Early Initiation Of Breastfeeding Research Articles

How did the use of the social marketing approach in Egyptian communities succeed in improving breastfeeding practices and infants’ growth?

IntroductionImproving breastfeeding practices does not always link to interventions relying only on improving nutrition awareness and education but needs cultural and behavioral insights. AimThis study aimed to evaluate the changes in core breastfeeding indicators as a result of the use of social marketing (SM) approach for improving breastfeeding practices of Egyptian women and the physical growth of infants aged 6 to 12 months. The core breastfeeding indicators were: Early initiation of breastfeeding within one hour of birth, Predominant and exclusive breastfeeding to 6 months (EBF), Bottle feeding with formula, continued breastfeeding to 1 and 2 years, and responsiveness to cues of hunger and satiety.MethodsA quasi-experimental longitudinal study with a posttest-only control design was done over 3 years in three phases; the first was in-depth interviews and formative research followed by health education and counseling interventions and ended by measuring the outcome. Motivating mothers’ voluntary behaviors toward breastfeeding promotion “feeding your baby like a baby” was done using SM principles: product, price, place, and promotion. The interventions targeted 646 pregnant women in their last trimester and delivered mothers and 1454 women in their childbearing period. The statistical analysis was done by using SPSS program, version 26.ResultsMost mothers showed significantly increased awareness about the benefits of breastfeeding and became interested in breastfeeding their children outside the house using the breastfeeding cover (Gawn) (p < 0.05). Breastfeeding initiation, exclusive breastfeeding under 6 months, frequency of breastfeeding per day, and percentage of children who continued breastfeeding till 2 years, were significantly increased (from 30%, 23%, 56%, and 32% to 62%, 47.3%, 69%, and 43.5% respectively). The girls who recorded underweight results over boys during the first year of life were significantly improved (p < 0.01) after the intervention (from 52.1% to 18.8% respectively). At the same time, girls found to be obese before the intervention (15.6%) became no longer obese.ConclusionsImprovement for the majority of the key breastfeeding indicators and physical growth of infants indicates that raising a healthy generation should start by promoting breastfeeding practices that are respectable to societal norms.

Paternal Participation in Optimal Infant and Young Child Feeding Practice and Associated Factors: A Community-Based Analytical Cross-Sectional Study from Chronically Food-Insecure Communities, Ethiopia

Evidence shows that paternal participation helps to improve the utilization of optimal infant and young child feeding (IYCF) practices. However, little has been known about chronically food-insecure (CFI) communities. The aim of this study to assess paternal participation in optimal IYCF practice and associated factors in the Dodota district of the Arsi zone, Ethiopia, 2022. A community-based cross-sectional study involving 1152 fathers was conducted after ethical clearance was obtained. Measures of optimal IYCF are based on criteria established by the World Health Organization. We analyzed the data using bivariate and multivariate logistic regression models. Results indicated that paternal participation in optimal IYCF practice was 26.2%. The percentages of early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), and minimum acceptable diet (MAD) were respectively 72.9%, 66.1%, and 37.3%. Paternal knowledge of IYCF (AOR:3.2, P &lt;0.01), education (AOR:2.1, P&lt;0.05), income (AOR:1.8, P&lt;0.05), child's age (AOR 1.7, P&lt;0.05), and the number of children (AOR:2.1, P&lt;0.05) were the predictors of the outcome. Large-scale, in-depth studies should be required to justify the result unequivocally.

