Breast-fed Children Research Articles

Predictors of milk cortisol in North American women.

Human milk content varies across mother-child dyads, environments, and populations. Among the hormones in milk is cortisol, a glucocorticoid; its impact on the breastfeeding child is unknown. Milk cortisol may constitute a signal to the child's developing physiology which can shape characteristics (e.g., growth, temperament) to prevailing environmental conditions. This exploratory study evaluated the maternal, breastfeeding, and infant characteristics associated with milk cortisol. We evaluated archived milk specimens for cortisol using enzyme immunoassay and employed an information-theoretic approach to assess associations between milk cortisol and participant characteristics with linear regression modeling. Because we employed secondary data, information for some variables likely to impact milk cortisol variation (e.g., time of day, socioeconomic status, maternal or infant body mass index, milk energy density) was unavailable. Participants were 48 lactating mothers from upstate New York, aged 21-40 years. Milk cortisol ranged from 0.098 to 1.007 μg/dL. Child age ranged from 1 to 26 months. In linear regression employing best fit modeling criteria, milk cortisol increased with child age (B: 0.069; p: .000; a 7.1% increase in milk cortisol for each month of child age), while child symptoms of illness (B: -0.398; p: .057; a 33% decrease) and consumption of complementary foods (B: -.525; p: .020; a 41% decrease) were associated with lower milk cortisol. We speculate that increasing milk cortisol with child age plays a role in signaling development (e.g., as increasing independence increases risk for injury and other negative health outcomes), independent of the maternal stressors we could capture.

The Relationship between Age, Education, and Maternal Employment with Exclusive Breastfeeding in Children Aged 6 - 23 Months in Kalirejo, Malang Regency

The target percentage of infants under 6 months old receiving exclusive breastfeeding is 40%. However, in 2020, in Kalirejo Sub-district, the number was 9.04%. This was presumably caused by the high number of working mothers. Therefore, this study was conducted to analyze the relationship between age, education, and occupation of mothers regarding exclusive breastfeeding in children aged 6-23 months in Kalirejo Sub-district, Malang Regency. The study design employed in this research was observational analytics with a cross-sectional design. The research population consisted of mothers residing in Kalirejo Sub-district, Malang Regency. The required sample size was 66 individuals. A questionnaire was used to collect research data. The required data was processed using SPSS software with the Chi-Square Test analysis technique. The result showed that 78.8% mothers were in the age group of 20-35%, and 21.2% were in the age group of >35 years. Based on the highest education level attained by the respondents, 1.5% had completed elementary school, 15.2% had completed junior high school, 57.6% had completed high school, and 25.8% had completed tertiary education. About 51.5% of respondents were employed, while 48.5% were not employed. The number of respondents' children receiving exclusive breastfeeding was 50%. The analysis indicated a relationship between occupation and exclusive breastfeeding with a p-value of 0.049 and a strength of relationship between the two variables at 0.236.

Immunomodulatory Effect of Infectious Disease of a Breastfed Child on the Cellular Composition of Breast Milk.

Recent studies suggest that the content of immune components in milk is influenced by the mother's health and also by the infant she feeds. We aimed to evaluate the effect of a child's respiratory tract infection on the cellular composition of breast milk (neutrophils, monocytes, eosinophils, lymphocytes, and their subpopulations). Twenty-six breastfeeding mothers whose children were hospitalized for respiratory tract infections were enrolled in the study. The control group consisted of 23 mothers of healthy children. Regarding the children, baseline laboratory blood tests were performed, and nasal swabs were taken for the presence of RS virus. In the next step, milk samples were collected from the mothers to assess the cellular composition of the milk, including neutrophils, monocytes, eosinophils, lymphocytes, and their subpopulations. Significantly higher percentages of T lymphocytes (helper and cytotoxic lymphocytes) were observed in the milk of the studied mothers. There was a significantly higher percentage of milk lymphocytes in the group of affected children with confirmed RSV etiology than in children with excluded RSV etiology. A significant positive correlation was observed between the duration of infection and the percentage of milk NK cells and between milk CD19 lymphocytes and the child's serum leukocytosis. This study may provide evidence of a link between cells in breast milk and disease in the breastfed infant. The severity of the infection, its duration, and the etiological agent of the infection may affect the cellular composition of milk.

