Feeding Choice Research Articles

Sustainable fodder crop-feed integration practices: Impact on dairy farm economics and agricultural diversity

The study aimed to identify factors influencing feed purchase among dairy farmers in Tamil Nadu. The study highlights the crucial relationship between fodder crop cultivation and dairy farming economics. Local fodder crops like Hybrid Napier grass (Pennisetum purpureum), Sorghum (Sorghum bicolor) and Cowpea (Vigna unguiculata) play a vital role in supplementing commercial cattle feed, potentially reducing feed costs by 15-20 %. Integrating sustainable fodder cultivation practices with commercial feed usage presents opportunities for improving dairy farm profitability while promoting agricultural diversity. A survey was conducted among 200 dairy farmers in the districts of Ariyalur and Perambalur to gain a deeper understanding of that consumer buying behaviour, cost of production, benefit-cost ratio, factors influence buying behaviour and constraints faced by the farmers while purchasing and using cattle feed, such as the fact that specific feeds are improperly prepared, that costs are prohibitively high and that obtaining credit to pay for feeds is difficult. Key determinants of feed choice include product-related factors, marketing, economic factors, distribution, farm and milk production, labour and Government support. It is concluded that producers, distributors and legislators have insightful information about how to raise feed quality, accessibility and affordability while also boosting the financial viability and sustainability of Tamil Nadus’ dairy industry.

Prevalence, Patterns, and Nomogram Model of Intimate Partner Violence Against Mothers During the Child-Rearing Stage: A Family System Analysis in China for Targeted Prevention Strategies.

Intimate partner violence (IPV) is a significant public health issue affecting many women worldwide. While extensive research exists on IPV during pregnancy and postpartum, there is limited information on IPV against mothers during the critical child-rearing stage, specifically the first three years following childbirth. This study examines the prevalence and patterns of IPV among mothers in China during this stage, identifying associated factors across four family subsystems: individual, husband-and-wife, mother-child, and family context, to guide the development of tailored prevention strategies. This study involved 1,099 Chinese mothers, surveyed within the first three years postpartum, through purposive sampling. The revised Conflict Tactics Scale (CTS2) was utilized to evaluate IPV, while a comprehensive questionnaire gathered data on potential risk and protective factors within the four family subsystems. Chi-square tests and lasso regression analyses were used to identify significant independent risk factors, which were used to construct nomograms of IPV among mothers during the critical child-rearing stage. The nomogram's discrimination, calibration, clinical applicability, and generalizability were evaluated using receiver operating characteristic curves (ROC), calibration curves, decision curve analysis (DCA), and internal validation. Approximately 30% of mothers had experienced IPV within three years postpartum, with psychological violence being the most common. Three main patterns of IPV were identified, with multiple forms of violence often co-occurring. Significant risk factors for IPV included age at childbirth, attachment styles, marital issues, marital stability, feeding choices, maternal sense of parenting competence, support from friends, and family stress events. A nomogram model was developed to identify associated factors of IPV, demonstrating good performance. This model integrates factors from individual, spousal, mother-child, and family context subsystems, providing a comprehensive approach to understanding and preventing IPV during the critical child-rearing stage. The high prevalence of IPV underscores the urgent need for targeted prevention strategies to support mothers during this vulnerable period.

Caring for a young child who is HIV exposed and whose HIV status is not yet known: a scoping review of mothers’ experiences