Investigating midwives and nurses reporting of ‘infant feeding at hospital discharge’: an online survey across NSW Australia

BackgroundThe collection of data on ‘infant feeding at hospital discharge’ is used to monitor breastfeeding outcomes, health service benchmarking, and research. While some Australian states have clear definitions of this data collection point, there is no operational definition of ‘infant feeding at hospital discharge’ in the Australian state of New South Wales. Little is known about how midwives interpret the term ‘infant feeding at hospital discharge’, in particular, the timeframe used to calculate these important indicators. The purpose of this study was to explore midwives’ and nurses’ practices of reporting ‘infant feeding at hospital discharge’ in the Australian state of New South Wales.MethodsAn online survey was distributed across public and private maternity hospitals in New South Wales, Australia. The survey asked midwives and nurses their practice of reporting ‘infant feeding at discharge’ from categories offered by the state Mothers and Babies report of either “full breastfeeding”, “any breastfeeding”, and “infant formula only”. The Qualtrics survey was available from December 2021 to May 2022.ResultsThere were 319 completed surveys for analysis and all 15 NSW Health Districts were represented. Some participants reported using the timeframe ‘since birth’ as a reference (39%), however, the majority (54%, n = 173) referenced one of the feeding timeframes within the previous 24 h. Most midwives and nurses (83%, n = 265) recommended 24 h before discharge as the most relevant reference timeframe, and 65% (n = 207) were in favour of recording data on ‘exclusive breastfeeding’ since birth.ConclusionThis study identified multiple practice inconsistencies within New South Wales reporting of ‘infant feeding at hospital discharge’. This has ramifications for key health statistics, state reporting, and national benchmarking. While the Baby Friendly Hospital Initiative accreditation requires hospitals to demonstrate and continuously monitor at least a 75% exclusive breastfeeding rate on discharge, only 11 New South Wales facilities have achieved this accreditation. We recommend introducing an option to collect ‘exclusive breastfeeding’ on discharge’ which is in line with participant recommendations and the Baby Friendly Hospital accreditation. Other important considerations are the updated World Health Organization indicators such as, “Ever breastfed”; “Early initiation of breastfeeding” (first hour); “Exclusively breastfed for the first two days after birth”.

Implementation of a quality improvement initiative for standardising essential newborn care in a teaching public hospital in rural central India

ObjectiveOur aim was to refine the essential newborn care practices by employing the multidisciplinary peer team-led quality improvement (QI) projects.DesignIn 2017, concerning the same, the department focused on early initiation...

Breastfeeding Practices among Lactating Mothers in a City of South India

Introduction: Breast feeding is the first fundamental right of the child. It provides a unique biological andemotional basis for the health and development of the children. The world health organization recommends that breastfeeding be initiated within one hour of birth. Early initiation of breastfeeding provides benefits for both mother and the baby.Objectives: To assess the knowledge and attitude and practices about breast-feeding and complimentary feeding practices among lactating mothers attending Outpatient department (OPD) of tertiary care centre in a city of South India.Materials and Methods: It was a cross-sectional observational study done amongst post-natal mothers attending OPD in Sri Siddhartha Medical College, Tumkur between October to November 2022. Data collected was entered on Microsoft Excel spread sheet. Descriptive statistics and Chi –square test as test of significance were used. P value less than 0.05 was taken as statistically significant. Statistical software Epi Info software version 7.2.5 was used for the statistical analysis.Results: Data was collected from 104 post-natal mothers attending the OPD. All of them knew about importance of exclusive breast-feeding, colostrum feeding (100%). 99% of them knew breast feeding improves immunity. 95 (91%) of the participants were willing to continue breastfeeding up to two years and beyond. Only 16 (15.4%) mothers fed the baby on demand, others followed scheduled feeding like once in 1-2 hours, once in 2 to 3 hours.In our study 78.8% women started complimentary feeding at 6 months.Conclusion: Healthy breastfeeding practices have significant effect on mothers and infants. The breastfeeding knowledge and positive practices are optimal among mothers. Focused breastfeeding counselling and advice by the health workers with emphasis on correct technique can improve the positive breastfeeding practices.

