Infant Health Research Articles

Complementary Feeding Practices and Weaning Practices in Morocco: A Systematic Review and Meta-Analysis

Introduction: Complementary feeding represents a crucial phase in an infant's developmental journey. Inadequate implementation, marked by an imbalance in both quantity and quality, can lead to varying degrees of nutritional disorders, whether from excess or deficiency. Study Objectives and Methods: Conducted from December 2023 to February 2024, this research aims to assess the weaning age and the age of initiating dietary diversification among Moroccan infants. Additionally, it seeks to scrutinize specific nutritional practices and behaviors within the Moroccan infant population. Our methodology involved an extensive bibliographic search using databases such as PubMed, Science Direct, Scopus, and Google Scholar, focusing on research conducted in Morocco from 2005 to 2020. Variables examined include the prevalence of breastfeeding at six months, the age of weaning, the commencement of dietary diversification at six months, and the prevalence of advice from healthcare professionals, particularly nursing experts, provided to Moroccan mothers. Results and Discussion: Complementary feeding practices in Morocco navigate the intersection of maternal nutritional beliefs and a plethora of infant feeding concepts, resulting in a complex landscape. The crucial role of medical and nursing personnel in conveying appropriate information and advice to Moroccan mothers is highlighted. Conclusion: Complementary feeding is a pivotal milestone in infant nutrition, necessitating adjustments and updates in Moroccan practices. The active involvement of medical and nursing personnel is essential to ensure optimal weight development and prevent infant nutritional disorders. Impact and Contribution of Patient or Public: Emphasizing the importance of the results in positively influencing infant feeding practices in Morocco, with a focus on the crucial role played by medical and nursing personnel in promoting infant health.

Assessing interstate racial and socioeconomic disparities in newborn screening policies in the United States.

This paper explores racial and socioeconomic disparities in newborn screening (NBS) policies across the United States. While inter-state inequality in healthcare policies is often considered a meaningful source of systemic inequity in healthcare outcomes, to the best of our knowledge, no research has explored racial and socioeconomic disparities in newborn screening policies based on state of residence. We investigate these disparities by calculating weighted average exposure to specific NBS tests by racial and socioeconomic group. We additionally estimate count models of the number (and type) of NBS conditions screened for by state racial and socioeconomic composition. Adding to the knowledge base that social determinants of health and health disparities are linked, our analysis surprisingly reveals little evidence of substantial inter-state inequity in newborn screenings along racial and socioeconomic lines. While there is substantial nationwide racial and socioeconomic inequity in terms of infant health, the distribution of state-level policies does not appear to be structured in a manner to be a driver of these disparities. Our findings suggest that efforts to reduce inequities in outcomes related to NBS should shift focus toward the delivery of screening results and follow-up care as discussion builds on expanding NBS to include more conditions and genomic testing.

Skin science to advance emollient therapy in the care and health of preterm infants

Skin science to advance emollient therapy in the care and health of preterm infants

Empowering Expecting Women to Obtain High-Quality Healthcare in Pakistan: An Evaluation of Khyber Pakhtunkhwa's Conditional Cash Transfer Program.

Maternal mortality, largely stemming from complications during pregnancy and childbirth, impacts poor expecting women with limited healthcare access in rural Pakistan. Conditional Cash Transfers (CCTs), commonly implemented in developing nations, are designed to improve the well-being of vulnerable populations by focusing on health and education. A CCT initiative named Chief Minister's Special Initiative for Mother and Child Health (CM-SIMCH) was launched in Khyber Pakhtunkhwa (KP), one of the less-developed provinces of Pakistan, to empower expecting women to access quality healthcare. This study investigates the factors influencing CM-SIMCH program participation and assesses its impact on the health of expecting women by analyzing health-seeking hospital visits in KP, Pakistan. The study utilizes the Propensity Score Matching (PSM) technique to analyze cross-sectional data obtained from 303 expecting women residing in the Nowshera district of KP. The PSM allows for a balanced comparison of participants who received the CM-SIMCH transfers with those who did not, assessing its impact on maternal healthcare access and outcomes. Empirical results show that factors such as education and family system positively influence the participation of expecting women in the CM-SIMCH program, whereas travel costs exert a negative effect. The intervention leads to a notable increase in hospital visits among these women, contributing to improved health outcomes in KP. This underscores the program's potential effectiveness in addressing maternal healthcare challenges and enhancing healthcare access for vulnerable women in less-developed areas. Therefore, empirical evidence supports the CM-SIMCH program's potential to promote maternal health and improve healthcare access in KP. The study recommends government intervention in health sector as a strategic imperative to empower women and enhance infant health.

