Absence Of Exclusive Breastfeeding Research Articles

A Study of the Clinical Profile and Respiratory Index of Severity in Children (RISC) Score in Infants Admitted With Acute Respiratory Infections at a Tertiary Care Hospital.

Background Pneumonia is a major infectious cause of mortality in young children worldwide. The Respiratory Index of Severity in Children (RISC) score was designed with the intent to provide an objective mean to quantify the severity of lower respiratory tract infection in young children based on their risk of mortality. Knowledge about the clinical profile of acute respiratory infections and the scoring system predicting the risk of mortality helps in modifying treatment strategies. This study was undertaken at a resource-limited, tertiary-care public hospital in southern India with the objectives of describing the clinical profile of infants admitted with acute respiratory infections and determining the association of the RISC score with mortality. Method This was a retrospective observational study conducted over six months. Case records of infants admitted with acute respiratory infections were reviewed. The socio-demographic and clinical details of each case were recorded. The RISC score was calculated using clinical parameters which included the history of refusal of feeds, oxygen saturation lower than 90%, chest in-drawing, wheezing, and low weight-for-age. The maximum score was six. Descriptive data was represented using mean, standard deviation, and percentage or proportion. The association between any two categorical variables was analyzed using the chi-square test. The differences between any two continuous variables were analyzed using the independent sample t-test. A p-value of < 0.05 was considered statistically significant. Results A total of 75 infants were admitted with a diagnosis of acute respiratory infection during the study period. Of these, 68 were included in the study. The mean age of infants was 6.69 ± 3.96 months; 58.8% were male, 41 (60%) were exclusively breastfed, and 51 (75%) were up-to-date immunized. Twenty (29.4%) infants had a history of exposure to indoor smoke. The majority (67.6%) had pneumonia. Nine (13.2%) were mechanically ventilated. The mean duration of hospital stay was 8.16 ± 5.45 days. Sixty-three (92.64%) infants recovered and there were five deaths. The presence of less than 90% oxygen saturation (p-value=0.004), a diagnosis of severe pneumonia (p-value <0.001), and the need for mechanical ventilation (p-value <0.001) were significantly associated with mortality. A statistically significant (p-value=0.001) association was observed between the RISC score and mortality. Conclusions Addressable factors like the absence of exclusive breastfeeding, partial-immunization status, exposure to indoor smoke, and malnutrition were observed in infants with acute respiratory infections, which reinforces the importance of protective and preventive strategies for the control of pneumonia. The RISC score was observed to be beneficial in predicting mortality in an infant with acute respiratory infection. Triaging and early identification of infants at risk of mortality using this score could be very helpful in initiating timely treatment to reduce mortality, especially in resource-limited settings.

Clinical and viral profile of children admitted in the paediatric intensive care unit due to severe acute respiratory infection during seasonal surge from a tertiary care centre in Eastern India

Background: Acute lower respiratory infections (ALRI), such as pneumonia and bronchiolitis are a leading cause of morbidity and mortality in young children worldwide. Aetiology in young children is mostly viral infection or viral and bacterial infection. Objectives: To study various clinical characteristics among different age groups and viral profiling in children requiring intensive care due to ALRI. Method: Children between 1 month to 12 years, who satisfied the case definition of severe acute respiratory infection (SARI) and who were shifted to the paediatric intensive care unit (PICU) for ventilatory support were included in the study. All children were subjected to history taking, detailed examination, required blood investigations, oropharyngeal and nasopharyngeal swab testing. Results: Of the total 46 cases 32 (69.5%) were &lt;1 year of age, 11 (24%) 1 to 5 years of age, and 3 (6.5%) above 5 years of age. There were 17 (36.9%) deaths. There was 2.3 times more risk of death in the absence of exclusive breastfeeding (OR- 2.3, 95% CI= 0.6-7.9) and 2.2 times higher risk of mortality in the absence of immunization (OR- 2.2, 95% CI=0.6-7.9). Mortality was significantly associated with mechanical ventilation (p&lt;0.0001). Mortality was 17 times higher in children with comorbidities (OR-17, 95% CI= 2-146), 4.7 times higher in children with congenital heart disease (CHD) (OR-4.7 95%CI= 1-22) and 1.3 times higher in children with pre-existing central nervous system (CNS) abnormality (OR-1.33, 95% CI=0.3-6.8). From the respiratory viral panel, 18 (41%) samples were positive for virus detection. Conclusions: In this study 69.5% children with SARI were infants. Mortality was 36.9%. There was a statistically significant increased risk of death in the absence of exclusive breastfeeding, absence of immunization, use of mechanical ventilation, presence of comorbidities, presence of CHD and presence of pre-existing CNS abnormality. Sri Lanka Journal of Child Health, 2023: 52(2): 175-181