Modeling time to death for under-five children in Malawi using 2015/16 Demographic and Health Survey: a survival analysis

BackgroundMalawi has one of the highest under-five mortality rates in Sub Sahara Africa. Understanding the factors that contribute to child mortality in Malawi is crucial for the development and implementation of effective interventions to reduce child mortality. The aim of this study is to use survival analysis in modeling time to death for under-five children in Malawi. In turn, identify potential risk factors for child mortality and inform the development of interventions to reduce child mortality in the country.MethodThis study used data from all births that occurred in the five years leading up to the 2015/16 Malawi Demographic and Health Survey. The Frailty hazard model was applied to predict infant survival in Malawi. In this analysis, the outcome of interest was death and it had two possible outcomes: "dead" or "alive". Age at death was regarded as the survival time variable. Infants who were still alive at the time of the study as of the day of the interview were considered as censored observations in the analysis.ResultsA total of 17,286 live births born during the 5 years preceding the survey were analysed. The study found that the risk of death was higher among children born to mothers aged 30–39 and 40 or older compared to teen mothers. Infants whose mothers attended fewer than four antenatal care visits were also found to be at a higher risk of death. On the other hand, the study found that using mosquito nets and early breastfeeding were associated with a lower risk of death, as were being male and coming from a wealthier household.ConclusionThe study reveals a notable decline in infant mortality rates as under-five children age, underscoring the challenge of ensuring newborn survival. Factors such as maternal age, birth order, socioeconomic status, mosquito net usage, early breastfeeding initiation, geographic location, and child's sex are key predictors of under-five mortality. To address this, public health strategies should prioritize interventions targeting these predictors to reduce under-five mortality rates.

Application of the integrated gateway model on child nutrition behaviors in Niger: An exploratory analysis.

To identify potential gateway factors and behaviors that are associated with infant and young child feeding (IYCF) practices in the Maradi and Zinder regions of Niger through application of the Integrated Gateway Model. We analyzed data from 2,727 married women of reproductive age including details on child feeding practices for their 2,551 children between the ages of 0 to 23 months. We assessed the association of three gateway behaviors (i.e., any antenatal care, facility delivery, and communication on nutrition practices) and gateway factors (i.e., behavioral determinants, exposure to information, decision-making agency, and woman's group participation) on four IYCF practices (i.e., early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency, and minimum dietary diversity) while controlling for age, parity, educational attainment, and household wealth. We found antenatal care was associated with exclusive breastfeeding of children 0-5 months [adjusted odds ratio (aOR): 1.17 (95% confidence interval (CI): 1.03-1.33)], and minimum meal frequency of children 6-23 months [aOR: 1.10 (95% CI: 1.03-1.17)], and facility delivery was associated with early initiation of breastfeeding among children 0-5 months [aOR: 2.08 (95% CI: 1.39-3.12)]. We found negative associations with exclusive breastfeeding and communication on nutrition practices with husbands, family/friends, and health workers. Exposure to nutrition messages through radio, women's groups participation, and with health workers was positively associated with minimum dietary diversity. Self-efficacy was positively associated with both early initiation of breastfeeding, exclusive breastfeeding among children 0-5 months and minimum dietary diversity among children 6-23 months. Women's agency was positively associated with early initiation of breastfeeding. The association of antenatal care and facility delivery with child nutrition outcomes suggest intervening before a woman becomes pregnant or early in her pregnancy could improve nutrition outcomes. Programs strengthening the continuum of care should identify gateway behaviors to maximize adoption of priority health behaviors.

IJCM_72A: A study on newborn care practices and associated factors influencing their health in urban slums of Kurnool city, Andhra Pradesh.