Human Milk Oligosaccharides: Potential Upshot on Health at Early Life Stage Development

In the crucial early months of life, an infant's health, growth, and safeguarding are paramount. Breastfeeding stands out as the optimal and natural means of nourishment, offering profound benefits for their development and overall wellness. Within breast milk, a rich array of bioactive components, including hormones, oligosaccharides, and immunoglobulins, provide neonates with an ideal nutritional balance. Among these, Human Milk Oligosaccharides (HMOs) rank prominently, serving both as prebiotics and shields against various neonatal ailments. Particularly, compounds like 2′-Fucosyllactose (2′-FL) and Lacto-N-Neotetraose (LNnT) have been deemed safe for integration into infant formulas, amplifying their benefits. Extensive research underscores the manifold advantages of HMOs, from modulating gut microbiota to bolstering immune function and thwarting pathogenic invaders. HMOs also exhibit a nuanced interplay with maternal genetics, influencing their quantity and diversity. Infants nursed by secretor mothers tend to enjoy enhanced HMO benefits compared to non-secretor counterparts. Incorporating HMOs like Lacto-N-Neotetraose and 2′-Fucosyllactose into infant formulas represents a pivotal stride in optimizing child nutrition. This review offers a thorough exploration of recent research on HMOs, delving into their varied types, concentrations, and compositions, while emphasizing their profound impact on infant health and safety. By consolidating current research findings and recent progress, this study seeks to clarify the diverse effects of HMOs on different facets of human physiology, immune system maturation, modulation of gut microbiota, neurological functioning, and lifelong health implications. Emphasizing the pivotal role of HMOs in influencing human well-being from infancy to maturity, this review emphasize the necessity for continued research and potential utilization in clinical settings and nutritional science.

Oral Health Awareness and Oral Hygiene Practices among Married Women of Al-Ahsa, Saudi Arabia

Abstract Objective Awareness of mothers about oral health and their oral hygiene practices may benefit both maternal and infant oral health. This study assessed the oral health awareness and oral hygiene practices among married females. Materials and Methods A cross-sectional study was conducted on 430 females using a self-administered close-ended questionnaire that was distributed through WhatsApp application. Chi-squared test and t-test were applied with significance level of p-value less than or equal to 0.05. Results Three hundred and fifty-six females responded to the survey. Ninety percent women brushed their teeth daily, 52% used dental floss, and 58% used mouthwash. Seventy-nine percent patients visited a dentist when had a dental problem. Females more than or equal 75% think that dentist visit is important or consider it safe and 34% had visited the dentist during pregnancy. Sixty-eight percent women think that incidence of oral disease increases during pregnancy, and 42% agreed that oral disease affect the baby's oral health. Sixty-seven percent were aware that women could develop pregnancy gingivitis and 8% think that poor oral health can lead to birth of premature baby. Mothers with less than or equal to 10 years of married life have shown significantly (≤0.04) higher knowledge and good oral hygiene practices than other older mothers. Regression analysis showed a significant (p ≤ 0.035) relationship between incidence of oral disease in pregnancy with married life years; effect of oral disease on baby' health with age and occupation; use of dental floss with income and living area; knowledge of pregnancy gingivitis with number of children; effect of bad oral hygiene on pregnancy outcome with income; and dentist visit during pregnancy with married life years. Conclusion Females with higher education, less years of married life, and higher number of children were better aware of oral health and oral hygiene practices and its effect on their baby's oral health.

