowledge, intentions, and practices as well as complementary feeding choices of 163 ethnically diverse, primiparous women over the first 18 months of motherhood. Results Although almost all women knew about the health benefits of (98%) breastfeeding and intended to (98%) breastfeed, only 85% initiated and 51% continued beyond 4 weeks. Breastfeeding for longer durations was associated with better feeding choices. Mothers who breastfed for more weeks were more likely to adhere to AAP guidelines on liquids other than breast milk at 4, 6, and 12 months, and introduce solids, liquids other than breast milk, and other complimentary foods at later ages. Furthermore, mothers who breastfed for less than 1 month were more likely to introduce solids by 2 months in comparison to mothers who breastfed for 1 month or more (OR=3.22). Conclusion Knowledge and intentions do not explain breastfeeding initiation or continuation. However, when women committed to more weeks of breastfeeding, especially more than 4 weeks, they made better nutrition choices for their infants. PMID:24062596

Carbohydrate composition, viscosity, solubility, and sensory acceptance of sweetpotato- and maize-based complementary foods

PubMed Central

Amagloh, Francis Kweku; Mutukumira, Anthony N.; Brough, Louise; Weber, Janet L.; Hardacre, Allan; Coad, Jane

2013-01-01

Background Cereal-based complementary foods from non-malted ingredients form a relatively high viscous porridge. Therefore, excessive dilution, usually with water, is required to reduce the viscosity to be appropriate for infant feeding. The dilution invariably leads to energy and nutrient thinning, that is, the reduction of energy and nutrient densities. Carbohydrate is the major constituent of food that significantly influences viscosity when heated in water. Objectives To compare the sweetpotato-based complementary foods (extrusion-cooked ComFa, roller-dried ComFa, and oven-toasted ComFa) and enriched Weanimix (maize-based formulation) regarding their 1) carbohydrate composition, 2) viscosity and water solubility index (WSI), and 3) sensory acceptance evaluated by sub-Sahara African women as model caregivers. Methods The level of simple sugars/carbohydrates was analysed by spectrophotometry, total dietary fibre by enzymatic-gravimetric method, and total carbohydrate and starch levels estimated by calculation. A Rapid Visco™ Analyser was used to measure viscosity. WSI was determined gravimetrically. A consumer sensory evaluation was used to evaluate the product acceptance of the roller-dried ComFa, oven-toasted ComFa, and enriched Weanimix. Results The sweetpotato-based complementary foods were, on average, significantly higher in maltose, sucrose, free glucose and fructose, and total dietary fibre, but they were markedly lower in starch content compared with the levels in the enriched Weanimix. Consequently, the sweetpotato-based complementary foods had relatively low apparent viscosity, and high WSI, than that of enriched Weanimix. The scores of sensory liking given by the caregivers were highest for the roller-dried ComFa, followed by the oven-toasted ComFa, and, finally, the enriched Weanimix. Conclusion The sweetpotato-based formulations have significant advantages as complementary food due to the high level of endogenous sugars and low starch content that reduce the viscosity, increase the solubility, impart desirable sensory characteristics, and potentially avoid excessive energy and nutrient thinning. PMID:23516115

Effects of varied energy density of complementary foods on breast-milk intakes and total energy consumption by healthy, breastfed Bangladeshi children.

PubMed

Islam, M Munirul; Peerson, Janet M; Ahmed, Tahmeed; Dewey, Kathryn G; Brown, Kenneth H

2006-04-01

Information is needed to design studies of the effects of complementary feeding regimens on children's intakes of complementary foods (CFs) and breast milk. We evaluated the effects of varied energy density of CFs on the time until stabilization of dietary intakes and on total daily energy intakes (EIs) and breast-milk intakes. CFs with low [0.4 kcal/g (LD)] and high [1.5 kcal/g (HD)] energy density were fed 3 times/d to 10 children (aged 9-18 mo) during 2 randomly assigned sequences of three 8-d diet periods (HD-LD-HD or LD-HD-LD) along with ad libitum breastfeeding. CF and breast-milk intakes were measured. Intakes of the HD diet and breast milk did not vary by day of period, but intake of the LD diet increased progressively. During days 5-7 of the last 2 diet periods in each sequence, more of the LD than of the HD diet was consumed (752 +/- 252 and 439 +/- 111 g/d, respectively; P < 0.001), but EIs from CFs were greater with the HD diet. Breast-milk consumption was slightly less (192 +/- 115 and 234 +/- 121 g/d, respectively; P = 0.03) but total daily EI was greater (774 +/- 175 and 441 +/- 85 kcal/d, respectively; P < 0.001) during the HD than during the LD diet period. New information on the effects of newly introduced diets on daily intakes of these diets and of breast milk can be used to design future studies. Total daily EIs were greater with the HD diet despite its negative effects on breast-milk intakes.

Dent and Flint maize diversity panels reveal important genetic potential for increasing biomass production.

PubMed

Rincent, R; Nicolas, S; Bouchet, S; Altmann, T; Brunel, D; Revilla, P; Malvar, R A; Moreno-Gonzalez, J; Campo, L; Melchinger, A E; Schipprack, W; Bauer, E; Schoen, C-C; Meyer, N; Ouzunova, M; Dubreuil, P; Giauffret, C; Madur, D; Combes, V; Dumas, F; Bauland, C; Jamin, P; Laborde, J; Flament, P; Moreau, L; Charcosset, A

2014-11-01

Genetic and phenotypic analysis of two complementary maize panels revealed an important variation for biomass yield. Flowering and biomass QTL were discovered by association mapping in both panels. The high whole plant biomass productivity of maize makes it a potential source of energy in animal feeding and biofuel production. The variability and the genetic determinism of traits related to biomass are poorly known. We analyzed two highly diverse panels of Dent and Flint lines representing complementary heterotic groups for Northern Europe. They were genotyped with the 50 k SNP-array and phenotyped as hybrids (crossed to a tester of the complementary pool) in a western European field trial network for traits related to flowering time, plant height, and biomass. The molecular information revealed to be a powerful tool for discovering different levels of structure and relatedness in both panels. This study revealed important variation and potential genetic progress for biomass production, even at constant precocity. Association mapping was run by combining genotypes and phenotypes in a mixed model with a random polygenic effect. This permitted the detection of significant associations, confirming height and flowering time quantitative trait loci (QTL) found in literature. Biomass yield QTL were detected in both panels but were unstable across the environments. Alternative kinship estimator only based on markers unlinked to the tested SNP increased the number of significant associations by around 40% with a satisfying control of the false positive rate. This study gave insights into the variability and the genetic architectures of biomass-related traits in Flint and Dent lines and suggests important potential of these two pools for breeding high biomass yielding hybrid varieties.

Timing of infant feeding in relation to childhood asthma and allergic diseases.

PubMed

Nwaru, Bright I; Takkinen, Hanna-Mari; Niemelä, Onni; Kaila, Minna; Erkkola, Maijaliisa; Ahonen, Suvi; Haapala, Anna-Maija; Kenward, Michael G; Pekkanen, Juha; Lahesmaa, Riitta; Kere, Juha; Simell, Olli; Veijola, Riitta; Ilonen, Jorma; Hyöty, Heikki; Knip, Mikael; Virtanen, Suvi M

2013-01-01

Emerging evidence questions current recommendations on the timing of infant feeding for the prevention of childhood allergies. The evidence for asthma is inconclusive. We sought to investigate the associations between the duration of breast-feeding and timing of introduction of complementary foods and the development of asthma and allergies by the age of 5 years. Data were analyzed for 3781 consecutively born children. The dietary exposures were categorized into thirds and analyzed as time-dependent variables. Asthma, allergic rhinitis, and atopic eczema end points were assessed by using the International Study of Asthma and Allergies in Childhood questionnaire, whereas IgE antibodies were analyzed from serum samples at the age of 5 years. Cox proportional hazard and logistic regressions were used for the analyses. The median duration of exclusive and total breast-feeding was 1.4 months (interquartile range, 0.2-3.5 months) and 7.0 months (interquartile range, 4.0-11.0 months), respectively. Total breast-feeding of 9.5 months or less was associated with an increased risk of nonatopic asthma. Introduction of wheat, rye, oats, or barley at 5 to 5.5 months was inversely associated with asthma and allergic rhinitis, whereas introduction of other cereals at less than 4.5 months increased the risk of atopic eczema. Introduction of egg at 11 months or less was inversely associated with asthma, allergic rhinitis, and atopic sensitization, whereas introduction of fish at 9 months or less was inversely associated with allergic rhinitis and atopic sensitization. Early introduction of wheat, rye, oats, and barley cereals; fish; and egg (respective to the timing of introduction of each food) seems to decrease the risk of asthma, allergic rhinitis, and atopic sensitization in childhood. Longer duration of total breast-feeding, rather than its exclusivity, was protective against the development of nonatopic but not atopic asthma, suggesting a potential differing effect of breast-feeding on different asthma phenotypes. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Grandmothers' knowledge positively influences maternal knowledge and infant and young child feeding practices.

PubMed

Karmacharya, Chandni; Cunningham, Kenda; Choufani, Jowel; Kadiyala, Suneetha

2017-08-01

To examine associations between grandmothers' knowledge and infant and young child feeding (IYCF) practices and to test whether the associations are independent of or operate via maternal knowledge. Cross-sectional household survey data from households with a child under 5 years (n 4080). We used multivariate regression analyses, adjusted for child, maternal, grandmother and household characteristics, and district-level clustering, to test associations between grandmothers' knowledge and IYCF practices for children aged 6-24 months living with a grandmother. We used causal mediation to formally test the direct effect of grandmothers' knowledge on IYCF practices v. maternal knowledge mediating these associations. Two hundred and forty rural communities, sixteen districts of Nepal. Children aged 6-24 months (n1399), including those living with grandmothers (n 748). We found that the odds of optimal breast-feeding practices were higher (early breast-feeding initiation: 2·2 times, P=0·002; colostrum feeding: 4·2 times, P<0·001) in households where grandmothers had correct knowledge v. those with incorrect knowledge. The same pattern was found for correct timing of introduction of water (2·6), milk (2·4), semi-solids (3·2), solids (2·9), eggs (2·6) and meat (2·5 times; all P<0·001). For the two pathways we were able to test, mothers' correct knowledge mediated these associations between grandmothers' knowledge and IYCF practices: colostrum feeding (b=10·91, P<0·001) and the introduction of complementary foods (b=5·18, P<0·001). Grandmothers' correct knowledge translated into mothers' correct knowledge and, therefore, optimal IYCF practices. Given grandmothers' influence in childcare, engagement of grandmothers in health and nutrition interventions could improve mothers' knowledge and facilitate better child feeding.

Undernutrition status and associated factors in under-5 children, in Tigray, Northern Ethiopia.

PubMed

Alemayehu, Mussie; Tinsae, Fitiwi; Haileslassie, Kiday; Seid, Oumer; Gebregziabher, Gebremedhin; Yebyo, Henock

2015-01-01

The aim of this study was to assess the nutritional status and associated factors in children <5 y in the Medebay Zana District, northern Ethiopia. A community-based cross-sectional study was conducted in the Medebay Zana District from September 8 to 29, 2013. A two-stage cluster-sampling technique was used to select 605 children age <5 y. Descriptive, binary, and multiple logistic regression analyses were performed. The results of this study demonstrated that the level of stunting was 56.6%, underweight 45.3%, and wasting 34.6%. Stunting was predicted by having mothers who attended high school (adjusted odds ratio [AOR], 0.75; 95% confidence interval [CI], 0.09-0.85), living in a household where providing priority food was given to the father (AOR, 4.32; 95% CI, 2.10-9.05), and water was taken from unprotected sources (AOR, 2.13; 95% CI, 1.09-4.14). In all children, initiation of breast-feeding within 1 to 3 h after birth (AOR, 4.06; 95% CI, 1.77-9.33), having mothers who could make financial decisions (AOR, 0.09; 95% CI, 0.02-0.51), and being breast-fed for 12 to 23 mo (AOR, 0.07; 95% CI, 0.01-0.40) were predictors of wasting. Moreover, in girls (AOR, 1.84; 95% CI, 1.25, 2.69), initiation of breast-feeding 6 h after birth (AOR, 12.94; 95% CI, 4.04-41.49) and having mothers who could make financial decisions (AOR, 0.33; 95% CI, 0.15-0.74) were predictors of being underweight. The undernutrition status among children <5 y was high. Children's age group, time initiation of breast-feeding, child's sex, source of water, parents' educational status, type of food used for starting of complementary feeding, and mothers' financial decision-making ability could have an influence in undernutrition of children in this age group. Copyright © 2015 Elsevier Inc. All rights reserved.

An Exploration of Edible Palm Weevil Larvae (Akokono) as a Source of Nutrition and Livelihood: Perspectives From Ghanaian Stakeholders.

PubMed

Laar, Amos; Kotoh, Agnes; Parker, Megan; Milani, Peiman; Tawiah, Charlotte; Soor, Shobhita; Anankware, Jacob P; Kalra, Nikhila; Manu, Grace; Tandoh, Akua; Zobrist, Stephanie; Engmann, Cyril; Pelto, Gretel

2017-12-01

Meeting the nutritive needs of infants and young children is a challenge in Ghana. Alternative animal source foods, including insects, could enhance infant and young child dietary quality while also improving livelihoods. To investigate the perspectives of Ghanaian stakeholders on the acceptability of the palm weevil larvae ( akokono) as a food source and the feasibility of micro-farming this local edible insect as a complementary food for infants and young children. We conducted an ethnographic study in the Brong-Ahafo Region of Ghana. First, 48 caregivers were asked questions about feeding and care practices, including attitudes toward production and consumption of akokono. Then, a selection of previously interviewed respondents joined 1 of 8 focus group discussions to provide further insight on key themes that emerged from earlier interviews. Concurrently, interviews with 25 other key local stakeholders were conducted. Respondents generally had favorable perceptions of akokono as a nutritious food. A small minority would not consume akokono for religious reasons. Key factors positively influencing the acceptability of akokono as a complementary food were familiarity with the consumption of akokono by the primary caregiver and health worker endorsement of akokono. Stakeholders consider the larvae farmable and were open to its domestication. Anticipated barriers to scaling up akokono micro-farming include a need for greater familiarity with and acceptance of the insect as food for infants and young children and creation of a sustainable market. Engagement with stakeholders, including health workers, will facilitate use of akokono as a complementary food.

Complementary and alternative medicine for pediatric otitis media.

PubMed

Levi, Jessica R; Brody, Robert M; McKee-Cole, Katie; Pribitkin, Edmund; O'Reilly, Robert

2013-06-01

To review the literature involving complementary and alternative medicine (CAM) for pediatric otitis media. Multiple modalities are discussed, including prevention involving breastfeeding, nutrition, and vaccination; symptomatic treatment involving homeopathy, natural health products, and probiotics; manual manipulations involving osteopathy and chiropractics; and traditional Chinese and Japanese medicine. The information presented will assist physicians in advising patients on their decision-making during the early stages of otitis media when antibiotics and surgery are not yet indicated. A systematic literature search was conducted through January 2012 in PubMed using MESH term "otitis media" in conjunction with "complementary therapies," "homeopathy," "manipulation, osteopathic," "manipulation, chiropractic," "acupuncture therapy," "probiotics," "naturopathy," and "xylitol." Theses searches yielded 163 unique results. Abstracts and titles were evaluated for relevance. Case reports, case series, randomized controlled trials, and basic science research were included. Publications not relevant to the discussion of alternative medicine in otitis media were excluded. Bibliographies were checked for further publications. Thirty-six unique publications were reviewed. Of all therapies in complementary and alternative medicine, only xylitol has been studied in well-designed, randomized, blinded trials; it is likely effective, but compliance limits its applicability. Management of acute otitis media begins with watchful waiting. Herbal eardrops may help relieve symptoms. Homeopathic treatments may help decrease pain and lead to faster resolution. Prevention should be emphasized with elimination of risk factors, such as second hand smoke and bottle-feeding, as well as maintaining nutrition and vaccinations. Vitamin supplementation may be helpful. Probiotics and xylitol may be beneficial as well. Traditional Chinese/Japanese therapies show promising results but remain speculative until further research is conducted. Severe cases of otitis media with complications or those that fail to improve with observation or CAM (after 48-72h) should be treated with antibiotics and, in some cases, surgical intervention. It is best to consult a physician when making treatment decisions for full guidance on the risks and benefits of any treatment option. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Modernization is associated with intensive breastfeeding patterns in the Bolivian Amazon.

PubMed

Veile, Amanda; Martin, Melanie; McAllister, Lisa; Gurven, Michael

2014-01-01

For many traditional, non-industrialized populations, intensive and prolonged breastfeeding buffers infant health against poverty, poor sanitation, and limited health care. Due to novel influences on local economies, values, and beliefs, the traditional and largely beneficial breastfeeding patterns of such populations may be changing to the detriment of infant health. To assess if and why such changes are occurring in a traditional breastfeeding population, we document breastfeeding patterns in the Bolivian Tsimane, a forager-horticulturalist population in the early stages of modernization. Three predictions are developed and tested to evaluate the general hypothesis that modernizing influences encourage less intensive breastfeeding in the Tsimane: 1) Tsimane mothers in regions of higher infant mortality will practice more intensive BF; 2) Tsimane mothers who are located closer to a local market town will practice more intensive BF; and 3) Older Tsimane mothers will practice more intensive BF. Predictions were tested using a series of maternal interviews (from 2003 to 2011, n = 215) and observations of mother-infant dyads (from 2002 to 2007, n = 133). Tsimane breastfeeding patterns were generally intensive: 72% of mothers reported initiating BF within a few hours of birth, mean (±SD) age of CF introduction was 4.1 ± 2.0 months, and mean (±SD) weaning age was 19.2 ± 7.3 months. There was, however, intra-population variation in several dimensions of breastfeeding (initiation, frequency, duration, and complementary feeding). Contrary to our predictions, breastfeeding was most intensive in the most modernized Tsimane villages, and maternal age was not a significant predictor of breastfeeding patterns. Regional differences accounted for variation in most dimensions of breastfeeding (initiation, frequency, and complementary feeding). Future research should therefore identify constraints on breastfeeding in the less modernized Tsimane regions, and examine the formation of maternal beliefs regarding infant feeding. Copyright © 2013 Elsevier Ltd. All rights reserved.

Local food-based complementary feeding recommendations developed by the linear programming approach to improve the intake of problem nutrients among 12-23-month-old Myanmar children.

PubMed

Hlaing, Lwin Mar; Fahmida, Umi; Htet, Min Kyaw; Utomo, Budi; Firmansyah, Agus; Ferguson, Elaine L

2016-07-01

Poor feeding practices result in inadequate nutrient intakes in young children in developing countries. To improve practices, local food-based complementary feeding recommendations (CFR) are needed. This cross-sectional survey aimed to describe current food consumption patterns of 12-23-month-old Myanmar children (n 106) from Ayeyarwady region in order to identify nutrient requirements that are difficult to achieve using local foods and to formulate affordable and realistic CFR to improve dietary adequacy. Weekly food consumption patterns were assessed using a 12-h weighed dietary record, single 24-h recall and a 5-d food record. Food costs were estimated by market surveys. CFR were formulated by linear programming analysis using WHO Optifood software and evaluated among mothers (n 20) using trial of improved practices (TIP). Findings showed that Ca, Zn, niacin, folate and Fe were 'problem nutrients': nutrients that did not achieve 100 % recommended nutrient intake even when the diet was optimised. Chicken liver, anchovy and roselle leaves were locally available nutrient-dense foods that would fill these nutrient gaps. The final set of six CFR would ensure dietary adequacy for five of twelve nutrients at a minimal cost of 271 kyats/d (based on the exchange rate of 900 kyats/USD at the time of data collection: 3rd quarter of 2012), but inadequacies remained for niacin, folate, thiamin, Fe, Zn, Ca and vitamin B6. TIP showed that mothers believed liver and vegetables would cause worms and diarrhoea, but these beliefs could be overcome to successfully promote liver consumption. Therefore, an acceptable set of CFR were developed to improve the dietary practices of 12-23-month-old Myanmar children using locally available foods. Alternative interventions such as fortification, however, are still needed to ensure dietary adequacy of all nutrients.

Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation123

PubMed Central

Rawat, Rahul; Nguyen, Phuong Hong; Tran, Lan Mai; Hajeebhoy, Nemat; Nguyen, Huan Van; Baker, Jean; Frongillo, Edward A; Ruel, Marie T; Menon, Purnima

2017-01-01

Background: Rigorous evaluations of health system–based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys (n = ∼500 children aged 6–23.9 mo and ∼1000 children aged 24–59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%). Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P < 0.05] and minimum acceptable diet (8.0 pps; P < 0.05). Significant stunting declines occurred in both intensive (7.1 pps) and nonintensive (5.4 pps) groups among children aged 24–59.9 mo, with no differential decline. Conclusions: When combined with MM and CM, an at-scale social franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623. PMID:28179488

Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation.

PubMed

Rawat, Rahul; Nguyen, Phuong Hong; Tran, Lan Mai; Hajeebhoy, Nemat; Nguyen, Huan Van; Baker, Jean; Frongillo, Edward A; Ruel, Marie T; Menon, Purnima

2017-04-01

Background: Rigorous evaluations of health system-based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys ( n = ∼500 children aged 6-23.9 mo and ∼1000 children aged 24-59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%). Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P < 0.05] and minimum acceptable diet (8.0 pps; P < 0.05). Significant stunting declines occurred in both intensive (7.1 pps) and nonintensive (5.4 pps) groups among children aged 24-59.9 mo, with no differential decline. Conclusions: When combined with MM and CM, an at-scale social franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623.

Severe physical violence between intimate partners during pregnancy: a risk factor for early cessation of exclusive breast-feeding.

PubMed

Moraes, Claudia L; de Oliveira, Alessandra S D; Reichenheim, Michael E; Lobato, Gustavo

2011-12-01

To investigate the role of severe physical violence during pregnancy (SPVP) between intimate partners in early cessation of exclusive breast-feeding (EBF). A health services survey. The revised Conflict Tactics Scale was used to characterize SPVP; premature breast-feeding cessation was identified using a current status data approach, which was based on the information reported from food recall during the preceding 7 d. The cumulative hazard function was estimated by complementary log-log transformation models, which allowed the ensuing estimation of early breast-feeding cessation rates in different age groups and the ratio of rates of weaning between women exposed and not exposed to violence. Five large public primary health-care facilities of Rio de Janeiro, Brazil. The sample comprised 811 randomly selected mothers of children under 5 months of age who were waiting to be consulted. SPVP is an independent risk factor of cessation of EBF since, after controlling for socio-economic, demographic, reproductive and lifestyle variables, women exposed to violence presented an incidence density that was 31% higher than those who were not exposed (hazard ratio = 1·30, 95% CI 1·01, 1·69). The findings corroborate the hypothesis that SPVP is an important risk factor for EBF. This indicates the need for incentives to adequately train health-care personnel in dealing with lactating women in order to gain a broader view of breast-feeding beyond the biological aspects of lactation, including the maternal psychological dimension.

What could infant and young child nutrition learn from sweatshops?

PubMed Central

2011-01-01

Background Adequate infant and young child nutrition demands high rates of breastfeeding and good access to nutrient rich complementary foods, requiring public sector action to promote breastfeeding and home based complementary feeding, and private sector action to refrain from undermining breastfeeding and to provide affordable, nutrient rich complementary foods. Unfortunately, due to a lack of trust, the public and private sectors, from both the North and the South, do not work well together in achieving optimal infant and young child nutrition. Discussion As the current debate in infant and young child nutrition is reminiscent of the "sweatshop" debate fifteen years ago, we argue that lessons from the sweatshops debate regarding cooperation between public and private sectors - and specific organizational experiences such as the Ethical Trading Initiative in which companies, trade unions, and civil society organizations work together to enhance implementation of labour standards and address alleged allegations - could serve as a model for improving cooperation and trust between public, civil society and private groups, and ultimately health, in infant and young child nutrition. Summary Lessons from the sweatshops debate could serve as a model to promote cooperation and trust between public and private groups, such that they learn to work together towards their common goal of improving infant and young child nutrition. PMID:21545745

What could infant and young child nutrition learn from sweatshops?

PubMed

Singer, Peter A; Ansett, Sean; Sagoe-Moses, Isabella

2011-05-05

Adequate infant and young child nutrition demands high rates of breastfeeding and good access to nutrient rich complementary foods, requiring public sector action to promote breastfeeding and home based complementary feeding, and private sector action to refrain from undermining breastfeeding and to provide affordable, nutrient rich complementary foods. Unfortunately, due to a lack of trust, the public and private sectors, from both the North and the South, do not work well together in achieving optimal infant and young child nutrition. As the current debate in infant and young child nutrition is reminiscent of the "sweatshop" debate fifteen years ago, we argue that lessons from the sweatshops debate regarding cooperation between public and private sectors - and specific organizational experiences such as the Ethical Trading Initiative in which companies, trade unions, and civil society organizations work together to enhance implementation of labour standards and address alleged allegations - could serve as a model for improving cooperation and trust between public, civil society and private groups, and ultimately health, in infant and young child nutrition. Lessons from the sweatshops debate could serve as a model to promote cooperation and trust between public and private groups, such that they learn to work together towards their common goal of improving infant and young child nutrition.

Overall review of feed-in tariff and renewable portfolio standard policy: A perspective of China

NASA Astrophysics Data System (ADS)

Yan, Q. Y.; Zhang, Q.; Yang, L.; Wang, X.

2016-08-01

A major share of China's total carbon dioxide (CO2) emissions is from the electric power sector. To solve this problem, Chinese government has implemented many renewable energy policies in the electric power sector. In China, the most popular renewable energy policies are Feed-in tariff (FIT) and renewable portfolio standard (RPS). This paper first introduces the current development of renewable electricity generation. Second the design plan and implement of FIT and RPS in China's thermal electricity generation sector are summarized in this paper. Third this paper establishes a complementary mode of FIT and RPS which can provide a stable environment to make the FIT and RPS work together. Finally, based on the above analysis, this paper proposes relative suggestions for the implementation of FIT and RPS in China making recommendation for the development of electricity generation from renewable energy.

Near-infrared microscopic methods for the detection and quantification of processed by-products of animal origin

NASA Astrophysics Data System (ADS)

Abbas, O.; Fernández Pierna, J. A.; Dardenne, P.; Baeten, V.

2010-04-01

Since the BSE crisis, researches concern mainly the detection, identification, and quantification of meat and bone meal with an important focus on the development of new analytical methods. Microscopic based spectroscopy methods (NIR microscopy - NIRM or/and NIR hyperspectral imaging) have been proposed as complementary methods to the official method; the optical microscopy. NIR spectroscopy offers the advantage of being rapid, accurate and independent of human analyst skills. The combination of an NIR detector and a microscope or a camera allows the collection of high quality spectra for small feed particles having a size larger than 50 μm. Several studies undertaken have demonstrated the clear potential of NIR microscopic methods for the detection of animal particles in both raw and sediment fractions. Samples are sieved and only the gross fraction (superior than 250 μm) is investigated. Proposed methodologies have been developed to assure, with an acceptable level of confidence (95%), the detection of at least one animal particle when a feed sample is adulterated at a level of 0.1%. NIRM and NIR hyperspectral imaging are running under accreditation ISO 17025 since 2005 at CRA-W. A quantitative NIRM approach has been developed in order to fulfill the new requirements of the European commission policies. The capacities of NIRM method have been improved; only the raw fraction is analyzed, both the gross and the fine fractions of the samples are considered, and the acquisition parameters are optimized (the aperture, the gap, and the composition of the animal feed). A mapping method for a faster collection of spectra is also developed. The aim of this work is to show the new advances in the analytical methods developed in the frame of the feed ban applied in Europe.