ABSTRACT Living with HIV can affect mothers’ wellbeing, functioning, and experiences of caregiving. Most research about caregiving in the context of HIV comes from studies of dyads where both mother and child are living with HIV. Less is known about how mothers experience caregiving when their children are HIV exposed, but their HIV-status is not yet known. We conducted a scoping review to map out existing evidence on this topic. Systematic database search was conducted combined with a purposive hand search and expert consultation to identify relevant peer-reviewed literature. Title and abstract screening followed by a full-text review was done to select eligible studies. Studies were eligible for inclusion if they related to maternal caregivers; young children exposed to HIV, confirmed to be uninfected or whose HIV-status is unknown; and caregiving including any maternal involvement with her child. We identified 19 relevant studies. Analysis revealed that many mothers’ caregiving experience was marked by feelings of fear and stress in the early months of motherhood, mostly to do with the possibility of the child receiving a positive HIV diagnosis. Two dominant themes emerged – (1) experiences related to feeding and (2) experiences related to HIV testing, medications and health care utilization. Mothers had concerns pertaining to HIV transmission, feeding choices, efficacy of antiretrovirals and infant testing at multiple stages. Finally, any kind of support received from family, community or health workers, acted as a facilitator to improve caregiving experiences. This review highlights the need to provide additional support to mothers in their caregiving roles, especially before a child’s negative HIV-status is confirmed. Further investigation is warranted to determine if mothers’ concerns and challenges with caregiving persist even after HIV has been ruled out in the child.

Bioactive peptides inhibit feeding activity in the grey garden slug, Deroceras reticulatum.

The grey garden slug (Deroceras reticulatum) is considered the most damaging slug pest in global agriculture. Control methods primarily rely on chemical pesticides, which pose environmental risks and potential hazards to human health. There is a need for sustainable management alternatives such as biologically-based slug control options. However, the efficacy of nonchemical measures for controlling pest slug populations remains limited, particularly in the context of variable outdoor conditions. Neuropeptides and their corresponding receptors have been proposed as promising biological targets for the development of new pest management strategies. A total of 23 bioactive peptides belonging to the PRX family, previously identified from the grey garden slug, D. reticulatum, were injected into or fed to this species. The detrimental effects of these peptides, including a reduction in body weight and an inhibition of feeding activity, were evaluated in feeding choice tests with D. reticulatum. Furthermore, the bioactive peptide formulated with a lipid particle demonstrated a feeding deterrent effect. One of the myomodulin (MM) peptides, APPLPRY, demonstrated a significant reduction in feeding activity, resulting in a reduction in slug weight or mortality in just 30 min. The results represent the first evidence of a bioactive peptide having detrimental effects on D. reticulatum including causing feeding deterrent for this slug pest. The in vivo results provide insights into the potential development of active ingredients for managing slugs in the field. © 2024 Society of Chemical Industry.

Lactation Support for Breastfeeding and Chestfeeding People with HIV: A Call for Research to Examine Telelactation Experience, HIV Knowledge, and Lactation Consultants' Attitudes Related to Infant Feeding with HIV.

Clinical guidelines for infant feeding among people with HIV in the U.S. were updated in 2023 to encourage providers to utilize a shared decision-making approach that includes breastfeeding/chestfeeding (B/CF) when appropriate. Despite this historic shift in policy to support B/CF as an infant feeding choice for people living with HIV, birthing people living with HIV who desire B/CF face many barriers, and there is currently a gap in research identifying best practices for facilitating safe and satisfying B/CF in this population. Lactation support specialists have been identified as a positive factor in successful B/CF and a key resource for supporting B/CF for people with HIV. Recent research has shown that telelactation, the provision of care from a qualified lactation consultant or counselor using telehealth, can increase access to quality lactation support in underserved areas and can effectively improve outcomes, such as increased rates of exclusive breastfeeding and decreased early breastfeeding cessation while maintaining high levels of patient satisfaction. Telelactation is an innovative approach to improving access to B/CF among birthing people living with HIV, but little is currently known about what kind of support lactation support specialists and other perinatal HIV care providers may need to meet the clinical and psychosocial needs of B/CF people living with HIV and their infants. More research is needed to identify possible gaps in knowledge and other needs within the lactation support community so that infant feeding specialists are adequately equipped with evidence-based strategies to support the unique needs of parents living with HIV.

