Baby Clinic Research Articles

Correction to: A Novel "Well Baby Clinic Service" Mobile Application: User Requirement Assessment and App Development.

Correction to: A Novel "Well Baby Clinic Service" Mobile Application: User Requirement Assessment and App Development.

Restoration of fractured anterior tooth with monochrome composite resin in pediatric dental patient

Direct restoration with monochromatic composite resin is a treatment option for teeth with coronal fracture after dentoalveolar trauma. This restorative material, in principle, is capable of mimicking the color of the dental substrate. This study aimed to report and discuss the technique of direct restoration with monochromatic composite resin, in a child patient. An 8-year-old male patient attended the Emergency Room of the Baby Clinic of the State University of Londrina for immediate treatment after dentoalveolar trauma that resulted in enamel and dentin fracture, without pulp involvement. As a procedure, restoration was performed with glass ionomer cement and referral to the institution's Dental Residency program. In this service, after case planning, the restoration of the coronal fracture of the substrates was performed with the insertion of multiple increments of the Vittra APS Unique (FGM) composite, with the aid of a silicone guide prepared based on a waxing model to facilitate the reestablishment of the palatal surface form and anatomy. In the clinical follow-up evaluation, the aesthetic and functional results obtained were considered highly satisfactory by patients, relatives and dental clinicians. Thus, it can be concluded that the option for monochromatic composite resin is a viable alternative to make it easier for the dental clinicians to perform the procedure and reduce the clinical time, a relevant fact because it is a case of caring for a pediatric dentistry patient.

A Novel “Well Baby Clinic Service” Mobile Application: User Requirement Assessment and App Development

Abstract Background Utilization of under 5 year old child health care services in Egypt is considered low, the highest proportion of well-baby visits is mainly for immunization in the first two years of age. Parents may rely upon the internet and mobile applications (apps) for support in handling day to day parenting situations. mHealth (Mobile Health) interventions have the potential to be a useful and low-cost way to disseminate information about proper nutrition, can be used to monitor children’s growth using the official charts of World Health Organization, also can help in accessing vaccine-related information and recommended immunization schedules. Objectives To assess needs and requirements for a new comprehensive well-baby clinic mobile app. Also, to develop a mobile app prototype covering all well baby clinic service components which are: Physical growth, Developmental milestones, Immunizations, Nutrition and Safety & emergency measures. Methods This work is done over two phases. In Exploratory phase, we assessed the need for the new app by performing bibliographic review of previous mHealth interventions in child-care field, market search of the available related apps and an online survey to assess the need and expectations of the new app. In preparatory phase, we developed the novel well baby clinic app that constituted all well baby clinic services for children’s health monitoring which are: Physical growth, Developmental milestones, Immunizations, Nutrition and Safety & emergency measures relying on evidence-based information and honoring data safety. Results 13 Arabic apps were downloaded and extracted for review. All of these apps (100%∼13/13) were in the form of written articles that offered no interactive features for parents. All offered general health education not tailored according to the status of the child. None of them were developed by a university or a certified health organization. Almost all of them (92.3%∼12/13) were commercial apps as they included ads. Our online survey on 374 mothers showed that almost all of them (97.5%) reported the need of a new app to regularly follow their children’s health. They also reported the need of nutrition, developmental milestones and physical growth services in the app. We developed “Sehhat Tefly” app constituting caregiver information, child sociodemographic characteristics and the 6 previously mentioned services, it also included health education videos and a conclusive report section. Conclusion After vigorous review of literature, market search and user requirement assessment, apps reviewed didn’t provide any comprehensive approach to well-baby clinic services on a scientific basis. Upon market requirement for child m-health, we developed “Sehhat Tefly” app. The full potential of this app is yet to be defined. Further studies are needed to assess accessibility and usability of the app and to explore difficulties and barriers faced by users in different services.

