Infancy Childhood Research Articles

Influence of Infant and Young Child Feeding Practices (IYCF) on Nutritional Status of Children Aged 6-59 Months in Moheshkhali, Cox’sbazar, Bangladesh: A Cross-Sectional Study

Background: This study addresses the critical issue of malnutrition among under-five children in Moheshkhali, Cox's Bazar, Bangladesh. Despite the alarming rates of stunting, wasting, and underweight in this region, there is a significant lack of localized data on socioeconomic factors, IYCF practices, and overall health status. Understanding these variables is essential for developing effective interventions. Methods: The research involved a cross-sectional study design, where anthropometric measurements were conducted to assess the nutritional status of children aged 6 to 59 months. Maternal education, age, and Body Mass Index (BMI) were also evaluated to explore their impacts on child nutrition. Data were analyzed using standard statistical methods to draw correlations and identify trends. Results: The findings revealed a high prevalence of malnutrition among under-five children, with notable gender disparities in stunting and underweight. The analysis indicated a strong relationship between maternal health indicators—particularly BMI—and child nutritional outcomes. Moreover, inadequate adherence to IYCF practices was observed, with many mothers failing to implement optimal breastfeeding and complementary feeding strategies. Conclusion: The study underscores the urgent need for targeted interventions aimed at improving maternal education and IYCF practices in Moheshkhali. A multi-sectoral approach involving government and non-government organizations is essential to address the malnutrition crisis effectively. Investing in preventive measures and promoting healthy feeding practices are crucial for ensuring the well-being of both mothers and their children.

Individual and community level determinants of minimum meal frequency among breastfeeding children aged 6-23 months in Ethiopia: a multilevel analysis of 2019 Ethiopian Demographic Health Survey data.

Minimum meal frequency (MMF) is a vital indicator of whether a child's energy needs are being met. Previous studies in Ethiopia on MMF have primarily focused on individual factors, often using basic logistic regression models with limited scope and small sample sizes. In contrast, this study aims to identify the key determinants of MMF among breastfed children aged 6-23 months in Ethiopia, examining both individual and community-level factors through multilevel logistic regression analysis, utilizing nationally representative data. The study utilized a community-based cross-sectional design with a sample of 1,245 6-23 month breastfed children in Ethiopia, using data from the 2019 Ethiopian Mini Demographic Health Survey. Mixed effect logistic regression was used to identify factors associated with MMF. Adjusted odds ratios (AOR) with 95% confidence intervals were used to assess variable associations, while Intra-cluster correlation (ICC), median odds ratio (MOR), and proportional change in variance (PCV) were employed to gauge random variation. The proportion of 6-23-month breastfeeding children with MMF was found to be 55.9% (95% CI: 53.2, 58.6). In mixed effect logistic regression; breastfeeding initiation time within days after birth [AOR = 0.44; 95%CI: (0.24, 0.80)], maternal primary educational level [AOR = 1.46; 95%CI: (1.03, 2.05)], maternal higher level education [AOR = 2.43; 95%CI: (1.22, 4.81)] and children from wealthiest household wealth index [AOR = 2.13; 95%CI: (1.04, 4.33)] were individual-level factors and children from city-based regions [AOR = 1.75; 95%CI: (1.10, 2.77)] was community level factors significantly associated with MMF. The final model indicates that 50.8% of the variation in MMF was explained by combined factors at both individual and community levels and also the variation across clusters remained statistically significant (ICC = 8.1% and variance = 0.29 with p < 0.001). Minimum meal frequency is a proxy for meeting energy requirements and it is a key indicator of infant and young child feeding (IYCF) practice. According to this study finding, the prevalence of MMF among 6-23-month children in Ethiopia was found to be low. The study also suggest that time of breastfeeding initiation, women's educational level, household wealth index, and contextual region were factors significantly associated with MMF. It is recommended that IYCF strategies should be implemented widely through women's education and empowerment and promoting early initiation of breast feeding to increase the proportion of children to be fed with MMF appropriate for their age.