Ameliorating Role of Lycopene, Tomato Puree, and Spirulina + Tomato Puree on the Hematology of Fluoride-Exposed Swiss Albino Mice.

PubMed

Sharma, Shweta; Parashar, Puneet; Sharma, Subhasini; Sharma, Kanta Prasad

2018-01-16

Plant species rich in antioxidants (vitamins, flavonoids, lignans, and carotenoids) have been explored for complementary therapy of chronic diseases (cancers, coronary heart disease) and mitigation of pollutant toxicity. This article investigates their ameliorative role on selective hematological and serum biochemical parameters in fluoride-exposed (190 mg/kg body weight) Swiss albino mice pretreated with the antioxidant-rich diet supplements tomato puree (with and without peels), spirulina (cyanobacteria), and lycopene (present in tomato) for 45 days prior to entry into experimental protocol. Compared with standard feed control, diet-modulated controls had more hairy and lustrous white fur, hemodilution, increase in platelet counts (2- to 5-fold), red blood cell (RBC) size (11%-14%), mean corpuscular hemoglobin (Hb) concentration (MCHC; 5%-14%), and serum albumin (23%-27%). Fluoride-exposed mice reared on standard feed had less hairy, pale white, lusterless fur and black nails, reduction in RBC and white blood cell (WBC) counts and Hb content, and morphological abnormalities in RBCs (poikilocytosis). By contrast, fur quality of fluoride-treated diet-modulated groups was similar to standard feed control; counts and morphology of their RBCs and Hb content similar to the respective controls, and increase in WBC counts greater than controls. In comparison to the fluoride-treated standard feed group, platelet counts were higher in the treated mice of the diet-modulated groups. This study thus revealed the hemoprotective role of diet supplements in fluoride-treated mice. Considering the prevalence of fluoride-induced chronic toxicity in developing countries, our findings have relevance in minimizing hematological disorders among people residing in the fluoride-affected areas, because indigenously cultivated low-price tomato fruits are easily available for consumption.

Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality

PubMed Central

Ogbo, Felix A.; Agho, Kingsley; Ogeleka, Pascal; Woolfenden, Sue; Page, Andrew; Eastwood, John

2017-01-01

Background The impacts of optimal infant feeding practices on diarrhoea have been documented in some developing countries, but not in countries with high diarrhoea mortality as reported by the World Health Organisation/United Nations Children’s Fund. We aimed to investigate the association between infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality. Method The study used the most recent Demographic and Health Survey datasets collected in nine sub-Saharan African countries with high diarrhoea mortality, namely: Burkina Faso (2010, N = 9,733); Demographic Republic of Congo (2013; N = 10,458); Ethiopia (2013, N = 7,251); Kenya (2014, N = 14,034); Mali (2013, N = 6,365); Niger (2013, N = 7,235); Nigeria (2013, N = 18,539); Tanzania (2010, N = 5,013); and Uganda (2010, N = 4,472). Multilevel logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between infant feeding practices and diarrhoea in these nine African countries. Results Diarrhoea prevalence was lower among children whose mothers practiced early initiation of breastfeeding, exclusive and predominant breastfeeding. Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with lower risk of diarrhoea (OR = 0.81; 95% confidence interval (CI): 0.77–0.85, P<0.001 and OR = 0.50; 95%CI: 0.43–0.57, respectively). In contrast, introduction of complementary foods (OR = 1.31; 95%CI: 1.14–1.50) and continued breastfeeding at one year (OR = 1.27; 95%CI: 1.05–1.55) were significantly associated with a higher risk of diarrhoea. Conclusion Early initiation of breastfeeding and exclusive breastfeeding are protective of diarrhoea in sub-Saharan African countries with high diarrhoea mortality. To reduce diarrhoea mortality and also achieve the health-related sustainable development goals in sub-Saharan African, an integrated, multi-agency strategic partnership within each country is needed to improve optimal infant feeding practices. PMID:28192518

Positive impact of child feeding training program for primary care health professionals: a cluster randomized field trial.

PubMed

Vitolo, Márcia Regina; Louzada, Maria Laura da Costa; Rauber, Fernanda

2014-12-01

To assess the impact of a child feeding training program for primary care health professionals about breastfeeding and complementary feeding practices. Cluster-randomized field trial conducted in the city of Porto Alegre, (RS), Brazil. Twenty primary health care centers (HCC) were randomized into intervention (n = 9) and control (n = 11) groups. The health professionals (n = 200) at the intervention group centers received training about healthy feeding practices. Pregnant women were enrolled at the study. Up to six months of child's age, home visits were made to obtain variables related to breastfeeding and introduction of foods. 619 children were evaluated: 318 from the intervention group and 301 from the control group. Exclusive breastfeeding prevalence in the first (72.3 versus 59.4%; RR = 1.21; 95%CI 1.08 - 1.38), second (62.6 versus 48.2%; RR = 1.29; 95%CI 1.10 - 1.53), and third months of life (44.0% versus 34.6%; RR = 1.27; 95%CI 1.04 - 1.56) was higher in the intervention group compared to the control group. The prevalence of children who consumed meat four or five times per week was higher in the intervention group than in the control group (36.8 versus 22.6%; RR = 1.62; 95%CI 1.32 - 2.03). The prevalence of children who had consumed soft drinks (34.9 versus 52.5%; RR = 0.66; 95%CI 0.54 - 0.80), chocolate (24.5 versus 36.7% RR = 0.66 95%CI 0.53 - 0.83), petit suisse (68.9 versus 79.7; 95%CI 0.75 - 0.98) and coffee (10.4 versus 20.1%; RR = 0.51; 95%CI 0.31 - 0.85) in their six first months of life was lower in the intervention group. The training of health professionals had a positive impact on infant feeding practices, contributing to the promotion of child health.

Nutritional interventions or exposures in infants and children aged up to 3 years and their effects on subsequent risk of overweight, obesity and body fat: a systematic review of systematic reviews.

PubMed

Patro-Gołąb, Bernadeta; Zalewski, Bartłomiej M; Kołodziej, Maciej; Kouwenhoven, Stefanie; Poston, Lucilla; Godfrey, Keith M; Koletzko, Berthold; van Goudoever, Johannes Bernard; Szajewska, Hania

2016-12-01

This study, performed as part of the international EarlyNutrition research project (http://www.project-earlynutrition.eu), provides a systematic review of systematic reviews on the effects of nutritional interventions or exposures in children (up to 3 years of age) on the subsequent risk of obesity, overweight and adiposity. Electronic databases (including MEDLINE, Embase and Cochrane Library) were searched up until September 2015. Forty systematic reviews were included. A consistent association of breastfeeding with a modest reduction in the risk of later overweight and obesity in childhood and adulthood was found (the odds decreased by 13% based on high-quality studies), but residual confounding cannot be excluded. Lowering the protein content of infant formula is a promising intervention to reduce the risk of later overweight and obesity in children. There is no consistent evidence of an association of the age of introducing complementary foods, sugar-sweetened beverage or energy intake in early childhood with later overweight/obesity, but there are some indications of an association of protein intake during the complementary feeding period with later overweight/obesity. There was inadequate evidence to determine the effects of other nutritional interventions or exposures, including modifications of infant formula composition, fat intake or consumption of different food groups. © 2016 World Obesity Federation.

The Pathways from a Behavior Change Communication Intervention to Infant and Young Child Feeding in Bangladesh Are Mediated and Potentiated by Maternal Self-Efficacy.

PubMed

Zongrone, Amanda A; Menon, Purnima; Pelto, Gretel H; Habicht, Jean-Pierre; Rasmussen, Kathleen M; Constas, Mark A; Vermeylen, Francoise; Khaled, Adiba; Saha, Kuntal K; Stoltzfus, Rebecca J

2018-02-01

Although self-efficacy is a potential determinant of feeding and care behaviors, there is limited empirical analysis of the role of maternal self-efficacy in low- and middle-income countries. In the context of behavior change interventions (BCIs) addressing complementary feeding (CF), it is possible that maternal self-efficacy can mediate or enhance intervention impacts. In the context of a BCI in Bangladesh, we studied the role of maternal self-efficacy for CF (MSE-CF) for 2 CF behaviors with the use of a theoretically grounded empirical model of determinants to illustrate the potential roles of MSE-CF. We developed and tested a locally relevant scale for MSE-CF and included it in a survey (n = 457 mothers of children aged 6-24 mo) conducted as part of a cluster-randomized evaluation. Qualitative research was used to inform the selection of 2 intervention-targeted behaviors: feeding green leafy vegetables in the last 24 h (GLV) and on-time introduction of egg (EGG) between 6 and 8 mo of age. We then examined direct, mediated, and potentiated paths of MSE-CF in relation to the impacts of the BCI on these behaviors with the use of regression and structural equation modeling. GLV and EGG were higher in the intensive group than in the nonintensive control group (16.0 percentage points for GLV; P < 0.001; 11.2 percentage points for EGG; P = 0.037). For GLV, MSE-CF mediated (β = 0.345, P = 0.010) and potentiated (β = 0.390, P = 0.038) the effect of the intensive group. In contrast, MSE-CF did not mediate or potentiate the effect of the intervention on EGG. MSE-CF was a significant mediator and potentiator for GLV but not for EGG. The divergent findings highlight the complex determinants of individual specific infant and young child feeding behaviors. The study shows the value of measuring behavioral determinants, such as MSE-CF, that affect a caregiver's capability to adopt intervention-targeted behaviors.

Complementary models of tree species-soil relationships in old-growth temperate forests

USGS Publications Warehouse

Cross, Alison; Perakis, Steven S.

2011-01-01

Ecosystem level studies identify plant soil feed backs as important controls on soil nutrient availability,particularly for nitrogen and phosphorus. Although site and species specific studies of tree species soil relationships are relatively common,comparatively fewer studies consider multiple coexisting speciesin old-growth forests across a range of sites that vary underlying soil fertility. We characterized patterns in forest floor and mineral soil nutrients associated with four common tree species across eight undisturbed old-growth forests in Oregon, USA, and used two complementary conceptual models to assess tree species soil relationships. Plant soil feedbacks that could reinforce sitelevel differences in nutrient availability were assessed using the context dependent relationships model, where by relative species based differences in each soil nutrient divergedorconvergedas nutrient status changed across sites. Tree species soil relationships that did not reflect strong feedbacks were evaluated using a site independent relationships model, where by forest floor and surface mineral soil nutrient tools differed consistently by tree species across sites,without variation in deeper mineral soils. We found that theorganically cycled elements carbon, nitrogen, and phosphorus exhibited context-dependent differences among species in both forest floor and mineral soil, and most of ten followed adivergence model,where by species differences were greatest at high-nutrient sites. These patterns are consistent with the oryemphasizing biotic control of these elements through plant soil feedback mechanisms. Site independent species differences were strongest for pool so if the weather able cations calcium, magnesium, potassium,as well as phosphorus, in mineral soils. Site independent species differences in forest floor nutrients we reattributable too nespecies that displayed significant greater forest floor mass accumulation. Our finding confirmed that site-independent and context-dependent tree species-soil relationships occur simultaneouslyinold-grow the temperate forests, with context-dependent relationships strongest for organically cycled elements, and site-independent relationships strongest for weather able elements with in organic cycling phases. These models provide complementary explanations for patterns of nutrient accumulation and cycling in mixed species old-growth temperate forests.

Atmospheric ammonia mixing ratios at an open-air cattle feeding facility.

PubMed

Hiranuma, Naruki; Brooks, Sarah D; Thornton, Daniel C O; Auvermann, Brent W

2010-02-01

Mixing ratios of total and gaseous ammonia were measured at an open-air cattle feeding facility in the Texas Panhandle in the summers of 2007 and 2008. Samples were collected at the nominally upwind and downwind edges of the facility. In 2008, a series of far-field samples was also collected 3.5 km north of the facility. Ammonium concentrations were determined by two complementary laboratory methods, a novel application of visible spectrophotometry and standard ion chromatography (IC). Results of the two techniques agreed very well, and spectrophotometry is faster, easier, and cheaper than chromatography. Ammonia mixing ratios measured at the immediate downwind site were drastically higher (approximately 2900 parts per billion by volume [ppbv]) than thos measured at the upwind site (< or = 200 ppbv). In contrast, at 3.5 km away from the facility, ammonia mixing ratios were reduced to levels similar to the upwind site (< or = 200 ppbv). In addition, PM10 (particulate matter < 10 microm in optical diameter) concentrations obtained at each sampling location using Grimm portable aerosol spectrometers are reported. Time-averaged (1-hr) volume concentrations of PM10 approached 5 x 10(12) nm3 cm(-3). Emitted ammonia remained largely in the gas phase at the downwind and far-field locations. No clear correlation between concentrations of ammonia and particles was observed. Overall, this study provides a better understanding of ammonia emissions from open-air animal feeding operations, especially under the hot and dry conditions present during these measurements.

Consensus Communication on Early Peanut Introduction and Prevention of Peanut Allergy in High-Risk Infants.

PubMed

Fleischer, David M; Sicherer, Scott; Greenhawt, Matthew; Campbell, Dianne; Chan, Edmond; Muraro, Antonella; Halken, Susanne; Katz, Yitzhak; Ebisawa, Motohiro; Eichenfield, Lawrence; Sampson, Hugh; Lack, Gideon; Du Toit, George; Roberts, Graham; Bahnson, Henry; Feeney, Mary; Hourihane, Jonathan; Spergel, Jonathan; Young, Michael; As'aad, Amal; Allen, Katrina; Prescott, Susan; Kapur, Sandeep; Saito, Hirohisa; Agache, Ioana; Akdis, Cezmi A; Arshad, Hasan; Beyer, Kirsten; Dubois, Anthony; Eigenmann, Philippe; Fernandez-Rivas, Monserrat; Grimshaw, Kate; Hoffman-Sommergruber, Karin; Host, Arne; Lau, Susanne; O'Mahony, Liam; Mills, Clare; Papadopoulos, Nikolaus; Venter, Carina; Agmon-Levin, Nancy; Kessel, Aaron; Antaya, Richard; Drolet, Beth; Rosenwasser, Lanny

2016-01-01

The purpose of this brief communication is to highlight emerging evidence regarding potential benefits of supporting early rather than delayed peanut introduction during the period of complementary food introduction in infants. This document should be considered as interim guidance based on consensus among the following organizations: American Academy of Allergy, Asthma, and Immunology, American Academy of Pediatrics, American College of Allergy, Asthma, and Immunology, Australasian Society of Clinical Immunology and Allergy, Canadian Society of Allergy and Clinical Immunology, European Academy of Allergy and Clinical Immunology, Israel Association of Allergy and Clinical Immunology, Japanese Society for Allergology, Society for Pediatric Dermatology, and World Allergy Organization. More formal guidelines regarding early-life, complementary feeding practices and the risk of allergy development will follow in the next year from the National Institute of Allergy and Infectious Diseases-sponsored Working Group and the European Academy of Allergy and Clinical Immunology. © 2015 the Authors. Published by Wiley Periodicals, Inc.

Mother, Infant, and Household Factors Associated with the Type of Food Infants Receive in Developing Countries

PubMed Central

Yarnoff, Benjamin; Allaire, Benjamin; Detzel, Patrick

2014-01-01

Objectives: We explore the complex factors associated with infant feeding by analyzing what mother, infant, and household factors are associated with the types of food given to infants. We seek to quantify associations in order to inform public health policy about the importance of target populations for infant feeding programs. Methods: We used data from the Demographic Health Survey in 20 developing countries for multiple years to examine mother, infant, and household factors associated with six types of food given to infants (exclusive breastfeeding, non-exclusive breastfeeding, infant formula, milk liquids, non-milk liquids, and solid foods). We performed a seemingly unrelated regressions analysis with community-year fixed effects to account for correlation between food types and control for confounding factors associated with community resources, culture, time period, and geography in the pooled analysis. Results: We found that several mother, infant, and household characteristics were associated with each of the feeding types. Most notably, mother’s education, working status, and weight are significantly associated with the type of food given to infants. We provide quantified estimates of the association of each of these variables with six types of food given to infants. Conclusion: By identifying maternal characteristics associated with infant feeding and quantifying those associations, we help public health policymakers generate priorities for targeting infant feeding programs to specific populations that are at greatest risk. Higher educated, working mothers are best to target with exclusive breastfeeding programs for young infants. Mothers with lower education are best to target with complementary feeding programs in infants older than 1 year. Finally, while maternal weight is associated with higher levels of exclusive breastfeeding the association is too weak to merit targeting of breastfeeding programs to low-weight mothers. PMID:24616887

Impact of small quantity lipid‐based nutrient supplements on infant and young child feeding practices at 18 months of age: results from four randomized controlled trials in Africa

PubMed Central

Abbeddou, Souheila; Kumwenda, Chiza; Okronipa, Harriet; Hemsworth, Jaimie; Jimenez, Elizabeth Yakes; Ocansey, Eugenia; Lartey, Anna; Ashorn, Ulla; Adu‐Afarwuah, Seth; Vosti, Stephen A.; Hess, Sonja Y.; Dewey, Kathryn G.

2016-01-01

Abstract Optimal infant and young child feeding (IYCF) practices can help ensure nutrient adequacy and support healthy growth and development. Small‐quantity lipid‐based nutrient supplements (SQ‐LNS) have been proposed to help fill nutrient gaps, but little is known about the impact of provision of SQ‐LNS on breastfeeding or complementary feeding practices. In the context of four coordinated randomized controlled nutrient supplementation trials in diverse sites in Africa, we compared IYCF practices at infant age 18 months (after 9–12 months of supplementation) between those receiving and not receiving SQ‐LNS. Practices were assessed by caregiver recall. Continued breastfeeding ranged from 74% (Ghana site) to 97% (Burkina Faso site) and did not differ between groups in any site; prevalence of frequent breastfeeding also did not differ. In two sites (Burkina Faso and Malawi), infants receiving SQ‐LNS were more likely to meet the World Health Organization recommendations for frequency of feeding (percentage point differences of 12–14%, P < 0.0001 and P = 0.005, respectively; the remaining two sites did not have data for this indicator). Most indicators of infant dietary diversity did not differ between groups in any site, but in the same two sites where frequency of feeding differed, infants receiving SQ‐LNS were less likely to have low frequency of consumption of animal‐source foods in the previous week (percentage point differences of 9–19% for lowest tertile, P = .02 and P = 0.04, respectively). We conclude that provision of SQ‐LNS did not negatively impact self‐reported IYCF practices and may have positively impacted frequency of feeding. PMID:27910260

Determinants of daily path length in black and gold howler monkeys (Alouatta caraya) in northeastern Argentina.

PubMed

Raño, Mariana; Kowalewski, Martin M; Cerezo, Alexis M; Garber, Paul A

2016-08-01

Models used to explain the social organization of primates suggest that variation in daily path length (DPL) is a response to variation in resource distribution and the intensity of intragroup feeding competition. However, daily path length may be affected by a number of other factors including the availability and distribution of nutritionally complementary food items, temperature which can influence activity budget, patterns of subgrouping, and the frequency and function of intergroup encounters. In this 6-month study (total 495 hr of quantitative data), we examined daily path lengths in two neighboring groups of black and gold howler monkeys (Alouatta caraya) inhabiting a semi-deciduous gallery forest in San Cayetano (27° 30'S, 58° 41'W), in the northwest province of Corrientes, Argentina. Both study groups were of similar size and composition. We identified relationships across groups between time spent feeding on fruits, leaves, and flowers, the number of trees visited, group spread, frequency of intergroup encounters, mean daily temperature, and DPL. Our results suggest that variation in food availability had a significant impact on howler ranging behavior by increasing DPL under conditions of high immature and mature fruit availability, and by decreasing DPL with increased availability and increased time invested in feeding on mature leaves. These results do not support the contention that a reduction in food availability or an increase in within-group feeding competition increased DPL in black and gold howler monkeys. DPL in black and gold howlers is influenced by several interrelated factors. In this regard we suggest that models of socio-ecology and ecological constraints need to reconsider how factors such as individual nutritional requirements, social tolerance and group cohesion, and the spatial and temporal availability of preferred and nearby food resources influence primate ranging behavior. Am. J. Primatol. 78:825-837, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A correlation between macronutrient balancing and insect host-plant range: evidence from the specialist caterpillar Spodoptera exempta (Walker).

PubMed

Lee, Kwang Pum; Raubenheimer, David; Behmer, Spencer T; Simpson, Stephen J

2003-12-01

In an earlier study, we showed that the ingestive responses of the generalist caterpillar Spodoptera littoralis to foods imbalanced in their protein:carbohydrate content is similar to generalist locusts, but differs from that of specialist-feeding locusts. Here we further pursued the comparison by repeating the experiments using a closely related specialist caterpillar, Spodoptera exempta. First, caterpillars were allowed to self-compose a diet of preferred protein:carbohydrate balance by mixing between nutritionally complementary foods. Then, they were confined to one of five imbalanced foods, in which we measured the trade-off between over- and under-ingesting the two nutrients. On complementary foods, the caterpillars actively regulated their protein and carbohydrate intake. In the no-choice experiment, those fed excess-protein foods ingested small surpluses of protein compared with generalist feeders, thus showing a pattern of nutrient balancing similar to that observed in specialist locusts. Utilisation data indicated that ingested excesses and deficits were to some extent offset by differential utilisation. Evidence also showed that post-ingestive responses of the specialist S. exempta were less flexible than those observed in the generalist S. littoralis, a pattern which is again in accordance with comparisons of acridids differing in their host-plant range.

Factors Associated with Salmonella Prevalence in U.S. Swine Grower-Finisher Operations, 2012.

PubMed

Bjork, Kathe E; Fields, Victoria; Garber, Lindsey P; Kopral, Christine A

2018-05-15

Nontyphoidal Salmonella is an important foodborne pathogen with diverse serotypes occurring in animal and human populations. The prevalence of the organism on swine farms has been associated with numerous risk factors, and although there are strong veterinary public health controls for preventing Salmonella from entering food, there remains interest in eradicating or controlling the organism in the preharvest environment. In this study, using data collected via the U.S. Department of Agriculture (USDA) National Animal Health Monitoring System Swine 2012 study, we describe nontyphoidal Salmonella and specific serotype prevalence on U.S. grower-finisher swine operations and investigate associations between Salmonella detection and numerous factors via multiple correspondence analysis (MCA) and regression analysis. MCA plots, complementary to univariate analyses, display relationships between covariates and Salmonella detection at the farm level. In the univariate analysis, Salmonella detection varied with feed characteristics and farm management practices, reports of diseases on farms and vaccinations administered, and administration of certain antimicrobials. Results from the univariate analysis reinforce the importance of biosecurity in managing diseases and pathogens such as Salmonella on farms. All multivariable regression models for the likelihood of Salmonella detection were strongly affected by multicollinearity among variables, and only one variable, pelleted feed preparation, remained in the final model. The study was limited by its cross-sectional nature, timelines of data collection, and reliance on operator-reported data via a convenience sample.

The contribution of breast milk to toddler diets in western Kenya.

PubMed Central

Onyango, Adelheid W.; Receveur, Olivier; Esrey, Steven A.

2002-01-01

OBJECTIVE: To understand the relative contributions of breast milk and the weaning diet to overall nutrient intake, with a view to designing and implementing appropriate programmes to improve complementary feeding in developing countries. METHODS: Complementary food intake was measured in a sample of 250 toddlers (mean baseline age: 13.9 +/- 2.4 months) using 24-h dietary recall interviews administered once every 3 weeks over a 6-month period. Breast-milk intake over a 24-h period was measured using the test-weighing method in a subsample of 50 children. Regression effects of age and sex on observed milk intakes were estimated and imputed to the whole sample to estimate mean intake over the observation period. Total energy and nutrient intakes were evaluated for adequacy with reference to published estimates of toddler requirements. FINDINGS: Total energy intake (1029 kcal/day) was adequate, with breast milk supplying an average of 328 kcal/day (32%), but vitamin A, riboflavin, calcium, iron and zinc intakes were below current estimates of required intakes. Observed limitations in nutrient intake were consistent with the finding that almost half of the toddlers were stunted. The prevalence of wasting was 6% at baseline and 4% at final assessment. Although food consumption increased when breastfeeding stopped, it could not fully compensate for the fat and vitamin A previously supplied by breast milk. CONCLUSIONS: The nutritional role of mother's milk in the second year is inversely related to the adequacy of the complementary diet. In this study, breast milk was an irreplaceable source of fat and vitamin A. When the weaning diet is inadequate for key nutrients because of low intake or poor bioavailability, breast milk assumes greater nutritional significance in the second year of life but does not guarantee adequate nutrient intakes. PMID:12075365

Predictors of blood pressure at 7-13 years: The "new millennium baby" study.

PubMed

Brambilla, P; Bedogni, G; Pietrobelli, A; Cianfarani, S; Agostoni, C

2016-08-01

The purpose of this study is to evaluate the association between blood pressure (BP) at 7-13 years of age and body mass index (BMI), early feeding, lifestyle indicators, and parental characteristics. Retrospective plus cross-sectional cohort study was started in 1294 children born in 2000-2004, right from their birth in primary care settings. Early feeding was estimated by measuring breast-feeding (BF) duration, complementary feeding (CF) introduction time, and lifestyle indicators such as daily screen time and weekly extracurricular sports activity time. Parental education, smoking, and obesity-related diseases were also considered. Multivariable linear regression and mediation analysis were used. CF introduction at 5-6 months of age was a negative predictor of systolic and diastolic BP (mean systolic BP-standard deviation score (SDS) -0.38 [95% CI: -0.47, -0.29] (p < 0.001); mean diastolic BP-SDS -0.32 [95% CI: -0.40, -0.24]) (p < 0.001); BMI was a positive predictor of systolic and diastolic BP (p < 0.001); and parental hypertension was a positive predictor of diastolic BP (p < 0.05). Predictors of mean BMI-SDS at 7-13 years of age were birth weight, screen time, and parental obesity and smoking (p < 0.001). BF had no effect on BP or BMI. Mediation analysis showed virtually no indication of the effect of CF on BP mediated by BMI. CF introduction between 5 and 6 months of age could be associated with low BP at 7-13 years. The effect of CF on BP seems to be independent of BMI. Low screen time is associated with low BMI. CF time may play a role in the occurrence of surrogates of noncommunicable disorders in future. Copyright © 2015 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Consumption of commercially produced snack foods and sugar-sweetened beverages during the complementary feeding period in four African and Asian urban contexts.