Cost effectiveness and optimal control analysis for bimodal pneumonia dynamics with the effect of children's breastfeeding

The global impact of exclusive versus inclusive nursing on particular baby mortalities and morbidities from conception to 6 months is examined in this study. Exclusive breastfeeding practices are more crucial and effective in preventing illness outbreaks when there is no access to appropriate medications or vaccinations. Additionally, this study takes optimal control theory into account, applying it to a system of differential equations that uses Pontryagin's Maximum Principle to describe a bimodal pneumonia transmission behavior in a vulnerable compartment. The proposed pneumonia transmission model was then updated to include two control variables. These include preventing illness exposure in susceptible children through various preventative measures and treating infected children through antibiotics, hospital care, and other treatments. If the threshold number (ℜ0) is less than one, then treatment and prevention rates are increased, and the disease will be wiped out of the population. However, when (ℜ0) is greater than one, then the disease persists in the population, which indicates that prevention and treatment rates are low. To evaluate the cost-effectiveness of all potential control techniques and their combinations, the incremental cost-effectiveness ratio (ICER) was determined. The simulation results of the identified model show that the interventions of prevention and treatment scenarios were the most successful in eradicating the dynamics of the pneumonia disease's propagation during the epidemic, but they were ineffective from a cost-saving perspective. Therefore, limiting pneumonia transmission to prevention alone during an outbreak is the most economical course of action.

The determinants of growth failure in children under five in 25 low- and middle-income countries.

Past studies have identified determinants of growth failure (GF) such as socio-economic, nutritional, parenting, and inequality factors. However, few studies investigate the numerous causes of GF across multiple countries. By analysing the data of children under five in 25 low and middle-income countries, this study aims to examine the correlations of determinants with GF to identify the strongest modifiable risk factors. Cross-sectional study design was used, and data were collected across 25 LMICs by the United Nations Children's Fund in 2019. Regions and households were randomly selected in participating LMICs. The four outcome measures were stunting, wasting, underweight and low body mass index (BMI). Multilevel analysis was performed to identify the impact of country, suburb, and household levels on the variance of outcome variables. GF measures were significantly correlated with low gross domestic product (GDP) per capita (odds ratio (OR) = 2.482), rural areas (OR = 1.223), lack of health insurance (OR = 1.474), low maternal education (OR = 2.260), lack of plain water (OR = 1.402), poor maternal physical caregiving ability (OR = 1.112), low carbohydrate consumption (OR = 1.470), and continued breastfeeding in children >12 months old (OR = 0.802). By identifying key GF risk factors, this study may provide valuable insights for policymaking and interventions. This may allow the prioritisation of resources within countries for preventative measures to be developed.

Calcium and Vitamin D Supplementation to Improve Linear Growth in Children

In India, the prevalence of vitamin D deficiency as assessed by vitamin D levels below 20 ng/ml is high across the country, in all socio-economic, age and sex groups. Studies from India have documented that prevalence of vitamin D deficiency is high in breast-fed infants. Stunting in young children continues to be a major public health problem in India. It is possible that in addition to low birth weight and chronic energy deficiency, vitamin D deficiency may contribute to the high stunting rates in breast-fed Indian children. If this were so, vitamin D supplementation may reduce the magnitude of linear growth retardation in the first two years of life. A community-based randomised, double-blind supervised daily supplementation of 250 mg of calcium and 250 IU of Vitamin D (Group A) or placebo (Group B) to breast-fed infants from the first month up to 23 months of age was undertaken to assess the impact, if any, of vitamin D supplementation on linear growth in children and height attained at 23 months. At enrolment, there were no significant differences in weight, length and BMI between infants belonging to Group A or Group B. There were no significant differences in infant and young child feeding practices, morbidity due to infection, or linear growth and height attained at 23 months between Group A and Group B. These data suggest that daily supplementation of calcium and vitamin D between 0-23 months did not have any significant impact on linear growth of children from urban low middle income families.

Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana

BackgroundExclusive breastfeeding is a public health priority in sub-Saharan Africa. However, systematic reviews on its determinants in Ghana remain scarce. Therefore, we systematically reviewed the prevalence and determinants of exclusive breastfeeding in children 0–6 months in Ghana.MethodsWe conducted systematic searches in Embase, Medline, and Africa-Wide Information from the databases’ inception until February 2021 for studies that assessed the prevalence and determinants of exclusive breastfeeding in children 0–6 months in Ghana. Random-effects meta-analysis was used to estimate the pooled prevalence of exclusive breastfeeding and narrative synthesis to summarise the determinants. We calculated the proportion of total variability that was due to between study heterogeneity using I² statistics, and Egger’s test assessed publication bias. The review is registered with PROSPERO, CRD42021278019.ResultsOut of the 258 articles identified, 24 met the inclusion criteria. Most of the included studies were cross-sectional and were published between 2005 and 2021. The pooled prevalence of exclusive breastfeeding (EBF) among children 0–6 months in Ghana was 50% (95%CI 41.0–60.0%). The prevalence was higher in rural areas (54%) than in urban areas (44%). Several factors were identified as facilitators of EBF, including older maternal age, self-employment, unemployment, living in a large house, being a house owner, giving birth in a health facility, non-caesarean delivery, adequate antenatal attendance, counselling services, participation in support groups, adequate knowledge about EBF, positive attitude towards EBF, and higher maternal education among rural dwellers. Additionally, having an average birthweight facilitated EBF. Barriers to EBF were also identified, including higher maternal education among urban dwellers, less than three months of maternity leave, maternal HIV-positive status, the experience of partner violence, lack of access to radio, inadequate breastmilk production, lack of family support, having a partner who wants more children, counselling on complementary feeding, healthcare worker recommendation of complementary feed, single marital status, and infant admission to neonatal intensive care units.ConclusionIn Ghana, EBF rates are low, with only about half of all children aged 0–6 months breastfed exclusively. A multi-dimensional approach is required to tackle the diverse sociodemographic, obstetric, and infant-related issues that hinder EBF practice in Ghana.

The deadly impact of COVID-19 among children from Latin America: The case of Ecuador.

The SARS-CoV-2 pandemic remains a critical global health concern, with older adults being the most vulnerable group. Nonetheless, it is crucial to recognize that COVID-19 has caused numerous deaths in children worldwide. Emerging evidence indicates that infants and breastfeeding children, particularly those aged below one year, face a greater risk of hospitalization and mortality than older children with COVID-19. This study aimed to describe the epidemiology of COVID-19 among children during the early phase of the pandemic in Ecuador. We conducted a country-wide population-based analysis of the epidemiology of COVID-19, using incidence and mortality data reported from Ecuador between February 15, 2020 and May 14 2021. Measurements of frequency, central tendency, dispersion, and absolute differences were calculated for all categorical and continuous variables. At least 34,001 cases (23,587 confirmed cases, 5,315 probable and 5,099 suspected) and 258 COVID-19 related deaths have been reported among children in Ecuador during the first 16 months of the pandemic. The overall incidence rate was 612 cases per 100,000 children, the mortality rate was 3 per 100,000, while the case fatality rate was 0.76%. The highest risk group for infection was children and adolescents between 15 and 19 years of age; however, the highest mortality rate occurred in children under one year of age. The largest provinces, such as Pichincha, Guavas and Manabí, were the ones that reported the highest number of cases, 27%, 12.1% and 10.8%, respectively. This study is the first to report on COVID-19 epidemics among children in Ecuador. Our findings reveal that younger children have a lower risk of SARS-CoV-2 infection, but a higher risk of mortality compared to older children and adolescents. Additionally, we observed significant disparities in infection rates and outcomes among children living in rural areas, those with comorbidities, and those from indigenous ethnic groups.