AAFS (Victorian branch) Symposium: Science and Medicine in the Courts—Learning from the wrongful conviction of Kathleen Folbigg

ABSTRACT Kathleen Folbigg spent 20 years in jail, wrongly convicted for smothering her four infant children. An unprecedented second judicial Inquiry found they died naturally. New genetic and psychiatric evidence unlocked the wrongful conviction, but it was always questionable. A Symposium held by the AAFS (Victorian Branch) detailed the timeline of the numerous events, then identified and discussed the issues. What were the failings and why were they missed? What part did expert witnesses, judges and lawyers play in this wrongful conviction? Did the prosecution appeal to misogyny? How did the first Inquiry get it so wrong? How did it fail to correctly understand the genetics? Was Ms Folbigg treated disrespectfully, and if so, what did that mean about fact finding? How did the failures of disclosure affect the original conviction and its various appeals? What explains the NSW Court of Appeal’s decision to reject an appeal based on jury misbehaviour during Ms Folbigg’s trial? Should we be more careful about the language we use in criminal trials? There was general agreement that the frailties of Kathleen Folbigg’s convictions were readily visible from the beginning. Will the criminal justice system learn the lessons that emerge from this case?

Prediction of Anemia Using Machine Learning Algorithms: Scoping Review

Introduction: One of the major public health problems is anemia, especially affecting newborn and infant children, adolescent girls, young women, pregnant women, and postpartum women. The cause of anemia is the reduced supply of red blood cells in the human body or the damage or weakening of the structure of red blood cells. One of the preferences of utilizing machine learning is the prediction of results. Objective: The purpose of this study is to compare effective algorithms, related to the origin or source of the data set, data set size, metric evaluation and accuracy and produce predictors in predicting anemia using machine learning. Method: This research uses a scoping review method on 4 databases, namely Scopus, EBSCO, PubMed, and IEEE Xplore from 2019 - 2024 with keywords anemia, algorithms, machine learning, and prediction. The results of screening articles on the Scopus, EBSCO, PubMed, and IEEE Xplore databases obtained 384 articles which were then selected through several stages and obtained 9 articles. Result: The review found that the highest algorithm performance in anemia prediction, namely Penalized Regression (LASSO regression) accuracy above 64%, XGboost accuracy 100% and execution time 0.2404 seconds, Catboost accuracy 97.6%, Random Forest accuracy 95.49% and 72%, J48 algorithm accuracy of 97.7%, Logistic Regression accuracy 66% and AUC 69%, and SVM linear AUC 79.9%. Conclusion: Machine learning can assist in the development of anemia prediction models by exploring large amounts of data and producing precise and fast predictors. The predictors obtained are determined by the selection of algorithms in the study.

Infant and young child feeding practices among conflict-affected Ukrainian households: A cross-sectional survey in Kyiv, Lviv and Odesa regions.

Infant and young child feeding practices (IYCF) are crucial for children's growth and development but often deteriorate during periods of instability. A cross-sectional survey conducted in three oblasts of Ukraine-Kyiv City and Kyiv, Lviv, and Odesa-enroled 724 children 0-23 months of age from 699 households. Using global WHO IYCF Guidelines, 12 indicators of optimal IYCF practices were evaluated. The study found IYCF practices to be relatively stable since 2015, despite the continued escalation of conflict, with an improvement in exclusive breastfeeding (EBF). EBF was reported by 51% of mothers, while breastfeeding was initiated early in 65% of children. Complementary feeding practices were optimal for most children, with 79% having a minimum acceptable diet. Infant formula assistance was independently associated with suboptimal breastfeeding practices in multi-variable models. Children from households that received formula assistance had 67% (adjusted odds ratio [aOR] 0.33, 95% confidence interval [CI] 0.14-0.73) lower odds of being exclusively breastfed, 65% (aOR 0.35, 95% CI 0.20-0.61) lower odds of continued breastfeeding at 12 months, and 3.3 times (95% CI 2.31-4.78) higher odds of being bottlefed. Baby food assistance did not independently predict a minimum acceptable diet. High levels of optimal complementary feeding sustained since 2015 suggest protective factors for child nutrition in Ukraine, such as domestic agriculture and social safety nets. Additionally, maternal education was consistently linked to better IYCF outcomes, highlighting the need for targeted support for less-educated mothers. The negative association of formula assistance with EBF warrants further research alongside reinforcement of guidelines to prevent inappropriate formula targeting.