Effects of COVID-19 Pandemic on Dental Care of Babies and Children

Background The COVID-19 pandemic impacted people's lives and also dental and medical care. Objective To evaluate parents' attitudes toward their children's dental care and habits during the early and intermediate stages of the COVID-19 pandemic in Brazil. Material and Methods A structured online questionnaire containing 22 questions (available from August 19th to September 18th, 2020) was used. The parents of babies and children (aged 0-6 years) who were visiting the Baby Clinics of the Dental Department were eligible to participate in this study. Results During the stay-at-home orders, only 21.1% of the parents continued to take their child to the pediatrician for routine follow-up; 22.6% took the children to the doctor only due to an emergency. Most parents (53.5%) reported being very afraid of going out with their babies/ children during the pandemic and became infected. Most parents (84.9%) reported having doubts about maintaining their baby/child’s oral health guidelines during quarantine, and 81.1% had doubts about what to do in case of eruption of their baby/ child’s teeth. Some parents reported a decrease in the oral hygiene and eating habits of their babies/ children during the pandemic. The parents with a reduced income reported a significantly greater reduction in oral hygiene habits. Conclusions During the early and intermediate stages of the pandemic, when stay-at-home orders were suggested, parents of children aged 0-6 were afraid to take their children to medical and dental appointments. Besides that, these caregivers also claimed that their family routines of food and oral hygiene were altered.

A Descriptive Survey to Assess and Compare the Breastfeeding Practices among Working and Non-Working Mothers of Infants (6-12 Months) Attending Well Baby Clinic of Selected Hospitals and MCH Centre

The findings of the study revealed that majority of the mothers 98 mothers (49%) had LSCS, 88 mothers (44%) had normal vaginal delivery and 14 mothers (7%) had abnormal delivery,180 mothers (90%) mothers delivered at full term whereas 13(6.5%) mothers delivered at preterm. 52(26%) mothers were giving water in between feeds to their infant who were less than 6 months and on exclusive breastfeeding. 108(74%) mothers used bottle for top feeding. 135(67.5%) mothers clean the utensils used for feeding by boiling. 16(32%) working mothers gave honey/ghutti immediately to their infants after birth whereas the number was 60(40%) for the non-working mothers. 20(40%) working mothers started complementary feeding within 4-6 months of their delivery whereas it was 95(63.3%) for non- working mothers. 18(36%) working mothers gave mashed food as complementary feed to their infants in the age group of 6-9 months whereas 32(21.3%) non-working mothers gave above items. Working mothers were giving better complementary feed to their infants but were having difficulty continuing breast feeding. The study findings revealed that there is need to impart knowledge on practice of mothers on infant feeding.

IJCM_3A: Child Sex Ratio – Declining trend and it’s determinants: a qualitative community- based study in a selected urban primary care setting, Puducherry.

Background: Child sex ratio (CSR) is defined as the number of females consistent with thousand males in the age group of zero to six years. This serves as a valuable indicator for measuring socio-economic development in a particular region. Objective: To understand community perspectives on gender preference at birth and its potential influence on the decreasing Child Sex Ratio in a selected urban primary care setting in Puducherry, aiming to identify key determinants contributing to the observed declining trend. Methodology: A qualitative study was conducted among residents of the 4 wards under the care of JIPMER Urban Health Centre, Puducherry. Participants were purposively selected among mothers, family members attending well baby clinic at the centre and frontline health workers. Two FGDs involving 8-10 participants were conducted till saturation of information is achieved. Collected data was transcribed in verbatim format. Descriptive manual content analysis was conducted to draw the categories and themes. Results: The qualitative study on Child Sex Ratio revealed that there is a prevailing inclination towards expecting female children. Moreover, the study found no evidence of gender selection practices at present. Participants mentioned awareness of schemes such as “CM Cares for the empowerment of newborn girl child” as contributing factors to these attitudes and behaviors. Gender revealment is found inadvertently in government and private hospitals in the studied population. Conclusion: The study region exhibits a declining CSR, and there is no evidence of gender selection practices at present in the selected region. While improving female literacy and economic standing is essential, it alone is insufficient for enhancing the overall life prospects of female children.

