Early Feeding Practices among Saudi Mothers and Dental Caries in Young Children: A Cross-sectional Study

BackgroundRecent studies have explored the relationship between early feeding practices and early childhood caries (ECC), with a focus on oral hygiene, fluoride exposure, and sugary food consumption. However, the risk factors for ECC are diverse, and limited prospective studies have comprehensively examined the impact of various early feeding behaviors on ECC risk in preschoolers, including breastfeeding patterns, timing of complementary feeding, dietary diversity, sugary food intake, and micronutrient supplementation. Further research is needed to provide evidence for effective early intervention strategies to reduce ECC prevalence in preschoolers.ObjectiveThis study aims to examine the association between early childhood feeding practices and dental caries risk in a birth cohort of Shanghai preschoolers, with a focus on breastfeeding pattern and duration, timing and types of complementary feeding, and early dietary habits.MethodsThis analysis draws on data from the Shanghai Maternal-Child Pairs Cohort (MCPC), a well-established prospective cohort designed to examine early life exposures and child health outcomes, including 3,505 maternal-child pairs aged 3 to 5 years. Dental caries status, including presence and severity (dmft), was assessed through clinical examinations. Data on early feeding practices, including breastfeeding, complementary feeding, and dietary habits, were collected via structured parent-reported questionnaires. Statistical analyses were performed using R4.3.3 and IBM SPSS Statistics 20, with adjusted Poisson regression models to assess associations and survival analysis to explore time-dependent effects.ResultsChildren with caries were more likely to have mothers with lower education levels, lower perceived family economic status, exposure to tobacco during pregnancy, and primary caregivers with dental caries. They also exhibited delayed tooth brushing initiation and behaviors such as eating after brushing and sleeping with a bottle. Our findings suggest that breastfeeding is not a risk factor for ECC. At 12 months of age, the consumption of sweets (aRR = 1.041, 95%CI: 1.020, 1.063) and sugar-sweetened beverages (aRR = 1.122, 95%CI: 1.080, 1.166) in the past 24 h significantly increased caries risk. Early introduction of complementary foods (< 6 months) also elevated the risk (aRR = 1.234, 95% CI: 1.019, 1.494). In contrast, consistent vitamin D supplementation (0–2 years) was protective (aRR = 0.980, 95% CI: 0.961, 0.998), and greater dietary diversity at 12 months was associated with lower dmft (β = -0.222, 95% CI: -0.442, -0.003). Survival analysis showed that sweet intake at 12 months shortened the caries-free survival time, whereas consistent vitamin D supplementation from birth to 2 years prolonged it.ConclusionScientific early feeding strategies, including limiting sugar intake, ensuring an appropriate timing for complementary feeding, maintaining consistent vitamin D supplementation, and promoting dietary diversity, play a key role in preventing ECC.

The impact of early childhood caries (ECC) seen in infants and young children to the society is enormous. Most studies on ECC have been focused on specific ethnic and lower socioeconomic communities, however fewer studies are conducted in India as compared to other developed countries. The study investigates the association between selected feeding practices and the presence of early ECC among 3-5 year-old children of Indore city. A cross-sectional sample consisted of 640 preschool children of different socioeconomic status (SES). A self-administered questionnaire was used to obtain information about demographic backgrounds and feeding history of the child. The caries experience of children was recorded. The data were evaluated using Chi-square and multivariate logistic regression. The prevalence of ECC was found to be 64%. ECC was found to be significantly associated with age, SES, breastfeeding for more than 1 year, bottle feeding, bottle content used other than water, feeding at night, and cup drinking after 1 year. The present study indicates that ECC and feeding habits have a significant relationship. The content of the bottle feed and feeding practices at night are the strongest factors among all feeding habits associated with ECC.