PubMed

Pries, Alissa M; Huffman, Sandra L; Champeny, Mary; Adhikary, Indu; Benjamin, Margaret; Coly, Aminata Ndeye; Diop, El Hadji Issakha; Mengkheang, Khin; Sy, Ndèye Yaga; Dhungel, Shrid; Feeley, Alison; Vitta, Bineti; Zehner, Elizabeth

2017-10-01

The availability and consumption of commercially produced foods and beverages have increased across low-income and middle-income countries. This cross-sectional survey assessed consumption of commercially produced foods and beverages among children 6-23 months of age, and mothers' exposure to promotions for these products. Health facility-based interviews were conducted among 218 randomly sampled mothers utilizing child health services in Dakar, Senegal; 229 in Dar es Salaam, Tanzania; 228 in Kathmandu Valley, Nepal; and 222 in Phnom Penh, Cambodia. In the day prior to the interview, 58.7% of 6-23-month-olds in Dakar, 23.1% in Dar es Salaam, 74.1% in Kathmandu Valley, and 55.0% in Phnom Penh had consumed a commercially produced snack food. In the previous week, the majority of children in Dakar (79.8%), Kathmandu Valley (91.2%), and Phnom Penh (80.6%) had consumed such products. Consumption of commercially produced sugar-sweetened beverages was noted among 32.0% of Phnom Penh, 29.8% of Dakar, 23.1% of Dar es Salaam, and 16.2% of Kathmandu Valley children. Maternal education was negatively associated with commercial snack food consumption in Dakar and Kathmandu Valley. Children of Phnom Penh mothers in the lowest wealth tercile were 1.5 times more likely to consume commercial snack food products, compared to wealthier mothers. These snack consumption patterns during the critical complementary feeding period demand attention; such products are often high in added sugars and salt, making them inappropriate for infants and young children. © 2017 John Wiley & Sons Ltd.

Maternal Literacy, Facility Birth, and Education Are Positively Associated with Better Infant and Young Child Feeding Practices and Nutritional Status among Ugandan Children.

PubMed

Ickes, Scott B; Hurst, Taylor E; Flax, Valerie L

2015-11-01

Understanding maternal factors that influence child feeding is necessary to inform intervention planning in settings in which mothers experience substantial social vulnerabilities. The purpose of this study was to assess maternal sociodemographic factors that may constrain women's caring capabilities and subsequent child nutrition in Uganda. We analyzed data from the 2006 and 2011 Uganda Demographic and Health Surveys to model the associations between maternal sociodemographic factors, child feeding practices, and anthropometry with multivariate logistic regression models. The proportion of children fed according to recommended guidelines declined in Uganda from 2006 to 2011. Mothers who lacked literacy skills were less likely to achieve recommended complementary feeding indicators; however, literacy was not associated with breastfeeding practices. Mothers in the upper 60% wealth percentile were more likely to meet minimum meal frequency, diversity, and adequacy indicators. Mothers who gave birth at health facilities (2006 OR: 0.49; 95% CI: 0.26, 0.91; P < 0.05) and who were in the upper 60% wealth percentile (2011 OR: 0.43; 95% CI: 0.21, 0.69) were less likely to exclusively breastfeed until 6 mo. There were no significant associations between age at first pregnancy, maternal education, and infant and young child feeding practices. Women with a formal education had children with lower stunting and underweight probabilities in both time periods (OR range: 0.43-0.74). Women who delivered in childbirth facilities were less likely to have a child with low weight-for-age, length-for-age, or weight-for-length z scores (OR range: 0.59-0.82). Marital status, the age at first child birth, not accepting domestic violence, freedom to travel away from home, and involvement in household and reproductive decisions were not associated with child anthropometry in either time period. Mothers with low literacy skills, who deliver their children at home, and who lack formal education are particularly at risk of poor child feeding and represent a group that may benefit from enhanced interventions that address their particular vulnerabilities. Factors that contribute to improved maternal feeding capabilities but may impair breastfeeding practices need to be better understood. © 2015 American Society for Nutrition.

Child nutrition in countries of the Commonwealth of Independent States: time to redirect strategies?

PubMed

Cattaneo, Adriano; Timmer, Arnold; Bomestar, Tamara; Bua, Jenny; Kumar, Sanjiv; Tamburlini, Giorgio

2008-12-01

Countries in the Commonwealth of Independent States made little progress in child nutrition and mortality between 1990 and 2005. The present paper assesses the nutritional status of children <5 years of age and discusses possible strategies for improvement. Data on low birth weight, infant and young child feeding, underweight, overweight and micronutrient deficiencies were compiled from available reports and databases, complemented through questionnaires to UNICEF Country Offices, and analysed by country, age, gender, urban/rural residence, maternal education and wealth quintiles. Exclusive breast-feeding in the first 6 months and continuing breast-feeding up to 2 years fall short of WHO and UNICEF recommendations. Complementary foods are introduced too early and may be poor in protein and micronutrients. Stunting and underweight are prevalent, especially in children aged 12 to 35 months; overweight is even more prevalent. Vitamin A and I deficiencies are still present in some countries, despite current control efforts. Anaemia ranges between 20 % and 40 %. Higher rates of malnutrition are found in rural areas, children of less educated mothers and lower-income families. Current public health strategies should be redirected to address: (i) overall protection, promotion and support of infant and young child feeding, in addition to breast-feeding; (ii) overweight, in addition to underweight and stunting; and (iii) malnutrition as a whole, in addition to micronutrient deficiencies. An equity lens should be used in developing policies and plans and implementing and monitoring programmes. Capacity building, cross-sectoral action, improved data collection within adequate legal frameworks and community engagement should be the pillars of redirected strategies.

Infant and Young Child Feeding Guidelines, 2016.

PubMed

Tiwari, Satish; Bharadva, Ketan; Yadav, Balraj; Malik, Sushma; Gangal, Prashant; Banapurmath, C R; Zaka-Ur-Rab, Zeeba; Deshmukh, Urmila; Visheshkumar, -; Agrawal, R K

2016-08-08

Shaping up the post-2015 development agenda is of crucial importance in the development process around the Globe as 2015 was the last year of milllionium development goals. It is the right time to asses our own progress vis-a-vis the Millennium Development Goals and these Guidelines are an attempt in that regard. The Infant and Young Child Feeding (IYCF) chapter of Indian Academy of Pediatrics invited a group of experts for National Consultative Meet for discussing and contributing on latest scientific advances and developments. Various partners from WHO, UNICEF, Ministry of Child Welfare Department, Ministry of Health and Family Welfare, Ministry of Chemical and Fertilizers of Govt of India, Human Milk Banking Association (of India), Indian Medico-Legal and Ethics Association (IMLEA), non-governmental organizations and academicians from various states of India contributed to these guidelines. The guidelines were finalized during the IYCNCON 2015 at New Delhi in August 2015. To formulate, endorse, adopt and disseminate guidelines related to Infant and Young Child feeding from an Indian perspective (including human milk banking, infant feeding in the HIV situation, and micro-nutrients). Early initiation of breastfeeding within first hour of birth, exclusive breastfeeding for the first six months followed by continued breastfeeding for up to two years and beyond with appropriate complementary foods after completion of 6 months is the most appropriate feeding strategy. Micro-nutrient supplementation in infants, and adequate nutrition and anemia control for adolescent girls, pregnant and lactating mothers is advocated. Concepts and need for human milk banks in India has also been incorporated.

[Nutritional interventions and child growth among under-two-year-olds: a systematic review].

PubMed

Valle, Neiva J; Santos, Iná S dos; Gigante, Denise P

2004-01-01

The aim of this study was to collect evidence of the impact of nutritional interventions on child growth. A systematic review of the literature on nutritional interventions in under-two-year-old children from 1980 to 2002 was conducted in the electronic databases (MEDLINE, LILACS, and MedCarib). The following descriptors were used: "nutrition", "child", "trial", "intervention", "growth", "infant", "programs", "impact", "counseling", "support", "body height", and "body weight". A complementary search was implemented by screening the bibliography cited in the previously located articles. Fourteen publications were found. The strategies used in the studies included distribution of nutritional supplements and/or nutritional counseling. Publication bias aside, most interventions presented a positive impact on child growth when applied during the first year of life. Nutritional counseling had the additional advantage of improving maternal and health professional practices on child nutrition and feeding.

Role of Social Support in Improving Infant Feeding Practices in Western Kenya: A Quasi-Experimental Study.

PubMed

Mukuria, Altrena G; Martin, Stephanie L; Egondi, Thaddeus; Bingham, Allison; Thuita, Faith M

2016-03-01

We designed and tested an intervention that used dialogue-based groups to engage infants' fathers and grandmothers to support optimal infant feeding practices. The study's aim was to test the effectiveness of increased social support by key household influencers on improving mothers' complementary feeding practices. Using a quasi-experimental design, we enrolled mothers, fathers, and grandmothers from households with infants 6-9 months old in 3 rural communities (1 intervention arm with fathers, 1 intervention arm with grandmothers, and 1 comparison arm) in western Kenya. We engaged 79 grandmothers and 85 fathers in separate dialogue groups for 6 months from January to July 2012. They received information on health and nutrition and were encouraged to provide social support to mothers (defined as specific physical actions in the past 2 weeks or material support actions in the past month). We conducted a baseline household survey in December 2011 in the 3 communities and returned to the same households in July 2012 for an endline survey. We used a difference-in-difference (DiD) approach and logistic regression to evaluate the intervention. We surveyed 554 people at baseline (258 mothers, 165 grandmothers, and 131 fathers) and 509 participants at endline. The percentage of mothers who reported receiving 5 or more social support actions (of a possible 12) ranged from 58% to 66% at baseline in the 3 groups. By endline, the percentage had increased by 25.8 percentage points (P=.002) and 32.7 percentage points (P=.001) more in the father and the grandmother intervention group, respectively, than in the comparison group. As the number of social support actions increased in the 3 groups, the likelihood of a mother reporting that she had fed her infant the minimum number of meals in the past 24 hours also increased between baseline and endline (odds ratio [OR], 1.14; confidence interval [CI], 1.00 to 1.30; P=.047). When taking into account the interaction effects of intervention area and increasing social support over time, we found a significant association in the grandmother intervention area on dietary diversity (OR, 1.19; CI, 1.01 to 1.40; P=.04). No significant effects were found on minimum acceptable diet. Engaging fathers and grandmothers of infants to improve their knowledge of optimal infant feeding practices and to encourage provision of social support to mothers could help improve some feeding practices. Future studies should engage all key household influencers in a family-centered approach to practice and support infant feeding recommendations. © Mukuria et al.

Attitudes toward and education about complementary and alternative medicine among adult patients with depression in Taiwan.

PubMed

Hsu, Mei-Chi; Moyle, Wendy; Creedy, Debra; Venturato, Lorraine; Ouyang, Wen-Chen; Sun, Gwo-Ching

2010-04-01

To investigate patients' attitudes toward complementary and alternative medicine, the education nurses provided about complementary and alternative medicine for treating depression and to test whether such education mediates the effect of complementary and alternative medicine use and attitudes toward complementary and alternative medicine. Although we know that attitudes influence behaviour, very few studies simultaneously explore the relationship between attitudes, education and complementary and alternative medicine use. Survey. This study was conducted as part of a larger survey, using face-to-face survey interviews with 206 adult patients aged 50 years or over and hospitalised in conventional hospitals in Taiwan for treatment of depression. The attitudes toward complementary and alternative medicine and patient education about complementary and alternative medicine instruments were specially developed for the study. Participants expressed slightly favourable attitudes toward complementary and alternative medicine. Many participants (50%) expressed that they were willing to try any potential treatment for depression. They believed that complementary and alternative medicine helped them to feel better and to live a happier life. However, 66.5% of participants reported that they had inadequate knowledge of complementary and alternative medicine. Participants with a higher monthly income, longer depression duration and religious beliefs hold more positive attitudes toward complementary and alternative medicine. Most participants were not satisfied with the education they received about complementary and alternative medicine. Patient education about complementary and alternative medicine was found to be a mediator for the use of complementary and alternative medicine. Patient education from nurses may predict patients' attitudes toward complementary and alternative medicine. Continuing nursing education is needed to enable nurses to respond knowledgeably to concerns patients may have about complementary and alternative medicine and treatment options. This study highlights the potential role of patient education about complementary and alternative medicine as an effective way of adjusting patients' attitudes toward complementary and alternative medicine and to link both patients' preferences for complementary and alternative medicine and health professionals' concerns about the proper use of complementary and alternative medicine for depression management and adverse drug interactions.

Modelling the cost of community interventions to reduce child mortality in South Africa using the Lives Saved Tool (LiST).

PubMed

Nkonki, Lungiswa Ll; Chola, Lumbwe L; Tugendhaft, Aviva A; Hofman, Karen K

2017-08-28

To estimate the costs and impact on reducing child mortality of scaling up interventions that can be delivered by community health workers at community level from a provider's perspective. In this study, we used the Lives Saved Tool (LiST), a module in the spectrum software. Within the spectrum software, LiST interacts with other modules, the AIDS Impact Module, Family Planning Module and Demography Projections Module (Dem Proj), to model the impact of more than 60 interventions that affect cause-specific mortality. DemProj Based on National South African Data. A total of nine interventions namely, breastfeeding promotion, complementary feeding, vitamin supplementation, hand washing with soap, hygienic disposal of children's stools, oral rehydration solution, oral antibiotics for the treatment of pneumonia, therapeutic feeding for wasting and treatment for moderate malnutrition. Reducing child mortality. A total of 9 interventions can prevent 8891 deaths by 2030. Hand washing with soap (21%) accounts for the highest number of deaths prevented, followed by therapeutic feeding (19%) and oral rehydration therapy (16%). The top 5 interventions account for 77% of all deaths prevented. At scale, an estimated cost of US$169.5 million (US$3 per capita) per year will be required in community health worker costs. The use of community health workers offers enormous opportunities for saving lives. These programmes require appropriate financial investments. Findings from this study show what can be achieved if concerted effort is channelled towards the identified set of life-saving interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

World Health Organization infant and young child feeding indicators and their associations with child anthropometry: a synthesis of recent findings.

PubMed

Jones, Andrew D; Ickes, Scott B; Smith, Laura E; Mbuya, Mduduzi N N; Chasekwa, Bernard; Heidkamp, Rebecca A; Menon, Purnima; Zongrone, Amanda A; Stoltzfus, Rebecca J

2014-01-01

As the World Health Organization (WHO) infant and young child feeding (IYCF) indicators are increasingly adopted, a comparison of country-specific analyses of the indicators' associations with child growth is needed to examine the consistency of these relationships across contexts and to assess the strengths and potential limitations of the indicators. This study aims to determine cross-country patterns of associations of each of these indicators with child stunting, wasting, height-for-age z-score (HAZ) and weight-for-height z-score (WHZ). Eight studies using recent Demographic and Health Surveys data from a total of nine countries in sub-Saharan Africa (nine), Asia (three) and the Caribbean (one) were identified. The WHO indicators showed mixed associations with child anthropometric indicators across countries. Breastfeeding indicators demonstrated negative associations with HAZ, while indicators of diet diversity and overall diet quality were positively associated with HAZ in Bangladesh, Ethiopia, India and Zambia (P < 0.05). These same complementary feeding indicators did not show consistent relationships with child stunting. Exclusive breastfeeding under 6 months of age was associated with greater WHZ in Bangladesh and Zambia (P < 0.05), although CF indicators did not show strong associations with WHZ or wasting. The lack of sensitivity and specificity of many of the IYCF indicators may contribute to the inconsistent associations observed. The WHO indicators are clearly valuable tools for broadly assessing the quality of child diets and for monitoring population trends in IYCF practices over time. However, additional measures of dietary quality and quantity may be necessary to understand how specific IYCF behaviours relate to child growth faltering. © 2013 John Wiley & Sons Ltd.

Seamless Tracing of Human Behavior Using Complementary Wearable and House-Embedded Sensors

PubMed Central

Augustyniak, Piotr; Smoleń, Magdalena; Mikrut, Zbigniew; Kańtoch, Eliasz

2014-01-01

This paper presents a multimodal system for seamless surveillance of elderly people in their living environment. The system uses simultaneously a wearable sensor network for each individual and premise-embedded sensors specific for each environment. The paper demonstrates the benefits of using complementary information from two types of mobility sensors: visual flow-based image analysis and an accelerometer-based wearable network. The paper provides results for indoor recognition of several elementary poses and outdoor recognition of complex movements. Instead of complete system description, particular attention was drawn to a polar histogram-based method of visual pose recognition, complementary use and synchronization of the data from wearable and premise-embedded networks and an automatic danger detection algorithm driven by two premise- and subject-related databases. The novelty of our approach also consists in feeding the databases with real-life recordings from the subject, and in using the dynamic time-warping algorithm for measurements of distance between actions represented as elementary poses in behavioral records. The main results of testing our method include: 95.5% accuracy of elementary pose recognition by the video system, 96.7% accuracy of elementary pose recognition by the accelerometer-based system, 98.9% accuracy of elementary pose recognition by the combined accelerometer and video-based system, and 80% accuracy of complex outdoor activity recognition by the accelerometer-based wearable system. PMID:24787640

Comparison of complementary feeding strategies to meet zinc requirements of older breastfed infants1234

PubMed Central

Krebs, Nancy F; Westcott, Jamie E; Culbertson, Diana L; Sian, Lei; Miller, Leland V; Hambidge, K Michael

2012-01-01

Background: The low zinc intake from human milk at ∼6 mo of age predicts the dependence on complementary foods (CF) to meet the zinc requirements of older breastfed-only infants. Objective: The objective of this study was to compare major variables of zinc homeostasis and zinc status in 9-mo-old breastfed infants who were randomly assigned to different complementary food regimens. Design: Forty-five exclusively breastfed 5-mo-old infants were randomly assigned to receive commercially available pureed meats, iron-and-zinc–fortified infant cereal (IZFC), or whole-grain, iron-only–fortified infant cereal (IFC) as the first and primary CF until completion of zinc metabolic studies between 9 and 10 mo of age. A zinc stable-isotope methodology was used to measure the fractional absorption of zinc (FAZ) in human milk and CF by dual-isotope ratios in urine. Calculated variables included the dietary intake from duplicate diets and 4-d test weighing, the total absorbed zinc (TAZ) from FAZ × diet zinc, and the exchangeable zinc pool size (EZP) from isotope enrichment in urine. Results: Mean daily zinc intakes were significantly greater for the meat and IZFC groups than for the IFC group (P < 0.001); only intakes in meat and IZFC groups met estimated average requirements. Mean (±SEM) TAZ amounts were 0.80 ± 0.08, 0.71 ± 0.09, and 0.52 ± 0.05 mg/d for the meat, IZFC, and IFC groups, respectively (P = 0.027). Zinc from human milk contributed <25% of TAZ for all groups. The EZP correlated with both zinc intake (r = 0.43, P < 0.01) and TAZ (r = 0.54, P < 0.001). Conclusion: Zinc requirements for older breastfed-only infants are unlikely to be met without the regular consumption of either meats or zinc-fortified foods. PMID:22648720

Breastfeeding, comnlementarv food introduction and overweight in preschool children.

PubMed

Lopes, Amanda Forster; Rocha, Elida Mara Braga; da Silva, Janaina Paula Costa; Nascimento, Viviane Gabriela; Bertoli, Ciro; Leone, Claudio

2016-09-01

Growing phenomenon, which involves high morbidity and consequently high costs for health systems, obesity has been found also among the pediatric population and is currently considered a public health problem. The aim of this study was to verify if in children in the early preschool age we can see the prevalence of overweight and if introducing complementary feeding as well as the type of food introduced, are associated with this condition in this age group. It is an observational analytic study with children born in 2011-2012 that attended public schools in Taubat6 -SP during 2014. In addition to the weight and height of children, information about the history of feeding and birth were collectedusing a standardized questionnaire.The nutritional status was defined as having overweight children with z-scores for body mass index (zIMC) > 1.We conducted bivariate analysis and then linear regression analysis of multiple variables.The prevalence of overweight was elevated (27.5%). Only birth weight showed significant correlation with respect to zIMC (r = 0.22, p < 0.0001). The multivariable analysis showed no relationship with the various foods, but showed birth weightas a high risk factor, the male and the total duration of breastfeeding as protective factors. As a result, we conclude that the early introduction of new foods is not a risk factor for the development of overweight at the beginning of pre-school age.

Nutrition in the First 1000 Days: The Origin of Childhood Obesity.

PubMed

Mameli, Chiara; Mazzantini, Sara; Zuccotti, Gian Vincenzo

2016-08-23

Childhood obesity is a major global issue. Its incidence is constantly increasing, thereby offering a threatening public health perspective. The risk of developing the numerous chronic diseases associated with this condition from very early in life is significant. Although complex and multi-factorial, the pathophysiology of obesity recognizes essential roles of nutritional and metabolic aspects. Particularly, several risk factors identified as possible determinants of later-life obesity act within the first 1000 days of life (i.e., from conception to age 2 years). The purpose of this manuscript is to review those key mechanisms for which a role in predisposing children to obesity is supported by the most recent literature. Throughout the development of the human feeding environment, three different stages have been identified: (1) the prenatal period; (2) breast vs. formula feeding; and (3) complementary diet. A deep understanding of the specific nutritional challenges presented within each phase might foster the development of future preventive strategies.

Behavioral and electroantennogram responses of plum curculio, Conotrachelus nenuphar, to selected noxious plant extracts and insecticides

PubMed Central

Gӧkçe, A.; Stelinski, L. L.; Nortman, D. R.; Bryan, W. W.; Whalon, M. E.

2014-01-01

Abstract Behavioral and electroantennogram responses of plum curculio, Conotrachelus nenuphar (Herbst) (Coleoptera: Curculionidae), adults were tested for several methanolic plant extracts and organically approved insecticides. Plant extracts were evaluated for their potential as antifeedants or oviposition deterrents. These extract responses were also compared to those elicited by the non-neurotoxic, organic irritant-insecticide kaolin clay. Both sexes of plum curculio exhibited antennal response as measured by electroantennogram, which ranged from 0.2 to 1.1 mV, to plant extracts and the organic irritant/insecticide, with the greatest response to the extract of rough cocklebur, Xanthium strumarium L. (1.1 mV). No choice tests were conducted to compare feeding and oviposition by plum curculio on untreated apples or on apples treated with one of the extracts or the insecticide. The insecticide pyrethrum and extracts of X. strumarium and greater burdock, Arctium lappa L., significantly reduced feeding. Also, pyrethrum , A. lappa, Humulus lupulus L. (common hop), X. strumarium, and Verbascum songaricum Schrenk extracts completely inhibited egg deposition. In no-choice assays, the effects of kaolin clay with incorporated plant extracts on plum curculio feeding and oviposition were monitored as complementary tests. A. lappa-kaolin, H. lupulus –kaolin, and X. strumarium-kaolin mixtures significantly reduced the feeding of plum curculio compared to the control or kaolin clay alone. Each of the plant extract-kaolin mixtures evaluated, with the exception of Bifora radians Bieberstein (wild bishop), completely inhibited plum curculio oviposition as compared to controls. PMID:25368046

Determining Factors and Critical Periods in the Formation of Eating Habits: Results from the Habeat Project.

PubMed

Issanchou, Sylvie

2017-01-01

Eating habits form early during childhood and are likely to track until the beginning of adulthood. Thus, understanding the formation of eating habits is important. Consequently, the population targeted in the European project Habeat comprised infants and young children up to 6 years of age. Habeat mainly focused on the qualitative dimension of eating habits with a particular attention on vegetables and to a lesser extent on fruit. Food intake of young children was also studied in 2 challenging situations where overeating may occur and the relation between children's behaviour and feeding parental practices was examined. Key Messages: Habeat found evidence that breastfeeding may facilitate the consumption of vegetables and fruit and a greater variety of healthy foods in later childhood. Introduction of a variety of vegetables at the beginning of the complementary feeding period increases later acceptance of novel foods. Repeated exposure is a powerful mechanism to increase children's intake of a novel vegetable in infants and young children. Offering energy-dense snacks before or after meals should be avoided. Moreover, food should be offered to children in response to their feelings of hunger, and not used as reward for a good behaviour or for any other reason. © 2017 S. Karger AG, Basel.

'Both parents should care for babies': A cross-sectional, cross-cultural comparison of adolescents' breastfeeding intentions, and the influence of shared-parenting beliefs.

PubMed

Swanson, Vivien; Hannula, Leena; Eriksson, Linda; Wallin, Malin Häggkvist; Strutton, Joan

2017-06-29

Many young men and women expect to co-parent their newborn infant. This may have a positive or negative impact on decisions to breastfeed, which is an important health behaviour, influenced by cultural and psycho-social norms. We investigated the relationship between shared parenting, infant feeding beliefs and intentions in male and female (non-parent) adolescents, comparing Nordic countries (Sweden, Norway, Finland) with high breastfeeding rates with others with low rates (Scotland, USA). We utilised cross-sectional surveys of male and female adolescents (n = 1064, age 12-18) administered directly in schools or via the internet. We assessed attitudes to breast and formula feeding and shared parenting, using a Theory of Planned Behaviour framework, assessing beliefs, attitudes, norms and control as predictors of intention. Male and female adolescents' breastfeeding intentions varied in line with national cultural norms. Young people from Nordic countries (high breastfeeding rates) were significantly more likely to intend to breastfeed than those from Scotland or the USA (low breastfeeding rates). Positive beliefs about breastfeeding, norms and 'exposure' to breastfeeding and feeding confidence were consistently stronger in Nordic countries, whereas young people in Scotland had more positive beliefs, norms and 'exposure' to formula feeding. Differences in parenting beliefs, norms and confidence were less consistent. In logistic regression, cultural group, positive breastfeeding beliefs and exposure, norms, and shared parenting beliefs were significant predictors of breastfeeding feeding intention. Positive beliefs about shared parenting and equal gender norms were related to future breastfeeding intentions for female and male adolescents. Health education programmes for young people could encourage positive breastfeeding choices by considering how this would fit with young people's ideal parenting roles, and by emphasising benefits of complementary maternal and paternal roles in breastfeeding newborn infants.

Complementary Feeding Diets Made of Local Foods Can Be Optimized, but Additional Interventions Will Be Needed to Meet Iron and Zinc Requirements in 6- to 23-Month-Old Children in Low- and Middle-Income Countries.

PubMed

Osendarp, Saskia J M; Broersen, Britt; van Liere, Marti J; De-Regil, Luz M; Bahirathan, Lavannya; Klassen, Eva; Neufeld, Lynnette M

2016-12-01

The question whether diets composed of local foods can meet recommended nutrient intakes in children aged 6 to 23 months living in low- and middle-income countries is contested. To review evidence of studies evaluating whether (1) macro- and micronutrient requirements of children aged 6 to 23 months from low- and middle-income countries are met by the consumption of locally available foods ("observed intake") and (2) nutrient requirements can be met when the use of local foods is optimized, using modeling techniques ("modeled intake"). Twenty-three articles were included after conducting a systematic literature search. To allow for comparisons between studies, findings of 15 observed intake studies were compared against their contribution to a standardized recommended nutrient intake from complementary foods. For studies with data on intake distribution, %< estimated average requirements were calculated. Data from the observed intake studies indicate that children aged 6 to 23 months meet requirements of protein, while diets are inadequate in calcium, iron, and zinc. Also for energy, vitamin A, thiamin, riboflavin, niacin, folate, and vitamin C, children did not always fulfill their requirements. Very few studies reported on vitamin B6, B12, and magnesium, and no conclusions can be drawn for these nutrients. When diets are optimized using modeling techniques, most of these nutrient requirements can be met, with the exception of iron and zinc and in some settings calcium, folate, and B vitamins. Our findings suggest that optimizing the use of local foods in diets of children aged 6 to 23 months can improve nutrient intakes; however, additional cost-effective strategies are needed to ensure adequate intakes of iron and zinc. © The Author(s) 2016.