A knowledge, attitude and practices based study to know the awareness and acceptance of contraceptive methods in married couples coming to well-baby clinic of a tertiary care centre in Panvel, Maharashtra, India

Background: Family planning plays a major role in improving the financial, nutritional, educational, social well-being of a family as a unit. To study the level of knowledge, attitude and practices of various family planning methods in eligible couples. Methods: Prospective Qualitative study was carried out from June 2021 - December 2022 on data of 180 eligible couples selected randomly from Well-Baby Clinic, collected through pretested and validated standardized questionnaire. Sample size was estimated scientifically. Results were arrived by descriptive statistical tests and correlational statistics using software’s like excel, SPSS. Results: The level of knowledge of contraceptive methods was 89.44% for OC pills, 67.08% depot medroxyprogesterone, 97.22% condoms, 84.03%, IUCD, 93.56% for female and 98.04% for male sterilization. Overall acceptance of any type of contraception was 55%, most commonly used method being condoms i.e.78.49%, OC pills 12.90%, IUCD 6.35%, depot 1.37% and 45% were using natural methods. Major factors affecting acceptance were desire to have more children, hesitancy to seek, lack of knowledge, decision making power of a woman in the family. Conclusions: Since our research finds contraceptive acceptance at 55% much lower than state average, we look into components of gender dynamics and offer array of choices to couples so that a well informed choice free of gender bias is taken. Continuity of personalized and dignified couple counseling from preconceptional, antenatal to postnatal period is emphasized to increase contraceptive acceptance. We recommend well baby clinics as effective point of delivery for family welfare activities using gender sensitive cafe-teria approach.

Screening of children attending well baby clinic for risk of autism using modified checklist for autism in toddlers in a pediatric tertiary care Centre in Chennai

Background: Autism spectrum disorder is a common neurodevelopmental disorder with core deficits in social communication, interaction, and restrictive/repetitive behavior. Early intervention provides opportunity for good functional outcome. The study aimed to screen children attending well baby clinic for risk of autism using modified checklist for autism in toddlers (MCHAT) questionnaire. Methods: This descriptive cross-sectional study was conducted on 302 children attending the pediatric well baby clinic. The children aged 16-30 months who met the inclusion criteria were screened for risk of autism using MCHAT. Results: 20 out of 302 children failed the MCHAT screening, 6.6% of the children were found to be at risk of autism. Boys: girls’ ratio was 2:1. Advanced parental age and higher socioeconomic status were found to have significant association with the risk of autism. 70% of children in the at-risk group were first born, 70% of children who failed the MCHAT screen were from a nuclear family. Conclusions: All toddlers attending the well-baby clinic should be screened for autism by pediatricians. MCHAT is a simple easy to use validated tool to screen for autism in a busy pediatric OPD. Timely referral for comprehensive assessment and intervention can help to improve the outcome in children with autism.

Determinant factors to initiate/maintain exclusive breastfeeding among mothers attending primary health care centers in second health cluster, Riyadh 2022-2023

Objective: This study aimed to evaluate the degree of knowledge regarding exclusive breastfeeding (EBF) and to explore the determining factors related to the initiation and maintenance of EBF. Methods: A cross-sectional observational study was carried out in the primary health care centers (PHCCs) in the Second Health Cluster, Riyadh, from December 2022 to June 2023. A total of 360 mothers visiting the Well Baby Clinic and whose babies were less than 2 years old were included in the study. A validated interview questionnaire was used for data collection. Results: Around 48.9% of participants were aged 20-30 years. Almost 32.5% reported pain as a barrier to breastfeeding and 18.3% reported fear of deformation of the shape of the breast due to breastfeeding. Furthermore, 31.9% had poor moral support for the mother before and after childbirth. 34.4% perceived insufficient breast milk production while 21.1% reported that the baby's father does not encourage breastfeeding. Additionally, 38.6% felt shame and embarrassment about breastfeeding in public places and 36.4% reported being too busy to breastfeed. Only 1.4% had a positive attitude towards absolute breastfeeding. Conclusion: The study showed a very poor attitude of mothers towards absolute breastfeeding. There was no significant association between any of the sociodemographic characteristics of participants and attitude scores towards absolute breastfeeding. Mothers should receive information and encouragement to practice EBF, with a focus on those who had never done it before because they were more likely to wean their children too young.