Early Social Experience and Digital-Media Exposure in Children with Autism Spectrum Disorder.

To study the early social experience and digital media exposure in children with autism spectrum disorder (ASD) in comparison with typically developed children. Details of digital-media exposure and early social experience in 65 children with ASD were compared with those in a control group of equal number of typically developed children, matched for age and gender. Prenatal and perinatal factors were also studied. The diagnosis of ASD was based on the International Clinical Epidemiology Network (INCLEN) diagnostic tool and Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) diagnostic criteria. Variables which were biologically relevant and has a P value of <0.05 in the univariate analysis were analyzed by logistic regression to obtain the adjusted effect measures. Children with ASD were exposed to digital media at an earlier age and spent significantly more time with digital media and less time with their mothers, compared to typically developed children. Exposure to digital media before 21 mo was associated with risk of ASD and the risk increased when mothers spent less than 6.5h per day with the baby. Family history of epilepsy and developmental delay, maternal stress during the antenatal period, and absence of exclusive breastfeeding during the first 6 mo were significantly more in children with ASD. There are significant differences in the early life social experience and digital-media exposure in children with ASD compared to typically developed counterparts. Given the reported rise in prevalence of ASD, these findings stress the need for further prospective studies to explore these potentially modifiable risk factors.

A cross-sectional study to assess acute malnutrition among under-5 children in the field practise area of a teaching hospital in Chennai.

Context:Malnutrition is one of the leading problem mainly in childhood, affecting growth and development especially under 5 years of age. According to NFHS-4, under-5 children about 27% are stunted, 20% are wasted and 24% are underweight. Determining acute malnutrition (wasting) and its factors is necessary to prevent complications.Aims:To assess acute malnutrition among under 5 years children and determine associated factors responsible.Settings and Design:Cross-sectional study done at field practice area under a teaching hospital in Chennai.Materials and Methods:Totally, 149 children under 5 years of age were selected and assessed for acute malnutrition using WHO standards (Z-scoring) by calculating weight for height. Questionnaire for checking associated factors was used.Statistical Analysis Used:Data were entered in excel spreadsheet and analyzed using SPSS software version 16 and for inferential statistical analysis was done using Chi square test.Result:Among the study population, 87.2% children were normal, 10% of children had wasting (below -2 S.D.) and 2.8% of children had severe wasting (below -3 S.D.). Wasting was also prevalent among people of low socioeconomic class and was maximum in children of age group 1-3 years. Low birth weight, absence of exclusive breast feeding and complementary feeding practices, partial immunization and other illnesses also had effect, leading to acute malnutrition.Conclusion:Level of acute malnutrition in the field practice area is lesser than the national average and determines few factors associated with malnutrition among under – 5 children.

Study of anemia in hospitalised infants with special reference to its risk factors