Abstract 1899: Breast density comparison of Hispanic versus Non-Hispanic patients undergoing screening mammograms: Influence of age, parity and breast-feeding

Abstract Background: Higher mammographic breast density is associated with a 4 to 6-fold increased risk of breast cancer. Some single institution retrospective studies show higher breast densities in Hispanic patients (Oppong et al. Breast J. 2018). The prevalence of breast density based on Hispanic ethnicity has not been studied in large database studies. Methods: We performed a retrospective review of women > 40 years undergoing screening mammograms from 2016-2022. Patients with prior history of breast cancer were excluded. We reviewed demographic variables such as race, self-reported ethnicity, body mass index (BMI), parity, breastfeeding and menopausal status. Breast density was characterized as predominantly fatty (PF), scattered fibroglandular (SF), heterogeneously dense (HD) and extremely dense (ED). We used Chi-square and Kruskal-Wallace tests to compare breast density across measured variables, and Ordinal Logistic Regression to compare breast density levels between self-declared ethnicity while adjusting for other variables. Results: 15946 patients were studied; 7317 (46%) identified as Hispanic, the rest non-Hispanic (NH). 6131 (83%) of Hispanics identified as white. Mean age on 1st screening mammogram was 57.64 (SD 7.21). Compared to NH, Hispanics had mean earlier age of 1st mammogram (56.8 vs. 58.3 years), higher BMI (30.5 vs. 28.6) and higher parity (2.53 vs. 1.71). There were significant differences in BI-RADS density categories by Hispanic vs. NH (p<0.001), with differences in PF (20.2% vs. 18.5%), SF (41.7% vs. 39.0%), HD (35.8% vs. 37.2%), and ED (2.3% vs. 5.3%). The ordinal logistic regression model suggests that Hispanics have 17% lower odds than NH of 1 category higher density (OR, 95% CI: 0.83, 0.78-0.88). There were also significant ethnicity differences in age at first exam, BMI, parity, and number of children breast-fed (P<0.001). Adjusting for these ethnicity-associated differences explained the observed differences in density between Hispanic and NH individuals (ORadj, 95% CI: 0.98, 0.92-1.04); adjusting only for BMI served to explain the observed differences in density (ORadj, 95% CI: 0.99, 0.94-1.05). Conclusions: Hispanics were observed to have a lower age of first screening mammogram, higher BMI, higher parity, and breast-fed children compared to non-Hispanics. On univariate analysis, Hispanics were noted to have lower breast density compared to non-Hispanics, these differences do not persist on multivariate analysis. This suggests that BMI likely plays a predominant role in driving the ethnicity-related differences in breast density noted here. Further research efforts should focus on the influence of BMI and other individual-level factors on mammographic density, with a view towards understanding their potential roles in describing differential ethnicity-specific breast cancer risk. Citation Format: Sangeetha Prabhakaran, Vernon S. Pankratz, Jennifer L. Saline, Emily J. Reese. Breast density comparison of Hispanic versus Non-Hispanic patients undergoing screening mammograms: Influence of age, parity and breast-feeding [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1899.

Determinants of early initiation of breastfeeding in children under 59 months' old in northeast Ethiopia

Background/Aims Early initiation of breastfeeding takes place within the first hour of life and has maternal and fetal benefits. Despite this, late initiation is prevalent in Ethiopia. This study's aim was to investigate early initiation of breastfeeding and its associated factors in children under 59 months' old in north Wollo, Ethiopia. Methods This institution-based cross-sectional study was conducted from November to December 2020 in the north Wollo zone. A total of 385 women who had a child aged 0–59 months and attended selected health institutions (one hospital and nine health centres) were included in the study. Data were collected using a structured questionnaire and analysed using univariable and multivariable logistic regression. Results Overall, 58.2% of women began breastfeeding within the recommended timeframe. Number of antenatal care visits, mode and place of birth and radio use were significantly associated with early initiation of breastfeeding. Conclusions Despite the crucial benefits of early initiation of breastfeeding for mothers and neonates, the prevalence of early initiation in the study area was below recommended levels. Therefore, the authors recommend that health professionals inform mothers to start breastfeeding as early as possible, particularly after a caesarean section. Early initiation should be promoted to all women during the antepartum and intrapartum periods. Understanding the in-depth causes of delayed breastfeeding initiation requires further study.