Neuropeptide Y and agouti-related peptide mediate complementary functions of hyperphagia and reduced energy expenditure in leptin receptor deficiency.

PubMed

Luo, Na; Marcelin, Genevieve; Liu, Shun Mei; Schwartz, Gary; Chua, Streamson

2011-03-01

Neuropeptide Y (NPY) and agouti-related peptide (AGRP) can produce hyperphagia, reduce energy expenditure, and promote triglyceride deposition in adipose depots. As these two neuropeptides are coexpressed within the hypothalamic arcuate nucleus and mediate a major portion of the obesity caused by leptin signaling deficiency, we sought to determine whether the two neuropeptides mediated identical or complementary actions. Because of separate neuropeptide receptors and signal transduction mechanisms, there is a possibility of distinct encoding systems for the feeding and energy expenditure aspects of leptin-regulated metabolism. We have genetically added NPY deficiency and/or AGRP deficiency to LEPR deficiency isolated to AGRP cells. Our results indicate that the obesity of LEPR deficiency in AGRP/NPY neurons can produce obesity with either AGRP or NPY alone with AGRP producing hyperphagia while NPY promotes reduced energy expenditure. The absence of both NPY and AGRP prevents the development of obesity attributable to isolated LEPR deficiency in AGRP/NPY neurons. Operant behavioral testing indicated that there were no alterations in the reward for a food pellet from the AGRP-specific LEPR deficiency.

Neuropeptide Y and Agouti-Related Peptide Mediate Complementary Functions of Hyperphagia and Reduced Energy Expenditure in Leptin Receptor Deficiency

PubMed Central

Luo, Na; Marcelin, Genevieve; Liu, Shun Mei; Schwartz, Gary

2011-01-01

Neuropeptide Y (NPY) and agouti-related peptide (AGRP) can produce hyperphagia, reduce energy expenditure, and promote triglyceride deposition in adipose depots. As these two neuropeptides are coexpressed within the hypothalamic arcuate nucleus and mediate a major portion of the obesity caused by leptin signaling deficiency, we sought to determine whether the two neuropeptides mediated identical or complementary actions. Because of separate neuropeptide receptors and signal transduction mechanisms, there is a possibility of distinct encoding systems for the feeding and energy expenditure aspects of leptin-regulated metabolism. We have genetically added NPY deficiency and/or AGRP deficiency to LEPR deficiency isolated to AGRP cells. Our results indicate that the obesity of LEPR deficiency in AGRP/NPY neurons can produce obesity with either AGRP or NPY alone with AGRP producing hyperphagia while NPY promotes reduced energy expenditure. The absence of both NPY and AGRP prevents the development of obesity attributable to isolated LEPR deficiency in AGRP/NPY neurons. Operant behavioral testing indicated that there were no alterations in the reward for a food pellet from the AGRP-specific LEPR deficiency. PMID:21285324

Portable device for generation of ultra-pure water vapor feeds

NASA Astrophysics Data System (ADS)

Velin, P.; Stenman, U.; Skoglundh, M.; Carlsson, P.-A.

2017-11-01

A portable device for the generation of co-feeds of water vapor has been designed, constructed, and evaluated for flexible use as an add-on component to laboratory chemical reactors. The vapor is formed by catalytic oxidation of hydrogen, which benefits the formation of well-controlled minute concentrations of ultra-pure water. Analysis of the effluent stream by on-line mass spectrometry and Fourier transform infrared spectroscopy confirms that water vapor can be, with high precision, generated both rapidly and steadily over extended periods in the range of 100 ppm to 3 vol. % (limited by safety considerations) using a total flow of 100 to 1500 ml/min at normal temperature and pressure. Further, the device has been used complementary to a commercial water evaporator and mixing system to span water concentrations up to 12 vol. %. Finally, an operando diffuse reflective infrared Fourier transform spectroscopic measurement of palladium catalysed methane oxidation in the absence and presence of up to 1.0 vol. % water has been carried out to demonstrate the applicability of the device for co-feeding well-controlled low concentrations of water vapor to a common type of spectroscopic experiment. The possibilities of creating isotopically labeled water vapor as well as using tracer gases for dynamic experiments are discussed.

Portable device for generation of ultra-pure water vapor feeds.

PubMed

Velin, P; Stenman, U; Skoglundh, M; Carlsson, P-A

2017-11-01

A portable device for the generation of co-feeds of water vapor has been designed, constructed, and evaluated for flexible use as an add-on component to laboratory chemical reactors. The vapor is formed by catalytic oxidation of hydrogen, which benefits the formation of well-controlled minute concentrations of ultra-pure water. Analysis of the effluent stream by on-line mass spectrometry and Fourier transform infrared spectroscopy confirms that water vapor can be, with high precision, generated both rapidly and steadily over extended periods in the range of 100 ppm to 3 vol. % (limited by safety considerations) using a total flow of 100 to 1500 ml/min at normal temperature and pressure. Further, the device has been used complementary to a commercial water evaporator and mixing system to span water concentrations up to 12 vol. %. Finally, an operando diffuse reflective infrared Fourier transform spectroscopic measurement of palladium catalysed methane oxidation in the absence and presence of up to 1.0 vol. % water has been carried out to demonstrate the applicability of the device for co-feeding well-controlled low concentrations of water vapor to a common type of spectroscopic experiment. The possibilities of creating isotopically labeled water vapor as well as using tracer gases for dynamic experiments are discussed.

Stunting Persists despite Optimal Feeding: Are Toilets Part of the Solution?

PubMed

Prendergast, Andrew J; Humphrey, Jean H

2015-01-01

Children in developing countries have an average length-for-age that is already below the World Health Organization standard at birth and show a further decline in linear growth over the first 24 months of life; however, complementary feeding interventions have only a modest impact on growth. Children living in conditions of poor sanitation and hygiene are frequently exposed to pathogenic microbes through feco-oral transmission. Acute diarrhea represents only the tip of the 'enteric disease iceberg', with a substantial underlying burden of chronic, subclinical enteropathy. Environmental enteric dysfunction (EED) is characterized by disturbance in small intestinal structure and impaired gut barrier function, enabling microbial translocation and chronic systemic inflammation, which may impair growth. Gut damage appears to arise early in infancy and markers of intestinal inflammation, intestinal permeability and systemic immune activation are inversely associated with linear growth. Reducing feco-oral microbial transmission by improving water, sanitation and hygiene (WASH) may theoretically prevent or ameliorate EED and improve linear growth; ongoing trials are exploring this hypothesis. Given the complex interplay of factors leading to stunting, multisectoral interventions are likely required. Improving WASH in addition to infant feeding may be one approach to improve the growth and developmental potential of infants in developing countries. © 2015 Nestec Ltd., Vevey/S. Karger AG, Basel.

[Nutrition intervention actions in relief situations: report on 4 experiences in Mexico].

PubMed

Madrigal-Fritsch, Herlinda; Ruíz Arregui, Liliana; Pérez Gil Romo, Sara Elena; Cervantes Turrubiates, Leticia; Torre Medina-Mora, Pilar; Ramírez García, Guadalupe; Escobar Pérez, Margarita

2004-06-01

In the last years Mexico faced several natural and human provoked disasters. We choose the Mexico City earthquake, the Chichonal volcano eruption, the Guatemala war and its refugees and the Chiapas armed movement. In all of them the INCMNSZ surveillance system proposal has been applied. To establish the intervention we classified the emergencies according to its magnitude and localization. The intervention consisted in: immediate attention of serious cases, immunizations, quimioprofilaxis, personal hygiene, environment control, nutritional assessment and diet definition. The affected population attended were: in the eruption 4.500, in the earthquake 1.000, in the Guatemala war 19.000 and in the Chiapas movement 6.940. Population damaged by the eruption and the war received mass feeding; complementary feeding (vulnerable groups) and therapeutic feeding (people with tuberculosis and serious undernutrition). In the earthquake people received first, prepared food and later they were organized to bring, plan, prepare and distribute their food. In the Chiapas armed movement people received only special baby food. In all cases, population also receive nutritional information and only with the refugees and the Chiapas damaged people the local food production was promoted. We suggest evaluating every emergency program and share experiences to afford this type of situations in a better way.

Eggs in Early Complementary Feeding and Child Growth: A Randomized Controlled Trial.

PubMed

Iannotti, Lora L; Lutter, Chessa K; Stewart, Christine P; Gallegos Riofrío, Carlos Andres; Malo, Carla; Reinhart, Gregory; Palacios, Ana; Karp, Celia; Chapnick, Melissa; Cox, Katherine; Waters, William F

2017-07-01

Eggs are a good source of nutrients for growth and development. We hypothesized that introducing eggs early during complementary feeding would improve child nutrition. A randomized controlled trial was conducted in Cotopaxi Province, Ecuador, from March to December 2015. Children ages 6 to 9 months were randomly assigned to treatment (1 egg per day for 6 months [ n = 83]) and control (no intervention [ n = 80]) groups. Both arms received social marketing messages to encourage participation in the Lulun Project ( lulun meaning "egg" in Kichwa). All households were visited once per week to monitor morbidity symptoms, distribute eggs, and monitor egg intakes (for egg group only). Baseline and end point outcome measures included anthropometry, dietary intake frequencies, and morbidity symptoms. Mothers or other caregivers reported no allergic reactions to the eggs. Generalized linear regression modeling showed the egg intervention increased length-for-age z score by 0.63 (95% confidence interval [CI], 0.38-0.88) and weight-for-age z score by 0.61 (95% CI, 0.45-0.77). Log-binomial models with robust Poisson indicated a reduced prevalence of stunting by 47% (prevalence ratio [PR], 0.53; 95% CI, 0.37-0.77) and underweight by 74% (PR, 0.26; 95% CI, 0.10-0.70). Children in the treatment group had higher dietary intakes of eggs (PR, 1.57; 95% CI, 1.28-1.92) and reduced intake of sugar-sweetened foods (PR, 0.71; 95% CI, 0.51-0.97) compared with control. The findings supported our hypothesis that early introduction of eggs significantly improved growth in young children. Generally accessible to vulnerable groups, eggs have the potential to contribute to global targets to reduce stunting. Copyright © 2017 by the American Academy of Pediatrics.

Ethical responsibilities of pharmacists when selling complementary medicines: a systematic review.

PubMed

Salman Popattia, Amber; Winch, Sarah; La Caze, Adam

2018-04-01

The widespread sale of complementary medicines in community pharmacy raises important questions regarding the responsibilities of pharmacists when selling complementary medicines. This study reviews the academic literature that explores a pharmacist's responsibilities when selling complementary medicines. International Pharmaceutical Abstracts, Embase, PubMed, Cinahl, PsycINFO and Philosopher's index databases were searched for articles written in English and published between 1995 and 2017. Empirical studies discussing pharmacists' practices or perceptions, consumers' expectations and normative studies discussing ethical perspectives or proposing ethical frameworks related to pharmacists' responsibilities in selling complementary medicines were included in the review. Fifty-eight studies met the inclusion criteria. The majority of the studies discussing the responsibilities of pharmacists selling complementary medicines had an empirical focus. Pharmacists and consumers identified counselling and ensuring safe use of complementary medicines as the primary responsibilities of pharmacists. No formal ethical framework is explicitly employed to describe the responsibilities of pharmacists selling complementary medicines. To the degree any ethical framework is employed, a number of papers implicitly rely on principlism. The studies discussing the ethical perspectives of selling complementary medicines mainly describe the ethical conflict between a pharmacist's business and health professional role. No attempt is made to provide guidance on appropriate ways to resolve the conflict. There is a lack of explicit normative advice in the existing literature regarding the responsibilities of pharmacists selling complementary medicines. This review identifies the need to develop a detailed practice-specific ethical framework to guide pharmacists regarding their responsibilities when selling complementary medicines. © 2018 Royal Pharmaceutical Society.

Early Dietary Patterns and Microbiota Development: Still a Way to Go from Descriptive Interactions to Health-Relevant Solutions.

PubMed

Iozzo, Patricia; Sanguinetti, Elena

2018-01-01

Early nutrition and growth in the initial years of life are important determinants of later body weight and metabolic health in humans, and the current epidemic of obesity involving children requires a better understanding of causal and protective mechanisms and components in infant foods. This review focuses on recent evidence implicating feeding modes (e.g., breast milk and formula milk) and dietary transitions toward complementary foods in the progression of microbiota maturation in children. The literature exploring body weight outcomes of microbiota changes induced by diet in early life is limited. Representative studies addressing the use of probiotics in pregnant women and infants are also examined. Methodological and geo-cultural variations make it difficult to avoid (apparently) controversial findings. Most studies indicate differences in the microbiota of formula versus breastfed infants, but some do not. Duration of breastfeeding delays the maturation of the microbiota toward an adult-like profile. However, the effect size of the early feeding pattern on microbial function was found to be very small, and absent after the third year of life. There are several interesting mediators whereby milk composition can affect infants' microbiota and their optimization is a desirable strategy for prevention. But prevention of what? Although there are few correlative evaluations relating microbiota and body weight in early life, studies demonstrating a cause-effect relationship between diet-induced changes in early microbiota development and subsequent metabolic health outcomes in humans are still missing.

Use of complementary and alternative medicine in children and adolescents with autism spectrum disorder: A systematic review.

PubMed

Höfer, Juliana; Hoffmann, Falk; Bachmann, Christian

2017-05-01

Despite limited evidence, complementary and alternative medicine treatments are popular in autism spectrum disorder. The aim of this review was to summarize the available evidence on complementary and alternative medicine use frequency in autism spectrum disorder. A systematic search of three electronic databases was performed. All research studies in English or German reporting data on the frequency of complementary and alternative medicine use in individuals with autism spectrum disorder were included. Two independent reviewers searched the literature, extracted information on study design and results, and assessed study quality using an established quality assessment tool. Twenty studies with a total of 9540 participants were included. The prevalence of any complementary and alternative medicine use ranged from 28% to 95% (median: 54%). Special diets or dietary supplements (including vitamins) were the most frequent complementary and alternative medicine treatments, ranking first in 75% of studies. There was some evidence for a higher prevalence of complementary and alternative medicine use in autism spectrum disorder compared to other psychiatric disorders and the general population. Approximately half of children and adolescents with autism spectrum disorder use complementary and alternative medicine. Doctors should be aware of this and should discuss complementary and alternative medicine use with patients and their carers, especially as the evidence is mixed and some complementary and alternative medicine treatments are potentially harmful.

Association between the Infant and Child Feeding Index (ICFI) and nutritional status of 6- to 35-month-old children in rural western China.

PubMed

Qu, Pengfei; Mi, Baibing; Wang, Duolao; Zhang, Ruo; Yang, Jiaomei; Liu, Danmeng; Dang, Shaonong; Yan, Hong

2017-01-01

The objective of this study was to determine the relationship between the quality of feeding practices and children's nutritional status in rural western China. A sample of 12,146 pairs of 6- to 35-month-old children and their mothers were recruited using stratified multistage cluster random sampling in rural western China. Quantile regression was used to analyze the relationship between the Infant and Child Feeding Index (ICFI) and children's nutritional status. In rural western China, 24.37% of all infants and young children suffer from malnutrition. Of this total, 19.57%, 8.74% and 4.63% of infants and children are classified as stunting, underweight and wasting, respectively. After adjusting for covariates, the quantile regression results suggested that qualified ICFI (ICFI > 13.8) was associated with all length and HAZ quantiles (P<0.05) and had a greater effect on the following: poor length and HAZ, the β-estimates (length) from 0.76 cm (95% CI: 0.53 to 0.99 cm) to 0.34 cm (95% CI: 0.09 to 0.59 cm) and the β-estimates (HAZ) from 0.17 (95% CI: 0.10 to 0.24) to 0.11 (95% CI: 0.04 to 0.19). Qualified ICFI was also associated with most weight quantiles (P<0.05 except the 80th and 90th quantiles) and poor and intermediate WAZ quantiles (P<0.05 including the 10th, 20th 30th and 40th quantiles). Additionally, qualified ICFI had a greater effect on poor weight and WAZ quantiles in which the β-estimates (weight) were from 0.20 kg (95% CI: 0.14 to 0.26 kg) to 0.06 kg (95% CI: 0.00 to 0.12 kg) and the β-estimates (WAZ) were from 0.14 (95% CI: 0.08 to 0.21) to 0.05 (95% CI: 0.01 to 0.10). Feeding practices were associated with the physical development of infants and young children, and proper feeding practices had a greater effect on poor physical development in infants and young children. For mothers in rural western China, proper guidelines and messaging on complementary feeding practices are necessary.

A child feeding index is superior to WHO IYCF indicators in explaining length-for-age Z-scores of young children in rural Cambodia

PubMed Central

Reinbott, Anika; Kuchenbecker, Judith; Herrmann, Johannes; Jordan, Irmgard; Muehlhoff, Ellen; Kevanna, Ou; Krawinkel, Michael

2015-01-01

Background: Adequate young child feeding practices are influenced by a multitude of factors which affect growth and development. A combination of indicators is needed to explain the role of complementary feeding practices in growth retardation. Methods: A cross-sectional nutrition baseline survey was conducted in rural Cambodia in September 2012. Villages in pre-selected communes were randomly selected using stunting as a primary indicator. Data were collected from 803 randomly selected households with children aged 6–23 months, based on a standardised questionnaire and on length/height and weight measurements of mother and child. WHO Infant and Young Child Feeding (IYCF) indicators [minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD)] and a child feeding index (CFI) were created. The latter consisted of five components: breastfeeding, use of bottle, dietary diversity, food frequency and meal frequency which were adjusted for three age groups: 6–8, 9–11 and 12–23 months. The highest possible score was 10. Associations between length-for-age Z-scores (LAZ) and WHO indicators or CFI were explored. Results: Mean (SD) LAZ was −1.25 (1.14) (n  =  801). Mean (range) CFI was 6.7 (1–10) (n  =  797). Mean CFI was highest in the 9–11-months age group (7.93) and lowest for those aged 12–23 months (5.96). None of the WHO IYCF indicators was associated with LAZ, whereas CFI showed significant association with LAZ (P < 0.01). The association between higher CFI scores and LAZ became weaker as age increased. Conclusion: The results highlight the need to include a wide range of information in the analysis in order to understand the association between appropriate infant feeding practices and child growth. PMID:25226288

Effectiveness of facility-based personalized maternal nutrition counseling in improving child growth and morbidity up to 18 months: A cluster-randomized controlled trial in rural Burkina Faso

PubMed Central

Huybregts, Lieven; Martin-Prevel, Yves; Donnen, Philippe; Lanou, Hermann; Grosemans, Joep; Offoh, Priscilla; Dramaix-Wilmet, Michèle; Sondo, Blaise; Roberfroid, Dominique; Kolsteren, Patrick

2017-01-01

The period from conception to 24 months of age is a crucial window for nutrition interventions. Personalized maternal counseling may improve childbirth outcomes, growth, and health. We assessed the effectiveness of facility-based personalized maternal nutrition counseling (from pregnancy to 18 months after birth) in improving child growth and health in rural Burkina Faso. We conducted a paired cluster randomized controlled trial in a rural district of Burkina Faso with 12 primary health centers (clusters). Healthcare providers in the intervention centers received patient-centered communication and nutrition counseling training. Pregnant women in the third trimester living in the center catchment areas and intending to stay for the next 2 years were prospectively included. We followed 2253 mother-child pairs quarterly until the child was aged 18 months. Women were interviewed about counseling experiences, dietary practices during pregnancy, and their child’s feeding practices and morbidity history. Anthropometric measurements were taken at each visit using standardized methods. The primary outcomes were the cumulative incidence of wasting, and changes in child weight-for-height z-score (WHZ). Secondary outcomes were the women’s prenatal dietary practices, early breastfeeding practices, exclusive breastfeeding, timely introduction of complementary food, child’s feeding frequency and dietary diversity, children’s mean birth weight, endpoint prevalence of stunting, and cumulative incidence of diarrhea, fever, and acute respiratory infection. All analyses were by intention-to-treat using mixed effects models. The intervention and control arms each included six health centers. Mothers in the intervention arm had a significantly higher exposure to counseling with 11.2% for breastfeeding techniques to 75.7% for counseling on exclusive breastfeeding. Mothers of infants below 6 months of age in the intervention arm were more likely to exclusively breastfeed (54.3% vs 42.3%; Difference of Proportion (DP) 12.8%; 95% CI: 2.1, 23.6; p = 0.020) as compared to the control arm. Between 6 and 18 months of age, more children in the intervention arm benefited from the required feeding frequency (68.8% vs 53.4%; DP 14.1%; 95% CI: 9.0, 19.2; p<0.001) and a larger proportion had a minimum dietary diversity (28.6% vs 22.0%; DP 5.9%; 95% CI: 2.7, 9.2; p<0.001). Birth weight of newborns in the intervention arm was on average 84.8 g (p = 0.037) larger compared to the control arm. However, we found no significant differences in child anthropometry or morbidity between study arms. Facility-based personalized maternal nutrition counseling was associated with an improved prenatal dietary practices, Infant and Young Child Feeding practices, and child birth weight. Complementary strategies are warranted to obtain meaningful impact on child growth and morbidity. This includes strategies to ensure good coverage of facility-based services and effective nutrition/care practices in early childhood. PMID:28542391

Use of complementary and alternative medicine by patients with cancer in northern Turkey: analysis of cost and satisfaction.

PubMed

Aydin Avci, Ilknur; Koç, Zeliha; Sağlam, Zeynep

2012-03-01

The aims of this study were to determine (1) the prevalence of complementary and alternative medicine use among patients with cancer, (2) the method of use of the particular therapy, (3) the reasons for using complementary and alternative medicine therapies, (4) the benefits experienced by the use of complementary and alternative medicine, (5) the source of information about complementary and alternative medicine therapies and, (6) the satisfaction and cost of complementary and alternative medicine. Complementary and alternative medicine consists of diverse medical and healthcare systems, practices and products that are not considered at present to be a part of conventional medicine. The majority of patients who use complementary and alternative medicine use more than one method. Complementary and alternative medicine use is more common in cases of advanced disease or poor prognosis. This is a descriptive study of complementary and alternative medicine. This study was conducted in the Chemotherapy Unit at Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey, between 18 March 2008-30 June 2008. Two hundred fifty-three patients with cancer, among 281 patients who applied to the chemotherapy clinic between these dates, agreed to take part in the study with whom contact could be made were included. A questionnaire including descriptive characteristics in collecting data, characteristics about diseases and their treatments, complementary and alternative medicine information and implementation situations and a control list about complementary and alternative medicine implementations were given. The collected data were evaluated by computer using descriptive statistics, the chi-square test and Student's t-test. In this study, 94·1% of the patients were content with medical treatment, 58·9% of them used complementary and alternative medicine treatments, 41·1% did not use any complementary and alternative medicine treatments. The satisfaction level of the patients with complementary and alternative medicine methods was slightly above mediocre (2·33 SD 0·64, on a scale of 1-3). The average cost per capita spent by the patients using complementary and alternative medicine for all the different methods was US$288·26. It was determined that although patients did not have enough knowledge about complementary and alternative medicine methods, the prevalence of complementary and alternative medicine and satisfaction levels are high that complementary and alternative medicine users spend substantial sums of money for these methods. To sustain medical treatment and prognosis of cancer, it is important for nurses to consult with their patients regarding the use and potential risks of some complementary and alternative medicine. © 2011 Blackwell Publishing Ltd.

Influences of different dietary contents of macrominerals on the availability of trace elements in horses.

PubMed

Neustädter, L-T; Kamphues, J; Ratert, C

2018-04-01

In this study, influences of a reduced macromineral intake on the trace element metabolism in horses at maintenance were investigated. Background of this study is the revised recommendation on the macromineral supply for horses (GfE ). Balance studies on three adult pony geldings with body weights of 405 / 348 / 384 kg were performed to obtain data on apparent digestibility (aD), retention and serum concentrations of different trace elements (Cu, Zn, Se) at different dietary macromineral levels. A mineral supplement or a complementary feed-with a reduced macromineral content-was added to a hay-based diet (daily 5.5 kg hay per animal, split in three servings a day), beside distilled water was offered. The diets were offered one after the other in a way that all ponies had the same sequence of treatments. The native macromineral contents of the daily offered amount of hay already surpassed the new recommendations whereas dietary trace elements needed to be supplemented. There were no statistically significant differences (p ≤ .05) concerning the aD of copper, zinc and selenium comparing the diets with and without macromineral supplementation. Serum levels of these three trace elements were not affected by the different macromineral content of the diet. Results of this study, based on a 22-day feeding period for each treatment, indicate that a macromineral supplementation of a hay-based diet for adult horses at maintenance was not necessary. However, no negative effects of added macrominerals on the trace element metabolism occurred in this study. © 2017 Blackwell Verlag GmbH.

Use of complementary and alternative medicine by pediatric patients with functional and organic gastrointestinal diseases: results from a multicenter survey.

PubMed

Vlieger, Arine M; Blink, Marjolein; Tromp, Ellen; Benninga, Marc A

2008-08-01

Many pediatric patients use complementary and alternative medicine, especially when facing a chronic illness for which treatment options are limited. So far, research on the use of complementary and alternative medicine in patients with functional gastrointestinal disease has been scarce. This study was designed to assess complementary and alternative medicine use in children with different gastrointestinal diseases, including functional disorders, to determine which factors predicted complementary and alternative medicine use and to assess the willingness of parents to participate in future studies on complementary and alternative medicine efficacy and safety. The prevalence of complementary and alternative medicine use was assessed by using a questionnaire for 749 children visiting pediatric gastroenterology clinics of 9 hospitals in the Netherlands. The questionnaire consisted of 35 questions on the child's gastrointestinal disease, medication use, health status, past and future complementary and alternative medicine use, reasons for its use, and the necessity of complementary and alternative medicine research. In this study population, the frequency of complementary and alternative medicine use was 37.6%. A total of 60.3% of this group had used complementary and alternative medicine specifically for their gastrointestinal disease. This specific complementary and alternative medicine use was higher in patients with functional disorders than organic disorders (25.3% vs 17.2%). Adverse effects of allopathic medication, school absenteeism, age

Complementary and Alternative Medicine for Patients

MedlinePlus

... Ask about Your Treatment Research Complementary and Alternative Medicine for Patients Complementary and alternative medicine (CAM) is ... based on scientific evidence from research studies. Complementary medicine refers to treatments that are used with standard ...

Poor management of low birth weight compounds obesity and chronic diseases in Cuba.

PubMed

Hernández-Triana, Manuel

2015-04-01

The Cuban population exhibits high prevalence of overweight and associated chronic non-communicable diseases, trends that begin in childhood. In addition to factors related to the mother's health, factors contributing to excess weight gain in Cuban children are: reduced prevalence of exclusive breastfeeding of infants up to six months of age, full-term low birth weight infants and nutritional mismanagement of this group, incorrect complementary feeding, obesogenic diet, family history and sedentary lifestyles. Thus, it is important to adopt comprehensive, multisectoral strategies that promote adequate nutrition and weight control. This is particularly important for full-term low birth weight infants, predisposed to body fat storage.