Understanding the longitudinal trends (2005-2018) and multilevel risk factors of complementary feeding in Guinea.

This study aimed to define complementary feeding trends in Guinea from 2005 to 2018 and complementary feeding risk factors at the individual, household, and community levels. Data from 2005 to 2018 demographic health surveys (DHS) and Multiple Indicator Cluster Surveys were used to describe complementary feeding trends in Guinea. The most recent DHS was used to examine complementary feeding risk factors at the individual, household, and community levels. Complementary feeding indicators including introduction to complementary foods (INTRO), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) were calculated based on the 2010 World Health Organisation guidance. Multivariate logistic regressions were used to identify significant risk factors (p < 0.05). Since 2005, there has been a marginal increase in MDD and MAD, but a decrease in INTRO and MMF. The 2018 DHS survey revealed various complementary feeding risk factors. At the individual level, travelling 1-60 min to get water was associated with decreased odds of meeting INTRO, while iron supplementation and maternal education were associated with increased odds of meeting MMF and MDD, respectively. Routine vitamin A supplementation, fever in the past 2 weeks, and low birth weight were associated with increased odds of meeting MAD. At the household level, being in a lower wealth quintile was associated with decreased odds of meeting MDD and MAD. National and subnational programmes and policies designed to improve infant and young child diets may consider tailored approaches that address the specific indicators and risk factors associated with poorer diets in this Guinean context.

Assessing the Compliance of Complementary Food Labeling Practices in Niger with International Guidelines

Optimal infant and young child feeding practices are among the specific interventions implemented during the first 1,000 days to prevent malnutrition. They include exclusive breastfeeding for the first 6 months after birth and continued breastfeeding for up to 2 years or more, and appropriate complementary feeding practices between 6 and 36 months. However, inappropriate labeling practices for complementary foods intended for children under 2 years of age could impact on parents' or guardians' choices. The aim of this study was to assess the conformity of labelling practices for complementary foods marketed in Niger. A survey was carried out at various sales outlets to identify all types of complementary foods sold in Niamey. The European nutrient profile model developed by WHO in 2019 was used to assess the compliance of the complementary foods surveyed with the model's requirements in terms of labeling practices. A total of 20 outlets selling complementary foods, corresponding to 85 complementary foods, were selected after elimination of repetitions. In terms of nutritional composition, 12.9% of imported supplements met this requirement. No local supplements complied, compared with 25% of supplements imported from Nigeria. Compliance is 100% for the requirement for legibility of the label and clarity of the product name, and 89.4% for the presentation of a clear list of ingredients on the label. The label is the interface between customers and products. It must be presentable and provide all the product information needed to guide the customer's choice. Our results will guide the government in creating national guideline for infant foods.

Adaptation of the Diet Quality Questionnaire as a Global Public Good for Use in 140 Countries