Background: Neonate is essential time for child to grow. Worldwide, Neonatal mortality are estimated to be about 3 million due to insufficient care. In 2021, 2.3 million neonates have died in first four weeks of life, roughly 6400 neonatal deaths per day. Lack of knowledge in new born care, inappropriate new born care practices are some of the contributors to neonatal mortality. Newborn care practice interventions can prevent neonatal deaths. Understanding the community and traditional newborn care practices is necessary to implement effective programme for promotion of newborns health. Hence present study was done to describe selected newborn care practices in urban slums of Kurnool. Objectives: To assess Newborn-Care Practices and to determine the relationship between Newborn-Care Practices and selected socio-demographic variables. Methodology: A Community-based, Cross-sectional study was done among 220mothers who were residing in urban slums of Kurnool City, Data were collected between October 2023 to November 2023 using Semi-structured questionnaire by Simple Random sampling technique. IEC permission was obtained. Written informed consent was obtained from participants. Data were analyzed using SPSS-Version23. Results: Mothers who were practicing delayed-bathing were observed in the age group 18-24 years 135(61.36%)followed by 25-30 years 60(27.2%),the difference was statistically significant(x2=9.84)(p=0.043),Safe cord care practices were observed more among 18-24 years132(60%),it was found to be statistically significant(x2=23.5)(p=&lt;0.001). Early initiation of breast feeding was more common among age group 18-24 years93(42.2%), it was found to be statistically significant(x2=6.51)(p=0.039). Conclusion: The practice of essential newborn care still needs to improve in Bareilly; There is strong need to implement community-based interventions to improve the newborn care practices &amp; to reduce the high-risk newborn care practices like unsafe cord care, delayed breast feeding, early bathing, Prelacteal feeding &amp; discarding colostrum need through health workers.

The Influence of Assistance and the Success of Early Breastfeeding Initiation on Maternity Mothers

Colostrum, which is yellowish breast milk, is considered vital because it is the first immunization for newborns and plays a significant role in the newborn's immune defence system. This research aimed to determine the effect of assistance in early breastfeeding initiation and the success of early breastfeeding initiation among mothers giving birth at the Independent Midwife Practice in Pematangsiantar City. The method used in this research was a quasi-experiment with a two-group design pretest-posttest with the control group, which was carried out on 67 mothers divided into two groups, using consecutive sampling (n=34 and unaccompanied mothers n=33). Assistance in the form of providing information on Early Breastfeeding Initiation (EBI) using materials, leaflets, and AVA/videos. The Early Breastfeeding Initiation Satisfaction Questionnaire was adopted from the Maternal Breastfeeding Evaluation Scale. The non-parametric Wilcoxon test was used for testing. Testing used the SPSS.The results of this study showed a significant relationship between mothers' knowledge and satisfaction with success before and after being given the intervention with (p=0.001) and (p=0.025). Assistance for mothers giving birth will increase the success of women in labour to breastfeed their babies as early as possible.

Humanizing Birth in a Third-Level Hospital: Revealing the Benefits of Natural Cesarean Sections.

Efforts to humanize childbirth focus on promoting skin-to-skin contact, labor accompaniment, and breastfeeding. Despite these advancements, cesarean sections often lack a consideration of immediate mother-child contact, early breastfeeding initiation, and follow-up. This underscores the need for a 'natural' approach to cesarean sections, aiming to 'humanize' the procedure and emulate some aspects of vaginal birth. An observational longitudinal cohort study was conducted, involving pregnant women scheduled for a cesarean section. Two comparison groups were established: one undergoing conventional cesarean sections and the other receiving a humanization intervention. While in "conventional cesarean sections," newborns are separated from mothers at birth, preventing actions such as early breastfeeding or skin-to-skin contact, and maternal companionship is lacking in the operating room, the intervention of cesarean section humanization was based on avoiding the separation of the mother and newborn, promoting skin-to-skin contact, early breastfeeding, and maternal accompaniment during surgery. Descriptive data on maternal and neonatal variables, including breastfeeding initiation, maintenance, and baby weight trends, were collected. Additionally, a validated survey assessed the pain, satisfaction, and anxiety among the 73 participating women. Women undergoing natural cesarean sections reported higher satisfaction, lower anxiety, and reduced postoperative pain, requiring less analgesia. Although their exclusive breastfeeding rates at 10 days postpartum showed no significant difference, statistically significant differences favored natural cesarean sections at 3 months (67.5% vs. 25%) and 6 months (50% vs. 4.5%). Neonates in the natural cesarean group exhibited greater weight gain at 10 days postpartum compared to those delivered conventionally (+49.90 g vs. -39.52 g). No significant differences in blood counts were observed between the groups. This study underscores the manifold advantages offered by the natural cesarean procedure compared to the conventional cesarean approach. Notably, a NC demonstrates superior outcomes in terms of heightened maternal satisfaction with the obstetric process, the enhanced sustainability of exclusive breastfeeding, and augmented neonatal weight gain.