“It Doesn’t Have to Be All or Nothing”: How Individuals Who Use Infant Formula Understand the Breastfeeding Master Narrative

ABSTRACT Despite clinical recommendations, only 24.9% of infants in the United States are exclusively breastfed at 6 months of age, and women who use formula report facing stigma and feeling like a failure. Individual experiences are often influenced by master narratives such as “breast is best,” and stories can reveal how the discourse may manifest unintended effects, potentially eliciting guilt and shame, which are known to result in negative maternal mental outcomes, including depression and anxiety. The purpose of this research was to use a narrative framework to analyze the stories of women who used formula and determine how they interpreted the master narrative of “breast is best.” We conducted interviews with 20 women who had used formula within the first 6 months after giving birth and had an infant no older than 12 months at the time of the interview. Qualitative analysis revealed that women integrated “breast is best” into their stories, and that the master narrative influenced conceptions of themselves as mothers including the bonded mother, the good mother, the shameful mother, and, ultimately, the multitudinous mother. Participants who used formula within the first six months desired that messaging about breastfeeding, particularly in online spaces, move away from all-or-nothing framing and instead show the diversity of infant feeding experiences. It is important to consider how breastfeeding discourse evolves online, considering the unintended effect of stigma, its impact on mental health, and the potential for individuals interacting in these spaces to curate more nuanced narrative messaging about breastfeeding to improve maternal and infant health.

THE INFLUENCE OF INFORMATION SOURCES, AVAILABILITY OF FACILITIES, THE ROLE OF THE MIDWIFE AND THE ATTITUDE OF THE MOTHER ON MOTIVATION IN MONITORING THE GROWTH OF TODDLERS

Background: Nationally, the coverage of infant, toddler and preschool health services tends to decrease compared to 2021, this is due to the impact of the COVID-19 pandemic. Efforts to fulfill the main essential services for infants and toddlers are exclusive breastfeeding,Vitamin A and monitoring of growth and development. It can be seen that the percentage of toddlers monitored for growth and development in Indonesia in 2021 is 69.6%. Meanwhile, the 2021 Strategic Plan target is 70%. Failure to achieve the target of Visit Coverage Percentage of Toddlers whose growth and development are monitored as a result of theCOVID 19 pandemic. Purpose of writing: is to find out the influence of information sources, availability of facilities, the role of midwives and mothers; attitudes towards motivation in monitoring toddler growth and development in several regions in Indonesia. Research Methods: This study used a descriptive correlational method with a cross sectional design. The population in this study were all mothers who had toddlers. The dataanalysis used was univariate and bivariate analysis using the chi square test. Results: From the three regions, the results of the Chy Square test for the TPMB Gunung Sindur Kab. Bogor Value of Midwives Role Obtained p value 0.043 & 0.005 and Kalanganyer Public Health Center District. Lebak p value 0.034;0.005 Meanwhile, in the Mandala Health Center area, the results of the Pearson Chi-Square test for Information Sources obtained p = 0.032 and the Mother Attitude value obtained p = 0.001 , so that Ho was rejected and Ha was accepted, meaning that there is a significant influence between the roles of midwives, sources of information andMother Attitude in Monitoring the Growth and Development of Toddlers. Conclusions: By conducting this research, it is hoped that all mothers who have toddlers can be motivated to monitor the growth and development of their children, given the importance of monitoring children health in order to prevent stunting rates in toddlers.

Experiences, Opinions, and Use of Complementary and Alternative Medicine Among Alberta Midwives

Background: Complementary and alternative medicines (CAMs) are widely used by individuals in many parts of the world to treat different ailments and maintain good health. Midwives are maternity care providers who may recommend or provide CAMs to assist clients with their pregnancies and childbirth and the early neonatal health of infants. There are currently no provincial data on the recommendation and use of CAMs by Alberta midwives. Objectives: To describe the use, experiences, and opinions of Alberta midwives about CAMs, as well as their self-reported educational needs relating to CAM. Method: A descriptive cross-sectional survey was distributed to all midwives registered with the Alberta Association of Midwives. Result: The response rate to the survey was 23.7% and the completion rate was 82.7%. About 90% of the participating midwives recommended CAM, and 45.8% provided CAM very often to their clients. Client preferences and scientific evidence of efficacy were the most commonly stated reasons for recommending CAM. More than two-thirds (70.8%) of respondents believed that they lacked adequate CAM education. Conclusion: CAM was frequently recommended by the midwives who participated in this study. However, the majority of the participants indicated that they lack adequate knowledge and education in regard to CAM. Consequently, providing more CAM education opportunities for midwives may be justified. This article has been peer reviewed.