Metamaterial-based half Maxwell fish-eye lens for broadband directive emissions

NASA Astrophysics Data System (ADS)

Dhouibi, Abdallah; Nawaz Burokur, Shah; de Lustrac, André; Priou, Alain

2013-01-01

The broadband directive emission from a metamaterial surface is numerically and experimentally reported. The metasurface, composed of non-resonant complementary closed ring structures, is designed to obey the refractive index of a half Maxwell fish-eye lens. A planar microstrip Vivaldi antenna is used as transverse magnetic polarized wave launcher for the lens. A prototype of the lens associated with its feed structure has been fabricated using standard lithography techniques. To experimentally demonstrate the broadband focusing properties and directive emissions, both the far-field radiation patterns and the near-field distributions have been measured. Measurements agree quantitatively and qualitatively with theoretical simulations.

Non-breast milk feeding in developing countries: challenge from microbial and chemical contaminants.

PubMed

Weisstaub, Gerardo; Uauy, Ricardo

2012-01-01

Complementary foods based on cow's milk or gruels consumed by children in developing countries are often contaminated by bacteria during preparation, and ambient temperature rapidly increases microbial load. Thus infant formula or other weaning foods may cause diarrhea in young infants accounting for 25-33% of all deaths <5 years globally. Environmental chemicals such as metals (As, Pb, Cu) and nitrates can cause vomiting/diarrhea. Polychlorinated biphenyls derived from plastics, present in formula and/or breast milk, are endocrine disruptors (the potential threats are not fully quantifiable). The prevailing view is that benefits from breastfeeding outweigh potential risks. Copyright © 2012 S. Karger AG, Basel.

Development of Kinetics and Mathematical Models for High Pressure Gasification of Lignite-Switchgrass Blends

DOE Office of Scientific and Technical Information (OSTI.GOV)

Agrawal, Pradeep K.

The overall objective of the current project was to investigate the high pressure gasification characteristics of a feed containing both coal and biomass. The two feed types differ in their ash contents and ash composition, particularly the alkali content. Gasification of a combined feed of coal and biomass has the potential for considerable synergies that might lead to a dramatic improvement in process economics and flexibility. The proposed study aimed to develop a detailed understanding of the chemistry, kinetics, and transport effects during high pressure gasification of coal-biomass blend feed. Specifically, we studied to develop: (a) an understanding of themore » catalytic effect of alkali and other inorganic species present in the biomass and coal, (b) an understanding of processing conditions under which synergistic effects of the blending of coal and biomass might be observed. This included the role of particle size, residence time, and proximity of the two feed types, (c) kinetics of high pressure gasification of individual feeds as well as the blends, and (d) development of mathematical models that incorporate kinetics and transport models to enable prediction of gasification rate at a given set of operating conditions, and (e) protocols to extend the results to other feed resources. The goal was to provide a fundamental understanding of the gasification process and guide in optimizing the configurations and design of the next generation of gasifiers. The approach undertaken was centered on two basic premises: (1) the gasification for small particles without internal mass transfer limitations can be treated as the sum of two processes in series (pyrolysis and char gasification) , and (2) the reactivity of the char generated during pyrolysis not only depends on the pressure and temperature but is also affected by the heating rates. Thus low heating rates (10-50 °C/min) typical of PTGA fail to produce char that would typically be formed at high heating rates (~10 4 °C/sec), encountered in entrained flow gasifiers. The char morphology, also a function of the heating rate, would influence the transport rates during the char gasification phase. Thus, heating rate plays a critical role through which both, pyrolysis and char gasification, are interconnected. We utilized two complementary gasification experiments: PEFR (pressurized entrained flow gasifier) and PTGA (pressurized thermo-gravimetric analyzer). The PEFR allowed us to study gasification at pressures, temperatures, and heating rates relevant for coal-biomass gasifiers. The PTGA work was useful in understanding the basic chemistry of the evolution of various gaseous species during pyrolysis. These results helped improved our understanding of the chemistry and chemical changes during pyrolysis. The role alkali metals and other inorganics in char gasification using steam and/or CO 2 was investigated. Finally, the mathematical models for char gasification without the transport effects were developed at commercial operating conditions.« less

Complementary and Alternative Medicine: A Cross-Sectional Observational Study in Pediatric Inpatients

PubMed Central

Dhankar, Mukesh

2018-01-01

The aim was to study the prevalence of complementary and alternative medicine use in acutely sick hospitalized children and factors associated with it. This is a cross-sectional, hospital-based study in a tertiary care center of Delhi, India. Children admitted to a pediatric unit during the study period were assessed using a specially designed questionnaire. Out of the total 887 admitted children, 161 (18.1%) were using complementary and alternate medicine in one form or another. Of these, 113 (70.2%) were using complementary and alternate medicine for the current illness directly leading to admission and the remaining 48 (29.8%) had used complementary and alternate medicine in past. The common complementary and alternate medicine use observed in our study was combined ayurveda and spiritual approach (25.5%), ayurveda (24.8%), spiritual (21.7%), homeopathic (13%), and 47.2% of children were using spiritual approach in form of Jhada (tying piece of cloth on arm or leg or keeping a knife by the side of child). The significant factors associated with complementary and alternate medicine use were younger age, female gender, and father being employed. Complementary and alternate medicine is commonly used even in acutely sick children. PMID:29616560

Nutrition (Micronutrients) in Child Growth and Development: A Systematic Review on Current Evidence, Recommendations and Opportunities for Further Research.

PubMed

Yakoob, Mohammad Yawar; Lo, Clifford W

2017-10-01

An important aspect of malnutrition is deficiency of different micronutrients during pregnancy or early childhood. We systematically reviewed the role of nutrition in child growth (weight or height gain) and development. A comprehensive literature search was done on PubMed/Cochrane Library browsing through 38,795 abstracts until December 31, 2016 to select systematic reviews/meta-analyses and individual randomized controlled trials (RCTs) of micronutrient supplementation. Micronutrients studied included iron, iodine, folate, zinc, calcium, magnesium, selenium, vitamin D, vitamin A, vitamin B complex, and multiple micronutrients. We summarize evidence with details and results of RCTs, highlight strengths/weaknesses, and critically interpret findings. Effects of breastfeeding-promotion, food-supplementation (complementary and school feeding), conditional-cash-transfers, and integrated nutrition/psychosocial interventions are discussed. Based on this evidence we make policy and programmatic recommendations for supplementation to mothers and children at high-risk of deficiency.

[Opinion of women from a family health unit about the quantity of mothermilk produced].

PubMed

Borges, Ana Luiza Vilela; Philippi, Sonia Tucunduva

2003-01-01

This is a study aimed at knowing the opinion of women about the quantity of mothermilk produced, since insufficient milk is one of the main reasons mentioned by women from different cultures when introducing complementary feeding in children's diet before the fourth month of life. The interviews were made at the homes of 41 women from a family health unit in the Eastern area of S o Paulo City in 1998 and 1999. The majority of the mothers (82.9%) considered they were producing a sufficient quantity of mothermilk. As evaluation criteria for the produced quantity of mothermilk, they used the size of the breasts, the spontaneous dropping of milk and the mood of the child after breastfeeding. All women introduced artificial milk before the fourth month, but those who mentioned insufficient milk did it earlier (p=0.0088).

Complementary and conventional providers in cancer care: experience of communication with patients and steps to improve communication with other providers.

PubMed

Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E

2017-06-08

Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers' experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire. The survey was developed to describe aspects of the communication pattern among oncology doctors, nurses, family physicians and complementary therapists (acupuncturists, massage therapists and reflexologists/zone-therapists). Between-group differences were analyzed using chi-square, ANOVA and Fisher's exact tests. Significance level was defined as p < 0.05 without adjustment for multiple comparisons. Conventional providers and complementary therapists had different patterns of communication with their cancer patients regarding complementary therapies. While complementary therapists advised their patients to apply both complementary and conventional modalities, medical doctors were less supportive of their patients' use of complementary therapies. Of conventional providers, nurses expressed more positive attitudes toward complementary therapies. Opportunities to improve communication between conventional and complementary providers were most strongly supported by complementary providers and nurses; medical doctors were less supportive of such attempts. A number of doctors showed lack of respect for complementary therapists, but asked for more research, guidelines for complementary modalities and training in conventional medicine for complementary therapists. For better quality of care, greater communication about complementary therapy use is needed between cancer patients and their conventional and complementary providers. In addition, more communication between conventional and complementary providers is needed. Nurses may have a crucial role in facilitating communication, as they are positive toward complementary therapies and they have more direct communication with patients about their treatment preferences.

Discovering complementary colors from the perspective of steam education

NASA Astrophysics Data System (ADS)

Karabey, Burak; Yigit Koyunkaya, Melike; Enginoglu, Turan; Yurumezoglu, Kemal

2018-05-01

This study explored the theory and applications of complementary colors using a technology-based activity designed from the perspective of STEAM education. Complementary colors and their areas of use were examined from the perspective of physics, mathematics and art, respectively. The study, which benefits from technology, makes the theory of complementary colors accessible to all through practical applications and provides a multidisciplinary, integrated and innovative technique of teaching the subject of colors, which could be used to teach complementary colors.

The Two-Brains Hypothesis: Towards a guide for brain-brain and brain-machine interfaces.

PubMed

Goodman, G; Poznanski, R R; Cacha, L; Bercovich, D

2015-09-01

Great advances have been made in signaling information on brain activity in individuals, or passing between an individual and a computer or robot. These include recording of natural activity using implants under the scalp or by external means or the reverse feeding of such data into the brain. In one recent example, noninvasive transcranial magnetic stimulation (TMS) allowed feeding of digitalized information into the central nervous system (CNS). Thus, noninvasive electroencephalography (EEG) recordings of motor signals at the scalp, representing specific motor intention of hand moving in individual humans, were fed as repetitive transcranial magnetic stimulation (rTMS) at a maximum intensity of 2.0[Formula: see text]T through a circular magnetic coil placed flush on each of the heads of subjects present at a different location. The TMS was said to induce an electric current influencing axons of the motor cortex causing the intended hand movement: the first example of the transfer of motor intention and its expression, between the brains of two remote humans. However, to date the mechanisms involved, not least that relating to the participation of magnetic induction, remain unclear. In general, in animal biology, magnetic fields are usually the poor relation of neuronal current: generally "unseen" and if apparent, disregarded or just given a nod. Niels Bohr searched for a biological parallel to complementary phenomena of physics. Pertinently, the two-brains hypothesis (TBH) proposed recently that advanced animals, especially man, have two brains i.e., the animal CNS evolved as two fundamentally different though interdependent, complementary organs: one electro-ionic (tangible, known and accessible), and the other, electromagnetic (intangible and difficult to access) - a stable, structured and functional 3D compendium of variously induced interacting electro-magnetic (EM) fields. Research on the CNS in health and disease progresses including that on brain-brain, brain-computer and brain-robot engineering. As they grow even closer, these disciplines involve their own unique complexities, including direction by the laws of inductive physics. So the novel TBH hypothesis has wide fundamental implications, including those related to TMS. These require rethinking and renewed research engaging the fully complementary equivalence of mutual magnetic and electric field induction in the CNS and, within this context, a new mathematics of the brain to decipher higher cognitive operations not possible with current brain-brain and brain-machine interfaces. Bohr may now rest.

Eggs early in complementary feeding increase choline pathway biomarkers and DHA: a randomized controlled trial in Ecuador.

PubMed

Iannotti, Lora L; Lutter, Chessa K; Waters, William F; Gallegos Riofrío, Carlos Andres; Malo, Carla; Reinhart, Gregory; Palacios, Ana; Karp, Celia; Chapnick, Melissa; Cox, Katherine; Aguirre, Santiago; Narvaez, Luis; López, Fernando; Sidhu, Rohini; Kell, Pamela; Jiang, Xuntian; Fujiwara, Hideji; Ory, Daniel S; Young, Rebecca; Stewart, Christine P

2017-12-01

Background: Choline status has been associated with stunting among young children. Findings from this study showed that an egg intervention improved linear growth by a length-for-age z score of 0.63. Objective: We aimed to test the efficacy of eggs introduced early in complementary feeding on plasma concentrations of biomarkers in choline pathways, vitamins B-12 and A, and essential fatty acids. Design: A randomized controlled trial, the Lulun ("egg" in Kichwa) Project, was conducted in a rural indigenous population of Ecuador. Infants aged 6-9 mo were randomly assigned to treatment (1 egg/d for 6 mo; n = 80) and control (no intervention; n = 83) groups. Socioeconomic data, anthropometric measures, and blood samples were collected at baseline and endline. Household visits were made weekly for morbidity surveillance. We tested vitamin B-12 plasma concentrations by using chemiluminescent competitive immunoassay and plasma concentrations of choline, betaine, dimethylglycine, retinol, essential fatty acids, methionine, dimethylamine (DMA), trimethylamine, and trimethylamine- N -oxide (TMAO) with the use of liquid chromatography-tandem mass spectrometry. Results: Socioeconomic factors and biomarker concentrations were comparable at baseline. Of infants, 11.4% were vitamin B-12 deficient and 31.7% marginally deficient at baseline. In adjusted generalized linear regression modeling, the egg intervention increased plasma concentrations compared with control by the following effect sizes: choline, 0.35 (95% CI: 0.12, 0.57); betaine, 0.29 (95% CI: 0.01, 0.58); methionine, 0.31 (95% CI: 0.03, 0.60); docosahexaenoic acid, 0.43 (95% CI: 0.13, 0.73); DMA, 0.37 (95% CI: 0.37, 0.69); and TMAO, 0.33 (95% CI: 0.08, 0.58). No significant group differences were found for vitamin B-12, retinol, linoleic acid (LA), α-linolenic acid (ALA), or ratios of betaine to choline and LA to ALA. Conclusion: The findings supported our hypothesis that early introduction of eggs significantly improved choline and other markers in its methyl group metabolism pathway. This trial was registered at clinicaltrials.gov as NCT02446873.

Eggs early in complementary feeding increase choline pathway biomarkers and DHA: a randomized controlled trial in Ecuador

PubMed Central

Lutter, Chessa K; Waters, William F; Gallegos Riofrío, Carlos Andres; Malo, Carla; Reinhart, Gregory; Palacios, Ana; Karp, Celia; Chapnick, Melissa; Cox, Katherine; Aguirre, Santiago; Narvaez, Luis; López, Fernando; Sidhu, Rohini; Kell, Pamela; Jiang, Xuntian; Fujiwara, Hideji; Ory, Daniel S; Young, Rebecca; Stewart, Christine P

2017-01-01

Background: Choline status has been associated with stunting among young children. Findings from this study showed that an egg intervention improved linear growth by a length-for-age z score of 0.63. Objective: We aimed to test the efficacy of eggs introduced early in complementary feeding on plasma concentrations of biomarkers in choline pathways, vitamins B-12 and A, and essential fatty acids. Design: A randomized controlled trial, the Lulun (“egg” in Kichwa) Project, was conducted in a rural indigenous population of Ecuador. Infants aged 6–9 mo were randomly assigned to treatment (1 egg/d for 6 mo; n = 80) and control (no intervention; n = 83) groups. Socioeconomic data, anthropometric measures, and blood samples were collected at baseline and endline. Household visits were made weekly for morbidity surveillance. We tested vitamin B-12 plasma concentrations by using chemiluminescent competitive immunoassay and plasma concentrations of choline, betaine, dimethylglycine, retinol, essential fatty acids, methionine, dimethylamine (DMA), trimethylamine, and trimethylamine-N-oxide (TMAO) with the use of liquid chromatography–tandem mass spectrometry. Results: Socioeconomic factors and biomarker concentrations were comparable at baseline. Of infants, 11.4% were vitamin B-12 deficient and 31.7% marginally deficient at baseline. In adjusted generalized linear regression modeling, the egg intervention increased plasma concentrations compared with control by the following effect sizes: choline, 0.35 (95% CI: 0.12, 0.57); betaine, 0.29 (95% CI: 0.01, 0.58); methionine, 0.31 (95% CI: 0.03, 0.60); docosahexaenoic acid, 0.43 (95% CI: 0.13, 0.73); DMA, 0.37 (95% CI: 0.37, 0.69); and TMAO, 0.33 (95% CI: 0.08, 0.58). No significant group differences were found for vitamin B-12, retinol, linoleic acid (LA), α-linolenic acid (ALA), or ratios of betaine to choline and LA to ALA. Conclusion: The findings supported our hypothesis that early introduction of eggs significantly improved choline and other markers in its methyl group metabolism pathway. This trial was registered at clinicaltrials.gov as NCT02446873. PMID:29092879

Family-based obesity prevention for infants: Design of the "Mothers & Others" randomized trial.

PubMed

Wasser, Heather M; Thompson, Amanda L; Suchindran, Chirayath M; Hodges, Eric A; Goldman, Barbara D; Perrin, Eliana M; Faith, Myles S; Bulik, Cynthia M; Heinig, M Jane; Bentley, Margaret E

2017-09-01

Our goal is to test the efficacy of a family-based, multi-component intervention focused on infants of African-American (AA) mothers and families, a minority population at elevated risk for pediatric obesity, versus a child safety attention-control group to promote healthy weight gain patterns during the first two years of life. The design is a two-group randomized controlled trial among 468 AA pregnant women in central North Carolina. Mothers and study partners in the intervention group receive anticipatory guidance on breastfeeding, responsive feeding, use of non-food soothing techniques for infant crying, appropriate timing and quality of complementary feeding, age-appropriate infant sleep, and minimization of TV/media. The primary delivery channel is 6 home visits by a peer educator, 4 interim newsletters and twice-weekly text messaging. Intervention families also receive 2 home visits from an International Board Certified Lactation Consultant. Assessments occur at 28 and 37weeks gestation and when infants are 1, 3, 6, 9, 12, and 15months of age. The primary outcome is infant/toddler growth and likelihood of overweight at 15months. Differences between groups are expected to be achieved through uptake of the targeted infant feeding and care behaviors (secondary outcomes) and change in caregivers' modifiable risk factors (mediators) underpinning the intervention. If successful in promoting healthy infant growth and enhancing caregiver behaviors, "Mothers and Others" will have high public health relevance for future obesity-prevention efforts aimed at children younger than 2years, including interventional research and federal, state, and community health programs. ClinicalTrials.gov, NCT01938118, August 9, 2013. Copyright © 2017 Elsevier Inc. All rights reserved.

Costs and cost-effectiveness of HIV community services: quantity and quality of studies published 1986-2011.

PubMed

Beck, Eduard J; Fasawe, Olufunke; Ongpin, Patricia; Ghys, Peter; Avilla, Carlos; De Lay, Paul

2013-06-01

Community services comprise an important part of a country's HIV response. English language cost and cost-effectiveness studies of HIV community services published between 1986 and 2011 were reviewed but only 74 suitable studies were identified, 66% of which were performed in five countries. Mean study scores by continent varied from 42 to 69% of the maximum score, reflecting variation in topics covered and the quality of coverage: 38% of studies covered key and 11% other vulnerable populations - a country's response is most effective and efficient if these populations are identified given they are key to a successful response. Unit costs were estimated using different costing methods and outcomes. Community services will need to routinely collect and analyze information on their use, cost, outcome and impact using standardized costing methods and outcomes. Cost estimates need to be disaggregated into relevant cost items and stratified by severity and existing comorbidities. Expenditure tracking and costing of services are complementary aspects of the health sector 'resource cycle' that feed into a country's investment framework and the development and implementation of national strategic plans.

Knowledge, Attitude, and Practice of Complementary and Alternative Medicine Among Residents of Wayu Town, Western Ethiopia.

PubMed

Belachew, Negash; Tadesse, Tarekegne; Gube, Addisu Alemayehu

2017-10-01

Complementary and alternative medicine covers a wide variety of therapies and practices, which vary from country to country and region to region. The study was conducted to assess the knowledge, attitude, and practice of complementary and alternative medicine among the residents of Wayu town, Western Ethiopia. A descriptive cross-sectional study was carried out on 302 residents. A systematic sampling was used to select households. Data were entered in SPSS (version 20; IBM Corp) and descriptive statistics was carried out. Of 302 participants, 51.65% have a good knowledge, 78.6% were aware of complementary and alternative medicine, and 74.22% used it in the past 2 years. A total of 23.83% believe that complementary and alternative medicine is more effective than modern medicine and 28.8% preferred complementary and alternative medicine to modern medicine. This study revealed that in Wayu town, there is relatively high public interest in complementary and alternative medicine practices and a significant number has a good knowledge but generally the attitude toward complementary and alternative medicine is relatively low.

Knowledge, Attitude, and Practice of Complementary and Alternative Medicine Among Residents of Wayu Town, Western Ethiopia

PubMed Central

Belachew, Negash; Tadesse, Tarekegne

2017-01-01

Complementary and alternative medicine covers a wide variety of therapies and practices, which vary from country to country and region to region. The study was conducted to assess the knowledge, attitude, and practice of complementary and alternative medicine among the residents of Wayu town, Western Ethiopia. A descriptive cross-sectional study was carried out on 302 residents. A systematic sampling was used to select households. Data were entered in SPSS (version 20; IBM Corp) and descriptive statistics was carried out. Of 302 participants, 51.65% have a good knowledge, 78.6% were aware of complementary and alternative medicine, and 74.22% used it in the past 2 years. A total of 23.83% believe that complementary and alternative medicine is more effective than modern medicine and 28.8% preferred complementary and alternative medicine to modern medicine. This study revealed that in Wayu town, there is relatively high public interest in complementary and alternative medicine practices and a significant number has a good knowledge but generally the attitude toward complementary and alternative medicine is relatively low. PMID:29250965

A review of nurses' knowledge, attitudes, and ability to communicate the risks and benefits of complementary and alternative medicine.

PubMed

Chang, Hsiao-Yun; Chang, Huai-Lu

2015-06-01

This study reviewed existing literature to investigate how frequently nurses include complementary and alternative forms of medicine in their clinical practice. In so doing, we investigated nurses' knowledge of and attitudes towards complementary and alternative medicine as well as their ability to communicate the risks and benefits of these therapies with patients. Little information is available concerning nurses' knowledge and attitudes towards complementary and alternative medicine or how they incorporate these therapies into their practice. In addition, little is known about the ability of nurses to communicate the risks and benefits of complementary and alternative medicine to their patients. This study used a scoping review method to map and synthesise existing literature. Both electronic and manual searches were used to identify relevant studies published between January 2007 and January 2014. The review was conducted in five stages: (1) identification of research question(s), (2) locate studies, (3) selection of studies, (4) charting of data, and (5) collating, summarising, and reporting of results. Fifteen papers met the inclusion criteria for this review, among which 53·7% referenced how frequently nurses include complementary and alternative medicine in their practice. We found that 66·4% of nurses had positive attitudes towards complementary and alternative medicine; however, 77·4% did not possess a comprehensive understanding of the associated risks and benefits. In addition, nearly half of the respondents (47·3-67·7%) reported feeling uncomfortable discussing complementary and alternative medicine therapies with their patients. The lack of knowledge about complementary and alternative medicine among nurses is a cause for concern, particularly in light of its widespread application. Findings from this study suggest that health care professionals need to promote evidence informed decision-making in complementary and alternative medicine practice and be knowledgeable enough to discuss complementary and alternative medicine therapies. Without involvement of complementary and alternative medicine communication on the part of our profession, we may put our patients at risk of uninformed and without medical guidance. © 2015 John Wiley & Sons Ltd.

The Effectiveness of Community-Based Nutrition Education on the Nutrition Status of Under-five Children in Developing Countries. A Systematic Review.

PubMed

Majamanda, J; Maureen, D; Munkhondia, T M; Carrier, J

2014-12-01

This systematic review aimed at examining the best available evidence on the effectiveness of community-based nutrition education in improving the nutrition status of under five children in developing countries. A systematic search of the literature was conducted utilising the following data bases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Medline, and Web of Knowledge. 9 studies were identified for the critical appraisal process. The Joanna Briggs Institute (JBI) critical appraisal check-list for experimental studies was utilised and two reviewers conducted the appraisal process independently. 7 studies were included for this review and data was extracted using the JBI data extraction form for experimental studies. The extracted data was heterogeneous as such narrative synthesis was conducted. The nutritional status of children in all studies improved and this was evidenced by increases in weight, height, mid upper arm circumference and reduced morbidity. Key messages about education were age at introduction of complementary foods, nutrition value on different types of feeds found locally and frequency of feeding the children. However, there were varied results regarding the effects of the intervention on the nutrition status of children. This was attributed by differences in implementers' characteristics, different intervention strategy and intensity, difference in age of the children at enrolment, pre-existing children's growth and nutritional status and follow-up periods. In addition to home visiting, conducting group meetings of care givers and community leaders, providing education twice a week and use of cooking demonstrations have shown that they produce highly significant findings. The evidence from the identified studies suggests that community- based nutrition education improves the nutrition status of under-five children in developing countries.

The combined action of omega-3 polyunsaturated fatty acids and grape proanthocyanidins on a rat model of diet-induced metabolic alterations.

PubMed

Ramos-Romero, Sara; Molinar-Toribio, Eunice; Pérez-Jiménez, Jara; Taltavull, Núria; Dasilva, Gabriel; Romeu, Marta; Medina, Isabel; Torres, Josep Lluís

2016-08-10

It has been suggested that food components such as ω-3 polyunsaturated fatty acids (ω-3 PUFAs) and (poly)phenols counteract diet-induced metabolic alterations by common or complementary mechanisms. To examine the effects of a combination of ω-3 PUFAs and (poly)phenols on such alterations, adult Wistar-Kyoto rats were fed an obesogenic high-fat high-sucrose diet supplemented, or not, for 24 weeks with: eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) 1 : 1 (16.6 g kg(-1) feed); proanthocyanidin-rich grape seed extract (GSE, 0.8 g kg(-1) feed); or EPA/DHA 1 : 1 + GSE. Body weight, feed intake, and plasma glucose were evaluated every 6 weeks, while adipose tissue weight, insulin, glucagon, ghrelin, leptin, adiponectin, cholesterol, and triglycerides were evaluated at the end of the experiment. ω-3 PUFAs reduced plasma leptin and cholesterol levels, but did not modify diet-induced perigonadal fat or plasma insulin levels; while GSE increased plasma triglyceride levels. The combined action of ω-3 PUFAs and the proanthocyanidins reduced plasma insulin and leptin, as well as partially prevented perigonadal fat accumulation. While separate supplementation with ω-3 PUFAs or grape proanthocyanidins may not counteract all the key metabolic changes induced by a high-energy-dense diet, the combination of both supplements reverts altered insulin, leptin and triglyceride levels to normal.

Point‐of‐sale promotion of breastmilk substitutes and commercially produced complementary foods in Cambodia, Nepal, Senegal and Tanzania

PubMed Central

Pereira, Catherine; Sweet, Lara; Khin, Mengkheang; Ndiaye Coly, Aminata; Sy Gueye, Ndeye Yaga; Adhikary, Indu; Dhungel, Shrid; Makafu, Cecilia; Zehner, Elizabeth; Huffman, Sandra L.