Enhanced Recovery After Caesarean Surgery (ERACS) versus Non-ERACS Delivery: A Comparative Study on the Effectiveness of Exclusive and Early Initiation of Breastfeeding

Background: Exclusive breastfeeding (EBF) for up to 6 months postpartum provides numerous benefits to both mother and child. Despite these advantages and the recommendation for EBF during the first 6 months postpartum, the global prevalence of EBF is on the decline. The method of delivery is one of the many factors that influence EBF rates. Enhanced Recovery After Cesarean Section (ERACS) has been shown to improve breastfeeding rates in comparison to the standard Cesarean section. Objectives: The purpose of this study was to investigate the association between ERACS and non-ERACS delivery methods with EBF and the early initiation of breastfeeding (EIBF). Methods: This cross-sectional study involved a minimum of 96 subjects for each category. Non-ERACS delivery was categorized into vaginal delivery and standard Cesarean section. The success rates of EBF at 0, 1, 3, and 6 months were evaluated using an exclusive breastfeeding questionnaire, which demonstrated a Cronbach's Alpha of 0.931, indicating a high level of reliability (≥ 0.60). The association between the variables was analyzed using the chi-square test. Results: The study identified a significant association between the method of delivery and EBF (P = 0.036), with vaginal delivery having a Relative Risk (RR) of 1.286 (0.858 - 1.927) and standard Cesarean section an RR of 1.679 (1.156 - 2.437) for not engaging in EBF for 6 months in comparison to ERACS. Furthermore, a significant association was observed between delivery methods and EIBF (P &lt; 0.001), with an RR of 1.190 (0.717 - 1.967) for vaginal delivery and an RR of 2.667 (1.762 - 4.035) for standard Cesarean section for not initiating breastfeeding early compared to ERACS. Conclusions: There is a significant association between ERACS and non-ERACS delivery methods with both EBF and EIBF. Both vaginal delivery and standard Cesarean section are associated with a higher risk of not engaging in exclusive breastfeeding at 6 months and not initiating breastfeeding early, compared to ERACS.

The relationships between optimal infant feeding practices and child development and attained height at age 2 years and 6-7 years.

Limited evidence exists on the long-term effects of early feeding practices on child growth and development. We examined the relationships between infant feeding practices and child height and development at ages 2 and 6-7 years. We studied 885 mother-child dyads from a randomized controlled trial of preconception supplementation in Vietnam. Early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), breastfeeding (BF) duration and minimum dietary diversity (MDD) were assessed using World Health Organization(WHO) guidelines. Child development was assessed by the Bayley Scales of Infant Development-III at 2 years and the Wechsler Intelligence Scale for Children®-IV at 6-7years. Child height-for-age z-score (HAZ) was calculated from child height and age. Multivariable regression and structural equation models were used in analyses that controlled for confounding. EIBF and EBF at 6monthsoccurred in 52% and 62% of children, respectively. Mean breastfeeding duration was 18 monthsand 83% achieved MDD at 1year. EIBF was associated with motor (β = 0.13, 95% confidence interval [CI]: 0.00, 0.28) and cognitive development at 2years(β = 0.12, 95%CI: -0.01, 0.26), which in turn were positively associated with cognitive development at 6-7years. EBF was directly associated with development at 6-7years (β = 0.21, 95% CI:0.08, 0.34) whereas motor and cognitive development at 2years explained 41%-75% of the relationship between EIBF and development at 6-7years. HAZ at 2years also mediated 70% of the association between MDD at 1year and HAZ at 6-7years. BF duration was not associated with child development and HAZ. Early infant feeding practices, especially EIBF and EBF, have important long-term implications for optimizing child linear growth and cognition as they begin school.

Factors related to stunting in children under 2 years old in the Papua, Indonesia: Does the type of residence matter?