BackgroundCurrent research has focused on exploring the sources of parents’ anxiety about children’s education (PAE), and we continue in this direction by exploring the factors influencing parental educational anxiety in primary and secondary school students and the interactions among them.MethodsParental Educational Anxiety Measurement Questionnaire was used to measure the level of PEA. Pearson correlation coefficient analysis was used to examine the correlation between the level of PAE and the demographic variables. The method of multiple stepwise regression analysis was used to explore the demographic factors correlated with PAE. Two-way interactions in moderated multiple regression to examine the moderating effects of educational attainment on monthly household mortgage payments and PAE.ResultsOur results indicate that there were statistical differences among education level, average monthly household income, child’s stage of learning and monthly household mortgage payments; PEA were negatively correlated with education level and average monthly household income, and positively correlated with monthly cost of educational inputs. The results of multiple regression analysis showed that education level, average monthly household income, monthly household mortgage payment, and monthly cost of educational inputs were direct influences on PEA. Education level has a significant moderating effect on the monthly mortgage payment and PEA.ConclusionEducation level, average monthly household income, monthly household mortgage payment, and monthly cost of educational inputs were direct influencing factor of PEA.

Ecotourism is one strategy for supporting conservation, generating income, and creating employment for communities living around protected areas. In Malaysia, the management of national parks (protected areas) focuses on the planning and implementation of various activities which contribute to the long-term conservation of the areas while mitigating or reducing conflicts between human and the environment. The issue is whether ecotourism development helps to improve income and reduce rural poverty. A case study was conducted in 2014 where 158 Malay households from Kampung Kuala Tahan were interviewed. Villagers engaged in economic activities related to ecotourism development in Kuala Tahan National Park (KTNP) area (2,477 sq. km) directly and indirectly. The result shows the average monthly household income of this village was RM4, 035. On the whole, about 90% of the average monthly household income was cash income while 10% income in kind. The income sources of villagers were from those within the state land forest areas (related to NTFP harvesting), and outside KTNP (related to forestry and ecotourism). Income generated outside KTNP(related to forestry and ecotourism) area was significantly high compared to those within state land forest and outside KTNP (non-forestry). On average, about RM1, 895 or 47% of the average monthly household income was generated from the ecotourism related activities and forest area. The highest percentage of cash income was from villagers’ engagement as tour guides. Income generated from this source accounted for 13% of household income. Ecotourism related retail stores or restaurant operators also significantly contributed to the average monthly household income at 10%. The incidence of poverty among the households in the village was 4% in 2014 compared to 3.4% among rural Malaysian households in 2012. The findings in this study showed that the income received from forestry related activities and ecotourism is important in reducing poverty among local households.

Background: Infant and young child feeding (IYCF) practices play vital role for the growth &amp; development in the early months of life. Objective: The purpose of the present study was to determine and to identify the patterns and influencing factors of feeding practices in infant and young children of 0-2 years old in Bangladesh. Methodology: A descriptive type of cross sectional study was carried out to assess the pattern of infant &amp; young child feeding practices by the rural mothers of Bangladesh with a sample size of 450 during the months of January to December of 2015.Result: Out of 450 children, 51.1% are female &amp; 48.9% are male. The proportions of infants with early initiation of breastfeeding (13.6%) and exclusive breastfeeding fewer than six months (57.3%) and infants who received complementary feeding at the age of 6–8 months (55.7%) were low. It showed that 90.4% of mothers have knowledge on exclusive breast feeding but only 57.3% of them have practiced it for 4-6 months. It further revealed that only 8.4% of mothers &amp; 13.6 % of fathers were illiterate. The main problems revealed from the study were late initiation of breastfeeding, low rates of exclusive breastfeeding, and inappropriate complementary feeding practices. It further revealed that 69.3% of the respondents had two or less children and 30.7% had three or more children.Conclusion: Majority of the respondents have the knowledge on complementary feeding, knowledge on preparation of complementary feeding, knowledge on preparation of food by grains, knowledge on preparation of food by milk and milk products and knowledge on preparation of food by meat, fish, poultry, liver.Journal of National Institute of Neurosciences Bangladesh, 2016;2(1):19-25