BackgroundFood group consumption data are useful for measuring and monitoring diet quality. To collect valid data across contexts, consistent and rigorous adaptation of survey questions is needed. ObjectivesThe objective of this research was to adapt food group consumption survey questions for 140 countries, by identifying the most common (sentinel) food items in each food group using a structured, participatory process and global standards for classification. MethodsSurvey questions were adapted for 29 food groups of the diet quality questionnaire (DQQ) and for additional questions for infant and young child feeding (IYCF) indicators. For each country, adaptation comprised the following: 1) review of existing questionnaires, dietary intake data, and other information to draft food lists; 2) key informant (KI) interviews with 5–12 experts to identify and prioritize sentinel items including terminology; 3) comparison of items across countries within the same region to identify discrepancies, and follow-up with KIs to resolve them. ResultsIn total, 1016 KIs contributed to the adapted DQQs for 140 countries and IYCF DQQs for 96 countries, amounting to ∼9550 h of collective effort (68 person-hours/country on average) from 2020 to 2024. The process revealed numerous challenges and decisions to ensure consistent classification of items and valid question formulation. ConclusionsCountry-specific questions adhering to global standards, and adapted through cumulative and iterative input of local experts, enable the collection of food group consumption data that are valid and comparable across time and geographies. The adapted survey questions have been implemented in the Demographic and Health Surveys and Gallup World Poll in 94 countries, generating the first cross-country data on minimum dietary diversity and other diet quality indicators. The finalized country-adapted DQQs and IYCF DQQs were translated to 143 national languages and are published online as a global public good for population-level diet quality measurement.

Progress in Improving Low-Cost Measurement of Feeding Behaviors and Diets

Information on infant and young child feeding practices and on the diets of vulnerable population groups is needed for global and national monitoring and for evaluating the impacts of interventions. Several population-level indicators have been developed to meet this need, but research to support selection of best data collection practices has been lacking. This supplement brings together a set of recent studies that address measurement issues with the objective of advancing knowledge of best practices, with a focus on low-cost measurement methods. Topics include social desirability bias, recall bias, and the cognitive validity of specific approaches and wording for asking questions on diets. The studies in the supplement provide examples of methods and results that can improve measurement and also identify gaps and areas where additional work is required.

Infant and young child feeding practices (IYCF): Its impact on nutritional status of infants 6-23 months in Akpabuyo, cross river state, Nigeria

Infant and young child feeding practices (IYCF): Its impact on nutritional status of infants 6-23 months in Akpabuyo, cross river state, Nigeria

Maternal feeding practices for sick children under 2 years in Wolkite town, Gurage Zone, Central Ethiopia, 2024: a community-based cross-sectional study

BackgroundOptimal feeding practices for sick children are crucial to prevent morbidity and mortality. Despite global and national policies emphasizing the importance of optimal feeding practices for sick children, studies have revealed varying levels of practice in different regions, including Ethiopia. However, there is a research gap in focusing on community-based contexts to determine sick child feeding practices among mothers with young children.ObjectiveTo assess maternal feeding practices for sick children under 2 years in Wolkite town, Gurage zone, Central Ethiopia: 2024.MethodsA community-based cross-sectional study involving a total of 419 mothers of young children was conducted in Wolkite town, Gurage zone, Central Ethiopia from September 15 to November 15, 2023. Participants were chosen using computer-generated random numbers. Structured, interviewer-administered, and pretested data collection tool were used. The data were coded and entered into EpiData 3.1 before being exported to SPSS version 25 for analysis. Logistic regression was employed to identify factors influencing mothers’ practice. Statistical significance was set at p < 0.05 with a 95% confidence interval.ResultsThe study found that 54.4% (95% CI: 50–59%) of mothers demonstrated good feeding practices for their sick children. Significant factors contributing to these practices included mothers having at least a secondary education (AOR: 3.7, 95% CI: 1.5–9.1), delivering their child in a health facility (AOR: 2.3, 95% CI: 1.4–3.8), and receiving support from the father (AOR: 2.3, 95% CI: 1.4–3.8). Additionally, mothers who were counseled on infant and young child feeding had higher odds of practicing good feeding (AOR: 4.1, 95% CI: 2.3–7.03), access to postnatal care (AOR: 3.8, 95% CI: 2.1–6.95) and having a good knowledge of feeding practices (AOR: 2.5, 95% CI: 1.4–4.5) were also strongly associated with effective feeding practices.ConclusionsThe study highlights more than half of mothers in Wolkite town, Gurage zone, Central Ethiopia have good sick child feeding practices. Factors such as the higher educational status of the mother, having the father’s support, place of delivery, receiving PNC services, counseling on infant and young child feeding, and knowledge about sick child feeding were significantly associated with their practice. Implementing targeted education programs, strengthening postnatal care services, counseling on infant and young child feeding, and encouraging the involvement of fathers in childcare and feeding were strongly recommended.