2016-01-01

Abstract In order to assess the prevalence of point‐of‐sale promotions of infant and young child feeding products in Phnom Penh, Cambodia; Kathmandu Valley, Nepal; Dakar Department, Senegal; and Dar es Salaam, Tanzania, approximately 30 retail stores per site, 121 in total, were visited. Promotional activity for breastmilk substitutes (BMS) and commercially produced complementary foods in each site were recorded. Point‐of‐sale promotion of BMS occurred in approximately one‐third of sampled stores in Phnom Penh and Dakar Department but in 3.2% and 6.7% of stores in Kathmandu Valley and Dar es Salaam, respectively. Promotion of commercially produced complementary foods was highly prevalent in Dakar Department with half of stores having at least one promotion, while promotions for these products occurred in 10% or less of stores in the other three sites. While promotion of BMS in stores is legal in Senegal, it is prohibited in Cambodia without prior permission of the Ministry of Health/Ministry of Information and prohibited in both Nepal and Tanzania. Strengthening legislation in Senegal and enforcing regulations in Cambodia could help to prevent such promotion that can negatively affect breastfeeding practices. Key messages Even in countries such as Cambodia, Nepal and Tanzania where point‐of‐sale promotion is restricted, promotions of BMS were observed (in nearly one‐third of stores in Phnom Penh and less than 10% in Dar es Salaam and Kathmandu).Limited promotion of commercially produced complementary foods was evident (less than 10% of stores had a promotion for such foods), except in Dakar Department, where promotions were found in half of stores.Efforts are needed to strengthen monitoring, regulation and enforcement of restrictions on the promotion of BMS.Manufacturers and distributors should take responsibility for compliance with national regulations and global policies pertaining to the promotion of breastmilk substitutes. PMID:27061961

[Considerations on family dynamics and the malnutrition syndrome in Mexican children].

PubMed

Vásquez-Garibay, Edgar Manuel; González-Rico, José Luis; Romero-Velarde, Enrique; Sánchez-Talamantes, Eva; Navarro-Lozano, María Eugenia; Nápoles-Rodríguez, Francisco

2015-01-01

Since the early 1990s we noted that family dysfunction was more common in children with severe primary malnutrition than in children admitted to the hospital without malnutrition. Defects on feeding habits during the first year of life, especially early weaning and inadequate complementary feeding were more common in dysfunctional families. We also observed that chronic malnutrition in preschool children, and overweight and obesity in schoolchildren were more common in children from dysfunctional families. Once the association between dysfunctional family dynamics and obesity in schoolchildren was demonstrated, it was observed that low education of fathers and mothers increased twofold the possibility of family dysfunction: OR: 2.06; 95% CI: 1.37-3.10 and OR: 2.47; 95% CI: 1.57-3.89, respectively. In addition, the low-income and the lower purchasing power of foods were associated to family dysfunction (p<0.05). A remaining task is to explore how to assess family dysfunction in composite, extended, single-parent families where there exist other persons vulnerable to the different entities of malnutrition syndrome and indeed depend on adults for their care, food and nutrition.

Benefits of donor human milk for preterm infants: current evidence.

PubMed

Bertino, Enrico; Giuliani, Francesca; Occhi, Luciana; Coscia, Alessandra; Tonetto, Paola; Marchino, Federica; Fabris, Claudio

2009-10-01

It's undoubted that optimum nutrition for term infants is breastfeeding, exclusive for the first six months, then followed by a complementary diet and carried on, if possible, for the first year of life or even more. During the last decades several data confirmed the great advantages of fresh mother's milk use also for feeding very low and extremely low birthweight preterm infants. When mother's milk is unavailable or in short supply, pasteurized donor breast milk is widely used in neonatal intensive care units. Pasteurization partially affects nutritional and immunological properties of breast milk, however it is known that pasteurized milk maintains some biological properties and clinical benefits. The substantial benefits of mother's own milk feeding of preterm infants are supported by strong evidence. However, there is increasing evidence also on specific benefits of donor breast milk. Future research is needed to compare formula vs. nutrient fortified donor breast milk, to compare formula and DM as supplements to maternal milk rather than as sole diet and to compare effects of different methods of heat treatments on donor human milk quality.

Position of the American Dietetic Association: Promoting and supporting breastfeeding.

PubMed

James, Delores C S; Dobson, Brenda

2005-05-01

It is the position of the American Dietetic Association (ADA) that exclusive breastfeeding provides optimal nutrition and health protection for the first 6 months of life, and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Breastfeeding is also a public health strategy for improving infant and child health survival, improving maternal morbidity, controlling health care costs, and conserving natural resources. ADA emphasizes the essential role of dietetics professionals in promoting and supporting breastfeeding by providing up-to-date, practical information to pregnant and postpartum women, involving family and friends in breastfeeding education and counseling, removing institutional barriers to breastfeeding, collaborating with community organizations and others who promote and support breastfeeding, and advocating for policies that position breastfeeding as the norm for infant feeding. ADA also emphasizes its own role by providing up-to-date information to the public, encouraging empirical research, providing continuing education opportunities, providing cultural sensitivity and cultural competence training to dietetics professionals, and encouraging universities to review and update undergraduate and graduate training programs.

Development and validation of duplex, triplex, and pentaplex real-time PCR screening assays for the detection of genetically modified organisms in food and feed.

PubMed

Huber, Ingrid; Block, Annette; Sebah, Daniela; Debode, Frédéric; Morisset, Dany; Grohmann, Lutz; Berben, Gilbert; Stebih, Dejan; Milavec, Mojca; Zel, Jana; Busch, Ulrich

2013-10-30

Worldwide, qualitative methods based on PCR are most commonly used as screening tools for genetically modified material in food and feed. However, the increasing number and diversity of genetically modified organisms (GMO) require effective methods for simultaneously detecting several genetic elements marking the presence of transgenic events. Herein we describe the development and validation of a pentaplex, as well as complementary triplex and duplex real-time PCR assays, for the detection of the most common screening elements found in commercialized GMOs: P-35S, T-nos, ctp2-cp4-epsps, bar, and pat. The use of these screening assays allows the coverage of many GMO events globally approved for commercialization. Each multiplex real-time PCR assay shows high specificity and sensitivity with an absolute limit of detection below 20 copies for the targeted sequences. We demonstrate by intra- and interlaboratory tests that the assays are robust as well as cost- and time-effective for GMO screening if applied in routine GMO analysis.

Identification of potentially emerging food safety issues by analysis of reports published by the European Community's Rapid Alert System for Food and Feed (RASFF) during a four-year period.

PubMed

Kleter, G A; Prandini, A; Filippi, L; Marvin, H J P

2009-05-01

The SAFE FOODS project undertakes to design a new approach towards the early identification of emerging food safety hazards. This study explored the utility of notifications filed through RASFF, the European Commission's Rapid Alert System for Food and Feed, to identify emerging trends in food safety issues. RASFF information and alert notifications published in the four-year period of July 2003-June 2007 were assigned to categories of products and hazards. For chronological trend analysis, a basic time unit of three months was chosen. Data within each hazard category were analyzed for chronological trends, relationships between product and hazard categories, regions of origin, and countries filing the notifications. Conspicuous trends that were observed included a rise in the incidence of food contact substances, particularly 2-isopropyl-thioxanthone, as well as of chemical substances migrating from utensils and fraud-related issues. Temporary increases were noted in the incidences of the unauthorized dye Para Red, genetically modified organisms, the pesticide isophenfos-methyl, and herring worm, Anisakis simplex. National and European authorities themselves have signaled these conspicuous trends and taken measures. It is recommended to add complementary data to RASFF data, including safety assessments, risk management measures, background data on hazards and surveillance patterns, for a holistic approach towards early identification of emerging hazards.

Breastfeeding increases microbial community resilience.

PubMed

Carvalho-Ramos, Isabel I; Duarte, Rubens T D; Brandt, Katia G; Martinez, Marina B; Taddei, Carla R

2017-09-05

Since the present group had already described the composition of the intestinal microbiota of Brazilian infants under low social economic level, the aim of the present study was to analyze the microbial community structure changes in this group of infants during their early life due to external factors. Fecal samples were collected from 11 infants monthly during the first year of life. The infants were followed regarding clinical and diet information and characterized according to breastfeeding practices. DNA was extracted from fecal samples of each child and subjected to denaturing gradient gel electrophoresis analysis. The results revealed a pattern of similarity between the time points for those who were on exclusive breastfeeding or predominant breastfeeding. Although there were changes in intensity and fluctuation of some bands, the denaturing gradient gel electrophoresis patterns in the one-year microbial analysis were stable for breastfeeding children. There was uninterrupted ecological succession despite the influence of external factors, such as complementary feeding and antibiotic administration, suggesting microbiota resilience. This was not observed for those children who had mixed feeding and introduction of solid food before the 5 th month of life. These results suggested an intestinal microbiota pattern resilient to external forces, due to the probiotic and prebiotic effects of exclusive breastfeeding, reinforcing the importance of exclusive breastfeeding until the 6 th month of life. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Use of complementary and alternative medicine by patients with arthritis.

PubMed

Unsal, Ayla; Gözüm, Sebahat

2010-04-01

The aims of this study were to determine the prevalence of complementary and alternative medicine use in patients with arthritis, the types of complementary and alternative medicine used, pertinent socio-demographic factors associated with complementary and alternative medicine use and its perceived efficacy. Arthritis is a major health issue, and the use of complementary and alternative medicine among patients with arthritis is common. This is a descriptive cross-sectional study. Data were obtained from 250 patients with arthritis at the physiotherapy and immunology clinics Atatürk University Hospital in eastern Turkey between May-July 2005 using a questionnaire developed specifically for this study. The instrument included questions on socio-demographic information, disease specifics and complementary and alternative medicine usage. Seventy-six per cent of participants reported use of at least one form of complementary and alternative medicine in the previous year. Complementary and alternative medicine users and non-users were not significantly different in most socio-demographic characteristics including age, gender, marital status and education level with the exception of economic status. We categorised treatment into six complementary and alternative medicine categories: 62.6% of patients used thermal therapies; 41.5% used oral herbal therapies; 40.5% used hot therapies; 32.6% used externally applied (skin) therapies; 28.4% used massage and 12.6% used cold therapies. All forms of complementary and alternative medicine except thermal and oral herbal therapies were perceived as very effective by more than half of study participants. Complementary and alternative medicine therapy is widely used by patients with arthritis and has perceived beneficial effects. It is important for nurses and other health care professionals to be knowledgeable about the use of complementary and alternative medicine therapies when providing care to patients with arthritis because of possible interactions with other treatments, delays in seeking care and the potential for poor quality products. It is also essential for health professionals to discuss treatment options with patients and to monitor treatment efficacy.

Nutritional vulnerability: An assessment of the 2010 feeding food programme in Mbire district, Zimbabwe, and its impact on pregnant women

PubMed Central

2017-01-01

Malnutrition contributes significantly to Zimbabwe’s high maternal mortality rate. The prevalence of malnutrition among vulnerable pregnant women in the Mbire district of Zimbabwe was studied to establish why they remained vulnerable despite benefiting from the Vulnerable Group Feeding Programme, a subsidiary of the World Food Programme. A case study on the demographic characteristics, nutritional provision of the programme and the vulnerable pregnant women benefiting from the programme was conducted. One hundred women were purposively sampled at health centres in the district. A two-stage sampling procedure was then utilised to select the most food-insecure wards. The two most food-insecure wards, namely Angwa and Chapoto, were chosen because of their proximity to each other. A questionnaire was administered to the pregnant women to collect their demographic information. Practising nurses at the health centres determined the women’s nutritional status and anthropometrics, and they also assessed the food baskets. Permission to conduct the study was obtained from the relevant authorities. The results indicated that the food hamper provided by the World Food Programme was complementary food aid given to all vulnerable members of the community regardless of the nutritional demands. The supplements that the pregnant women received were also inadequate to cater for their nutritional needs or those of the foetuses. It was therefore recommended that the government, through the Ministry of Health, should make more provisions available for vulnerable pregnant women in order to reduce the risks facing pregnant women in the country.

The focused ethnographic study 'assessing the behavioral and local market environment for improving the diets of infants and young children 6 to 23 months old' and its use in three countries.

PubMed

Pelto, Gretel H; Armar-Klemesu, Margaret; Siekmann, Jonathan; Schofield, Dominic

2013-01-01

The concept of a focused ethnographic study (FES) emerged as a new methodology to answer specific sets of questions that are required by agencies, policymakers, programme planners or by project implementation teams in order to make decisions about future actions with respect to social, public health or nutrition interventions, and for public-private partnership activities. This paper describes the FES on complementary feeding that was commissioned by the Global Alliance for Improved Nutrition and highlights findings from studies conducted in three very different country contexts (Ghana, South Africa and Afghanistan) burdened by high levels of malnutrition in older infants and young children (IYC). The findings are analysed from the perspective of decision-making for future interventions. In Ghana, a primary finding was that in urban areas the fortified, but not instant cereal, which was being proposed, would not be an appropriate intervention, given the complex balancing of time, costs and health concerns of caregivers. In both urban and rural South Africa, home fortification products such as micronutrient powders and small quantity, lipid-based nutrient supplements (LNS) are potentially feasible interventions, and would require thoughtful behaviour change communication programmes to support their adoption. Among the important results for future decision-making for interventions in Afghanistan are the findings that there is little cultural recognition of the concept of special foods for infants, and that within households food procurement for IYC are in the hands of men, whereas food preparation and feeding are women's responsibilities. © 2012 Blackwell Publishing Ltd.

Nutrition in the first 1000 days and respiratory health: A descriptive review of the last five years' literature.

PubMed

Verduci, E; Martelli, A; Miniello, V L; Landi, M; Mariani, B; Brambilla, M; Diaferio, L; Peroni, D G

The aim of this paper is to discuss the current evidence regarding short and long-term health respiratory effects of nutrients and dietary patterns during the first 1000 days from conception. Population of interest included children from birth to two years and their mothers (during pregnancy and lactation). Studies were searched on MEDLINE® and Cochrane database, inserting individually and using the Boolean ANDs and ORs, 'nutrients', 'micronutrients', 'LC-PUFA', 'Mediterranean Diet', 'human milk', 'complementary food', 'pregnancy', 'respiratory disease', 'pulmonary disease', 'asthma', 'epigenetics', 'first 1000 days', 'maternal diet' and 'respiratory health'. All sources were retrieved between 01-09-2015 and 07-12-2016. While unhealthy maternal dietary patterns (high fat intake) during pregnancy can result in alteration of foetal lung development, with increased risk of respiratory disorders, Mediterranean diet has been associated with a lower risk of allergic sensitisation and allergic rhinitis. Breastfeeding has beneficial effects on respiratory infections while evidences about its protective effect on allergic disorders are unclear. During complementary feeding there is no evidence to avoid or encourage exposition to 'highly allergenic' foods to have modification of tolerance development. In children from birth to two years of age, Mediterranean diet has been associated with a lower risk of atopy, wheezing and asthma. Micronutrients, antioxidant and LCPUFA supplementation is not recommended and a whole food approach should be preferred, except for Vitamin D. Copyright © 2017 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

Household food insecurity, maternal nutritional status, and infant feeding practices among HIV-infected Ugandan women receiving combination antiretroviral therapy.

PubMed

Young, Sera L; Plenty, Albert H J; Luwedde, Flavia A; Natamba, Barnabas K; Natureeba, Paul; Achan, Jane; Mwesigwa, Julia; Ruel, Theodore D; Ades, Veronica; Osterbauer, Beth; Clark, Tamara D; Dorsey, Grant; Charlebois, Edwin D; Kamya, Moses; Havlir, Diane V; Cohan, Deborah L

2014-11-01

Household food insecurity (HHFI) may be a barrier to both optimal maternal nutritional status and infant feeding practices, but few studies have tested this relationship quantitatively, and never among HIV-infected individuals. We therefore described the prevalence of HHFI and explored if it was associated with poorer maternal nutritional status, shorter duration of exclusive breastfeeding (EBF) and fewer animal-source complementary foods. We assessed these outcomes using bivariate and multivariate analyses among 178 HIV-infected pregnant and breastfeeding (BF) women receiving combination antiretroviral therapy in the PROMOTE trial (NCT00993031), a prospective, longitudinal cohort study in Tororo, Uganda. HHFI was common; the prevalence of severe, moderate, and little to no household hunger was 7.3, 39.9, and 52.8 %, respectively. Poor maternal nutritional status was common and women in households experiencing moderate to severe household hunger (MSHH) had statistically significantly lower body mass index (BMIs) at enrollment (21.3 vs. 22.5, p < 0.01) and prior to delivery (22.6 vs. 23.8, p < 0.01). BMI across time during pregnancy, but not gestational weight gain, was significantly lower for MSHH [adjusted beta (95 % CI) -0.79 (-1.56, -0.02), p = 0.04; -2.06 (-4.31, 0.19), p = 0.07], respectively. The prevalence (95 % CI) of EBF at 6 months was 67.2 % (59.7-73.5 %), and the proportion of women BF at 12 months was 80.4 % (73.3-85.7 %). MSHH was not associated with prevalence of EBF at 6 months or BF at 12 months. However, among those women still EBF at 4 months (81.4 % of population), those experiencing MSHH were significantly more likely to cease EBF between 4 and 6 months (aHR 2.38, 95 % CI 1.02-5.58). The prevalence of HHFI, maternal malnutrition, and suboptimal infant feeding practices are high and the causal relationships among these phenomena must be further explored.

The use of linear programming to determine whether a formulated complementary food product can ensure adequate nutrients for 6- to 11-month-old Cambodian infants.

PubMed

Skau, Jutta K H; Bunthang, Touch; Chamnan, Chhoun; Wieringa, Frank T; Dijkhuizen, Marjoleine A; Roos, Nanna; Ferguson, Elaine L

2014-01-01

A new software tool, Optifood, developed by the WHO and based on linear programming (LP) analysis, has been developed to formulate food-based recommendations. This study discusses the use of Optifood for predicting whether formulated complementary food (CF) products can ensure dietary adequacy for target populations in Cambodia. Dietary data were collected by 24-h recall in a cross-sectional survey of 6- to 11-mo-old infants (n = 78). LP model parameters were derived from these data, including a list of foods, median serving sizes, and dietary patterns. Five series of LP analyses were carried out to model the target population's baseline diet and 4 formulated CF products [WinFood (WF), WinFood-Lite (WF-L), Corn-Soy-Blend Plus (CSB+), and Corn-Soy-Blend Plus Plus (CSB++)], which were added to the diet in portions of 33 g/d dry weight (DW) for infants aged 6-8 mo and 40 g/d DW for infants aged 9-11 mo. In each series of analyses, the nutritionally optimal diet and theoretical range, in diet nutrient contents, were determined. The LP analysis showed that baseline diets could not achieve the Recommended Nutrient Intake (RNI) for thiamin, riboflavin, niacin, folate, vitamin B-12, calcium, iron, and zinc (range: 14-91% of RNI in the optimal diets) and that none of the formulated CF products could cover the nutrient gaps for thiamin, niacin, iron, and folate (range: 22-86% of the RNI). Iron was the key limiting nutrient, for all modeled diets, achieving a maximum of only 48% of the RNI when CSB++ was included in the diet. Only WF and WF-L filled the nutrient gap for calcium. WF-L, CSB+, and CSB++ filled the nutrient gap for zinc (9- to 11-mo-olds). The formulated CF products improved the nutrient adequacy of complementary feeding diets but could not entirely cover the nutrient gaps. These results emphasize the value of using LP to evaluate special CF products during the intervention planning phase. The WF study was registered at controlled-trials.com as ISRCTN19918531.

Evaluation of the nutritional characteristics of a finger millet based complementary food.

PubMed

Mbithi-Mwikya, Stephen; Van Camp, John; Mamiro, Peter R S; Ooghe, Wilfried; Kolsteren, Patrick; Huyghebaert, Andre

2002-05-08

Finger millet (Eleusine coracana), kidney beans (Phaseolus vulgaris), peanuts (Arachis hypogoea), and mango (Mangifera indica) were processed separately and then combined, on the basis of their amino acid scores and energy content, into a complementary food for children of weaning age. The finger millet and kidney beans were processed by germination, autoclaving, and lactic acid fermentation. A mixture containing, on a dry matter basis, 65.2, 19.1, 8.0, and 7.7% of the processed finger millet, kidney beans, peanuts, and mango, respectively, gave a composite protein with an in vitro protein digestibility of 90.2% and an amino acid chemical score of 0.84. This mixture had an energy density of 16.3 kJ.g(-1) of dry matter and a decreased antinutrient content and showed a measurable improvement in the in vitro extractability for calcium, iron, and zinc. A 33% (w/v) pap made from a mix of the processed ingredients had an energy density of 5.4 kJ.g(-1) of pap, which is sufficient to meet the energy requirements of well-nourished children of 6-24 months of age at three servings a day and at the FAO average breast-feeding frequency.

76 FR 59707 - National Center for Complementary & Alternative Medicine; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-27

... Complementary & Alternative Medicine; Notice of Closed Meetings Pursuant to section 10(d) of the Federal... for Complementary and Alternative Medicine Special Emphasis Panel, Training and Education. Date... Complementary and Alternative Medicine Special Emphasis Panel, Clinical Studies of CAM Therapies. Date: November...

DNA Repair Mechanism Gene, XRCC1A ( Arg194Trp) but not XRCC3 ( Thr241Met) Polymorphism Increased the Risk of Breast Cancer in Premenopausal Females: A Case-Control Study in Northeastern Region of India.

PubMed

Devi, K Rekha; Ahmed, Jishan; Narain, Kanwar; Mukherjee, Kaustab; Majumdar, Gautam; Chenkual, Saia; Zonunmawia, Jason C

2017-12-01

X-ray repair cross complementary group gene is one of the most studied candidate gene involved in different types of cancers. Studies have shown that X-ray repair cross complementary genes are significantly associated with increased risk of breast cancer in females. Moreover, studies have revealed that X-ray repair cross complementary gene polymorphism significantly varies between and within different ethnic groups globally. The present case-control study was aimed to investigate the association of X-ray repair cross complementary 1A (Arg194Trp) and X-ray repair cross complementary 3 (Thr241Met) polymorphism with the risk of breast cancer in females from northeastern region of India. The present case-control study includes histopathologically confirmed and newly diagnosed 464 cases with breast cancer and 534 apparently healthy neighborhood community controls. Information on sociodemographic factors and putative risk factors were collected from each study participant by conducting face-to-face interviews. Genotyping of X-ray repair cross complementary 1A (Arg194Trp) and X-ray repair cross complementary 3 (Thr241Met) was carried out by polymerase chain reaction-restriction fragment length polymorphism. For statistical analysis, both univariate and multivariate logistic regression analyses were performed. We also performed stratified analysis to find out the association of X-ray repair cross complementary genes with the risk of breast cancer stratified based on menstrual status. This study revealed that tryptophan allele (R/W-W/W genotype) in X-ray repair cross complementary 1A (Arg194Trp) gene significantly increased the risk of breast cancer (adjusted odds ratio = 1.44, 95% confidence interval = 1.06-1.97, P < .05 for R/W-W/W genotype). Moreover, it was found that tryptophan allele (W/W genotype) at codon 194 of X-ray repair cross complementary 1A (Arg194Trp) gene significantly increased the risk of breast cancer in premenopausal females (crude odds ratio = 1.66, 95% confidence interval = 1.11-2.46, P < .05 for R/W-W/W genotype). The present study did not reveal any significant association of X-ray repair cross complementary 3 (Thr241Met) polymorphism with the risk of breast cancer. The present study has explored that X-ray repair cross complementary 1A (Arg194Trp) gene polymorphism is significantly associated with the increased risk of breast cancer in premenopausal females from northeastern region of India which may be beneficial for prognostic purposes.

DNA Repair Mechanism Gene, XRCC1A (Arg194Trp) but not XRCC3 (Thr241Met) Polymorphism Increased the Risk of Breast Cancer in Premenopausal Females: A Case–Control Study in Northeastern Region of India

PubMed Central

Ahmed, Jishan; Narain, Kanwar; Mukherjee, Kaustab; Majumdar, Gautam; Chenkual, Saia; Zonunmawia, Jason C.

2017-01-01

X-ray repair cross complementary group gene is one of the most studied candidate gene involved in different types of cancers. Studies have shown that X-ray repair cross complementary genes are significantly associated with increased risk of breast cancer in females. Moreover, studies have revealed that X-ray repair cross complementary gene polymorphism significantly varies between and within different ethnic groups globally. The present case–control study was aimed to investigate the association of X-ray repair cross complementary 1A (Arg194Trp) and X-ray repair cross complementary 3 (Thr241Met) polymorphism with the risk of breast cancer in females from northeastern region of India. The present case–control study includes histopathologically confirmed and newly diagnosed 464 cases with breast cancer and 534 apparently healthy neighborhood community controls. Information on sociodemographic factors and putative risk factors were collected from each study participant by conducting face-to-face interviews. Genotyping of X-ray repair cross complementary 1A (Arg194Trp) and X-ray repair cross complementary 3 (Thr241Met) was carried out by polymerase chain reaction-restriction fragment length polymorphism. For statistical analysis, both univariate and multivariate logistic regression analyses were performed. We also performed stratified analysis to find out the association of X-ray repair cross complementary genes with the risk of breast cancer stratified based on menstrual status. This study revealed that tryptophan allele (R/W-W/W genotype) in X-ray repair cross complementary 1A (Arg194Trp) gene significantly increased the risk of breast cancer (adjusted odds ratio = 1.44, 95% confidence interval = 1.06-1.97, P < .05 for R/W-W/W genotype). Moreover, it was found that tryptophan allele (W/W genotype) at codon 194 of X-ray repair cross complementary 1A (Arg194Trp) gene significantly increased the risk of breast cancer in premenopausal females (crude odds ratio = 1.66, 95% confidence interval = 1.11-2.46, P < .05 for R/W-W/W genotype). The present study did not reveal any significant association of X-ray repair cross complementary 3 (Thr241Met) polymorphism with the risk of breast cancer. The present study has explored that X-ray repair cross complementary 1A (Arg194Trp) gene polymorphism is significantly associated with the increased risk of breast cancer in premenopausal females from northeastern region of India which may be beneficial for prognostic purposes. PMID:29332455

Role of Social Support in Improving Infant Feeding Practices in Western Kenya: A Quasi-Experimental Study

PubMed Central

Mukuria, Altrena G; Martin, Stephanie L; Egondi, Thaddeus; Bingham, Allison; Thuita, Faith M

2016-01-01

ABSTRACT Background: We designed and tested an intervention that used dialogue-based groups to engage infants’ fathers and grandmothers to support optimal infant feeding practices. The study’s aim was to test the effectiveness of increased social support by key household influencers on improving mothers’ complementary feeding practices. Methods: Using a quasi-experimental design, we enrolled mothers, fathers, and grandmothers from households with infants 6–9 months old in 3 rural communities (1 intervention arm with fathers, 1 intervention arm with grandmothers, and 1 comparison arm) in western Kenya. We engaged 79 grandmothers and 85 fathers in separate dialogue groups for 6 months from January to July 2012. They received information on health and nutrition and were encouraged to provide social support to mothers (defined as specific physical actions in the past 2 weeks or material support actions in the past month). We conducted a baseline household survey in December 2011 in the 3 communities and returned to the same households in July 2012 for an endline survey. We used a difference-in-difference (DiD) approach and logistic regression to evaluate the intervention. Results: We surveyed 554 people at baseline (258 mothers, 165 grandmothers, and 131 fathers) and 509 participants at endline. The percentage of mothers who reported receiving 5 or more social support actions (of a possible 12) ranged from 58% to 66% at baseline in the 3 groups. By endline, the percentage had increased by 25.8 percentage points (P=.002) and 32.7 percentage points (P=.001) more in the father and the grandmother intervention group, respectively, than in the comparison group. As the number of social support actions increased in the 3 groups, the likelihood of a mother reporting that she had fed her infant the minimum number of meals in the past 24 hours also increased between baseline and endline (odds ratio [OR], 1.14; confidence interval [CI], 1.00 to 1.30; P=.047). When taking into account the interaction effects of intervention area and increasing social support over time, we found a significant association in the grandmother intervention area on dietary diversity (OR, 1.19; CI, 1.01 to 1.40; P=.04). No significant effects were found on minimum acceptable diet. Conclusion: Engaging fathers and grandmothers of infants to improve their knowledge of optimal infant feeding practices and to encourage provision of social support to mothers could help improve some feeding practices. Future studies should engage all key household influencers in a family-centered approach to practice and support infant feeding recommendations. PMID:27016544

Treating infants’ colic

PubMed Central

Rogovik, Alex L.; Goldman, Ran D.