The effects of different positions on neurodevelopment in preterm infants admitted in neonatal intensive care units: a systematic review protocol

Introduction Preterm birth poses significant challenges to infant health, with neurodevelopmental outcomes often affected. In the Neonatal Intensive Care Unit (NICU), positioning strategies are commonly employed with the aim of mitigating adverse effects and promoting neurodevelopment in preterm infants. However, the evidence regarding the impact of different positions on neurodevelopmental outcomes remains heterogeneous and inconclusive. Objective The aim of this systematic review is to evaluate the effects of different positioning strategies on neurodevelopmental outcomes in preterm infants admitted to Neonatal Intensive Care Units (NICUs). Methods A comprehensive search will be conducted in electronic databases including PubMed, MEDLINE, EMBASE, and Cochrane Library. To comply with the established guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, the systematic review will be conducted to identify relevant studies published up to the date of the search. This systematic review protocol has been registered in PROSPERO to ensure thorough and transparent reporting of the search process, synthesis of findings, and analysis methods. Discussion In the context of preterm infants admitted to Neonatal Intensive Care Units (NICUs), the discussion surrounding the effects of different positions on neurodevelopmental outcomes is multifaceted and warrants careful consideration. Variations in study methodologies, including sample sizes, outcome measures, and follow-up durations, underscore the need for standardized approaches to facilitate comparison and synthesis of findings. The heterogeneity in reported outcomes, ranging from cognitive and motor development to sensory processing, highlights the complexity of neurodevelopmental assessment in this population and emphasizes the importance of comprehensive evaluation frameworks. Through rigorous synthesis and analysis of existing literature, our protocol aims to contribute meaningful insights that can drive future research agendas and enhance neurodevelopmental outcomes for this vulnerable population. Systematic Review Registration number CRD42023492163

Implementation and early effects of medicaid policy interventions to promote racial equity in pregnancy and early childhood outcomes in Pennsylvania: protocol for a mixed methods study

BackgroundThere are large racial inequities in pregnancy and early childhood health within state Medicaid programs in the United States. To date, few Medicaid policy interventions have explicitly focused on improving health in Black populations. Pennsylvania Medicaid has adopted two policy interventions to incentivize racial health equity in managed care (equity payment program) and obstetric service delivery (equity focused obstetric bundle). Our research team will conduct a mixed-methods study to investigate the implementation and early effects of these two policy interventions on pregnancy and infant health equity.MethodsQualitative interviews will be conducted with Medicaid managed care administrators and obstetric and pediatric providers, and focus groups will be conducted among Medicaid beneficiaries. Quantitative data on healthcare utilization, healthcare quality, and health outcomes among pregnant and parenting people will be extracted from administrative Medicaid healthcare data. Primary outcomes are stakeholder perspectives on policy intervention implementation (qualitative) and timely prenatal care, pregnancy and birth outcomes, and well-child visits (quantitative). Template analysis methods will be applied to qualitative data. Quantitative analyses will use an interrupted time series design to examine changes over time in outcomes among Black people, relative to people of other races, before and after adoption of the Pennsylvania Medicaid equity-focused policy interventions.DiscussionFindings from this study are expected to advance knowledge about how Medicaid programs can best implement policy interventions to promote racial equity in pregnancy and early childhood health.