Factors Affecting Non Compliance with Exclusive Breastfeeding Among Mothers: A Survey at District Hospital Dadu

Background: According to standard guideline for breastfeeding, t is mandatory to practice exclusive breastfeeding during the first six months of a baby's life to provide the finest physiological support for all neonates. In Pakistan there is visible underuse of exclusive breastfeeding among lactating mothers. This study aims to assess the variables affecting the non-compliance to exclusive breastfeeding among mothers at a district hospital in Pakistan. Materials and methods: A descriptive cross sectional study was conducted to in Pediatric OPD at the district hospital Dadu from January to June 2022, 162 breast feeding mothers were interviewed regarding their practice towards exclusive breast feeding. Results: We observed that only 29. 5% mothers practiced exclusive breast feeding. All the mothers in the study had a breastfeeding child. Most of the mothers in this study were aged between 20 to 40 years (62%). The most common reason for non-compliance with the exclusive breastfeeding was the use of formula milk by the mothers. Conclusion: Inclination to use formula milk, insufficient breast milk, early weaning and lack of the education among mothers were most common causes of non-compliance towards exclusive breastfeeding. Mass level health education for maternal and child health are recommended. Keywords Breast feeding, Exclusive breastfeeding, Neonate, Maternal factors,

Gestational exposure to organophosphate esters and adiposity measures of children up to 6 years: Effect modification by breastfeeding

Organophosphate esters (OPEs) are synthetic chemicals used in various commercial products. Accumulating evidence has shown that they may act as metabolic disruptors. However, no study has investigated the long-term effects of gestational OPEs exposure on childhood adiposity. Breast milk represents the optimal nutritional form of feeding for infants and may protect against the adverse effects of gestational OPEs exposure on offspring development. Using data from the Shanghai-Minhang birth cohort study, we investigated the associations of gestational OPEs exposure with adiposity measures in children up to 6 years of age, and whether breastfeeding could modify these associations. A total of 733 mother-child pairs with available data on OPE concentrations and child anthropometry were included. Eight OPE metabolites were assessed in maternal urine samples collected at 12-16 weeks of pregnancy. Information on children's weight, height, arm circumference, and waist circumference was collected at birth and 0.5, 1, 4, and 6 years of age. Weight-for-age and body mass index-for-age z scores were calculated. The duration of children's breastfeeding was categorized as ≤4 months or >4 months. The generalized estimate equation and Bayesian Kernel Machine Regression models were used to examine the associations of OPEs exposure with children's adiposity measures. Selected OPEs exposure was associated with higher children's adiposity measures. Particularly, we found stronger associations of bis(1-chloro-2-propyl) phosphate (BCIPP), bis(2-chloroethyl) phosphate (BCEP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP), and di-o-cresyl phosphate and di-p-cresyl phosphate (DCP) with higher adiposity measures in children breastfed for ≤4 months, while little evidence of associations was found among those breastfed for >4 months. Our study suggested that gestational OPEs exposure could alter children's adiposity measures, but the potential effects were attenuated if children were breastfed for >4 months.

Influence of the COVID-19 pandemic on labor and childbirth care practices in Brazil: a cross-sectional study