To analyze factors related to stunting in Papua region. Secondary data from the 2021 Indonesian National Nutrition Status Survey were used in this study. Samples of 2,937 Papuan children under the age of two were gathered for the study. This study analyzed independent variables (type of residence, mother's age, marriage, mother's education, employment, wealth, child's age, gender, and early breastfeeding initiation (EBFI) with stunting. The relationship was analyzed using logistic regression tests. Stunting is more common among children in Papua's rural areas than in urban (AOR 1.168, 95% CI, 1.128-1.209). Stunting is more common in children who mother do not work than in mothers who do (AOR 1.174, 95% CI, 1.142- 1.207). Stunting is more common in children aged 12-23 months compared to children <12 months (AOR 3.381, 95% CI, 3.291-3.474). Compared to girls, boys are more likely to become stunted (AOR 1.348, 95% CI, 1,314-1,383). Children under the age of two who do not experience EBFI are at higher risk than those who have (AOR 1.078, 95% CI, 1.050-1.106). There are eight variables associated with stunting, namely residence, age of mother, mother's education, mother's occupation, economic status, child's age, gender, and EBFI. Prioritization of stunting interventions in Papua should be targeted at mothers who living in rural, having low education, and not doing early breastfeeding initiation.

Scenario of Newborn Care Practices in Private Healthcare Setting in India: An Insights From NFHS-5 Survey

Background: The private sector contributes significantly to health care service delivery in India. Study shows the prevalence of newborn care practices like early initiation of breastfeeding, kangaroo mother care, and hepatitis B birth dose practices in private sector hospitals across India. Methods: We conducted a basic analysis of unit-level data from the NFHS-5 survey; to understand the newborn care practices in private hospitals in India. Result: The place of the delivery has a significant impact on newborn care practices like kangaroo mother care, early breastfeeding within an hour of birth, and hepatitis-B vaccination at birth. The private sector accounts for 20.73 percent of deliveries wherein, 39.56 percent of private sector hospitals follow EIBF practice. Pre-lacteals were provided to 14.95 percent of the children within the first three days after birth. The better practice of kangaroo mother care was seen in the public sector. The prevalence of the hepatitis B vaccine at birth is very low with 3.25 percent in India.

EFFECT OF IMPLEMENTING EARLY BREASTFEEDING (IMD) TO PROMOTE EXCLUSIVE BREASTFEEDING

Introduction: Early initiation of breastfeeding is beneficial for both mother and baby and determines the success of breastfeeding. The benefits of IMD include reducing the risk of maternal and infant mortality, increasing the success of exclusive breastfeeding for 6 months, and increasing bonding attachment between mother and baby. This study aims to determine the effect of early breastfeeding initiation on the success of exclusive breastfeeding. Methods: This research is an observational, cross-sectional study designed with a retrospective approach.   The population in this study were mothers who had babies aged 7-12 months in the Tambakrejo Health Centre Area, Jombang Regency. The technique used to determine the sample in this study used purposive sampling with a total of 60 respondents. Data collection using a questionnaire. Results: The results of the chi-square statistical test showed p value = 0.110 (p&gt;0.05), meaning that there was no relationship between the implementation of IMD and the success of exclusive breastfeeding. The results of the calculation of the prevalence ratio (PR) show that mothers who carry out IMD have a 1.699 times chance of successful exclusive breastfeeding compared to those who do not carry out IMD. Conclusion: There is no influence between the implementation of IMD on the success of exclusive breastfeeding. Suggestion: Future researchers are expected to examine other factors that influence the success of exclusive breastfeeding other than early breastfeeding initiation, such as husband and family support factors and daily food factors consumed by mothers during breastfeeding

Evaluating Decadal Changes in Determinants of Early Childhood Stunting and Assessing Their Contribution to Socio-economic Disparity in Child Nutritional Status Across India