Unravelling the Mystery of Arterial Tortuosity Syndrome: A Case Report of an Unexpected Rare Diagnosis in a Well-Baby Clinic at a Primary Care Center in Qatar

A case of Arterial Tortuosity Syndrome (ATS) is a rare autosomal recessive genetic disorder characterized by significant alterations in the structure and function of the arterial system. Mutations in the SLC2A10 gene, responsible for encoding the transporter protein GLUT10, lead to the development of ATS. Keywords: Arterial Tortuosity Syndrome, case report, well baby clinic, Qatar

Multivitamins Supplement Uses and Reason Uses by Mother'S for Their Children Less than 24 Months Age Visiting King Abdulaziz Medical City

Background: This study aimed to assess mothers' knowledge regarding multivitamin use for their children in primary health care settings. Methods: It is a cross-sectional survey targeting mothers visiting Primary Health Care. A questionnaire with 14 questions was distributed among two major primary care clinics. Sampling was convenient, and randomness was assumed by visit sequence, on a first-come, first-served basis, and those who agreed to participate. Mothers visiting the Pediatric and Well Baby Clinic within the PHC centers for immunization of their children (under 2 years old) may have been disproportionately selected by this sampling method. The data were entered and analyzed using SPSS with univariate analysis on each question and use of chi-square, exploring mothers' reasons and practices of vitamin use. Results: In our survey, most mothers (62.3%) believed that the best age of giving multivitamins to their children is in the 1st year of life. Twenty-five percent (25%) believed giving at 2 years old is best. Forty-five percent (45%) believed that multivitamins are good for both boys and girls, whereas 33.5% believed that only girls needed it, and 21% believed that only boys need multivitamins. Mothers who believed that children need multivitamins in the first year of life were 2.3 times more likely to give multivitamins to their children than mothers who believed that multivitamins are important after the first year of life. Mothers who believed that their children benefit most from multivitamins in the first year of life were 1.85 times more likely to give them multivitamins to help increase their weight and physical development. Conclusion: Mothers who know foods containing vitamins are 3 times more likely to give multivitamins to their children. In this study, there is no significant difference between the opinions of mothers giving and not giving multivitamins to increase appetite for physical development beyond the first year of life or prevent diseases or for children with chronic illnesses. Others knowledgeable about foods containing multivitamins were similar to mothers who had no knowledge of buying and preparing foods at home.

Ochrona zdrowia społeczności żydowskiej na Górnym Śląsku w latach 1945–1950

Health care of the Jewish community in Upper Silesia 1945–1950 The post-war activities of the Jewish health care in Upper Silesia, were part of a centuries-old tradition of activity by Jewish aid organisations. Its task was not only to spread medical aid, but also to provide, under adverse conditions and at short notice, the basis of existence and a sense of security for several thousand people. In the first half of 1945, issues of health care for the Jewish population settled in Upper Silesia after the Second World War remained the responsibility of the health departments at the field committees of the Central Committee of Jews in Poland. Starting from August 1945, the health policy and the protection of the health of Jews in Poland rested on the shoulders of the Society for the Protection of the Health of the Jewish People (TOZ) reactivated within the structures of the CKŻP. The organisation’s functioning was based on provincial branches, with interventions including: primary and specialist medical care, preventive measures including spa stays or maternal and child health. The Katowice branch was established in April 1946. At its busiest, it was the second largest branch of TOZ in Poland and covered five cities in Upper Silesia: Bytom, Chorzów, Zabrze, Gliwice and Opole. Among other things, there were nine outpatient clinics, mother and baby clinics, a maternity home and a dental surgery. Their activities came to an end in 1950, when all social organisations, including Jewish ones, were nationalised in Poland.

Awareness of Childhood Immunization among Well Baby Clinic Attendees in Al Ahsa, Saudi Arabia: A Cross-Sectional Study

Awareness of Childhood Immunization among Well Baby Clinic Attendees in Al Ahsa, Saudi Arabia: A Cross-Sectional Study

Justification of Universal Iron Supplementation for Infants 6-12 months in Regions with a High Prevalence of Thalassemia.