A global target of increasing exclusive breast-feeding (EBF) to at least 50% by the year 2025 was set by the WHO for infants under 6 months. The lowest prevalence in the world was found in the Eastern Mediterranean region in 2010-18 and little is known about the status of mothers' feeding practices in Saudi Arabia. The present study aimed to assess mothers' actual feeding and weaning practices used with their infants by the mothers' different age groups. The present study was conducted among 247 mothers of infants aged 4-12 months who were attending public well-baby clinics. Quantitative data were obtained by nutritionists using an electronic semi-structured questionnaire about mothers' feeding practices. Only 5·3% of mothers engaged in EBF, 44·9% breast-fed their infants after an hour of birth, while 92·7% of infants had ever been breast-fed. The average intent/plan to continue breast-feeding was 4·9(±3·1) months. Younger mothers introduced weaning food around 4 weeks earlier than older mothers (mean differences were -0·4, 95% CI -0·71, -0·13; P = 0·031). A total of 64·3% of infants received complementary feeding before completing 17 weeks. Maternal age group and delivery mode were the only factors associated with the early introduction of complementary feeding. A total of 69·2% of the mothers believed that 'it is a good time' and 61·1% felt that 'infants are hungry and need other sources of food'. Online sources and family advice were the top sources of information on mothers' feeding practices. Provision of professional advice about EBF and optimal weaning practices are significant areas for improvement in terms of compliance with recommended infant feeding practices.

Feeding practices during early childhood play an important aetiological role in early childhood caries (ECC). The role of feeding practices in causation of ECC is debated. The objective of this study was to assess the aetiological role of feeding practices on ECC. A descriptive cross sectional study was conducted at a paediatric unit in Sri Lanka. Two hundred and eighty-five children between 36 to 60 months, admitted to the unit were randomly selected for the study. An interviewer administered questionnaire asked about socio-demographic characteristics and feeding practices. The mouths of children were examined for dental caries. Out of 285 children, 61% had exclusive breast feeding up to six months, 69% continued breast feeding beyond two years and 82% had overnight feeding after two years of age. One hundred and thirty-six children (47.7%) had dental caries with a mean deft score of 1.81. Overnight feeding with any type of milk beyond two years significantly increased dental caries incidence and severity. Children exclusively breast fed for six months or had breast feeding beyond two years had a higher prevalence of caries than children not exclusively breast fed or who were not breast feed beyond two years, but the difference was not significant. Overnight feeding with any type of milk beyond two years should be discouraged.

Background: The World Health Organization (WHO) recommends optimal feeding practices during infancy and early childhood for better health and growth of children. Objective: To determine the factors affecting exclusive breastfeeding (EBF) duration and the time of introducing complementary feeding (CF) in Mecca City, Saudi Arabia. Methods: This cross-sectional study recruited 814 Saudi mothers. All mothers filled out a closed questionnaire on family sociodemographics, health status of mothers and infants, and postpartum breastfeeding habits and patterns. The patterns of CF and bottle-feeding were examined, and binary logistic regression was performed. Results: The mean ± standard deviation EBF duration was 4.6 ± 2.5 months. The EBF rate showed a sharp decrease from 50.6% at birth to 14.4% at 6 months among children. Employment of mothers, weight at childbirth &lt;2.5 kg, weight of 2.6–3 kg at child birth, postnatal disease in infants, and pacifier use for infants were associated with a low EBF rate. Intermediate education of the mother was found to increase EBF duration as compared to mothers with higher levels of education. Most mothers introduced plant-based CFs to infants at 4 months of age (median), but animal-based CFs were introduced only after 8 months (median). The median age of starting milk formula was 3 months. Conclusion and Recommendation: The reported rate of EBF is far below the current international recommendations. The patterns of CF practices and bottle-feeding differ widely from the WHO recommendations in Mecca City. National campaigns should be implemented to promote EBF in Saudi Arabia.

This study examines the relationship between health beliefs and fear of cancer recurrence among breast cancer (BC) patients and develops a predictive model for cancer recurrence fear. A total of 120 patients from the Breast Surgery Department of a top tertiary hospital, spanning December 2022 to December 2023, were included in the study. Data were collected using general information questionnaires, Champion&amp;rsquo;s Health Belief Model Scale (CHBMS) and the Fear of Progression Questionnaire-Short Form (FoP-Q-SF). The analysis revealed that CHBMS and FoP-Q-SF scale scores of BC patients were 94.17 &amp;plusmn; 15.59 points and 34.90 &amp;plusmn; 7.15 points, respectively. The total CHBMS score, perceived benefits, health motivation, and self-efficacy were negatively correlated with the total FoP-Q-SF score and its dimension scores (P &lt; 0.05), whereas perceived severity, perceived susceptibility, type of operation, radiotherapy and chemotherapy treatment, and perceived barriers showed a positive correlation (P &lt; 0.05). Significant differences in FoP-Q-SF scores were observed among patients of different ages, marital statuses, education levels, average monthly household incomes, levels of family caregiving, tumor node metastasis (TNM) stages, and types of medical insurance (P &lt; 0.05). Multivariate logistic regression analysis identified age, marital status, education level, average monthly household income, family caregiving, TNM stage, chemoradiotherapy treatment, and CHBMS scale scores as significant factors influencing cancer recurrence fear (P &lt; 0.05). A predictive model regression equation was established, and the model&amp;rsquo;s area under the ROC curve was 0.759 (95% confidence interval = 0.702 &amp;ndash; 0.834, P &lt; 0.001). Patients aged 50 years and older exhibited higher fear levels. This fear is also affected by age, marital status, education level, average monthly household income, family caregiving, TNM stage, and chemoradiotherapy treatment. The predictive model based on these factors demonstrates good predictive efficacy for cancer recurrence fear, providing a basis for early identification of high-risk patients and targeted nursing interventions.