Dietary enrichment and feed preferences of threatened goitered gazelle (Gazella subgutturosa) in captivity

Arid-adapted ungulates species, such as gazelles, have faced tremendous population declines in recent decades. Numerous breeding stations were established across Asia and the Middle East to facilitate the captive breeding of endangered gazelle species. We intended to improve the feed quality of goitered gazelle (Gazella subguttorosa) in captivity at the Kızılkuyu Gazelle Breeding Station in Şanlıurfa Province in southern Turkey. In a feed choice experiment, five different types of supplementary feed were offered to the gazelles (black barley, white barley, forage wheat, white barley flake and a combination of black barley and white barley flake). Statistical analysis revealed a significant difference between the amount of feed types consumed. The mixture of black barley and white barley flake was the most preferred feed type. Black barley alone was the least preferred feed type, while white barley flake was the second most consumed feed, suggesting that white barley flake was particularly attractive to the gazelles. However, nutrient content analysis revealed no significant difference between feed types. When feed consumption was examined between sampling days, a significant difference was unravelled between day 1, 2, 8 and day 3–7. Results were discussed with respect to improving the gastro-intestinal health of captive gazelles, which is imperative when choosing suitable individuals for reintroduction, which should be in good physical condition to increase the chances for survival in the wild.

Genetic Variation in Trophic Avoidance Behaviour Shows Fruit Flies are Generally Attracted to Bacterial Substrates.

Pathogen avoidance behaviours are often assumed to be an adaptive host defence. However, there is limited experimental data on heritable, intrapopulation phenotypic variation for avoidance, a strong prerequisite for adaptive responses to selection. We investigated trophic pathogen avoidance in 122 inbred Drosophila melanogaster lines, and in a derived outbred population. Using the FlyPAD system, we tracked the feeding choice that flies made between substrates that were either clean or contained a bacterial pathogen. We uncovered significant, but weakly heritable variation in the preference index amongst fly lines. However, instead of avoidance, most lines demonstrated a preference for substrates containing several bacterial pathogens, showing avoidance only for extremely high bacterial concentrations. Bacterial preference was not associated with susceptibility to infection and was retained in flies with disrupted immune signalling. Phenotype-genotype association analysis indicated several novel genes (CG2321, CG2006, and ptp99A) associated with increased preference for the bacterial substrate, while the amino-acid transporter sobremesa was associated with greater aversion. Given the known fitness benefits of consuming high-protein diets, our results suggest that bacterial attraction may instead reflect a dietary preference for protein over carbohydrate. More work quantifying intrapopulation variation in avoidance behaviours is needed to fully assess its importance in host-pathogen evolutionary ecology.

Modulating the fatty acid composition of black soldier fly larvae via substrate fermentation

Black soldier fly larvae (BSFL, Hermetia illucens) contain high amounts of proteins and essential amino acids, and are therefore an appropriate feed source. However, they lack essential fatty acids (FAs), specifically ω-3 and ω-6, making them a less desirable feed choice for aquaculture. The aim of this study was to increase the ω-3 and ω-6 FA concentrations in BSFL by manipulating the FA composition in their rearing substrate. Specifically, the potential of substrate fermentation using the ω-3 and ω-6 FA producing fungus Mortierella alpina was assessed. Fermentation of two agricultural side streams (wheat bran (WB) and WB with distiller’s dried grains with solubles (DDGS)) increased substrate total crude fat concentration by 2.1 – 4.6%, as well as the concentration of several essential FAs, including the ω-6 FAs arachidonic acid (from less than 0.2 mg/g fat to a maximum of 44.2 mg/g fat) and gamma-linolenic acid (from less than 1.2 mg/g fat to a maximum of 45.8 mg/g fat and the ω-3 FA eicosapentaenoic acid (EPA) (from less than 0.7 mg/g fat to a maximum of 49.9 mg/g fat). Rearing BSFL on feeds from such fermented substrates resulted in similar changes in larval FA composition, specifically a higher concentration of EPA (from less than 0.2 mg/g fat to a maximum of 26.6 mg/g fat in the larvae fed on fermented diets), however larval growth was reduced. Feeds made from fermented substrates were prone to stickiness and dehydration, possibly limiting larval movement and feeding, thereby affecting larval growth. Furthermore, proximate analysis of the substrates revealed sugar depletion after fermentation, which could be detrimental for larval growth and illustrate important attention points going forward. This study shows that fermentation of agricultural side streams WB and a mixture of WB with DDGS with M. alpina alters their FA profile, increasing their ω-3 and ω-6 FA concentrations and that of BSFL fed with those substrates. Therefore, these results suggest that BSFL with tailor-made FA profiles for a specific application could be successfully produced.