BackgroundIt has been hypothesized that the coronavirus disease 2019 (COVID-19) pandemic may have changed the conduct of obstetric practices at the time of labor, delivery, and birth. In Brazil, many practices lacking scientific evidence are implemented in this care, which is charcaterized by excessive use of unnecessary interventions. This scenario may have been worsened by the pandemic. Thus, we analyzed the effects of the pandemic on care during prenatal care and delivery by comparing the results of two surveys (one was administered before the pandemic and the other during the pandemic) in public hospitals in Belo Horizonte - Minas Gerais (MG), Brazil.MethodsThis cross-sectional and comparative study analyzed preliminary data from the study “Childbirth and breastfeeding in children of mothers infected with SARS-CoV-2”, which was conducted in three referral maternity hospitals in Belo Horizonte - MG during the pandemic in the first half of 2020 in Brazil. The final sample consisted of 1532 eligible women. These results were compared with data from 390 puerperae who gave birth in the three public hospitals in the study “Birth in Belo Horizonte: labor and birth survey”, conducted before the pandemic to investigate the changes in practices of labor and delivery care for the mother and her newborn, with or without COVID-19 infection, before and during the pandemic. In this research, “Birth in Belo Horizonte: labor and birth survey”, data collection was performed between November 2011 and March 2013 by previously trained nurses. Between study comparisons were performed using Pearson’s chi-square test, with a confidence level of 95%, and using Stata statistical program.ResultsWe found a significant increase in practices recommended by the World Health Organization during the pandemic including the following: diet offering (48.90 to 98.65%), non-pharmacological pain relief (43.84 to 67.57%), and breastfeeding in the newborn´s first hour of life (60.31 to 77.98%) (p < 0.001). We found a significant reduction of non-recommended interventions, such as routine use of episiotomy (15.73 to 2.09%), the Kristeller maneuver (16.55 to 0.94%), oxytocin infusion misused (45.55 to 28.07%), amniotomy (30.81 to 15.08%), and lithotomy position during labor (71.23 to 6.54%) (p < 0.001).ConclusionOur study revealed a statistically significant increase in the proportion of use of recommended practices and a reduction in non-recommended practices during labor and delivery. However, despite advances in the establishment of World Health Organization recommended practices in labor, delivery, and birth, the predominance of interventionist and medicalized practices persists, which is worsened by events, such as the pandemic.

Breastfeeding status and determinants of current breastfeeding of Syrian refugee children in Turkey

BackgroundTurkey hosts the highest number of refugees in the World including 65% of Syrian refugees who reside in Turkey. Mothers and children were the most negatively affected among the Syrian refugees who had to migrate from their countries as a result of the civil war in Syria. One of the most important issues in terms of child health is breastfeeding. Breastfeeding in migrants should be promoted worldwide to mitigate infant mortality and diseases. The aim of this study is to examine the association between breastfeeding status in Syrian refugee children under two years and socio-demographic characteristics of Syrian refugee mothers with further analysis of Turkey Demographic and Health Survey-Syrian Migrant-2018 (TDHS-SM-2018) data. MethodsThe data source is the TDHS-SM-2018. Data for the last-born children with a gestational duration greater than 32 weeks from the mothers’ singleton pregnancy, aged less than two years old and living with the mother were included (unweighted n = 744). The dependent variable was the breastfeeding status (breastfeeding in the last 24 h during the study period) in children under two years. Complex sample logistic regression evaluated the associations.ResultsThe percentage of breastfeeding in children under the age of two years was found to be 62.4%, and the total median breastfeeding duration was 14.6 months. Univariate analysis showed that the earlier mothers immigrated to Turkey, the higher the current breastfeeding rate. Breastfeeding rates were found to be higher among people living in the South and East regions (65.2% and 65.1% respectively). Multivariable binary complex sample logistic regression revealed that breastfeeding status at the study period was associated with long preceding birth interval; delivery in a public hospital; absence of prelacteal feeding; being non-pregnant; and the region and age of the child. No relationship for current breastfeeding was found with maternal activities, maternal life satisfaction, financial satisfaction, and educational status.ConclusionCurrent breastfeeding in our sample was more likely among mothers with a longer birth interval who avoided prelacteal feeding. The Baby-Friendly approach and family planning services should be integrated into refugee health centers.

Dietary Protein Intake in Young Children in Selected Low-Income Countries Is Generally Adequate in Relation to Estimated Requirements for Healthy Children, Except When Complementary Food Intake Is Low

