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Introduction: Breastfeeding confidence affects how long exclusive breastfeeding lasts. Furthermore, support from close ones is important. Objectives: To establish a model and explore the relationship among support from husbands, family, healthcare providers, breastfeeding self-efficacy, and the duration of exclusive breastfeeding. Method: The study employed a cross-sectional design involving 117 mothers with children aged 6-24 months in the Pengasinan Health Centre area, Depok City, Indonesia. Participants were chosen randomly. The endogenous variables of the study were the duration of exclusive breastfeeding and breastfeeding self-efficacy, while the exogenous variables included support from husbands, family, and healthcare providers. Data analysis utilized partial least square-structural equation modeling to establish a suitable model and examine the relationships between the constructs. Results: The model was found to be a good fit for Indonesian mothers [standardized root mean square residual (SRMR) = 0.072] and demonstrated good predictive relevance (Q square = 0.299). All indicators comprising the constructs were deemed valid and reliable. There was a relationship between husband's support (p=0.004) and healthcare provider (p=0.015) with breastfeeding self-efficacy. Breastfeeding self-efficacy directly correlated with the duration of exclusive breastfeeding (p=0.000). Indirectly, there was a relationship between husband's support (p=0.027) and healthcare provider (p=0.028) with the duration of exclusive breastfeeding through breastfeeding self-efficacy. Conclusions: The duration of exclusive breastfeeding was indirectly influenced by husband's support and healthcare provider support through breastfeeding self-efficacy.

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Background: Acute febrile encephalopathy (AFE) is characterized by fever, altered mental state, and/or seizures due to infections agents, metabolites and toxins. Objectives: To determine the clinical profile and risk factors of mortality in children with AFE. Method: A two-year retrospective observational study was done on paediatric intensive care unit admitted children, aged 1 month to 12 years, with a history of recent onset fever and altered sensorium with or without seizures. Children with space occupying lesion, cerebrovascular accident, traumatic brain injury, and seizure disorder were excluded. Demographic, clinical and relevant laboratory data were extracted from medical records. Student’s t-test, Chi-square test and univariate / multi-variate regression model were used for statistical analysis. Results: Males outnumbered females and 63.8% were less than 5 years old. Two-third were from lower-socio-economic class of rural residences. Almost two-third presented during winter and summer. All cases presented with fever and altered sensorium and 81.9% had seizures. Glasgow coma scale (GCS) score <8 was noted in 46.8% cases, with mean score 7.65±2.87. Signs included raised intracranial pressure (82.7%), meningeal irritation (59.6%), abnormal pupillary size (42.6%) and abnormal tone (87.2%). Pyogenic meningitis and viral encephalitis were the common causes. Mortality was 40.4%; 60.7% survivors had neurological sequelae. GCS score <8, hypotension, respiratory distress/cyanosis, need for mechanical ventilation, low serum albumin, low sugar and high protein in cerebrospinal fluid (CSF) were the risk factors for mortality. Conclusions: Hypotension, respiratory distress, need for mechanical ventilation and presence of high protein in CSF were the independent predictors of mortality.

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Background: The expanded programme of immunisation (EPI) has been a major success in Sri Lanka. However, despite its success, vaccine hesitancy remains a concern. Timely vaccination is crucial, as delays and missed doses reduce herd immunity and increase susceptibility to vaccine-preventable diseases. Objectives: To evaluate vaccine compliance, parental attitudes toward childhood immunization, and the factors influencing vaccination compliance among parents in the Doluwa Medical Officer of Health (MOH) area. Method: A community-based cross-sectional descriptive study was conducted with 176 participants attending vaccination and well-baby clinics in conveniently selected Public Health Midwife (PHM) areas within the Doluwa MOH area in Kandy district. Data were collected using a structured interviewer-administered questionnaire and Child Health Development Records. Results: Study involved 176 parents, with mean participant age of 31 years. All participants had appropriately vaccinated their children for their age, except for 47 (26.7%) who reported vaccination delays, primarily due to child illness (23.4%). There were no non-vaccinated participants. A significant association was found between child’s age and vaccination delay (OR= 1.045, 95% CI=1.02–1.07). All participants obtained vaccines from government sector. A majority (96.6%) had positive attitudes towards EPI, citing the high responsibility of the government sector (76.7%). Conclusions: Despite excellent vaccination coverage, vaccination delays persist, indicating areas for improvement in the implementation of EPI.

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Introduction: Movement and sleep behaviours profoundly impact children's health, particularly concerning childhood obesity and overall well-being. Global research on these behaviours remains sparse, exacerbated by the COVID-19 pandemic's impact on screen time and physical activity. Studies indicate varied impacts across income levels, with Sri Lanka facing rising childhood obesity rates despite intervention efforts. Objectives: To assess the movement and sleep behaviours of 3-5-year-old children in selected public health areas in the Colombo District, Sri Lanka, alongside the World Health Organisation (WHO) guidelines. Method: This descriptive cross-sectional study was conducted over 6 months in 7 public health areas within the Colombo District. Study population comprised children registered in birth and immunization registry. Data were collected via an interviewer-administered questionnaire, Preschool-age children's Physical Activity Questionnaire (Pre-PAQ), and 1-week movement diary. Data was analysed with SPSS version 25 using appropriate statistical tests. Results: Study included 425 participants (51.8% female). Of participants, 52.2% on weekdays and 55.5% on weekends met WHO guideline of 180 minutes or more of daily physical activity (PA) but only 23.1% met recommendation of 60 minutes of moderate to vigorous PA. Sedentary behaviour exceeded WHO recommendations, with 47.5% and 46.1% adhering to guidelines on weekdays and weekends, respectively. Most children (72.3%) adhered to sleep guidelines. No significant demographic or socio-economic predictors of compliance with movement behaviour guidelines were identified, except for the number of siblings influencing weekend PA compliance. Conclusions: Whilst 23.1% children met the WHO recommendation of 60 minutes of moderate to vigorous PA, 72.3% children adhered to WHO sleep guidelines and 47% adhered to WHO sedentary behaviour guidelines.

Background: In paediatric emergencies, actual weight measurement is not always feasible and estimated weights are derived from an accepted formula. In many low and middle-income countries, it has been shown that these formulas overestimate the weight leading to prescription errors. Objectives: To determine the applicability of the modified advanced paediatric life support (APLS) weight-for-age formula in Sri Lanka. Method: Our targeted population was children aged 1 month to 12 years, attending paediatric wards in Teaching Hospital Peradeniya from 01/07/2023-31/08/2023. Children with prolonged illnesses that affect their weight were excluded. Weights measured with calibrated scales and documented in the bedhead tickets were used for comparison with the estimated weights using the formula. Convenience sampling was done until the sample size of 387 children meeting the inclusion criteria was reached. Results: A mean estimation error of 3.61kg with a mean percentage error (95% CI) of 26.9% (23.2% - 30.7%) was observed for the whole sample. The percentage of estimated weights within 20% of the measured weight (PW20 value) was 44.6% for the 1-11 months category, 20.9% for the 1-5 years category, and 10.1% for the 6-12 years category showing a significant increment in the error of estimation with advancing age. Mann-Whitney U test did not reveal a statistically significant difference between the two genders in the PW20 values across all ages. Conclusions: According to this study, the modified APLS formula significantly overestimated the actual weights with the degree of overestimation increasing with age making it less accurate for older children. No significant difference in the error of weight estimations was seen among boys and girls.