Preterm infant attachment is independent of breast milk intake during neonatal care

Background Following preterm birth, breast milk feeding is recommended because it confers broad health benefits to preterm infants. Breast milk has been suggested to promote secure attachment in infancy, but this is uncertain. Elucidating the relationship between breast milk intake and infant attachment is crucial for supporting parents of preterm infants to make feeding choices and providing accurate counselling when breast milk is not available. We aimed to investigate if breast milk exposure during neonatal care associates with attachment outcomes derived from infants’ responses to the Still-Face Paradigm (SFP) at nine months of age. Methods We studied 77 preterm (< 33 weeks’ gestation) and 71 term infants. Preterm infant feeding data were collected from birth until hospital discharge. Infant responses to the SFP were videocoded at nine months corrected age. Infants’ distress, fretfulness, attentiveness to caregivers and attachment classification were compared between preterm infants who received exclusive breast milk for ≥ 75% of inpatient days, those who received exclusive breast milk for < 75% of inpatient days, and term infants. Milk intake thresholds were chosen based on our previous work demonstrating positive associations between breast milk intake and MRI markers of brain maturation. Results There were no significant differences in infant distress, fretfulness, attentiveness to caregivers (p-values > 0.19), or in the odds of secure versus insecure attachment classification (relative risk ratio = 0.57–0.89, p-values = 1.00) between preterm infants with high or low breast milk exposure, or term comparators. Conclusions Attachment outcomes at nine months were similar between term and preterm infants, and breast milk exposure did not associate with attachment in the preterm group. Although breast milk feeding has clear benefits, these findings may alleviate some of the pressures experienced by parents who are unable to provide breast milk for infants cared for in the neonatal unit.

HIV postnatal prophylaxis and infant feeding policies vary across Europe: results of a Penta survey.

This survey was conducted to describe current European postnatal prophylaxis (PNP) and infant feeding policies with the aim of informing future harmonized guidelines. A total of 32 senior clinicians with relevant expertise, working in 20 countries within the European Region, were invited to complete a REDCap questionnaire between July and September 2023. Twenty-three of the 32 invited paediatricians responded, representing 16/20 countries. There were multiple respondents from the same country for Italy (n = 5), the UK (n = 2), Germany (n = 2) and France (n = 2). All countries use risk stratification to guide PNP regimen selection. Nine out of 16 countries reported three risk categories, six out of 16 reported two, and one country reported differences in categorization. Criteria used to stratify risk varied between and within countries. For the lowest risk category, the PNP regimen reported ranged from no PNP to up to four weeks of one drug; the drug of choice reported was zidovudine, apart from one country which reported nevirapine. For the highest risk category, the most common regimen was zidovudine/lamivudine/nevirapine (20/23 respondents); regimen duration varied from twoto six weeks with variation in recommended dosing. Guidelines support breastfeeding for infants born to people living with HIV in eight out of 16 countries; in the other eight, guidelines do not support/specify. Guidelines and practice for PNP and infant feeding vary substantially across Europe and within some countries, reflecting the lack of robust evidence. Effort is needed to align policies and practice to reflect up-to-date knowledge to ensure the vertical transmission risk is minimized and unnecessary infant HIV testing and PNP avoided, while simultaneously supporting families to make informed decisions on infant feeding choice.