Background: Anemia is a major nutritional problem in India. Anemia in infancy and early childhood affects growth and development and is associated with increased morbidity and mortality. The aim of this study was to determine the prevalence, severity and types of anemia and study the risk factors for anemia in hospitalised infants. Methods: A prospective study was conducted at a tertiary care hospital in Western India from July 2016 to December 2017. Complete hemogram of all hospitalised infants between 6-12 months of age was done and those with haemoglobin levels<11g/dl were considered anemic. Results: Out of 206 hospitalised infants,131(63.6%) had anemia. Male: female ratio was1.3:1. The most common illness for which they were admitted was respiratory tract infections.35.1% of the anemic infants had low birth weight, 19.1% were born prematurely and 59.5% had a history of maternal anemia. Only 42% were exclusively breast fed till 6 months of age and improper complementary feeding practices was observed in 61.8% of infants. Mild, moderate and severe anemia was seen in 41.2%, 50.4% and 8.4% infants respectively. The most common type of anemia was microcytic hypochromic anemia (67.2%). Conclusion: Anemia is a major problem in infants with a high prevalence. Most infants have mild to moderate anemia and the most common type is microcytic hypochromic anemia most likely due to iron deficiency. Preterm gestation, absence of exclusive breastfeeding, consumption of cow’s milk, improper complementary feeding practices and presence of maternal anemia were the risk factors found to be associated with development of anemia in the present study.

Prevalence of Severe Acute Malnutrition in Children Admitted to the Emergency Paediatric Unit at a Tertiary Centre in North Central Nigeria

Background: Malnutrition is of major public health concern worldwide. The prevalence of severe acute malnutrition/wasting is increasing nationally and globally. The aim of this study is to determine the prevalence of Severe Acute Malnutrition (SAM) at Dalhatu Araf Specialist Hospital, Lafia Nasarawa State. Methods: This was a cross-sectional prospective study. All children admitted between the months of June to October 2016 had their anthropometry taken. All children 6 months to 60 months with SAM based on the WHZ score were identified and a pre-designed proforma was administered to obtain information from the parents of children with SAM. Results: SAM was present in 44.4% of all admitted children. No child above the age of 36 months had SAM and 84.8% of all SAM patients were less than 24 months old. Most mothers (72.9%) of the children with SAM were unemployed and (55.9%) had no formal education. Only 18.6% of these mothers practiced exclusive breastfeeding and as many as 62.7% of the children with SAM had been introduced to complementary feeds before 6 months of age. Conclusion: This is the first time a very high prevalence of SAM has been reported in Nasarawa State. The absence of exclusive breastfeeding, early commencement of complementary feeds and lower educational status were prevalent among mothers of children with SAM.

Factors associated with malnutrition among underfive children in developing countries: A review

Malnutrition is a consequence of consumption of dietary nutrient either insufficiently or exclusively by especially children. The aim of this study was to carry out a review of malnutrition-dependent factors among under-five children in developing countries. The study was carried out by reviewing publications on researches on malnutrition conducted in Africa and Asia with particular reference to factors associated with malnutrition. It was found that, of the 162 million children under five years who were stunted, 36% of them resided in Africa while 56% were found in Asia. It was also observed that an estimated 60 million under-five children in developing countries were found to be stunted out of which 11 million were Nigerian children. The severity of childhood malnutrition was observed to steadily increase from 11% in 2003 to 18% in 2013 for wasting; 24% in 2003 to 29% in 2013 for underweight, although there was a decline from 42% in 2003 to 37% in 2013 for stunted children. It was observed that high rates of mortality of malnourished children in Sub-saharan Africa result from factors such as low intake of calories, high rates of Human Immuno Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), political instability, conflicts among groups and poor implementation of government policies. For instance, 50% mortality of malnourished children in Malawi, Burundi and Madagascar were stunted as a result of poor dietary intake or poor consumption of vital nutrient. Other major factors observed were poverty, absence of exclusive breastfeeding, maternal factors such as poor nutrition during pregnancy, lack of appropriate weight gain, poor consumption of vitamin supplement, illness, environmental factors, and socioeconomic/ household factors, all of which affect the nutritional status of children. In conclusion, governments of developing countries and the global community should work together to remove these factors. Keywords : Malnutrition, under-five children, factors, illiteracy, poverty.