Various efforts have been made over the years to bring about reduction in child malnutrition; the latest among them involves Goal 2 of the SDGs. The SDG Target 2.2 recognizes the global dimension of the nutrition issue and aims to end all forms of malnutrition by 2030, including achieving, by 2025, (WHO, 2015). The present evidence on childhood malnutrition suggests that while improvement in maternal and child covariates have resulted in decline of childhood stunting over time. The present study aims to investigate how the effect of maternal and child covariates on early childhood malnutrition have changed over the last decade and examining the socio-economic disparity in the nutritional status of children across India. The present study utilizes data from the last two rounds of the National Family Health Survey, NFHS-3 in 2005-06 and NFHS-4 in 2015-16 of children in the age group 6-23 months for whom data on height-for-age was available from the last two rounds of the National Family Health Survey (NFHS-3 and NFHS-4). After dropping the missing and flagged cases, the total sample size was 12,507 and 68,246 children from NFHS-3 (2005-06) and NFHS-4 (2015-16), respectively. The selected indicator of childhood under nutrition for this study is stunting. The exposure variables selected for the study were child factors such as sex, age, birth order, size at birth, place of delivery, diet diversity, meal frequency and early initiation of breastfeeding. Maternal factors such as maternal education, media exposure, and mother’s BMI were taken into account. For healthcare service utilization we considered the variable of complete antenatal care. Other background characteristics like religion, caste, wealth index, place of residence and geographical region were also considered. We utilized chi-square test to test for the association of various factors with early childhood stunting followed by t-test to assess the changes in prevalence by each factor. We also carried out bivariate and multivariate logistic analysis to effect of various factors on childhood stunting. Lastly, we carried out Oaxaca decomposition to examine the contribution of the determinants of childhood stunting towards the changes in its prevalence over the last ten years. Concentration Index was calculated to examine the disparity in early childhood stunting across India for both rounds of the National Family Health Survey. The predictive probabilities were calculated for each category of the wealth index after fitting a logistic model to control for other determinants of early childhood stunting to assess the change in prevalence of stunting across each socio-economic group in the last ten years. The study reveals an overall decline in prevalence of early childhood stunting across India over the last ten years from 2005-16. However, high levels of variation continue to exist across all the states in India. The study reveals institutional delivery as the highest contributing factor for this decline. Maternal education, body mass index and complete antenatal care during pregnancy also contribute significantly to the improvement in childhood stunting

Determinants of Stunting Among Children Under Five Years in Indonesia: Evidence from the 2021-2022 Demographic and Health Survey

At the global level, the prevention of stunting is one of the Sustainable Development Goals (SDGs). Indonesia is currently working towards achieving the second Sustainable Development Goal, which entails ending hunger, ensuring food security, improving nutrition, and supporting sustainable agriculture. As a part of this objective, efforts are being made to decrease the prevalence of stunting in children by 2025. Attention towards stunting is crucial as it can adversely affect children's physical and cognitive development well into adulthood if not addressed appropriately. This paper conducted a literature review from various sources, with a focus on google scholar and prioritizing sources from the last five years, as well as research on the population in Indonesia. It was determined through the analysis of several sources that maternal, child, and environmental factors pose various risks for stunting in Indonesia. Maternal factors that may play a role in child development include the mother's age, upper arm circumference, height, breastfeeding or complementary feeding practices, early initiation of breastfeeding and food quality during pregnancy. A history of low birth weight or prematurity, male sex, neonatal illness, frequent and recurrent diarrhea, infectious diseases, and lack of immunization are among the child factors associated with developmental outcomes. Factors such as living in a low socio-economic environment, limited family education, especially maternal education, insufficient household income, open defecation in rivers, gardens or inadequate latrines, consumption of untreated drinking water and high exposure to pesticides are also associated with the prevalence of stunting.