Pigs Can Detect Multiple Amino Acid Deficiencies in a Choice Feeding Setting

BackgroundIt is unknown whether pigs can detect deficiencies in multiple amino acids (AA) and consequently change their feed choice. ObjectivesWe investigated whether pigs compensate for a diet deficient in three AA (Thr, Trp, and Val) by selecting multiple diets and whether this compensation is affected by the supplemented AA concentration. MethodsPair-housed 5-wk-old pigs (n = 96) were exposed to one of four treatments: 1) AA-adequate: offered a low-protein (LP) diet adequate in AA for growth (LP+); 2) AA-deficient: offered LP diet deficient in Thr, Trp, and Val by 20% (LP–); 3) Two-choice between LP+ and LP–; and 4) Four-choice between LP– and three diets supplemented with Thr, Trp, Val at +40% (n = 12 pens/treatment) from d0 to d21 (phase 1). From d21 to d28, AA concentration of supplemented diets increased to +60% (phase 2). Average daily feed intake (ADFI) and gain (ADG) were recorded. ResultsDietary treatment did not affect ADFI and ADG in phase 1 (P > 0.05). In phase 2, ADFI and ADG were higher in AA-adequate and two-choice treatments than in AA-deficient treatment with four-choice in between (P < 0.05). In both phases, Thr, Trp, and Val intake was lower in AA-deficient treatment than in other treatments. For the two-choice treatment, consumption of LP– was higher than LP+ in both phases (P < 0.05 and P < 0.001). Four-choice treatment consumed more LP– and Trp-supplemented than Thr- and Val-supplemented diets in phase 1 (P < 0.001); in phase 2, consumption of the Trp-supplemented diet was the highest (P < 0.01). ConclusionsPigs can detect multiple AA deficiencies and compensate by consuming AA-supplemented diets. In a two-choice setting, pigs proportionally decrease consumption of a supplemented diet with increased dietary AA concentration. However, when given the choice between individual AA-supplemented diets, pigs proportionally decrease consumption of a highly concentrated Val diet and increase preference for a highly concentrated Trp diet.

Infant feeding knowledge among women living with HIV and their interaction with healthcare providers in a high-income setting: a longitudinal mixed methods study

BackgroundRecent changes in the infant feeding guidelines for women living with HIV from high-income countries recommend a more supportive approach focusing on shared decision-making. Limited information is available on the infant feeding knowledge of women living with HIV and how healthcare providers engage with them in this context. This multicenter, longitudinal, mixed methods study aims to get a comprehensive and nuanced understanding of infant feeding knowledge among women living with HIV of Nordic and non-Nordic origin living in Nordic countries, and their interaction with healthcare providers regarding infant feeding planning.MethodsPregnant women living with HIV in Denmark, Finland, and Sweden were recruited in 2019–2020. The Positive Attitudes Concerning Infant Feeding (PACIFY) questionnaire was completed in the 3rd trimester (T1), three (T2), and six (T3) months postpartum. Women who completed the quantitative survey were also invited to participate in qualitative semi-structured interviews at T1 and T3. Results from the survey and interviews were brought together through merging to assess for concordance, complementarity, expansion, or discordance between the datasets and to draw meta-inferences.ResultsIn total, 44 women living with HIV completed the survey, of whom 31 also participated in the interviews. The merged analyses identified two overarching domains: Knowledge about breastfeeding in the U = U era and Communications with healthcare providers. The women expressed confusion about breastfeeding in the context of undetectable equals untransmittable (U = U). Women of Nordic origin were more unsure about whether breastfeeding was possible in the context of U = U than women of non-Nordic origin. Increased postpartum monitoring with monthly testing of the mother was not seen as a barrier to breastfeeding, but concerns were found regarding infant testing and infant ART exposure. Infant feeding discussions with healthcare providers were welcome but could also question whether breastfeeding was feasible, and many participants highlighted a need for more information.ConclusionsHealthcare providers caring for women living with HIV must have up-to-date knowledge of HIV transmission risks during breastfeeding and engage in shared decision-making to optimally support infant feeding choices.

Navigating dementia feeding decisions in Asia: a mixed methods study of caregivers.