Early childhood caries (ECC) is one of the most prevalent dental diseases among children and is related to their early feeding practices. This multi-factorial disease involves susceptible tooth and host, fermentable carbohydrates in the diet, cariogenic micro-organisms and time (American Academy of Pediatric Dentistry, 2008). Thus, this study aimed to identify the associations between bottle-feeding and weaning practices, and ECC formation. By using convenience sampling, 201 children were recruited from the IIUM Outpatient Dental Clinic and ten kindergartens around the area of Kuantan, in the state of Pahang (Malaysia). Examination for caries was conducted visually to determine caries status (with or without caries). The caregivers were requested to fill in a questionnaire regarding feeding practices of their children. The findings of the study indicated that 67% of the children identified with caries practiced bottle-feeding in bed either sometimes or always (every night/day) (p=0.005). The prevalence of ECC was also significantly (p4 years) among the study population. In addition, the mean intake of sweetened drinks among children with ECC was significantly higher than those with no ECC (5.4 vs. 3.1 servings/week, p=0.001). The results of this research indicated that the increased frequency and prolonged duration of bottle-feeding practices, as well as high consumption of sweet drinks during weaning, could be associated with the formation of ECC. In conclusion, these findings would increase the awareness particularly among parents regarding bottle-feeding practices and weaning diet contents and its potential implication on their children’s oral health.

A descriptive type of cross sectional study was carried out to assess the pattern of infant &amp; young child feeding practices by the rural mothers of Bangladesh with a sample size of 450 during the months of January, 2015 to December, 2015. Out of 450 children, 51.1% are female &amp; 48.9% are male. The proportions of infants with early initiation of breastfeeding (13.6%) and exclusive breastfeeding fewer than six months (57.3%) and infants who received complementary feeding at the age of 6-8 months (55.7%) were low. It showed that 90.4% of mothers have knowledge on exclusive breast feeding but only 57.3% of them have practiced it for 4-6 months. It further revealed that only 8.4% of mothers &amp; 13.6 % of fathers are illiterate. The main problems revealed from the study were late initiation of breastfeeding, low rates of exclusive breastfeeding and inappropriate complementary feeding practices. It further revealed that 69.3% of the respondents had two or less children and only 30.7% had three or more children.Medicine Today 2016 Vol.28(1): 1-5

Early childhood feeding practices and dental caries among Australian preschoolers

In South Asia, childhood undernutrition persists while overweight is increasing. Internationally recommended infant and young child feeding (IYCF) practices promote healthy nutritional status; however, little is known about IYCF in Bhutan, investigated here using 2015 National Nutrition Survey data. WHO/UNICEF IYCF indicators, anthropometry and household socio‐economic status were available for 441 children <24 months. Stunting, wasting, and underweight prevalence (<−2Z length‐for‐age [LAZ], weight‐for‐age, [WAZ] and weight‐for‐length [WLZ], respectively) were 15%, 9%, and 5%, respectively, whereas overweight (WLZ >2) prevalence was 6%. In survey‐design‐adjusted analyses, 52% of mothers of 0‐ to 5‐month olds reported exclusive breastfeeding (EBF), with EBF less common for girls than boys (OR: 0.2 [95% CI: 0.1–0.9]). Although 61% of children were breastfed at 2 years and 75% of children >6 months met a minimum daily meal frequency, only 18% of children 6–23 months met minimum dietary diversity. IYCF was unassociated with risk of stunting, wasting, or underweight, possibly due to relatively low prevalence of anthropometric failure and small sample size. However, currently‐breastfed children were less often overweight [OR: ~0.1 (95% upper limit ≤1.0)]. Neither breastfeeding nor most complementary feeding practices differed by socio‐economic status, but children in the highest two fifth of a wealth index had 7.8 (1.3–46.9) and 5.3 (1.1–25.2) times greater odds than children in the lowest fifth of meeting minimum dietary diversity criteria. Low rates of EBF, given possible protection of breastfeeding against overweight, and inadequate dietary diversity offer evidence to guide future program interventions to improve nutritional status of young children.