Many clinicians hesitate to adopt a universal infant iron supplementation program due to the risk of increased iron absorption for those with thalassemia. We aimed to determine thalassemia prevalence in 6- to 12-month-old infants, along with the iron status of those with and without thalassemia. We performed a cross-sectional descriptive study of infants attending the Well Baby Clinic at Thammasat University Hospital for routine checkups. Complete blood count, hemoglobin electrophoresis, iron parameters, and molecular genetics for common α- and β-thalassemia were evaluated. Overall, 97 of 206 (47%) participants had thalassemia minor, the majority having Hb E traits. None had thalassemia intermedia or major. Familial history of anemia or thalassemia presented an increased risk of detecting thalassemia minor in offspring (OR 5.18; 95% CI 2.60-10.33, p=0.001). There were no statistical differences in transferrin saturation, serum ferritin and hepcidin between iron-replete infants with thalassemia minor and those without. However, one-third of infants with thalassemia minor (31/97) also had iron deficiency anemia (IDA), with a similar risk of having iron deficiency to infants without thalassemia. There was no hepcidin suppression in our infants with thalassemia minor as compared to controls. Both thalassemia and IDA are endemic to Southeast Asia. Infants with thalassemia minor, particularly with Hb E and α-thalassemia traits, are at risk of IDA. Our short-term universal iron supplementation program for 6- to 12-month-old infants does not appear to increase the risk of those with thalassemia minor developing iron overload in the future.

Using the COM-B model and Behaviour Change Wheel to develop a theory and evidence-based intervention for women with gestational diabetes (IINDIAGO)

BackgroundIn South Africa, the prevalence of gestational diabetes (GDM) is growing, concomitant with the dramatically increasing prevalence of overweight/obesity among women. There is an urgent need to develop tailored interventions to support women with GDM to mitigate pregnancy risks and to prevent progression to type 2 diabetes post-partum. The IINDIAGO study aims to develop and evaluate an intervention for disadvantaged GDM women attending three large, public-sector hospitals for antenatal care in Cape Town and Soweto, SA. This paper offers a detailed description of the development of a theory-based behaviour change intervention, prior to its preliminary testing for feasibility and efficacy in the health system.MethodsThe Behaviour Change Wheel (BCW) and the COM-B model of behaviour change were used to guide the development of the IINDIAGO intervention. This framework provides a systematic, step-by-step process, starting with a behavioural analysis of the problem and making a diagnosis of what needs to change, and then linking this to intervention functions and behaviour change techniques to bring about the desired result. Findings from primary formative research with women with GDM and healthcare providers were a key source of information for this process.ResultsKey objectives of our planned intervention were 1) to address women’s evident need for information and psychosocial support by positioning peer counsellors and a diabetes nurse in the GDM antenatal clinic, and 2) to offer accessible and convenient post-partum screening and counselling for sustained behaviour change among women with GDM by integrating follow-up into the routine immunisation programme at the Well Baby clinic. The peer counsellors and the diabetes nurse were trained in patient-centred, motivational counselling methods.ConclusionsThis paper offers a rich description and analysis of designing a complex intervention tailored to the challenging contexts of urban South Africa. The BCW was a valuable tool to use in designing our intervention and tailoring its content and format to our target population and local setting. It provided a robust and transparent theoretical foundation on which to develop our intervention, assisted us in making the hypothesised pathways for behaviour change explicit and enabled us to describe the intervention in standardised, precisely defined terms. Using such tools can contribute to improving rigour in the design of behavioural change interventions.Trial registrationFirst registered on 20/04/2018, Pan African Clinical Trials Registry (PACTR): PACTR201805003336174.