Predicting stunting in Rwanda using artificial neural networks: a demographic health survey 2020 analysis

Background Stunting is a serious public health concern in Rwanda, affecting around 33.3% of children under the age of five in 2020. Several examples of research have employed machine learning algorithms to predict stunting in Rwanda; however, no study used artificial neural networks (ANNs), despite their strong capacity to predict stunting. The purpose of this study was to predict stunting in Rwanda using ANNs and the most recent Demographic and Health Survey (DHS) data from 2020. Methods We used a multilayer perceptron (MLP) architecture to train and test the ANN model on a subset of the DHS dataset. The input variables for the model included child, parental and socio-demographic’s characteristics. The output variable was a binary indicator of stunting status (stunted vs. not stunted). Results An overall accuracy of 72.0% on the test set was observed, with an area under the receiver operating characteristic curve (AUC-ROC) of 0.84, indicating the model’s good performance. Several factors appear as important contributors to the probability of stunting among the negative value aspects. First and foremost, the mother’s height is important, as a lower height suggests an increased risk of stunting in children. Positive value characteristics, on the other hand, emphasie elements that reduce the likelihood of stunting. The timing of the initiation of breastfeeding stands out as a crucial factor, showing that early breastfeeding initiation has been linked with a decreased risk of stunting. Conclusions Our findings suggest that ANNs can be a useful tool for predicting stunting in Rwanda and identifying the most important associated factors for stunting. These insights can inform targeted interventions to reduce the burden of stunting in Rwanda and other low- and middle-income countries.

Quality of maternal and newborn health services and their impact on maternal-neonatal outcome at a primary health center.

The utilization of the maternal and newborn health services has increased, but mere increase in utilization of services does not ensure that quality services are being provided. The aim of the study was to assess the quality of maternal and newborn services and their impact on maternal and neonatal outcome at a primary health center of Western Rajasthan in India. An exploratory study was undertaken at a conveniently selected primary health center providing 24-hour delivery services. Information regarding the availability of services was collected from the available medical officer in charge using an Indian Public Health Standards (IPHS) Proforma. Assessment of quality of services was performed by using WHO standards of care based on assessment of quality of maternal and newborn services tool by the perspectives of the provider as well as the mothers utilizing the services. 36 mothers who delivered at the selected PHC were interviewed. All basic obstetric care services were available at the selected primary health centers including the 24 × 7 delivery services. The assessment of quality by provider's perspective revealed that the system of referral could be improved. Quality of maternal and newborn services assessment revealed that the practice of skin to skin contact between the mother and newborn just after the delivery was not being followed and few (30%) mothers informed that they could not start breastfeeding within 1 hours of birth. 47% mothers reported that they were not given the freedom to ask questions during delivery. Maternal and newborn outcome revealed that all mothers (100%) had a normal vaginal delivery, and 22% mothers had an episiotomy. All (100%) newborns cried immediately after birth, and average birthweight was 2.89 kg. PHCs are the first point of contact of mothers and healthcare delivery system. Assessment of quality of services is an important tool for quality assurance. Inclusion of evidence-based practices like skin-to-skin contact and early initiation of breastfeeding is important to improve the maternal and newborn well-being.

The Relationship Between Exclusive Breastfeeding And Baby's Weight

FELNIYAWATI AHMAD, The Relationship between Exclusive Breastfeeding and Increased Baby Weight in the Telaga Health Center. Supervised by HARISMAYANTI as chairman and ANI RETNI as member.&#x0D; Exclusive breastfeeding is giving only breast milk without other food and drink by not giving prelactal food, giving formula milk because the milk is not coming out, stopping breastfeeding because the baby or mother is sick, the mother has to work, and the mother wants to try formula milk. Predisposing factors for failure to provide exclusive breastfeeding include the mother not being facilitated to carry out early breastfeeding initiation (IMD). The aim of this research is to find out the relationship between exclusive breastfeeding and increased baby weight in the Telaga Community Health Center working area. This research uses an analytical survey research design using a cross sectional study research design. Samples were taken using a purposive sampling technique. Sampling was based on certain criteria at the time the research took place. Data collections uses questionnaires and observations. Data analysis used the Chi Square test with a significance level (α=0.05). The statistical test obtained a p value=0.000 with α &lt; 0.05, so there is a relationship between the increase in weight of babies who are exclusivey breastfed and those who are not exclusively breastfed in the working area of the Telaga Community Health Center.