Background Previous research indicates that young children in low-income countries (LICs) generally consume greater amounts of protein than published estimates of protein requirements, but this research did not account for protein quality based on the mix of amino acids and the digestibility of ingested protein.Objective: Our objective was to estimate the prevalence of inadequate protein and amino acid intake by young children in LICs, accounting for protein quality.Methods: Seven data sets with information on dietary intake for children (6–35 mo of age) from 6 LICs (Peru, Guatemala, Ecuador, Bangladesh, Uganda, and Zambia) were reanalyzed to estimate protein and amino acid intake and assess adequacy. The protein digestibility–corrected amino acid score of each child's diet was calculated and multiplied by the original (crude) protein intake to obtain an estimate of available protein intake. Distributions of usual intake were obtained to estimate the prevalence of inadequate protein and amino acid intake for each cohort according to Estimated Average Requirements.Results The prevalence of inadequate protein intake was highest in breastfeeding children aged 6–8 mo: 24% of Bangladeshi and 16% of Peruvian children. With the exception of Bangladesh, the prevalence of inadequate available protein intake decreased by age 9–12 mo and was very low in all sites (0–2%) after 12 mo of age. Inadequate protein intake in children <12 mo of age was due primarily to low energy intake from complementary foods, not inadequate protein density.Conclusions Overall, most children consumed protein amounts greater than requirements, except for the younger breastfeeding children, who were consuming low amounts of complementary foods. These findings reinforce previous evidence that dietary protein is not generally limiting for children in LICs compared with estimated requirements for healthy children, even after accounting for protein quality. However, unmeasured effects of infection and intestinal dysfunction on the children's protein requirements could modify this conclusion.

Assessment of nutrient adequacy of complementary foods for infants and young children in Morogoro, Tanzania

Women sustain household health by operationalizing and maximizing nutrition through food preparation. Thus, information and the women's knowledge on nutrient adequacy of meals prepared at home is crucial for the design, implementation and performance of nutrition interventions. However, there is limited evidence on the adequacy of homemade complementary meals for children below two years in Tanzania. This study aimed to assess the dietary quality of the prepared complementary foods provided to infants and children. A cross-sectional survey was used to collect demographic and nutritional information. A total of 119 breastfeeding children aged 6 to 22 months were recruited. The dietary intake patterns were assessed using a seven-day food frequency questionnaire, and a 3-day 24 h recall. The dietary diversity score and Food consumption score evaluated dietary patterns. Food consumed by 27 children in a day (24 h) was weighed and recorded and samples were collected for nutrient analysis. Nutrient adequacy ratios were obtained by comparing FAO/WHO recommended intakes. Results revealed that 15% of the children had poor food consumption patterns. The median dietary diversity score of the children was four out of eight food groups. For most households, median adequacy ratios for energy, fat and micronutrient contributed from complementary foods were less than one. Although breastfeeding was present and supported at home, the nutrient densities of complementary meals were inadequate to achieve the WHO/FAO recommended nutrient intakes. Promotion of community food fortification and diversification programs, along with nutrition education, health and sanitation are necessary as they can improve the intake of critical micronutrients and nutrition status.

Knowledge about breastfeeding of children 0-6 months among mothers attending hospital services in Kosovo

Aim: The aim of this study was to assess the level of knowledge and socio-demographic correlates of breastfeeding of children aged 0-6 months among mothers with young children in post-war Kosovo. Methods: A cross-sectional study was conducted in Kosovo during the period December 2017 – February 2018 including a representative sample of 201 mothers (aged 29.4±6.0 years) with young children attending hospital services. In addition to socio-demographic data, a structured 13-item questionnaire inquiring about breastfeeding of children aged 0-6 months was administered to all women. A summary score was calculated for all 13 items related to women’s knowledge on breastfeeding (0 denoting incorrect answers to all 13 items, and 13 denoting correct answers to all 13 questions). General linear model was used to assess the association between summary score of the knowledge about breastfeeding and socio-demographic characteristics of the women. Results: Mean summary score of the 13 items related to knowledge about breastfeeding was 10.3±1.9; median score was 11 (interquartile range: 9-12). In multivariable-adjusted models, the mean summary score of knowledge about breastfeeding of children 0-6 months was slightly but non-significantly higher among “older” women, those residing in urban areas, highly educated women, those currently employed, and women with a higher income level. Conclusion: Generally, the level of knowledge about breastfeeding of children aged 0-6 months was satisfactory among mothers with young children included in this survey in Kosovo. Furthermore, there were seemingly no significant socio-demographic differences in the level of knowledge about breastfeeding of young infants among women in this study carried out in Kosovo.