Nutritional Status and Associated Factors among 24 to 59 Months old Urban Slum Children of Dhaka City

Introduction: Malnutrition is one of the leading causes of disease in children. Prevention of under nutrition is one of the priority efforts to reduce childhood mortality. About 20% of the population is forced to reside in urban slum due to rapid urbanization. Lack of basic human necessities in the urban slum, adversely affects the nutritional status resulting in poor growth and development of the slum children.Objectives: To assess nutritional status and associated factors among 24 to 59 months old urban slum children of Dhaka city in Bangladesh.Materials and Methods: This cross sectional study was conducted during the period of March 2009 to June 2009 among 24 to 59 months old children of Vashantek slum of Dhaka. A total of 207 children who were available along with their mother during data collection period, were included as the study participants. For data collection face to face interview of the mother was performed and to determine the nutritional status of children anthropometric measurement was carried out.Results: Among the total 207 children, 54.1% were male and 45.9% were female. The mean age± standard deviation of the children was 43.6±11.0 months. As per Z-score of National Centre for Health Statistics (NCHS) reference classification, 45.4% children were underweight, 48.3% were stunted and 28.1% were wasted. Majority of the malnourished children were within 46 months of age. There was a little difference in nutritional status between male and female children. As per immunization schedule, 85.0% of the children completed their immunization. A higher proportion of the underweight children (57.7%) were not exclusively breastfed in comparison to that of the wasted children (42.3%). Moreover, it was revealed that there was a positive association between incomplete immunization and underweight, stunting and wasting (p&lt;0.05). The study also showed that there was an association between history of absence of exclusive breast feeding and underweight (p&lt;0.005) and wasting (p&lt;0.001) status of the children.Conclusion: The study revealed that none of the slum children had normal nutrition, all of them were suffering from malnutrition and majority of them had stunted growth or were underweight. As the slum children are a part of urban society and will be the future generation, it is expected that the finding of this study will sensitize the policy makers to formulate policy and undertake measures to prevent malnutrition amongst the slum children.Journal of Armed Forces Medical College Bangladesh Vol.11(1) 2015: 14-18

Effect of breastfeeding on malocclusions: a systematic review and meta-analysis.

The objective of this systematic review was to investigate whether breastfeeding decreases the risk of malocclusions. Six databases were systematically searched to the end of October 2014. Observational and interventional studies were included. Breastfeeding was evaluated in three categories: (i) ever versus never; (ii) exclusive versus absence of exclusive; and (iii) longer periods versus shorter periods. All types of malocclusion were considered as the outcome. Pooled adjusted odds ratio and its 95% confidence interval (95%CI) were obtained from meta-analyses. Heterogeneity was assessed with both the Q-test and the I-square. Funnel plots and Egger's test were employed to assess publication bias. Forty-eight studies were included in the systematic review, and 41 were included in the overall meta-analysis (n = 27 023 participants). Subjects who were ever breastfed were less likely to develop malocclusions than those never breastfed (OR 0.34; 95% CI 0.24; 0.48), those who were exclusively breastfed presented lower risk to present malocclusion than those with absence of exclusive breastfeeding (OR 0.54; 95% CI 0.38; 0.77), and subjects longer breastfed were less likely to have malocclusions than those shorter breastfed (OR 0.40; 95% CI 0.29; 0.54). Breastfeeding decreases the risk of malocclusions.

Fatores determinantes do uso de chupeta entre crianças participantes de programa de incentivo ao aleitamento materno

Objetivo avaliar a introdução de chupeta entre crianças assistidas por um programa interdisciplinar de incentivo ao aleitamento materno durante os primeiros seis meses de vida, investigando os possíveis determinantes do seu uso. Métodos foi realizado um estudo descritivo, exploratório, longitudinal, quantitativo, por meio do acompanhamento de 120 díades mãe-crianças. Foram coletados dados sobre características pessoais, demográficas, e variáveis referentes aos períodos pré, peri e pós-natal. Foram realizadas análises bivariadas pelo teste Qui-quadrado e teste Exato de Fisher e análise de regressão múltipla de Poisson com ajuste robusto do erro padrão. Resultados verificou-se que 13,33% das crianças usavam chupeta ao final do primeiro mês de vida e que 23,33% apresentavam este hábito ao término do sexto mês. O uso de chupeta esteve associado positivamente à ausência de aleitamento materno exclusivo ao final do primeiro mês (RP:5,44; IC95%:2,38-12,44). Ao final do sexto mês, mostrou-se associado à ausência de aleitamento materno exclusivo no momento da alta hospitalar (RP:4,91; IC95%:1,79-13,48) e ausência de aleitamento materno exclusivo aos seis meses de vida (RP:2,32; IC95%:1,32-4,08). Conclusão o uso de chupeta durante os primeiros seis meses de vida entre crianças assistidas por um programa de promoção à amamentação mostrou-se associado à ausência de aleitamento materno exclusivo.