2005-01-01

QUESTION Young parents often visit my office because their infants are crying inconsolably. Results of physical examination are unremarkable, so colic is the most likely cause. Colic has been known for many years, but I am unaware of any good remedy for it. Are there any modern, effective, safe methods of managing colic? ANSWER In most cases, colic is a “noisy phenomenon” for which there is no good explanation or treatment. Changing babies’ feedings rarely helps, and effective pharmacologic remedies are as yet unavailable. Several behavioural and complementary therapies have been suggested, but they have not been found effective. Addressing parental concerns and explaining about colic is the best solution until the colic goes away. PMID:16190173

Vertical stratification of the nutritional value of fruit: macronutrients and condensed tannins.

PubMed

Houle, Alain; Conklin-Brittain, Nancy L; Wrangham, Richard W

2014-12-01

Competing successfully for the best feeding sites is an important behavioral strategy but little is known about how feeding sites vary nutritionally within a fruit tree. To answer this question we tested how the nutritional value of a fruit is influenced by its ripeness and its height within the tree crown. A complementary objective was to assess the nutritional value of the midripe fruit, a food item rarely mentioned in the literature despite being exploited on a daily basis by many frugivores. We measured how the dry weight of pulp, water content, and concentration of macronutrients and condensed tannins varied within the tree crowns of 15 fruit species. Collections occurred early in the fruiting cycle, so as to assess the amount of food in the tree before its exploitation by primates. We found that (1) the upper crown produced fruit densities 4.2 times higher, and a fruit crop 4.8 times larger, than the lower crown of the same tree; (2) considering only midripe and ripe stages, upper-crown fruits contained 28.6% more dry pulp, 21.1% more water, and 13.5% more sugars per dry matter than lower-crown fruits of the same tree; (3) midripe fruits contained 80% of the concentrations of sugars of ripe fruits, making them a sweeter food item than one would expect from the intermediate color of their epidermis; (4) cellulose, hemicellulose, proteins, and ash proportionally decreased in concentration while dry pulp and sugars increased during ripening; and (5) ripe fruits were usually rare in the tree (<0.5% of all fruit available) compared to midripe fruits (3-8%). Overall, upper-crown feeding sites produced a higher density and quality of food than lower-crown sites of the same tree. Our data therefore provide a clear nutritional explanation for why tree-feeding frugivores compete for the highest feeding sites. © 2014 Wiley Periodicals, Inc.

Use of Complementary Health Practices in a Church-Based African American Cohort.

PubMed

Escoto, Kamisha Hamilton; Milbury, Kathrin; Nguyen, Nga; Cho, Dalnim; Roberson, Crystal; Wetter, David; McNeill, Lorna H

2018-06-08

Few studies have examined the use of complementary health practices (e.g., mind/body practices and dietary supplements) among African Americans, particularly those who identify as being spiritual and/or religious. Furthermore, research on the health and health behavior profiles of such complementary health users is scant. The purpose of this study was to explore the use of complementary health practices and their lifestyle and health indicator correlates in a large, church-based African American population. Cross-sectional analysis of 1467 African American adults drawn from a church-based cohort study. Participants reported use of complementary health practices, lifestyle behaviors (e.g., diet and smoking status), and health indicators (e.g., physical health and medical problems). Multiple logistic regressions were conducted to examine associations between lifestyle variables, health indicators, and use of complementary health practices. Outcomes included prevalence of mind/body practices (e.g., meditation and Reiki) and dietary supplements (multivitamins) along with health indicator and lifestyle correlates of use. Use of complementary health practices was high; 40% reported using any mind/body practice and 50% reported using dietary supplements. Poorer physical health was associated with use of mind/body practices, while likelihood of meeting fruit and vegetable recommendations was significantly associated with dietary supplement use. Complementary health practices were used heavily in a church-based sample of African American adults. Poorer physical health was associated with use of complementary health practices, yet users also displayed health conscious behaviors. Given the high engagement in complementary health practices, it may be prudent to consider adapting complementary health approaches for use in wellness interventions targeting African Americans in faith-based settings.

Using Complementary Learning Clusters in Studying Literature to Enhance Students' Medical Humanities Literacy, Critical Thinking, and English Proficiency.

PubMed

Liao, Hung-Chang; Wang, Ya-Huei

2016-04-01

This study examined whether students studying literature in complementary learning clusters would show more improvement in medical humanities literacy, critical thinking skills, and English proficiency compared to those in conventional learning clusters. Ninety-three students participated in the study (M age = 18.2 years, SD = 0.4; 36 men, 57 women). A quasi-experimental design was used over 16 weeks, with the control group (n = 47) working in conventional learning clusters and the experimental group (n = 46) working in complementary learning clusters. Complementary learning clusters were those in which individuals had complementary strengths enabling them to learn from and offer assistance to other cluster members, hypothetically facilitating the learning process. Measures included the Medical Humanities Literacy Scale, Critical Thinking Disposition Assessment, English proficiency tests, and Analytic Critical Thinking Scoring Rubric. The results showed that complementary learning clusters have the potential to improve students' medical humanities literacy, critical thinking skills, and English proficiency. © The Author(s) 2016.

Behavioral and electroantennogram responses of plum curculio, Conotrachelus nenuphar, to selected noxious plant extracts and insecticides.

PubMed

Gӧkçe, A; Stelinski, L L; Nortman, D R; Bryan, W W; Whalon, M E

2014-01-01

Behavioral and electroantennogram responses of plum curculio, Conotrachelus nenuphar (Herbst) (Coleoptera: Curculionidae), adults were tested for several methanolic plant extracts and organically approved insecticides. Plant extracts were evaluated for their potential as antifeedants or oviposition deterrents. These extract responses were also compared to those elicited by the non-neurotoxic, organic irritant-insecticide kaolin clay. Both sexes of plum curculio exhibited antennal response as measured by electroantennogram, which ranged from 0.2 to 1.1 mV, to plant extracts and the organic irritant/insecticide, with the greatest response to the extract of rough cocklebur, Xanthium strumarium L. (1.1 mV). No choice tests were conducted to compare feeding and oviposition by plum curculio on untreated apples or on apples treated with one of the extracts or the insecticide. The insecticide pyrethrum and extracts of X. strumarium and greater burdock, Arctium lappa L., significantly reduced feeding. Also, pyrethrum, A. lappa, Humulus lupulus L. (common hop), X. strumarium, and Verbascum songaricum Schrenk extracts completely inhibited egg deposition. In no-choice assays, the effects of kaolin clay with incorporated plant extracts on plum curculio feeding and oviposition were monitored as complementary tests. A. lappa-kaolin, H. lupulus-kaolin, and X. strumarium-kaolin mixtures significantly reduced the feeding of plum curculio compared to the control or kaolin clay alone. Each of the plant extract-kaolin mixtures evaluated, with the exception of Bifora radians Bieberstein (wild bishop), completely inhibited plum curculio oviposition as compared to controls. This is an open access paper. We use the Creative Commons Attribution 3.0 license that permits unrestricted use, provided that the paper is properly attributed.

[Effects of fish on field resource utilization and rice growth in rice-fish coculture].

PubMed

Zhang, Jian; Hu, Liang Liang; Ren, Wei Zheng; Guo, Liang; Wu, Min Fang; Tang, Jian Jun; Chen, Xin

2017-01-01

Rice field can provide habitat for fish and other aquatic animals. Rice-fish coculture can increase rice yield and simultaneously reduce the use of chemicals through reducing rice pest occurrence and nutrient complementary use. However, how fish uses food sources (e.g. phytoplankton, weeds, duckweed, macro-algal and snail) from rice field, and whether the nutrients releasing from those food sources due to fish transforming can improve rice growth are still unknown. Here, we conducted two field experiments to address these questions. One was to investigate the pattern of fish activity in the field using the method of video recording. The other was to examine the utilization of field resources by fish using stable isotope technology. Rice growth and rice yield were also exa-mined. Results showed that fish tended to be more active and significantly expanded the activity range in the rice-fish coculture compared to fish monoculture (fish not living together with rice plants). The contributions of 3 potential aquatic organisms (duckweed, phytoplankton and snail) to fish dietary were 22.7%, 34.8% and 30.0% respectively under rice-fish coculture without feed. Under the treatment with feed, however, the contributions of these 3 aquatic organisms to the fish die-tary were 8.9%, 5.9% and 1.6% respectively. The feed contribution was 71.0%. Rice-fish coculture significantly increased the nitrogen concentration in rice leaves, prolonged tillering stage by 10-12 days and increased rice spike rate and yield. The results suggested that raising fish in paddy field may transform the nutrients contained in field resources to bioavailable for rice plants through fish feeding activity, which can improve rice growth and rice yield.

World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low-income countries.

PubMed

Marriott, Bernadette P; White, Alan; Hadden, Louise; Davies, Jayne C; Wallingford, John C

2012-07-01

Eight World Health Organization (WHO) feeding indicators (FIs) and Demographic and Health Survey data for children <24 months were used to assess the relationship of child feeding with stunting and underweight in 14 poor countries. Also assessed were the correlations of FI with country gross national income (GNI). Prevalence of underweight and stunting increased with age and ≥ 50% of 12-23-month children were stunted. About 66% of babies received solids by sixth to eighth months; 91% were still breastfeeding through months 12-15. Approximately half of the children were fed with complementary foods at the recommended daily frequency, but <25% met food diversity recommendations. GNI was negatively correlated with a breastfeeding index (P < 0.01) but not with other age-appropriate FI. Regression modelling indicated a significant association between early initiation of breastfeeding and a reduction in risk of underweight (P < 0.05), but a higher risk of underweight for continued breastfeeding at 12-15 months (P < 0.001). For infants 6-8 months, consumption of solid foods was associated with significantly lower risk of both stunting and underweight (P < 0.001), as was meeting WHO guidance for minimum acceptable diet, iron-rich foods (IRF) and dietary diversity (P < 0.001); desired feeding frequency was only associated with lower risk of underweight (P < 0.05). Timely solid food introduction, dietary diversity and IRF were associated with reduced probability of underweight and stunting that was further associated with maternal education (P < 0.001). These results identify FI associated with growth and reinforce maternal education as a variable to reduce risk of underweight and stunting in poor countries. © 2011 Blackwell Publishing Ltd.

Length and weight of very low birth weight infants in Germany at 2 years of age: does it matter at what age they start complementary food?

PubMed

Spiegler, J; Eisemann, N; Ehlers, S; Orlikowsky, T; Kannt, O; Herting, E; Göpel, W

2015-06-01

We analysed at what age parents start complementary food in very low birth weight infants, determined risk factors for early introduction of complementary food (post-term age) and analysed whether the age at introduction of complementary food influences height or weight at 2 years of age. Parents of premature infants born in 2009-2011 answered questionnaires regarding introduction of complementary food in the first year of life (N=2262) and were followed up at a post-term age of 2 years (N=981). Length and weight were compared with full-term infants from the KiGGs study. Logistic and linear regression analyses were conducted to study predictors for early introduction of complementary food and the influence of age at introduction of complementary food on later height and weight. Average age at introduction of complementary food was 3.5 months post-term age. The lower the gestational age at birth, the earlier (post-term age) vegetables and meat were introduced. Age at introduction of complementary food was influenced by intrauterine growth restriction, gestational age at birth, maternal education and a developmental delay perceived by the parents. Length and weight at a post-term age of 2 years was not negatively influenced by early introduction of complementary food. VLBW infants are introduced to complementary food on average before a post-term age of 4 months. There was no negative effect of early introduction of complementary food on height and weight at 2 years of age.

Predictors of College Students' Use of Complementary and Alternative Medicine

ERIC Educational Resources Information Center

Chng, Chwee Lye; Neill, Kweethai; Fogle, Peggy

2003-01-01

This study assessed the use of complementary and alternative medicine among college students (N=913), the relationships between health locus of control with use of complementary and alternative medicine, and health local of control with attitudes toward complementary and alternative medicine and what predicts their use. A majority (66%, n-913) of…

The Prevalence of Complementary and Alternative Medicine Use Among Dermatology Outpatients in Shiraz, Iran

PubMed Central

Dastgheib, Ladan; Farahangiz, Saman; Adelpour, Zeinab; Salehi, Alireza

2017-01-01

The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers (P = .037). Patients with acne and alopecia significantly used more complementary and alternative medicine (odds ratio: 2.48 and 3.19, respectively). There was a significant relationship between education and using complementary and alternative medicine (P < .001). Complementary and alternative medicine use is prevalent among our patients and we should think of ways of educating general population about complementary and alternative medicine methods and their potential risks and benefits and encourage our health care workers to communicate these materials with their patients. PMID:28446027

The Prevalence of Complementary and Alternative Medicine Use Among Dermatology Outpatients in Shiraz, Iran.

PubMed

Dastgheib, Ladan; Farahangiz, Saman; Adelpour, Zeinab; Salehi, Alireza

2017-10-01

The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers ( P = .037). Patients with acne and alopecia significantly used more complementary and alternative medicine (odds ratio: 2.48 and 3.19, respectively). There was a significant relationship between education and using complementary and alternative medicine ( P < .001). Complementary and alternative medicine use is prevalent among our patients and we should think of ways of educating general population about complementary and alternative medicine methods and their potential risks and benefits and encourage our health care workers to communicate these materials with their patients.

[Traditional and Complementary Medicine in Brazil: inclusion in the Brazilian Unified National Health System and integration with primary care].

PubMed

Sousa, Islandia Maria Carvalho de; Tesser, Charles Dalcanale

2017-01-23

This study aimed to analyze the inclusion of Traditional and Complementary Medicine in Brazilian Unified National Health System (SUS) and its integration with primary healthcare (PHC). A qualitative study drew on institutional data, indexed articles, and case studies in selected Brazilian cities: Campinas (São Paulo State), Florianópolis (Santa Catarina State), Recife (Pernambuco State), Rio de Janeiro, and São Paulo. The analysis adopted the perspective of inclusion of Traditional and Complementary Medicine in the healthcare network and its integration with primary healthcare, based on the following dimensions: presence of Traditional and Complementary Medicine on the municipal agenda; position in the services; mode of access to Traditional and Complementary Medicine; Traditional and Complementary Medicine practitioners; types of practices; demand profile; and potential for expansion in the SUS. The authors identified and characterized four types of inclusion and integration of Traditional and Complementary Medicine, whether in association or not: Type 1 - in primary healthcare via professionals from the family health teams - Integrated; Type 2 - in primary healthcare via professionals with full-time employment - Juxtaposed; Type 3 - in primary healthcare via matrix-organized teams - Matrix Organization; Type 4 - in specialized services - Without Integration. The combination of types 1 and 3 was considered a potential guideline for the expansion of Traditional and Complementary Medicine in the SUS and can orient the growth and integration of Traditional and Complementary Medicine with primary healthcare. The growing presence of Traditional and Complementary Medicine in the SUS requires conceiving its strategic expansion, while existing experiences should not be wasted.

Assessment of health and nutritional status of infants in relation to breast feeding practices in Karmouz area, Alexandria.

PubMed

Deghedi, B; Mahdy, N H; Abd, el-A H

1999-01-01

Infants are most precious part of nation's life. Infant health is a reflection of the health of the mother and it gives an indication of the health of the adult population of the future. The present work was designed to study the health and nutritional status of infants in Karmouz area in Alexandria as well as the effect of breast feeding practices on the health status of infants. Accordingly, a house to house survey was conducted through cluster sampling technique. The total sample amounted to 396 mothers and 409 infants. Data were collected about infants health status and their feeding practices. Weight and length were measured for all infants. Stool samples were collected and examined. The results revealed that 55.3% of infants had acute respiratory tract infections (ARI); 16.4% had bronchitis and 4.9% had pneumonia, 44% of the infants suffered from diarrhea, 13.2% were infected with parasites, Gardia lamblia was the most commonly found parasite (9.0%). High proportion of infants was found to be stunted (22.7%), 8.6% were wasted and 7.6% were underweight, 40.3% of mothers were in partial practice level. Infants below six months of age who received solid foods at three months or less had a significantly higher percentage of diarrhea (70.6%) compared to 51.5% among those of late weaning (four months or later). The diarrhea was significantly more common among infants aged 12 - < 18 months with about two times of risk relative to those aged < 6 months. A significantly higher risk of diarrhea was found for infants of bottle--or complementary feeding (OR = 2.05, 2.07 respectively, model X2 = 9.71, P < 0.01), in addition the protective effect of breast feeding persisted after adjustment of confounders by multiple logistic regression. High proportion of mothers (63.8%) continued to breast-feed their babies during diarrheal episodes. On the other hand breast-feeding was not significantly protective against the acute respiratory tract infection. Stunting of the infants increases rapidly with age from 12.6% among infants under six months to 30.4% among those aged from 9 - < 12 months. The percentage of stunted infants varied greatly by education of the mothers, it was doubled from 14.7% among those of mothers of high level of education to 28.9% of non educated mothers with a significant high risk of 2.31 times. The repeated attacks of diarrhea throughout the two years of life was still significantly associated with stunting even after adjustment of confounders by multiple logistic regression;, those with three attacks or more had about three times of risk relative to those without the disease (OR = 2.56, 95% CL = 1.12-5.81, model X2 = 19.03, P < 0.01). Health education program should be emphasized to all mothers to improve their knowledge and practice about breast-feeding and its importance in prevention of diarrhea.

Nurses' beliefs, experiences and practice regarding complementary and alternative medicine in Taiwan.

PubMed

Smith, Graeme D; Wu, Shu-Chen

2012-09-01

To gain an insight into this issue, this study used a qualitative approach and aims to explore and describe nurses' beliefs, experiences and practice regarding complementary and alternative medicine in Taiwan. The integration of complementary and alternative medicine with conventional medicine has become more common worldwide in recent years. An increase in patient use and an expansion of nurses using complementary and alternative medicine has spawned further investigation. Most published studies have concentrated on the usage of complementary and alternative medicine in western societies and have focused principally on physicians' attitudes and practice patterns in this regard. Despite the large amount of time and the unique relationship that nurses share with their patients, little research has investigated the nurse's attitudes and practice regarding complementary and alternative medicine. Moreover, there has been no previous research into understanding this issue from the Taiwanese nursing perspective. A qualitative research design. By using an exploratory, descriptive, qualitative approach, data were collected from 11 registered nurses. The methods of the data collection were in-depth, semi-structured interviews, field notes and memos and the data were analysed using the constant comparative method. Three major categories emerged from the data; namely, a 'lack of clear definition', 'limited experience' and 'high interest' towards complementary and alternative medicine. These results suggest that the definition of complementary and alternative medicine is often unclear for nurses in Taiwan. Due to the organisational policies and personal knowledge base, very few nurses integrate complementary and alternative medicine into their daily practice. However, the nurses in Taiwan show a great desire to participate in complementary and alternative medicine continuing education programmes. This study is not only significant in filling the gap in the existing literature, but is also important in understanding this issue from the nurses' perspective, to offer a series of recommendations for policy, nursing education, nursing practice and suggestions for further research. This study highlights the importance of nursing attitude in the use of complementary and alternative medicine. Clinical nurses have the potential to provide appropriate information to their patients to ensure safe complementary and alternative medicine use. © 2012 Blackwell Publishing Ltd.

Discovering Complementary Colors from the Perspective of STEAM Education

ERIC Educational Resources Information Center

Karabey, Burak; Koyunkaya, Melike Yigit; Enginoglu, Turan; Yurumezoglu, Kemal

2018-01-01

This study explored the theory and applications of complementary colors using a technology-based activity designed from the perspective of STEAM education. Complementary colors and their areas of use were examined from the perspective of physics, mathematics and art, respectively. The study, which benefits from technology, makes the theory of…

Incorporating elements of social franchising in government health services improves the quality of infant and young child feeding counselling services at commune health centres in Vietnam.

PubMed

Nguyen, Phuong H; Kim, Sunny S; Keithly, Sarah C; Hajeebhoy, Nemat; Tran, Lan M; Ruel, Marie T; Rawat, Rahul; Menon, Purnima

2014-12-01

Although social franchising has been shown to enhance the quality of reproductive health services in developing countries, its effect on nutrition services remains unexamined. This study assessed the effects of incorporating elements of social franchising on shaping the quality of infant and young child feeding (IYCF) counselling facilities and services in Vietnam. Process-related data collected 12 months after the launch of the first franchises were used to compare randomly assigned Alive & Thrive-supported health facilities (AT-F, n = 20) with standard facilities (SF, n = 12) across three dimensions of service quality: 'structure', 'process' and 'outcome' that capture the quality of facilities, service delivery, and client perceptions and use, respectively. Data collection included facility assessments (n = 32), staff surveys (n = 96), counselling observations (n = 137), client exit interviews (n = 137) and in-depth interviews with mothers (n = 48). Structure: AT-F were more likely to have an unshared, well-equipped room for nutrition counselling than SF (65.0% vs 10.0%). Compared with SF providers, AT-F staff had better IYCF knowledge (mean score 9.9 vs 8.8, range 0-11 for breastfeeding; mean score 3.6 vs 3.2, range 0-4 for complementary feeding). AT-F providers also demonstrated significantly better interpersonal communication skills (score 9.6 vs 5.1, range 0-13) and offered more comprehensive counselling sessions. Overall utilization of franchises was low (10%). A higher proportion of pregnant women utilized franchise services (48.9%), compared with mothers with children 6-23.9 months (1.4%). There was no quantitative difference in client satisfaction with counselling services between AT-F and SF, but franchise users praised the AT-F for problem solving related to child feeding. Incorporating elements of social franchising significantly enhances the quality of IYCF counselling services within government primary healthcare facilities, particularly their structural and process attributes. Provided that service utilization is improved through demand generation, this model has the potential to impact IYCF practices and child nutrition. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

COMPLEMENTARY FEEDING WITH FORTIFIED SPREAD IS LIKELY TO REDUCE THE INCIDENCE OF SEVERE STUNTING AMONG 6–18 MONTH OLD RURAL MALAWIAN INFANTS

PubMed Central

Phuka, John C.; Maleta, Kenneth; Thakwalakwa, Chrissie; Cheung, Yin Bun; Briend, André; Manary, Mark J.; Ashorn, Per

2013-01-01

Objective To compare growth and incidence of malnutrition among infants receiving long-term dietary complementation with ready-to-use fortified spread (FS) or micronutrient fortified maize-soy flour (LP). Design Randomized, controlled, single-blind trial Setting Rural Malawian population with high incidence of malnutrition Participants 182 six-month-old infants. Intervention Participants were randomized to receive 1-year-long daily supplementation with either 71g of LP (282 kcal energy / day), 50g FS50 (256 kcal), or 25g FS25 (127 kcal). Main outcome measures Weight and length gain, incidence of severe stunting, underweight, and wasting. Results The mean weight and length gains in LP, FS50 and FS25 groups were 2.37, 2.47, and 2.37 kg (p= 0.658) and 12.7, 13.5, and 13.2 cm (p=0.234), respectively. In the same groups, cumulative 12-month incidence of severe stunting was 14.0%, 0.0% and 4.0% (p=0.011), severe underweight 15.0%, 22.5% and 16.9% (p=0.706), and severe wasting 1.8%, 1.9% and 1.8% (p=0.999). Compared to LP-supplemented infants, those given FS50 gained on average (95%CI;p) 100 g (−143 to 343; p=0.419) more weight and 0.8 cm (−0.1 to 1.7; p=0.091) more length. There was a significant interaction between baseline length and intervention (p=0.042); among children with below-median length at enrolment, those given FS50 gained on average 1.9 cm (0.3 to 3.5; p=0.020) more than individuals receiving LP. Conclusions One-year-long complementary feeding with FS does not have significantly larger effect than maize-soy flour on the average weight gain of all infants, but it seems to boost linear growth in the disadvantaged individuals and hence decrease the incidence of severe stunting. PMID:18606932

A Delivery Model for Home Fortification of Complementary Foods with Micronutrient Powders: Innovation in the Context of Vietnamese Health System Strengthening.

PubMed

Nguyen, Marie; Poonawala, Alia; Leyvraz, Magali; Berger, Jacques; Schofield, Dominic; Nga, Tran Thuy; Van, Tran Khan; Hoa, Do Thi Bao; Wieringa, Frank Tammo

2016-04-29

Adding micronutrient powders (MNP) to complementary foods at the point of preparation (home fortification) can improve micronutrient status of young children. Ensuring sustained access to MNPs at scale, however, remains challenging in many countries. The Global Alliance for Improved Nutrition (GAIN) partnered with the National Institute of Nutrition (NIN) in Vietnam to pioneer the distribution of a locally-produced MNP, provided for sale through the public health system with counseling on optimal infant and young child feeding practices by trained health workers. Different packaging options were available to adapt to caregivers' disposable income. During the six-month pilot, 1.5 million sachets were sold through 337 health centers across four provinces, targeting children 6-59 months of age. Sales were routinely monitored, and a cross-sectional survey in 32 communes for caregivers (n = 962) and health staff (n = 120) assessed MNP coverage and compliance, five months after the start of distribution. A total of 404 caregivers among the 962 caregivers surveyed (i.e., 42%) had visited the health center in the past year. Among them, 290 caregivers had heard about the product and a total of 217caregivers had given the MNP to their child at least once, representing a conversion rate from product awareness to product trial of 74.8%. The effective coverage (i.e., consumption of ≥3 sachets/child/week) was 11.5% among the total surveyed caregivers and reached 27.3% amongst caregivers who visited health centers in the previous month. The MNP purchase trends showed that the number of sachets bought by caregivers was positively correlated with the wealth index. The pilot showed that providing MNPs for sale in packs of various quantities, combined with infant and young child feeding (IYCF) counseling at the health center, is effective for groups accessing the health system.