The relationship between feeding practices and stunting among children under two years in Tanzania mainland: a mixed-method approach

BackgroundProper infant and young child feeding practices have gained attention over the years as one of the interventions to reduce childhood stunting. However, there is still a gap in research to determine these relationships in children under two years and the reasons for improper feeding.ObjectiveThis study aimed to assess the relationship between feeding practices, stunting and barriers among children under two years.MethodologyUtilizing a mixed-method approach, the study involved secondary analysis of 1806 records of children aged 6–23 month, from the Next Generation Nutrition Program conducted in Tanzania (2015–2019). Both quantitative and qualitative data analyses were employed. Frequency distribution tables were utilized to describe study participants stratified by their stunting status. Subsequently, modified Poisson regression models identified predictors of stunting. Qualitative analysis encompassed deductive and inductive approaches, to extract themes that address the behaviors contributing to inappropriate feeding practices.ResultsStunting prevalence was 28.8% among children aged 6–23 months, with the majority (65%) of stunted children aged 1 year or older. Dietary diversity was low: 88.3% and 86.3% of stunted and non-stunted children, respectively, consumed less than 5 food groups. Surprisingly, early initiation of breastfeeding, time of stopping breastfeeding, and minimum dietary diversification were not significantly associated with child stunting (p-value > 0.05). Barriers to proper feeding practices identified were inadequate knowledge of feeding, maternal condition, economic hardship, cultural issues, and seasonality.ConclusionEarly breastfeeding and minimum dietary diversity were not significant predictors of stunting. However, the mother’s age and height > 150 cm reduced stunting risk while child sex, age, birth weight, marital status, and place of delivery also influenced stunting risk. It is crucial for initiatives to emphasize good feeding practices while addressing the complex factors that may hinder optimal feeding practices in this age group to reduce childhood stunting effectively.

Roma mothers of infant children in the health system - a qualitative study

Abstract Background The Roma in Bulgaria constitute the third largest group - 4% of the population. Data on demographic processes by ethnicity are scarce. A national survey in 2003 found significant differences in infant mortality - 9.9‰ for Bulgarian, 18‰ for Turkish, and 28‰ for Roma infants. Poverty among Roma children, risk of poor education, especially for girls, barriers to accessing health services remain high. We aim to reveal the cultural specificity in prenatal behavior and infant care among Roma mothers in the context of the role of the Bulgarian health service. Methods In-depth interviews with Roma mothers of infants up to 1 year were utilized for data collection. To ensure heterogeneity among the interviewees, several “nests” with varying socio-cultural status in the Varna district were identified in advance for participants recruitment. A list of interview themes concerning respondents’ relationships with the public health system with an emphasis on the experiences of mothers was drawn up. Results Ten interviews with mothers having between 1 and 7 children were conducted in 2023. The mothers recounted discriminatory experiences during their interactions with certain health facilities (maternity wards), which act as barriers to accessing and utilizing health services. Maternity and infant counselling services are highly esteemed with favorable influence on child health outcomes. There has been a positive shift away from early marriage and childbirth towards prioritizing education for Roma girls. Mothers prioritize their children, and there is no neglect in their care. Family relations and support are being upgraded, with Roma fathers becoming involved in child care. Respondents express their educational needs and hopes for community-based support to better cope with their roles as mothers. Conclusions Ethno-cultural factors shaping the mother’s role maintain traditional family support, while also reflecting significant modernization that needs societal support. Key messages • A glimpse into people’s experiences of the healthcare system - a clue to its effectiveness. • Тhe ethno-cultural factors in Roma are subject to modernization.