Tube feeding is discouraged among older adults with advanced dementia; nevertheless, caregivers often find feeding decisions challenging to navigate. This study aims to gain a comprehensive understanding of tube feeding among community-dwelling older adults with advanced dementia in Singapore and its relationship to older adult quality of life (QoL) and caregiver psychological distress. We use a convergent mixed-methods design, synthesising analysis of qualitative caregiver interviews (n= 25) and two-year prospective, longitudinal cohort survey data (n= 215, 1018 observations). Findings from the qualitative interviews revealed caregivers' expectations of reduced QoL for older adults with feeding tubes and their own distress related to making feeding decisions and fears prompting plans to tube-feed. Sixteen percent of community-dwelling older adults with advanced dementia relied on feeding tubes during the two-year study period. Adjusting for potential confounding and using instrumental variables estimation, tube feeding was associated with reduced older adult QoL (P< .05) and increased caregiver anxiety and depression (P< .10). Consistent with expert guidelines, we found that tube feeding was associated with significantly reduced QOL among older adults living with dementia and increased distress among caregivers relative to those of older adults without feeding tubes. Despite caregivers' recognition of reduced QOL associated with older adult use of feeding tubes, many expressed angst related to feeding choices. Our findings suggest the need for decision tools to support caregivers in making informed decisions concordant with their values.

Understanding infant and young child feeding (IYCF) practices among Muslim mothers/caregivers: A qualitative study in the Bangsamoro Autonomous Region in Muslim Mindanao, Philippines

BackgroundThe study focused on understanding infant and young child feeding practices (IYCF) among Muslim mothers in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), Philippines.ObjectiveRecognizing the cultural and religious sensitivities associated with these practices, the research aimed to identify influencing factors and assess the influence of advertisements on maternal decisions regarding infants' and children's diets.MethodsA total of 74 Muslim mothers with infants 6-23 months old were recruited and participated in the focus group discussions (FGD). Ten FGD sessions were conducted in Maguindanao Province, Philippines from July to August 2021. Verbatim transcriptions of audio-recorded discussions were transcribed into Microsoft Word files and QSR NVivo version 12 was used in the coding and analysis of the transcripts.ResultsMothers exhibited limited awareness of such important complementary feeding issues as preferring fruits and vegetables while avoiding junk food as chips. IYCF information came primarily from health workers and other mothers - their own mothers, mothers-in-law, and midwives. Television commercials were identified as particularly influential in shaping maternal feeding decisions.ConclusionsThere was a diversity of breastfeeding practices and limited knowledge, especially of complementary feeding among these Muslim mothers. Both traditional beliefs and marketing were said to influence feeding choices. This underscores the need for culturally-sensitive interventions and targeted educational initiatives to enhance maternal knowledge and advocate for optimal infant feeding practices within Muslim communities, as well as regulation of the marketing of commercial infant foods.

PSIV-26 Extent of use of supplemental feeding in beef cattle operations across the Southeast: A report of the regional survey

Abstract With input costs on the rise, researchers and producers, alike, are seeking alternative management strategies for profitable and sustainable beef production. Studies suggest that supplemental feed provided to grazing cattle may be used to offset some of the cost. However, there is a lack of knowledge on the extent of supplemental feeding programs in the southeastern US and which feeds may be used in these programs. Thus, the objective of this study was to better understand supplemental feeding practices and choices among beef producers in the southeastern US. To address this objective, a 24-question survey was distributed through Extension and commodity organizations to beef producers across the Southeast. This survey received 118 complete responses. The majority of respondents operated cow-calf production systems (65.6%) on either tall fescue or bermudagrass pastures (32.7 and 28.0%, respectively). Approximately 88% of these producers employed some type of supplemental feeding strategy, but there is no clear decision on whether commodity or byproduct feedstuffs were preferred. The leading commodity used was corn (61.4%), while common byproducts included whole cottonseed, corn gluten feed, and soybean hulls (17.1, 16.6, and 14.4%, respectively). At the end of the survey, the participants were asked to submit a sample of their byproduct supplements to have a nutritive analysis completed to better understand what nutritional components the products they are feeding contain and how they may vary from place to place. Some of the products that were sent in include whole cottonseed, cotton byproduct, corn gluten meal, distillers grain, chicken litter, and others. The nutritional test being run on these samples included crude protein and fiber analysis. The crude protein of the samples received ranged from 13.3% to 30.3% with an average of 21.5%. The fiber profile received ranged from 45.5% to 76.3% with an average of 59.9%. With the information recorded from these tests, recommendations can be provided on different feeding methods in both commercial settings as well as research settings.