In South Asia, childhood undernutrition persists while overweight is increasing. Internationally recommended infant and young child feeding (IYCF) practices promote healthy nutritional status; however, little is known about IYCF in Bhutan, investigated here using 2015 National Nutrition Survey data. WHO/UNICEF IYCF indicators, anthropometry and household socio-economic status were available for 441 children <24months. Stunting, wasting, and underweight prevalence (<-2Z length-for-age [LAZ], weight-for-age, [WAZ] and weight-for-length [WLZ], respectively) were 15%, 9%, and 5%, respectively, whereas overweight (WLZ >2) prevalence was 6%. In survey-design-adjusted analyses, 52% of mothers of 0- to 5-month olds reported exclusive breastfeeding (EBF), with EBF less common for girls than boys (OR: 0.2 [95% CI: 0.1-0.9]). Although 61% of children were breastfed at 2years and 75% of children >6months met a minimum daily meal frequency, only 18% of children 6-23months met minimum dietary diversity. IYCF was unassociated with risk of stunting, wasting, or underweight, possibly due to relatively low prevalence of anthropometric failure and small sample size. However, currently-breastfed children were less often overweight [OR: ~0.1 (95% upper limit ≤1.0)]. Neither breastfeeding nor most complementary feeding practices differed by socio-economic status, but children in the highest two fifth of a wealth index had 7.8 (1.3-46.9) and 5.3 (1.1-25.2) times greater odds than children in the lowest fifth of meeting minimum dietary diversity criteria. Low rates of EBF, given possible protection of breastfeeding against overweight, and inadequate dietary diversity offer evidence to guide future program interventions to improve nutritional status of young children.

&amp;lt;i&amp;gt;Background: &amp;lt;/i&amp;gt;Early Childhood Caries (ECC) remains a prevalent public health concern globally. Feeding practices, particularly breastfeeding and bottle-feeding, along with oral hygiene behaviors and caregiver knowledge, are critical factors influencing ECC risk. This study aimed to compare the impact of breastfeeding and bottle-feeding on the prevalence and severity of ECC among children under five years of age. &amp;lt;i&amp;gt;Methods: &amp;lt;/i&amp;gt;This cross-sectional comparative study was conducted among 105 children aged under five years at City Dental College and General Hospital, Dhaka, Bangladesh, from March 2004 to June 2004. Participants were categorized into breastfed (n = 58) and bottle-fed (n = 47) groups. Data were collected on demographic characteristics, feeding and brushing practices. &amp;lt;i&amp;gt;Results: &amp;lt;/i&amp;gt;The mean age of bottle-fed children was slightly higher than that of breastfed children, though not statistically significant. Night-time feeding and higher feeding frequency (≥5 times/day) were significantly more common in bottle-fed children (p &amp;lt; 0.001 and p = 0.005, respectively). Oral hygiene habits did not differ significantly between groups (p &amp;gt; 0.05). The prevalence of ECC was significantly higher among bottle-fed children (61.7%) compared to breastfed children (31.0%) (p &amp;lt; 0.001). Gingivitis was more prevalent among breastfed children (32.7%; p = 0.017). Maternal knowledge was generally poor to average, with only 33.3% correctly identifying factors responsible for dental caries. &amp;lt;i&amp;gt;Conclusion: &amp;lt;/i&amp;gt;Bottle-feeding is significantly associated with a higher prevalence and severity of ECC, particularly in children with frequent and night-time feeding. Oral hygiene practices were similar between groups, but maternal knowledge on dental caries prevention remains inadequate.