Evaluation of Complementary Feeding Indicators Among Children Aged 6–23 Months According to the Health Literacy Status of Their Mothers

Background/Objectives: Infant and young child feeding (IYCF) practices directly affect child health, development, and survival, especially under 2 years of age and ultimately affect adult life well-being. As the primary caregivers of the children, mothers with higher health literacy may better perceive the benefits of optimal complementary feeding practices, leading to improved health outcomes for their children. In this study, we aimed to assess complementary feeding practices among children aged 6–23 months in Turkey according to 2021 World Health Organization IYCF indicators [minimum dietary diversity (MDD); minimum meal frequency (MMF); minimum acceptable diet (MAD); egg and/or flesh food consumption (EFF); sweet beverage consumption (SwB); unhealthy food consumption (UFC); zero vegetable or fruit consumption (ZVF); and bottle feeding (BoF)] and investigate their associations with sociodemographic characteristics and mothers’ health literacy. Methods: With a descriptive study design, we reached 572 mothers of children aged 6–23 months from five regions of Turkey. We used the Turkey Health Literacy Scale-32 (TSOY-32) to assess mothers’ health literacy. Results: While maternal and child age are significantly associated with more complementary feeding practices, specifically MDD, MAD, and EFF, having multiple children has negative impacts on several complementary feeding indicators, including MDD, MMF, MAD, UFC, and ZVF. The only indicator associated with mothers’ TSOY-32 scores was zero fruit and vegetable consumption. Conclusion: Raising awareness among mothers about the importance of complementary feeding practices and identification of vulnerable groups will guide practitioners and policymakers to improve child health and nutrition.

Developmental trajectories in infants and pre-school children with Neurofibromatosis 1

BackgroundChildren with Neurofibromatosis 1 (NF1) show cognitive, behavioural and social differences compared to their peers. However, the age and sequence at which these differences begin to emerge is not fully understood. This prospective cohort study examines the cognitive, behavioural, ADHD trait and autism symptom development in infant and pre-school children with NF1 compared with typically developing (TD) children without a family history of neurodevelopmental conditions.MethodsData from standardised tests was gathered at 5, 10, 14, 24 and 36 months of age (NF1 n = 35, TD n = 29). Developmental trajectories of cognitive (Mullen Scales of Early Learning, MSEL) and adaptive behavioural (Vineland Adaptive Behavior Scales, VABS) development from 5 to 36 months were analysed using linear mixed modelling. Measures of ADHD (Child Behavior Checklist) and autism traits (ADOS-2, BOSA-MV and ADI-R) were assessed at 24 and 36 months.ResultsThe developmental trajectory of cognitive skills (all domains of the MSEL) and behavioural skills (four domains of the VABS) differed significantly between NF1 and TD groups. Post-hoc tests demonstrated that the NF1 participants scored significantly lower than TD participants at 24 months on all MSEL and VABS domains. The NF1 cohort demonstrated higher mean autism and ADHD traits at 24 months and 14% of the NF1 cohort met a research diagnostic classification for autism at 36 months.LimitationsThe study has a relatively small sample size due to variable retention and rolling recruitment. Due to limitations imposed by the COVID-19 pandemic, we utilised the Brief Observation of Symptoms of Autism for Minimally Verbal children (BOSA-MV) for some participants, which was administered online and may not gather as accurate a picture of traits as ADOS-2. The BOSA-MV was utilised for 41% of participants with NF1 at 36 months compared to 11% at 24 months. This may explain the reduction in the percentage of children with NF1 that met autism criteria at 36 months.ConclusionsBy 24 months of age, the NF1 cohort show lower cognitive skills and adaptive behaviour and higher levels of autism and ADHD traits as compared to TD children. This has implications for developmental monitoring and referral for early interventions.Trial registrationNot applicable.

Geographical variation, socioeconomic inequalities of low birth weight, and its relationship with maternal dietary diversity: Insights from the maternal infant and young child nutrition programme in Bangladesh.