Close Relations, Practitioners or Social Networks: What Affects the Selection of Infant Formula Products?

This study examines which factors influence the preferences of mothers seeking advice on the use of infant formula in feeding practices. The effects of their close social circle, medical professionals and social network forums on feeding choices were evaluated. Data were collected from 638 questionnaires from mothers and were statistically analyzed. Our findings suggest that age may influence the preference to seek advice from a close social circle over consulting with medical professionals (p-value = 0.019 < 0.05). The educational level and the number of children impact the preferences of using infant formula over combining it with breastfeeding (p-value = 0.000 < 0.05 and p-value = 0.004 < 0.05, respectively). The research contributes to the understanding of the complex interplay between various demographic and socioeconomic factors and the decision-making process of mothers based on multiple social and digital sources of influence. The research presents valuable insights for healthcare policymakers and professionals in supporting mothers and providing them with up-to-date information. Feeding information can be distributed through all the communication channels that were examined in this study to benefit different socio-economic groups and to contribute to the well-being of infants in the long-run.

Factors affecting infant feeding choices with a focus on barriers to exclusive breastfeeding in Western Jamaica: a qualitative study

BackgroundDespite the many benefits of exclusive breastfeeding to infants and mothers, only 33% of Jamaican infants are exclusively breastfed up to the recommend six months. This study was conducted to identify factors affecting mothers’ feeding choices focusing on barriers to exclusive breastfeeding of infants six weeks to less than six months old.MethodsA qualitative study consisting of four focus group discussion sessions was conducted among 22 mothers attending postnatal clinics in western Jamaica from May to August 2016. The transcripts were coded by three independent coders and content analysis conducted to generate themes.ResultsFour themes were identified namely, perceived advantages of breastfeeding centered mainly on the benefits of breastfeeding for the infant and mother, perceived barriers of breastfeeding highlighting physical pain and fatigue, supplementing culturally acceptable complementary foods and herbal remedies, and cultural norms including perception of how breastfeeding affects a woman’s body, societal sources of breastfeeding information, satiation of infants, and family and other support. Mothers overwhelmingly agreed that breastfeeding was inexpensive, allowed them to bond with their infants and was good for the overall health and intellectual development of the infants. They identified painful nipples, engorged breasts, lack of sleep, physical exhaustion and pressure to return to work as barriers to breastfeeding. Mothers named a number of complementary foods, such as pumpkin, carrots, potato, banana, and chocho (Chayote), that were culturally accepted for feeding infants in Jamaica and discussed herbs that were considered to aid in infants’ nutrition and overall health. Other cultural factors that were noted to influence exclusive breastfeeding were mothers feeling that breastfeeding would help their bodies, especially their bellies, go back to their pre-maternity figure, sources of breastfeeding information in the society including the internet, belief that breast milk alone does not satisfy babies, and family and other support.ConclusionMothers in this study identified unique challenges to exclusive breastfeeding that if addressed, would help to increase exclusive breastfeeding so that the World Health Organization’s exclusive breastfeeding recommendations can be achieved.