A Cross-Sectional Study to Find Prevalence and Risk Factors for Childhood Asthma in Pune City, India

We aimed to determine current prevalence of asthma and risk factors associated with it in Pune, India.Methods. This was a cross-sectional school-population-based study in which parents of school children aged 6-7 and 13-14 were administered an ISAAC questionnaire and an additional set of questions that detected the presence of potential risk factors known to be associated with asthma during 2008-2009 academic years.Results. Prevalence of current asthma was 6.7% (7% amongst 6-7-year olds and 6.3% amongst 13-14 year olds. Asthma was more common amongst boys (8.1%) than girls (4.9%) and more frequent in students studying in private schools (7.3%) than in those studying in public schools (5.8%). Risk factors such as family history of atopy, caesarian delivery, use of biomass fuel for cooking, absence of separate kitchen, absence of exclusive breastfeeding during the first 6 months of life, preterm birth, snoring, dampness at home, male sex, and parental smoking were significantly associated with asthma.Conclusion. There was a high prevalence of childhood asthma in Pune, India, which was associated with genetic and environmental risk factors.

Aleitamento materno exclusivo em lactentes atendidos na rede pública do município de Joinville, Santa Catarina, Brasil

OBJETIVOS: identificar a prevalência do aleitamento materno exclusivo entre lactentes atendidos na rede pública municipal e sua associação com variáveis maternas e do lactente. MÉTODOS: estudo transversal realizado durante a Campanha Nacional de Vacinação em 2005, em Joinville, Santa Catarina, Brasil. Foi aplicado um questionário aos acompanhantes de 889 lactentes menores de um ano de idade nos postos de vacinação incluindo aspectos maternos e do lactente. Para a análise, utilizou-se estatística descritiva e o teste do qui-quadrado, com nível de significância de 5%. RESULTADOS as prevalências de amamentação foram 90,7%, 84,2% e 73,5%, nos lactentes com idade inferior a quatro, seis e doze meses, respectivamente. O índice de aleitamento materno exclusivo foi de 53,9% em menores de quatro e de 43,6% em menores de seis meses. O uso de chupeta esteve significativamente associado à amamentação não-exclusiva nas crianças com menos de quatro ou seis meses de idade (p&lt;0,001) e o trabalho materno, entre aquelas com até seis meses (p=0,001). CONCLUSÕES: as taxas de amamentação exclusiva entre menores de um ano de idade atendidos na rede pública estão aquém do preconizado pela Organização Mundial da Saúde. O uso de chupeta e o trabalho materno podem interferir negativamente com o aleitamento materno exclusivo.

A Study Of Epidemiological Factors Related To Acute Respiratory Infection (ARI) In Under Five Children Attending The Immunization Clinic Of Calcutta National Medical College And Hospital

A Study Of Epidemiological Factors Related To Acute Respiratory Infection (ARI) In Under Five Children Attending The Immunization Clinic Of Calcutta National Medical College And Hospital

Breast feeding and the dietary habits of children in rural Somalia.

Breast feeding and dietary habits were studied prospectively in a cohort of children under the age of five years in a rural Somali community. The median duration of breast feeding was 19.5 months. However, all the children also received cow's milk by cup from the first day of life and onwards. Energy supplements (mainly sugar and oil) as well as additional water were given daily from early infancy. Staples, protein-rich foods (beans and meat), vegetables and fruits were usually introduced when the children reached the age of 12-18 months. There was a seasonal variation with the lowest intake of protein-rich and vitamin-rich foods during the rains in May to June. Thus, there was a complete absence of exclusive breast feeding. Energy-reinforced cow's milk and human milk dominated the diet up to the age of one year. Staples were mixed with oil and supplemented with milk, thereby leading to a much higher energy density in the complementary food than is usually the case in African communities.