Globally, every year, 20 million neonates are born with weights below 2500 g and are considered low birth weight (LBW). About 90% of these births occur in low- and middle-income countries. Information regarding the geographical variation, socioeconomic inequalities of LBW neonates, and the relationship between maternal inadequate dietary diversity and LBW is limited in rural areas of Bangladesh. We aimed to explore the geographical disparities and socioeconomic inequalities in the prevalence of LBW and its association with inadequate maternal dietary diversity. We extracted data from a large-scale evaluation programme conducted as a part of the maternal infant and young child nutrition phase two in Bangladesh, implemented by BRAC. We used the concentration index (CIX) to measure the socioeconomic inequalities of LBW. We performed a cluster-adjusted multiple logistic regression analysis to determine the association between LBW and maternal dietary diversity. A total of 4651 children aged <5 years with their mother's information were included. The overall prevalence of LBW was 13.5%. About 16% of mothers living in the poorest wealth quintile gave birth to LBW babies, whereas 10% of mothers living in the richest households gave birth to LBW babies. The CIX exhibited LBW babies were more prevalent among the socioeconomically worst-off (poorest) group (CIX = -0.08), indicating mothers of the poorest households are vulnerable to giving birth to normal-weight babies. An adjusted multiple logistic regression model indicated that mothers with inadequate dietary diversity had higher odds (adjusted odds ratio (AOR) = 1.27; 95% confidence interval (CI) = 1.04, 1.54) of giving birth to LBW babies. Notably, in the interaction of mothers' age and dietary diversity, we found that adolescent mothers (aged ≤ 19 years) with inadequate dietary diversity had 2.56 times (AOR = 2.56; 95% CI = 1.14, 5.76) higher odds of giving birth to LBW babies compared to adult mothers (aged >19 years) who consumed diversified foods. Intervention strategies for reducing LBW prevalence should target the poorest households. Also, interventions for improving the dietary diversity of adolescent pregnant mothers are expected to reduce the number of LBW babies from the rural areas of Bangladesh.

Infant and young child feeding practices as mediators in the relationship between early temperament and children's eating behaviors: A longitudinal study during COVID-19 pandemic

Simultaneously investigating the influence of multiple early temperament dimensions on children's eating behaviors through infant and young child feeding practices may be essential for developing optimal intervention strategies. This longitudinal study gathered data at two assessment points: Time 1, evaluation of infant and young child feeding practices and children's temperament when they were between 6 and 12 months, and Time 2, assessment of children's eating behaviors at age 2. This study included sociodemographic characteristics, the Child Eating Behavior Questionnaire for Toddlers (CEBQ-T), the short form of Children Behavior Questionnaire (Revised IBQ-RSF), and the Infant Feeding Style Questionnaire (IFSQ) in eastern China. Structural equation modeling (SEM) was utilized to examine the pathways from three dimensions of early temperament to five types of children's eating behaviors mediated by three styles of infant and young child feeding practices. A total of 972 children, children's mean age was 14.58 ± 5.11 months, 464 (47.74%) being girls, while the mothers' mean age was 30.23 ± 3.56 years. Effortful control exhibited significant effects on food responsiveness and satiety responsiveness mediated by responsive feeding. Additionally, effortful control influenced enjoyment of food and satiety responsiveness mediated by restrictive feeding. Surgency had a significant effect on food responsiveness mediated by indulgent feeding. Negative affectivity impacted satiety responsiveness, enjoyment of food, and food responsiveness mediated by responsive feeding. This longitudinal study delineates the pathways from early temperament to eating behaviors mediated by infant and young child feeding practices among children aged 6–23 months. These findings highlight the need to prioritize intervention programs aimed at nurturing early temperament through appropriate infant and young child feeding practices to promote healthy eating behaviors for upper- and middle-income countries (UMICs) with similar contexts.

Strengthening nutrition policy and service delivery: Lessons learned from a six-country assessment of Alive and Thrive's technical assistance.