Practices for introducing complementary foods in Taiwan: A nationwide survey from 2013 to 2016

Background/purposeIntroducing complementary foods to infants is a critical stage in their healthy growth and development process. In this study, we analyzed the feeding habits and choices of caregivers in Taiwan during this essential transition period. MethodsData from the 2013–2016 Nutrition and Health Survey in Taiwan were analyzed. Using a multistage stratified sampling technique, we collected data through questionnaires on the feeding practices, challenges, and information sources associated with complementary feeding. We also investigated the timing of introducing various foods. Certain feeding indicators recommended by the World Health Organization were modified and used for analysis. ResultsAmong 439 caregivers of infants aged 2–24 months, complementary feeding typically began at 5 months, and it primarily began with cereals and pureed foods. At 6–8 months of age, 98.29% of the infants received these foods. Only 48.39% of infants aged 6–24 months consumed eggs or flesh foods. Among the primary challenges for caregivers were concerns regarding infants’ adaptation to new foods (38.2%), refusal of foods by infants (37.1%), and uncertainty regarding which foods to introduce (11.4%). The main sources of information were friends and family (46.9%), the Internet (46.5%), and baby care books (35.6%). Notably, approximately 51% of the respondents used commercial baby foods. ConclusionIn Taiwan, although the majority of infants begin complementary feeding on time, the introduction of eggs and flesh foods is typically delayed. Given the growing reliance on the Internet in the modern age, accurate feeding information should be disseminated online.

Women’s and Partners’ Experiences With a Closed-loop Insulin Delivery System to Manage Type 1 Diabetes in the Postpartum Period

ObjectivesClosed-loop insulin delivery has the potential to offer women with type 1 diabetes a break from intense diabetes self-care efforts postpartum. Our aim in this study was to explore the views and opinions of hybrid closed-loop users and their partners in the first 24 weeks postpartum. MethodsThis qualitative study was embedded in a controlled study of women with type 1 diabetes randomized to closed-loop insulin delivery (MiniMed™ 670G or 770G) or sensor-augmented pump use for 1 to 11 weeks 6 days postpartum, with all on closed-loop delivery from 12 to 24 weeks postpartum. Semistructured interviews were conducted with 16 study participants and their partners at 12 and 24 weeks postpartum. Thematic analyses were used to examine participants’ and partners’ experiences. ResultsParticipants’ positive perceptions of closed-loop use related to reduced hypoglycemia, in contrast to previous experiences with nonautomated insulin delivery. These perceptions were balanced against frustrations with the system, allowing blood glucose levels to be higher than desired. Closed-loop use did not influence infant feeding choice, but infant feeding and care impacted participants’ diabetes management. Partners expressed uncertainty about the closed loop taking away control from participants who were highly skilled with diabetes self-management. ConclusionsParticipants reported that closed-loop insulin delivery resulted in less time spent in hypoglycemia when compared with the previously used nonautomated delivery. Yet, participants desired a greater understanding of the workings of the closed-loop algorithm. Our study provides potential users with realistic expectations about the experience with the MiniMed 670G or 770G closed-loop system in the postpartum period.

Dog and owner demographics impact dietary choices in Dog Aging Project cohort.

To describe the demographic factors of owners and their dogs associated with owner feeding choices and the regularity with which those diets were fed to a US-based population of dogs. This cross-sectional analysis examined 40,367 initial survey responses from US dog owners participating in the Dog Aging Project. The surveys were collected from January 2, 2020, to December 31, 2022, and included primary and secondary diet component types and dog and owner demographic variables. Each demographic variable was compared across diet type choices with a χ2 test of independence. Most owners (82%) fed a commercially prepared extruded dry diet (kibble) as the primary diet component. Most owners (89%) reported that they fed their dogs a consistent diet over time. Owner demographic factors (income, education level) were less correlated with difference in diet choices than dog demographic factors (size, neuter status, purebred status, activity level), but owner age did correlate with choice: younger owners tended to feed kibble more compared to older owners. Home-cooked diets were most often consumed by small (< 30-lb) dogs, purebred dogs in poorer health status, and dogs with owners aged 45 years or older. Raw diets were more commonly fed to purebred, intact, and highly active dogs. Ten percent of service dogs were reportedly fed a raw diet of some sort. Demographic variables are associated with statistically significant differences in diet types selected. Nutrition studies examining health outcomes associated with the feeding of different diet types should account for these factors during design or analysis in order to avoid bias. An epidemiological tool, the directed acyclic graph, is presented. This information will help clinicians in their discussions with clients about pet nutrition.