Influence of Husband Involvement during Antenatal Clinic on Knowledge of Neonatal Danger Signs among Mothers Attending Well Baby Clinics in Nakuru County-Kenya: A Quasi Experimental Study

Introduction: Male involvement is associated with improved maternal and newborn outcomes as they play a vital role in decision making in health seeking.
 Objective: To determine the influence of husbands’ accompaniment to the antenatal clinic on maternal knowledge of neonatal danger signs (NDS) after nurses’ capacity building.
 Study design: A quasi experimental study.
 Method: Eight health facilities were selected at random among facilities in Nakuru County. Mothers attending well baby clinics with children <1 year were interviewed using structured questionnaires. Analysis was done using the SPSS software (version 23).
 Results: Two different cohorts of 414 mothers each were interviewed at baseline and at the end with 176 (42.5%) and 200 (48.3%) of mothers respectively being accompanied by husbands for antenatal clinic. At baseline they were likely to identify inability to breastfeed, convulsions and hypothermia as NDS and these were statistically significant with p <0.004, P< 0.003 and P< 0.033 respectively. Identification of more 3 NDS increased from 37 (21%) at baseline to 99 (49.5%) with all mentioning at least one NDS at the end point.
 Conclusion: Male partner accompaniment to antenatal care was found to have a positive correlation to maternal knowledge of NDS with nurses’ capacity building playing a big role.

A qualitative study to explore strategies to improve the Road to Health Application for maternal and child health outcomes in South Africa.

The Road to Health Application (RTHA) is essentially a digitalized version of the National Department of Health's Road to Health book, and a hand-printed booklet given to mothers at the birth of each baby. The RTHA, like the booklet, provides guidelines for maternal and child health outcomes, with the goal of creating a database of children and caregivers in South Africa and teaching them how to raise a healthy child. This paper explored potential barriers and enablers to using the RTHA in the South African context based on user experiences. Using a qualitative design, we conducted 50 serial interviews (two separate interviews, 1 month apart). Through convenience, sampling eligible participants were 18 years or older women who were pregnant and/or had a child under the age of 5 years. Participants included 25 existing users and 25 new users of the RTHA, who owned android smart phones at enrollment. Existing users were recruited telephonically through the National Department of Health database, and new users were approached at the antenatal care unit and wellness baby clinic (women with children under 5 years) at the Chris Hani Baragwaneth Academic Hospital. Upon enrollment, participants completed a brief survey on sociodemographics and mobile phone use, and thereafter, they had a baseline interview followed by a telephonic interview 1 month later. A semistructured interview guide was used to explore barriers, enablers, and the usability of the RTHA. Using thematic data analysis, we identified enablers and barriers to the use of the RTHA. A third (33%) of all participants reported IsiZulu as their main language of communication, and 6% of the participants reported English as their main language of communication. The RTHA was an important addition to the booklet that helped keep new mothers informed about child immunization and provided important information about healthy child rearing practices. However, multiple barriers were cited to using the RTHA; these included the fact that the app was only available in two languages, high data costs, lack of access to smart phones, and app functionalities. The enablers to using the RTHA included the accessibility of important information regarding prenatal and postnatal childcare. This study gives insight into the barriers and enablers from the end-user perspective to improve the RTHA for future use in South Africa and offers guidance on how to improve the RTHA to be more user-friendly, which could increase its usability among mothers. It further emphasizes the need to consider the challenges experienced by users in South Africa when developing future mobile health interventions to increase uptake.

Promoting oral and dental health in early childhood - knowledge, views and current practices among paediatricians in Israel.