Alive & Thrive (A&T) provides strategic technical assistance (TA) to develop effective policies; improve maternal, infant, and young child nutrition (MIYCN) programme design and implementationand enhance system capacity to sustain quality MIYCN service delivery at scale. A qualitative assessment was conducted using document review and stakeholder interviews (n = 79) to describe a selection of A&T's TA in six countries and systematically assess the contextual and TA process-related factors that influenced the results achieved and document the lessons learned about MIYCN TA design and implementation. To facilitate the selection of different types of TA, we classified TA into two levels of stakeholder engagement and intensity. Under the Technical Advisor TA category, we assessed A&T's support to strengthen national policy formulation, monitoring, and implementation of the International Code of Marketing of Breast-milk Substitutes. For Capacity Development TA, we assessed A&T support to scale-up maternal nutrition services and to increase strategic use of data. Factors important for TA provision included identifying and engaging with the right people, using evidence to support advocacy and decision-making, using multiple ways to strengthen capacity, developing packages of tools to support programme scale-up, and reinforcing feedback mechanisms to improve service provision and data quality. Challenges included shifts in the political context, poorly functioning health systems, and limited resources to replicate or sustain the progress made. Continued investment in evidence-based and practical TA that strengthens the institutionalization of nutrition across all stakeholders-including government, medical associations, civil societyand development partners-is essential. Future TA must support governments to strengthen system capacity for nutrition, including financial and human resource gaps that hamper full scale-up.

Fatalism or vigilance? Exposure to infant and maternal deaths and subsequent use of maternal health services in Malawi

In developing contexts, where formal health services are still expanding, understanding what factors discourage individuals from using health services is critical to advance population health. A long theorized, but rarely investigated, conjecture is that in high-mortality contexts, exposure to death can beget fatalism, or even foster distrust of formal healthcare, locking families into cycles of low use of health services. A counter perspective, however, suggests exposure to death can encourage individuals’ health vigilance, corresponding with their higher use of health services. We test these competing ideas by analyzing the associations between women’s intimate exposure to death in the context of pregnancy and delivery via (1) a sister’s maternal death and (2) an infant child’s neonatal death, and their subsequent use of maternal health services. We focus on the context of Malawi, a setting that features high maternal and infant mortality rates, similar to those observed across much of sub-Saharan Africa, as well as persistent gaps in service use. Specifically, we use Malawi Demographic and Health Survey (2015–16) data to examine if a sister’s maternal death or a child’s neonatal death corresponds with a woman’s odds of attending full antenatal care during a subsequent pregnancy or delivering the pregnancy at a formal health facility. Given the qualitatively distinct nature of losing one’s only or first child, we also assess if the effect of a child’s neonatal death varies by birth order. The results show that maternal and neonate death exposures correspond generally with women’s higher use of maternal health services, challenging the notion that exposure to death fosters fatalism or distrust. Although the results vary in significance, the nuanced findings highlight women’s vigilance in the face of health threats, emphasizing their resilience amid a high burden of familial loss.

Nutrient Composition And Sensory Evaluation Of Sorghum Based Complementary Food Fortified With Soybean, Carrot And Crayfish

The nutritional composition and sensory characteristics of sorghum-based complementary food fortified with soybean, carrot and crayfish at different substitutional levels were evaluated using standard analytical procedures. The results revealed that moisture,ash,fat,fibre,protein and carbohydrate content values range from 7.73% to 13.07%, 1.84% to 4.66%, 39.48% to 44.02%, 0.02% to 2.01%, 13.59% to 24.51% and 16.31% to 27.44% respectively. The selected minerals showed that calcium, zinc, magnesium, manganese, and iron varied from 1.61 to 15.56mg/100g, 0.05 to 4.71mg/100g, 3.51 to 8.80mg/100g, 0.22 to 7.78mg/100g and 0.02 to 6.68mg/100g respectively. Vitamin A showed an appreciable amount in the sample with the inclusion of carrot.Values obtained met the Codex Alimentarius Commission Guidelines for formulated complementary foods for older infant and young children. The sensory properties revealed that sample E (60% sorghum, 25% soybean, 10% carrot and 5% crayfish) was most preferred and this has provided a basis for the development of an acceptable complementary food that can provide the needed protein and other nutrients, thereby combating protein energy malnutrition in infants