Factors Related To Exclusive Breastfeeding With Nutritional Status Aged 7-23 Months: In the Working Area of Maubara Health Center Liquisa Municipallity Timor Leste

Exclusive breastfeeding is the percentage of infants, less than six months old, who receive only breast milk and no other solids or liquids, including water, with the exception of drops or syrups that comprise vitamin or mineral supplements or medicines.This study was conducted with the aim of determining the factors related to exclusive breastfeeding with nutritional status aged 7-23 months: In the Working Area of Maubara Liquisa Health Center Timor Leste. This type of research is observational analytical research with a cross sectional approach. The study respondents amounted to 85 people according to the specified criteria selected by the simple random sampling method. Data collection was carried out by questionnaires and interviews. Data analysis was performed using chi square and multiple logistic regression. Factors associated with history of exclusive breastfeeding and nutritional status in children 7 – 23 months were education (p = 0.001), occupation (p = 0.002), age (p = 0.001), knowledge (p = 0.001), attitude (p = 0.001), nutritional status (p = 0.001). The most dominant variable was age with an PR of 23,469 (7.392-74,515). Conclusion that age has the greatest influence on exclusive breastfeeding. Factors associated with history of exclusive breastfeeding and nutritional status in children 7 – 23 months were education (p = 0.001), occupation (p = 0.001), age (p = 0.001), knowledge (p = 0.001), attitude (p = 0.001), nutritional status (p = 0.001). The most dominant variable was age with an OR of 23,469 (7,392-75,515). Conclusion that community age has the greatest influence on exclusive breastfeeding. Health workers to provide information about the benefits of exclusive breastfeeding in children

«Երեխաներին կրծքով կերակրման խրախուսման և մանկական սննդի շրջանառության մասին» ՀՀ օրենքի խախտման «նուրբ» արվեստը / "Fine" Art of Violating the RA Law "Օn the Promotion of Breastfeeding and the Circulation of Baby Food"

In the Republic of Armenia, since 2014, breastfeeding of children has been encouraged by the relevant law, which was adopted within the framework of obligations arising from membership in international organizations. Breastfeeding is essential for a baby's survival and health. Breast milk is a safe, natural, nutritious and sustainable food for babies, and it contains antibodies that help protect against many common childhood illnesses such as diarrhea and respiratory illnesses. It seems that breastfeeding is a natural process and should be obtained automatically, without special efforts... But, it wasn’t there ... Even natural phenomena can have a number of nuances and peculiarities, the insufficient mastery of which often leads to seemingly insurmountable problems, encouraging desperate mothers to give up the exclusive gift of breastfeeding. Instead of appropriate specialized support in the given situation, it is often recommended to feed babies with artificial milk in maternity hospitals, which, apart from being a gross violation of the existing law, inadvertently hints at the tendencies to artificially forming an offer for disguised business interests...

Trend and correlation of obesity and continued breastfeeding in children from six to 3 months old

Resumo Objetivos: analisar a tendência e a correlação de obesidade e o aumento do aleitamento materno continuado em crianças de seis a 23 meses no Brasil, de 2015-2019. Métodos: estudo ecológico de série temporal com dados do Sistema de Vigilância Alimentar e Nutricional. A variável dependente foi a prevalência de obesidade. A regressão linear de Prais-Winsten foi usada para verificar a tendência. Adotou-se a correlação de Spearman para verificar a relação entre as prevalências de obesidade e o aumento do aleitamento materno continuado. Resultados: verificou-se tendência de redução da prevalência de obesidade em todas as suas regiões do Brasil (Variação Percentual Anual [VPA]: -4,14; IC95%=-4,50; -3,79). A prevalência do aleitamento materno continuado apresentou tendência de aumento nas regiões Norte (VPA=4,89; IC95%=2,92; 6,90), Sudeste (VPA=3,36; IC95%=2,32; 4,41) e Sul (VPA= 2,67; IC95%=0,98; 4,38). Houve correlação negativa e significativa entre obesidade e aleitamento materno continuado nas regiões Norte, Nordeste, Sudeste e Sul. Conclusão: a redução da prevalência da obesidade e o aumento do aleitamento materno continuado ocorreram somente em algumas regiões, requerendo implementação de estratégias eficazes para esteja presente em todo o país. Ações de promoção, proteção e apoio ao aleitamento materno continuado e a alimentação saudável devem ser mais priorizadas para promover o crescimento saudável da criança.