The interplay between emotional and breastfeeding difficulties in first-time mothers

ABSTRACT Aim/Background Both mental maternal health and breastfeeding difficulties impact maternal and infant health. The present study analyses the association between psychosocial and breastfeeding variables and maternal mental health. Design/Methods The participants were 107 first-time mothers from Chile. Sociodemographic variables and breastfeeding difficulties were assessed at 6 weeks postpartum. Depression and anxiety symptoms, parental self-efficacy, and perceived social support were measured using validated, self-report questionnaires at 6 weeks and 5 months postpartum. This study is a secondary analysis of an intervention trial. Results 76% of the women reported having experienced some breastfeeding difficulty in the first postpartum weeks. The number of breastfeeding difficulties was associated with maternal mental health symptoms at 6 weeks postpartum and parental self-efficacy at both assessment times. Women who did not experience breastfeeding difficulties presented significantly fewer depressive (t(102) = 2.5, p = .015) and anxiety symptoms (t(50) = 2.3, p = .028) at 6 weeks postpartum than those who did. Mothers who exclusively breastfed at 5 months postpartum presented significantly higher parental self-efficacy (t(94) = 2.4, p = .044). A higher number of breastfeeding difficulties and low perceived social support contributed to higher depressive symptoms (R2 = .30; F(3,103) = 14.6, p < .001), anxiety symptoms (R2 = .32, F(3.103) = 17.27, p < .001) and lower parental self-efficacy at 6 weeks postpartum (R2 = .39; F(2,103) = 9.4, p < .001). Conclusion Breastfeeding difficulties and social support are associated with fewer mental health symptoms and higher parental self-efficacy during early postpartum in first-time mothers.

Adverse birth outcome among women who gave birth at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia

BackgroundIn Ethiopia, various maternal and child health interventions, including comprehensive and basic obstetric cares were conducted to curb high neonatal and infant morbidity and mortality. As such, adverse birth outcome has been a public health concern in the country. Thus, this study aimed to assess the burden and associated factors with adverse birth outcomes among women who gave birth at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.MethodsA health facility-based cross-sectional study was employed from 30 March to 01 May 2021 at the University of Gondar Comprehensive Specialized Hospital. A total of 455 women were interviewed using a structured questionnaire. A binary logistic regression model was fitted Adjusted Odds Ratio (AOR) with 95%CI and p-value < 0.05 were used to declare factors significantly associated with adverse birth outcomes.ResultsIn this study, 28% of women had adverse birth outcomes (8.4% stillbirths, 22.9% preterm births, and 10.11% low birth weights). Women aged 20–34) (AOR: 0.32, 95%CI: 0.14, 0.76), rural dwellers (AOR: 2.7, 95%CI: 1.06, 6.32), lack of ANC visits (AOR: 4.10, 95%CI: 1.55, 10.85), APH (AOR: 3.0, 95%CI: 1.27, 7.10) and fever (AOR: 7.80, 95%CI: 3.57, 17.02) were associated to stillbirths. Multiple pregnancy (AOR:7.30, 95%CI:1.75, 20.47), rural dwellers (AOR:4.60, 95%CI:1.36, 15.52), preterm births (AOR: 8.60, 95% CI: 3.88, 19.23), previous perinatal death (AOR:2.90, 95%CI:1.35, 6.24), fever (AOR:2.7,95%CI:1.17 ,6.23) and premature rupture of membrane (AOR:2.60, 95% CI:1.02, 6.57) were affecting low birth weights. In addition, previous antepartum hemorrhage (AOR: 2.40, 95%CI: 1.37, 4.10) and fever (AOR: 3.8, 95%CI: 2.13, 6.89) were also factors contributing to preterm births.ConclusionAdverse birth outcomes continue to pose a significant public health concern. Such high rates of adverse birth outcomes, such as preterm birth, low birth weight, and birth defects, can have serious and long-lasting effects on the health and well-being of both infants and their families, and the community at large. As such, public health efforts are crucial in addressing and mitigating the risk factors associated with adverse birth outcomes. This may involve implementing interventions and policies to improve maternal health, access to prenatal care and nutritional support, and reducing exposure to environmental risks.