A Delivery Model for Home Fortification of Complementary Foods with Micronutrient Powders: Innovation in the Context of Vietnamese Health System Strengthening

PubMed Central

Nguyen, Marie; Poonawala, Alia; Leyvraz, Magali; Berger, Jacques; Schofield, Dominic; Nga, Tran Thuy; Van, Tran Khan; Hoa, Do Thi Bao; Wieringa, Frank Tammo

2016-01-01

Adding micronutrient powders (MNP) to complementary foods at the point of preparation (home fortification) can improve micronutrient status of young children. Ensuring sustained access to MNPs at scale, however, remains challenging in many countries. The Global Alliance for Improved Nutrition (GAIN) partnered with the National Institute of Nutrition (NIN) in Vietnam to pioneer the distribution of a locally-produced MNP, provided for sale through the public health system with counseling on optimal infant and young child feeding practices by trained health workers. Different packaging options were available to adapt to caregivers’ disposable income. During the six-month pilot, 1.5 million sachets were sold through 337 health centers across four provinces, targeting children 6–59 months of age. Sales were routinely monitored, and a cross-sectional survey in 32 communes for caregivers (n = 962) and health staff (n = 120) assessed MNP coverage and compliance, five months after the start of distribution. A total of 404 caregivers among the 962 caregivers surveyed (i.e., 42%) had visited the health center in the past year. Among them, 290 caregivers had heard about the product and a total of 217caregivers had given the MNP to their child at least once, representing a conversion rate from product awareness to product trial of 74.8%. The effective coverage (i.e., consumption of ≥3 sachets/child/week) was 11.5% among the total surveyed caregivers and reached 27.3% amongst caregivers who visited health centers in the previous month. The MNP purchase trends showed that the number of sachets bought by caregivers was positively correlated with the wealth index. The pilot showed that providing MNPs for sale in packs of various quantities, combined with infant and young child feeding (IYCF) counseling at the health center, is effective for groups accessing the health system. PMID:27136585

Complementary and alternative medicine usage and its determinant factors among Iranian infertile couples.

PubMed

Dehghan, Mahlagha; Mokhtarabadi, Sima; Heidari, Fatemeh Ghaedi

2018-04-04

Background The aim of this study was to determine the status of utilizing some complementary and alternative medicine techniques in infertile couples. Methods This was a cross-sectional study conducted on 250 infertile couples referred to a hospital in Kerman using convenience sampling. A researcher-made questionnaire was used to study the prevalence and user satisfaction of complementary and alternative medicines. Results Results indicated that 49.6% of the infertile couples used at least one of the complementary and alternative medicines during the past year. Most individuals used spiritual techniques (71.8% used praying and 70.2% used Nazr) and medicinal plants (54.8%). Safety is the most important factor affecting the satisfaction of infertile couples with complementary treatments (couples think that such treatments are safe (54.8%)). Discussion Concerning high prevalence of complementary and alternative treatments in infertile couples, incorporating such treatments into the healthcare education and promoting the awareness of infertile individuals seem crucial.

An investigation on factors associated with malnutrition among underfive children in Nakaseke and Nakasongola districts, Uganda.

PubMed

Habaasa, Gilbert

2015-09-24

Malnutrition is one of the major causes of mortality and morbidity among under-five children in Sub Saharan Africa. To understand the factors associated with malnutrition among under-five children, a study was conducted in Nakaseke and Nakasongola districts of Uganda. Cross sectional secondary data of 104 underfive children in Nakaseke and Nakasongola districts was used. Epi Info programme-Nutrition module and Stata statistical softwares were used in analyses. Descriptive statistics, cross tabulations and binary logistic regression results were generated. Stunting was found to be the most malnutrition condition with the highest prevalence (38.5%) in the two districts followed by wasting (16.5%) and underweight (13.5%) respectively. Results also showed that children aged 39-59 months were less likely to be underweight than those aged below twelve months. Children of peasant farmers were more likely to be stunted than their counterparts with mothers in pastoralist's family. No significant factors were found to be associated with wasting among the underfive children in the two districts although the prevalence was slightly higher than that of child underweight. The study is essential in pointing out the particular age-groups among underfive children as well as the maternal occupations that may be factors associated with malnutrition in the districts of Nakaseke and Nakasongola. The author recommends exclusive breast feeding and proper complementary feeding especially among children under three years. Furthermore, special arrangement could be put in place to have children of mothers engaged in cultivation brought to them regularly for breastfeeding.

Does Cry1Ab protein affect learning performances of the honey bee Apis mellifera L. (Hymenoptera, Apidae)?

PubMed

Ramirez-Romero, R; Desneux, N; Decourtye, A; Chaffiol, A; Pham-Delègue, M H

2008-06-01

Genetically modified Bt crops are increasingly used worldwide but side effects and especially sublethal effects on beneficial insects remain poorly studied. Honey bees are beneficial insects for natural and cultivated ecosystems through pollination. The goal of the present study was to assess potential effects of two concentrations of Cry1Ab protein (3 and 5000 ppb) on young adult honey bees. Following a complementary bioassay, our experiments evaluated effects of the Cry1Ab on three major life traits of young adult honey bees: (a) survival of honey bees during sub-chronic exposure to Cry1Ab, (b) feeding behaviour, and (c) learning performance at the time that honey bees become foragers. The latter effect was tested using the proboscis extension reflex (PER) procedure. The same effects were also tested using a chemical pesticide, imidacloprid, as positive reference. The tested concentrations of Cry1Ab protein did not cause lethal effects on honey bees. However, honey bee feeding behaviour was affected when exposed to the highest concentration of Cry1Ab protein, with honey bees taking longer to imbibe the contaminated syrup. Moreover, honey bees exposed to 5000 ppb of Cry1Ab had disturbed learning performances. Honey bees continued to respond to a conditioned odour even in the absence of a food reward. Our results show that transgenic crops expressing Cry1Ab protein at 5000 ppb may affect food consumption or learning processes and thereby may impact honey bee foraging efficiency. The implications of these results are discussed in terms of risks of transgenic Bt crops for honey bees.

Ground Characterization Studies in Canakkale Pilot Site of LIQUEFACT Project

NASA Astrophysics Data System (ADS)

Ozcep, F.; Oztoprak, S.; Aysal, N.; Bozbey, I.; Tezel, O.; Ozer, C.; Sargin, S.; Bekin, E.; Almasraf, M.; Cengiz Cinku, M.; Ozdemir, K.

2017-12-01

The our aim is to outline the ground characterisation studies in Canakkale test site. Study is based on the EU H2020 LIQUEFACT project entitled "Liquefact: Assessment and mitigation of liquefaction potential across Europe: a holistic approach to protect structures / infrastructures for improved resilience to earthquake-induced liquefaction disasters". Objectives and extent of ground characterization for Canakkale test site includes pre-existing soil investigation studies and complementary field studies. There were several SPT and geophysical tests carried out in the study area. Within the context of the complementary tests, six (6) study areas in the test site were chosen and complementary tests were carried out in these areas. In these areas, additional boreholes were opened and SPT tests were performed. It was decided that additional CPT (CPTU and SCPT) and Marchetti Dilatometer (DMT) tests should be carried out within the scope of the complementary testing. Seismic refraction, MASW and micro tremor measurements had been carried out in pre-existing studies. Shear wave velocities obtained from MASW measurements were evaluated to the most rigorous level. These tests were downhole seismic, PS-logging, seismic refraction, 2D-ReMi, MASW, micro tremor (H/V Nakamura method), 2D resistivity and resonance acoustic profiling (RAP). RAP is a new technique which will be explained briefly in the relevant section. Dynamic soil properties had not been measured in pre-existing studies, therefore these properties were investigated within the scope of the complementary tests. Selection of specific experimental tests of the complementary campaign was based on cost-benefit considerations Within the context of complementary field studies, dynamic soil properties were measured using resonant column and cyclic direct shear tests. Several sieve analyses and Atterberg Limits tests which were documented in the pre-existing studies were evaluated. In the complementary study carried out, additional sieve analyses and Atterberg Limit tests were carried out. It was aimed to make some correlations between geophysical measurements and other field measurements; such as SPT, blow count values.

Racial and Ethnic Profiles of Complementary and Alternative Medicine Use Among Young Adults in the United States: Findings From the National Longitudinal Study of Adolescent Health.

PubMed

Upchurch, Dawn M; Wexler Rainisch, Bethany K

2012-10-01

This study describes complementary and alternative medicine use among a national sample of young adults, with an emphasis on characterizing racial and ethnic differences, highlighting variation across subgroups of Hispanics. The authors examined young adults ages 18 to 27 years (n = 14 128) from wave III (2001-2002) of the National Longitudinal Study of Adolescent Health. Prevalence estimates and logistic regression results were weighted and adjusted for complex sample design. The study examined recent complementary and alternative medicine use in the past 12 months, recent use for each of 15 specific complementary and alternative medicine modalities, and the 5 most commonly used modalities (herbs, massage, chiropractic, relaxation, and vitamins). Results showed that 29% of young adults aged 18 to 27 years recently used complementary and alternative medicine. Prevalence was highest among Cuban Americans (42%) and lowest among blacks (22%). Young adults used a diversity of complementary and alternative medicine modalities and there were substantial differences in use across racial and ethnic groups.

Racial and Ethnic Profiles of Complementary and Alternative Medicine Use Among Young Adults in the United States: Findings From the National Longitudinal Study of Adolescent Health

PubMed Central

Upchurch, Dawn M.; Wexler Rainisch, Bethany K.

2013-01-01

This study describes complementary and alternative medicine use among a national sample of young adults, with an emphasis on characterizing racial and ethnic differences, highlighting variation across subgroups of Hispanics. The authors examined young adults ages 18 to 27 years (n = 14 128) from wave III (2001–2002) of the National Longitudinal Study of Adolescent Health. Prevalence estimates and logistic regression results were weighted and adjusted for complex sample design. The study examined recent complementary and alternative medicine use in the past 12 months, recent use for each of 15 specific complementary and alternative medicine modalities, and the 5 most commonly used modalities (herbs, massage, chiropractic, relaxation, and vitamins). Results showed that 29% of young adults aged 18 to 27 years recently used complementary and alternative medicine. Prevalence was highest among Cuban Americans (42%) and lowest among blacks (22%). Young adults used a diversity of complementary and alternative medicine modalities and there were substantial differences in use across racial and ethnic groups. PMID:23869288

Attitudes towards and personal use of complementary and alternative medicine amongst clinicians working in audiovestibular disciplines.

PubMed

Crundwell, G; Baguley, D M

2016-08-01

Literature indicates that complementary and alternative medicine is used by patients with auditory and vestibular symptoms. This study sought to determine the prevalence of complementary and alternative medicine uptake, and examine attitudes towards complementary and alternative medicine in clinicians working with audiovestibular disorder patients. The Holistic Complementary and Alternative Medicine Questionnaire and a devised questionnaire about recent and lifetime use of complementary and alternative medicine were used. Fifty-four individuals, including audiologists, ENT surgeons, nurses and rehabilitationists, completed the questionnaires (67 per cent response rate). Lifetime prevalence of complementary and alternative medicine uptake was 44 per cent, and 12-month prevalence was 22 per cent. Uptake was more common in females, but there was no significant difference in use when comparing age, seniority or profession. Attitudes towards complementary and alternative medicine were mildly adverse, but sizeable standard deviation indicates wide-ranging attitudes. Clinicians working with patients with audiovestibular disorders have a range of attitudes towards complementary and alternative medicine. Personal uptake of complementary and alternative medicine was lower than that of the general UK population, but remains sizeable.

Resourcing the clinical complementary medicine information needs of Australian medical students: Results of a grounded theory study.

PubMed

Templeman, Kate; Robinson, Anske; McKenna, Lisa

2016-09-01

The aim of this study was to identify Australian medical students' complementary medicine information needs. Thirty medical students from 10 medical education faculties across Australian universities were recruited. Data were generated using in-depth semi-structured interviews and constructivist grounded theory method was used to analyze and construct data. Students sought complementary medicine information from a range of inadequate sources, such as pharmacological texts, Internet searches, peer-reviewed medical journals, and drug databases. The students identified that many complementary medicine resources may not be regarded as objective, reliable, differentiated, or comprehensive, leaving much that medical education needs to address. Most students sought succinct, easily accessible, evidence-based information to inform safe and appropriate clinical decisions about complementary medicines. A number of preferred resources were identified that can be recommended and actively promoted to medical students. Therefore, specific, evidence-based complementary medicine databases and secondary resources should be subscribed and recommended to medical schools and students, to assist meeting professional responsibilities regarding complementary medicines. These findings may help inform the development of appropriate medical information resources regarding complementary medicines. © 2016 John Wiley & Sons Australia, Ltd.

Determinants of infant and young child feeding practices by mothers in two rural districts of Sindh, Pakistan: a cross-sectional survey.

PubMed

Khan, Gul Nawaz; Ariff, Shabina; Khan, Ubaidullah; Habib, Atif; Umer, Muhammad; Suhag, Zamir; Hussain, Imtiaz; Bhatti, Zaid; Ullah, Asmat; Turab, Ali; Khan, Ali Ahmad; Garzon, Alba Cecilia; Khan, Mohammad Imran; Soofi, Sajid

2017-01-01

Infant and young child feeding (IYCF) practices during the first two years of life are important for the growth and development of a child. The aim of this study was to assess IYCF practices and its associated factors in two rural districts of Pakistan. A cross-sectional study was conducted in two rural districts of Sindh province, Pakistan as part of a stunting prevention project between May and August 2014. A standard questionnaire on IYCF practices recommended by World Health Organization was used to collect information from 2013 mothers who had a child aged between 0 and 23 months. Only 49% of mothers initiated breastfeeding within one hour of birth. Thirty-seven percent of mothers exclusively breastfed their infants for six months. Seventy-percent mothers introduced complementary feeding at 6-8 months of age. Eighty-two percent of mothers continued breastfeeding for at least one year and 75% for at least two years of age. IYCF practices were not significantly different for boys and girls in the study area. Being an employed mother (AOR 2.14; 95% CI 1.02, 4.51) was positively associated with the early initiation of breastfeeding. Children who were born at a health facility (AOR 0.65; 95% CI 0.50, 0.84) and were aged six to eleven months (AOR 0.70; 95% CI 0.54, 0.90) were less likely to be have an early initiation of breastfeeding. Mothers aged 25 to 29 years (AOR 1.83; 95% CI 1.05, 3.18), being literate (AOR 1.79; 95% CI 1.15, 2.78), and higher income (AOR 10.6; 95% CI 4.40, 25.30) were more likely to have an improved dietary diversity. Being an employed mother (AOR 2.18; 95% CI 1.77, 4.03) and higher income were more likely to have minimum acceptable diet (AOR 9.7; 95% CI 4.33, 21.71). IYCF practices were below the acceptable level and associated with maternal age, maternal illiteracy, unemployment, and poor household wealth status. Emphasis should be given to improve maternal literacy and reduction in poverty to improve IYCF practices.

Arsenic Metabolites, Including N-Acetyl-4-hydroxy-m-arsanilic Acid, in Chicken Litter from a Roxarsone-Feeding Study Involving 1600 Chickens.

PubMed

Yang, Zonglin; Peng, Hanyong; Lu, Xiufen; Liu, Qingqing; Huang, Rongfu; Hu, Bin; Kachanoski, Gary; Zuidhof, Martin J; Le, X Chris

2016-07-05

The poultry industry has used organoarsenicals, such as 3-nitro-4-hydroxyphenylarsonic acid (Roxarsone, ROX), to prevent disease and to promote growth. Although previous studies have analyzed arsenic species in chicken litter after composting or after application to agricultural lands, it is not clear what arsenic species were excreted by chickens before biotransformation of arsenic species during composting. We describe here the identification and quantitation of arsenic species in chicken litter repeatedly collected on days 14, 24, 28, 30, and 35 of a Roxarsone-feeding study involving 1600 chickens of two strains. High performance liquid chromatography separation with simultaneous detection by both inductively coupled plasma mass spectrometry and electrospray ionization tandem mass spectrometry provided complementary information necessary for the identification and quantitation of arsenic species. A new metabolite, N-acetyl-4-hydroxy-m-arsanilic acid (N-AHAA), was identified, and it accounted for 3-12% of total arsenic. Speciation analyses of litter samples collected from ROX-fed chickens on days 14, 24, 28, 30, and 35 showed the presence of N-AHAA, 3-amino-4-hydroxyphenylarsonic acid (3-AHPAA), inorganic arsenite (As(III)), arsenate (As(V)), monomethylarsonic acid (MMA(V)), dimethylarsinic acid (DMA(V)), and ROX. 3-AHPAA accounted for 3-19% of the total arsenic. Inorganic arsenicals (the sum of As(III) and As(V)) comprised 2-6% (mean 3.5%) of total arsenic. Our results on the detection of inorganic arsenicals, methylarsenicals, 3-AHPAA, and N-AHAA in the chicken litter support recent findings that ROX is actually metabolized by the chicken or its gut microbiome. The presence of the toxic metabolites in chicken litter is environmentally relevant as chicken litter is commonly used as fertilizer.

Soy- and rice-based processed complementary food increases nutrient intakes in infants and is equally acceptable with or without added milk powder.

PubMed

Paul, Keriann H; Dickin, Katherine L; Ali, Nadra S; Monterrosa, Eva C; Stoltzfus, Rebecca J

2008-10-01

Processed complementary foods (PCF) might mitigate several complementary feeding barriers in developing countries. Efficacy trials, however, have not shown substantial improvements in child growth, possibly due to inadequate formative research to assess acceptability and identify pitfalls. Milk powder might improve palatability of PCF but incurs a higher cost. We compared the acceptability of an instant soy-rice PCF without (SR) and with (SRM) milk powder. Best practices for formative evaluation of PCF are not established. We therefore compared findings from randomized trials of SR vs. SRM in 1-d sensory tests (n = 71 mother-infant dyads) vs. Trials of Improved Practices (TIPs), a 2-wk in-home mixed methods evaluation (n = 54 dyads). TIPs included interviews, disappearance rates, observations, and 24-h dietary recalls to assess acceptance, consumption of the 50 g/d ration, and impact on diet. Although mothers preferred SRM to SR in the sensory tests, children in the TIPs consumed >50 g/d of SR (87 +/- 9 g/d) and SRM (89 +/- 8 g/d) with no difference between the foods (P = 0.55). Despite some replacement of family food, energy (574 kJ/d; P < 0.001) and protein (19 g protein/d; P < 0.001) increased in both groups. Mothers' preferences for milk, more sugar in SR, and preparation with hot water were concerns raised in the sensory tests that proved insignificant in TIPs. However, TIPs uncovered new concerns of overconsumption and food safety. We found milk did not improve the acceptability of the soy-rice PCF and recommend TIPs as a useful tool for formative research of PCF interventions.

Lessons Learned in a Breastfeeding Media Campaign.

PubMed

Ware, Julie L; Mzayek, Fawaz; Levy, Marian

2016-09-01

Breastfeeding is well accepted as the optimal nutrition for babies. The American Academy of Pediatrics states that infant feeding should no longer be thought of as a lifestyle choice, but rather as a public health issue. In Shelby County, Tennessee, rates of breastfeeding continue to be disparately low. To address this public health problem, a focus group study was conducted with the Shelby County population least likely to breastfeed. Following participants' suggestion to use a billboard campaign with pictures of local mothers and families, one highway billboard and ten bus stop signs were placed around the city in areas of the lowest breastfeeding rates. Self-administered surveys were completed by convenience sampling in target population areas with women least likely to breastfeed, both before placing the signs and 6 months later. No significant differences were noted in knowledge, attitudes, or practices after the media campaign, but trends toward increased intention to breastfeed were noted among expectant mothers. With collapsed data (pre and post), a majority of participants believed that breastfeeding is the best way to feed a baby and they were significantly more likely to plan to breastfeed if they knew about health benefits to the baby and to themselves. If they had heard about breastfeeding on the TV or radio, they were more likely to believe breastfeeding is important for long-term health. These findings suggest that a media campaign could have a complementary role in promoting breastfeeding among women with low initiation rates.

Process and reactor design for biophotolytic hydrogen production.

PubMed

Tamburic, Bojan; Dechatiwongse, Pongsathorn; Zemichael, Fessehaye W; Maitland, Geoffrey C; Hellgardt, Klaus

2013-07-14

The green alga Chlamydomonas reinhardtii has the ability to produce molecular hydrogen (H2), a clean and renewable fuel, through the biophotolysis of water under sulphur-deprived anaerobic conditions. The aim of this study was to advance the development of a practical and scalable biophotolytic H2 production process. Experiments were carried out using a purpose-built flat-plate photobioreactor, designed to facilitate green algal H2 production at the laboratory scale and equipped with a membrane-inlet mass spectrometry system to accurately measure H2 production rates in real time. The nutrient control method of sulphur deprivation was used to achieve spontaneous H2 production following algal growth. Sulphur dilution and sulphur feed techniques were used to extend algal lifetime in order to increase the duration of H2 production. The sulphur dilution technique proved effective at encouraging cyclic H2 production, resulting in alternating Chlamydomonas reinhardtii recovery and H2 production stages. The sulphur feed technique enabled photobioreactor operation in chemostat mode, resulting in a small improvement in H2 production duration. A conceptual design for a large-scale photobioreactor was proposed based on these experimental results. This photobioreactor has the capacity to enable continuous and economical H2 and biomass production using green algae. The success of these complementary approaches demonstrate that engineering advances can lead to improvements in the scalability and affordability of biophotolytic H2 production, giving increased confidence that H2 can fulfil its potential as a sustainable fuel of the future.

Mixed-methods study identifies key strategies for improving infant and young child feeding practices in a highly stunted rural indigenous population in Guatemala.

PubMed

Brown, Kelley; Henretty, Nicole; Chary, Anita; Webb, Meghan Farley; Wehr, Heather; Moore, Jillian; Baird, Caitlin; Díaz, Anne Kraemer; Rohloff, Peter

2016-04-01

Guatemala's rural indigenous population suffers from one of the highest rates of chronic child malnutrition (stunting) in the world. Successfully addressing stunting requires defining the barriers to and opportunities for new behaviour-change initiatives. We undertook a mixed-methods assessment of feeding practices and food purchasing behaviours around infants and young children aged 6-36 months in two rural indigenous Guatemalan communities. We found that most caregivers were aware only of acute forms of child malnutrition and that they greatly underestimated the local prevalence of malnutrition. Despite moderate adherence to exclusive breastfeeding and timing of complementary food introduction, diets had poor diversity and inadequate meal frequency. Furthermore, perceptions of food insecurity were high even in the presence of land ownership and agricultural production. Although fortified foods were highly valued, they were considered expensive. At the same time, proportionally equivalent amounts of money were spent on junk foods or other processed foods by most participants. Biological mothers often lacked autonomy for food purchasing and nutritional decisions because of the power exerted by husbands and paternal grandmothers. Our findings suggest several creative and community-based programming initiatives including education about the acute vs. chronic malnutrition distinction, engaging landowners in discussions about domestic food consumption, engaging with caregivers to redirect funds towards fortified foods rather than junk food purchases and directing behaviour-change initiatives towards all household stakeholders. © 2014 John Wiley & Sons Ltd.

Identifying priorities to improve maternal and child nutrition among the Khmu ethnic group, Laos: a formative study

PubMed Central

de Sa, Joia; Bouttasing, Namthipkesone; Sampson, Louise; Perks, Carol; Osrin, David; Prost, Audrey

2013-01-01

Chronic malnutrition in children remains highly prevalent in Laos, particularly among ethnic minority groups. There is limited knowledge of specific nutrition practices among these groups. We explored nutritional status, cultural beliefs and practices of Laos' Khmu ethnic group to inform interventions for undernutrition as part of a Primary Health Care (PHC) project. Mixed methods were used. For background, we disaggregated anthropometric and behavioural indicators from Laos' Multiple Indicator Cluster Survey. We then conducted eight focus group discussions and 33 semi-structured interviews with Khmu villagers and health care workers, exploring beliefs and practices related to nutrition. The setting was two rural districts in Luang Prabang province, in one of which the PHC project had been established for 3 years. There was a higher prevalence of stunting in the Khmu than in other groups. Disaggregation showed nutrition behaviours were associated with ethnicity, including exclusive breastfeeding. Villagers described strong adherence to post-partum food restrictions for women, while little change was described in intake during pregnancy. Most children were breastfed, although early introduction of pre-lacteal foods was noted in the non-PHC district. There was widespread variation in introduction and diversity of complementary foods. Guidance came predominantly from the community, with some input from health care workers. Interventions to address undernutrition in Khmu communities should deliver clear, consistent messages on optimum nutrition behaviours. Emphasis should be placed on dietary diversity for pregnant and post-partum mothers, encouraging exclusive breastfeeding and timely, appropriate complementary feeding. The impact of wider governmental policies on food security needs to be further assessed. PMID:22515273

Looking for new treatments of Infantile Colic

PubMed Central

2014-01-01

Infantile colic is a common disturbance occurring in the first three months of life. It is a benign condition and one of the main causes of pediatric consultation in the early part of life because of its great impact on family life. Some pediatricians are prone to undervalue this issue mainly because of the lack of evidence based medicine guidelines. Up to now, there is no consensus concerning management and treatment. Literature reports growing evidence about the effectiveness of dietary, pharmacological, complementary and behavioral therapies as options for the management of infantile colic. Dietary approach, usually based on the avoidance of cow’s milk proteins in breast-feeding mothers and bottle-fed infants, more recently has seen the rise of new special formulas, such as partially hydrolyzed proteins and low lactose added with prebiotics or probiotics: their efficacy needs to be further documented. Investigated pharmacological agents are Simethicone and Cimetropium Bromide: the first is able to reduce bloating while the second could reduce fussing crying, but it has been tested only for severe infantile colic. No other pain relieving agents have been proposed until now, but some clinical trials are ongoing for new drugs. There is limited evidence supporting the use of complementary and alternative treatments (herbal supplements, manipulative approach and acupuncture) or behavioral interventions. Recent studies have focused the role of microbiota in the pathogenesis of this disturb and so new treatments, such as probiotics, have been proposed, but only few strains have been tested. Further investigations are needed in order to provide evidence-based guidelines. PMID:24898541

Plant genotypic diversity reduces the rate of consumer resource utilization

PubMed Central

McArt, Scott H.; Thaler, Jennifer S.

2013-01-01

While plant species diversity can reduce herbivore densities and herbivory, little is known regarding how plant genotypic diversity alters resource utilization by herbivores. Here, we show that an invasive folivore—the Japanese beetle (Popillia japonica)—increases 28 per cent in abundance, but consumes 24 per cent less foliage in genotypic polycultures compared with monocultures of the common evening primrose (Oenothera biennis). We found strong complementarity for reduced herbivore damage among plant genotypes growing in polycultures and a weak dominance effect of particularly resistant genotypes. Sequential feeding by P. japonica on different genotypes from polycultures resulted in reduced consumption compared with feeding on different plants of the same genotype from monocultures. Thus, diet mixing among plant genotypes reduced herbivore consumption efficiency. Despite positive complementarity driving an increase in fruit production in polycultures, we observed a trade-off between complementarity for increased plant productivity and resistance to herbivory, suggesting costs in the complementary use of resources by plant genotypes may manifest across trophic levels. These results elucidate mechanisms for how plant genotypic diversity simultaneously alters resource utilization by both producers and consumers, and show that population genotypic diversity can increase the resistance of a native plant to an invasive herbivore. PMID:23658201