The aim of this study was to evaluate the knowledge and practice of paediatricians in promoting oral and dental health among young patients (under age 36 months) and their parents. 145 anonymous questionnaires were distributed among paediatricians, 130 of them were 90% or above answered and were suitable for analysis for this study.75% of the questionnaires were distributed during the national convention of the Israeli Association of Clinical Paediatrics, 10% in paediatric ambulatory clinics and 15% in paediatric departments in hospitals. Questionnaires were distributed between 2018 and 2020. The inclusion criteria were physicians specialists in paediatrics or residents in paediatrics, all have Israeli licences to practice in Israel. exclusion criteria were partially filled questionnaires. The questionnaire was validated in a pilot study during the years 2010-2012. In addition to demographic variables that included medical training, post-graduate education and clinical practice the questionnaire included 42 questions. Eleven questions on demographics and amount of dental training during academic and clinical training 31 questions belonged to several sections that referred to the participants' awareness of the AAP guidelines regarding oral and dental health and knowledge of oral health. In each section paediatricians were asked to answer or give an opinion on a specific issue, their answers were coded to scores on a scale of 0-5 and summed per section. Correlations between different variables were analysed. The t-test and Mann-Whitney U test were performed for comparing two variables. For comparing more than two variables, we used the Kruskal-Wallis one-way analysis of variance test or ANOVA. The response rate was 89% (130 questionnaires out of 145). The survey showed that most paediatricians (80%) recognized their role in maintaining the oral and dental health of their young patients. Nevertheless, most admitted that they do not perform simple procedures on a regular basis, like dental examinations (64.6%), or asking parents about feeding habits (59.2%) or teeth brushing (75.4%). Only 21% of the participants expressed adequate knowledge of dental care for children younger than age 3 years. Fifty-eight percent of the participants never had any dental training during their entire paediatric medicine training, including medical school. Paediatricians in private or baby clinics received higher scores in practicing caries prevention, 24.15 ± 5.17 (SD), than paediatricians in hospitals, 2.79 ± 0.54 (SD) (p = 0.006). Caries prevention practice was not found to correlate with paediatricians' knowledge or attitudes regarding oral and dental caries prevention. Oral and dental knowledge should be incorporated into the paediatric medicine curriculum. With their heavy workload, paediatricians generally do not implement dental caries risk assessment and counselling.

SCREEN TIME USE AND ITS HEALTH EFFECTS AMONG CHILDREN ATTENDING WELL BABY CLINIC AT PRIMARY HEALTH CARE CENTERS, MAKKAH, SAUDI ARABIA2020

Objectives: To determine prevalence of screen time use among children aged between less than 1 year to 5 years old, and to identify the association of screen time and obesity in this age group. Methods: A cross-sectional study included 355 children from less than 1year of age to 5 years, that was conducted at well baby clinics primary health care in Makkah, kingdom of Saudi arabia, between July 2021 and august 2021. The data were collected by a validated questionnaire. SPSS version 21.0 was used to gather and analyse all data. There was statical analysis of the prevalence of excessive screen time. The Chi-Square and correlations were used to test associations where appropriate. Results: The age groups were from less than 1 year to 5 years. The level of electronic device usage was excessive among 22.3 percent of children. There was a significant correlation between BMI and screen time, with a higher BMI related with increased screen time for overweight and obese children. Conclusion: There is a high prevalence of screen use among children more than 1 year of age. Also, high levels of nutritional problems were shown to be associated with excessive screen time including overweight and obesity.

Knowledge attitudes and practice of breastmilk expression and storage among working mothers with infants under six months of age in Kenya

BackgroundExpression and storage of breastmilk is a strategy that ensures continued breast milk consumption in the event of temporary separation of an infant from the mother. However, many studies show that working mothers are unable to exclusively breastfeed for six months successfully. Working mothers are forced to wean early because of minimal support at the workplace, lack of knowledge on breast milk expression and lack of storage facilities. The 2017 Kenya Health Act mandates employers to provide lactation rooms for facilitation of breast milk expression in support of the lactating mother. This study analyses the knowledge attitude and practice of breast milk expression among working women in Kenya.MethodsThis was a cross sectional study done between December 2018 and February 2019. Study participants were 395 working women with infants aged six months and below, attending well baby clinics in two large public hospitals in Nairobi Kenya. A structured questionnaire with open and closed ended questions was used to establish the knowledge and practice while a Likert scale was used to explore attitudes of the mothers towards expression and storage of breast milk.ResultsOverall satisfactory knowledge on breast milk expression and storage was attained by only 34% of working mothers. Eighty four percent positively agreed that expression and storage of breast milk would help them achieve six months of exclusive breastfeeding. Challenges experienced were breast pain and cumbersome nature of expressing milk. Only 41% (161) were expressing breast milk either regularly or occasionally. The most common reason (24.7%) for expressing milk was to enable someone else feed the baby when they were at work. Most mothers (77%) expressed at home as the workplace did not seem to provide adequate equipment to facilitate breastmilk expression and storage.ConclusionsThere is a substantial knowledge gap on expression and storage of breast milk. Working mothers have a good attitude towards attainment of exclusive breast milk feeding through expression of breast milk. The workplace does not have adequate facilities to support expression and storage of breast milk.