The Significance of Providing the Optimal Micronutrients to the Preterm Low Birth Weight Infants to Prevent Long-Term Health Consequences

Premature infants have less nutritional storage capacity and an underdeveloped body, which makes them particularly susceptible to malnutrition. Nutrient surplus and deficiency are possibilities when supplemental feeding is unbalanced. However, little is known about what kids should eat once they are discharged from the hospital. Since many bodily processes depend on micronutrients, it&amp;apos;s critical to plan supplemental nutrition with an optimum consumption in mind. This written summary describes the requirements for long-chain polyunsaturated fatty acids (LCPUFA), iron, zinc, vitamin D, calcium, and phosphate for premature newborns receiving supplemental feeding. The scientific community is beginning to acknowledge the advantages of giving premature babies iron and vitamin D supplements. But as of right now, there isn&amp;apos;t enough information available to make firm recommendations about the addition of calcium, phosphorus, zinc, and LCPUFAs. Nonetheless, the health of premature infants depends on the following micronutrients: Large chain polyunsaturated fats (LCPUFAs) support the development of the retina and brain, while calcium and phosphorus dosages are necessary to prevent metabolic bone disease (MBD) in preterm infants. It is obvious how understanding the variability of the premature population may help adapt nutritional planning in connection to the development rate, comorbidities, and thorough clinical history of the preterm newborn, even while we wait for consensus on these micronutrients.

Modelling the dynamics of hand, foot, and mouth disease transmission through fomites and immigration

Hand, foot, and mouth disease (HFMD) is widely spread in China Mainland, seriously threatening the health of infants and young children. We develop a meta‐population model that includes both local and ecdemic populations to study the impacts of fomites and immigration on the transmission of HFMD in Shanghai. The model includes both direct transmission between susceptible and infected individuals (asymptomatic or symptomatic) and indirect transmission via fomites. The forward bifurcation shows that if the basic reproduction number is less than unity, the epidemic will die out; otherwise, the epidemic will spread. The fitting results show that the basic reproduction numbers of the local population and the ecdemic population are 1.4696 and 1.7288, respectively. Sensitivity analysis of the basic reproduction number showed that there was a high correlation between the basic reproduction number and the transmission rate of asymptomatic infected individuals, as well as the parameters related to the fomites (such as indirect transmission rate and virus shedding rate). Hence, asymptomatic infected individuals and fomites have a significant impact on the new HFMD infection. The numerical simulations on the prevention and control strategy show that reducing the transmission rate between susceptible and asymptomatic infected individuals or reducing the fomites can delay the outbreak of the epidemic and weaken the severity of HFMD. Our findings can provide guidance for the eradication of HFMD epidemic in the presence of indirect transmission and other factors.

Genetic Susceptibility, Mendelian Randomization, and Nomogram Model Construction of Gestational Diabetes Mellitus.

Gestational diabetes mellitus (GDM) is a pregnancy-complicated disease that poses a risk to maternal and infant health. However, the etiology of the disease has been not yet elucidated. To detect the genetic susceptibility and construct a nomogram model with significantly associated polymorphisms and key clinical indicators for early prediction of GDM. Eleven functional single nucleotide polymorphisms (SNPs) screened by genome-wide association study were genotyped in 554 GDM cases and 641 healthy controls. Functional analysis of GDM positively associated SNPs, multivariate mendelian randomization (MVMR), and a GDM early predictive nomogram model construction were performed. rs1965211, rs3760675, and rs7814359 were significantly associated with genetic susceptibility to GDM after adjusting age and prepregnancy body mass index (pre-BMI). It seems that GDM-associated SNPs have effects on regulating target gene transcription factor binding, posttranscriptional splicing, and translation product structure. Besides, rs3760675 can be expression quantitative trait loci and increase the XAB2 mRNA expression level (P = .047). The MVMR analysis showed that the increase of clinical variables of BMI, hemoglobin A1c (HbA1c), and fasting plasma glucose (FPG) had significant causal effects on GDM (BMI-ORMVMR = 1.52, HbA1c-ORMVMR = 1.32, FPG-ORMVMR = 1.78), P < .05. A nomogram model constructed with pre-BMI, FPG, HbA1c, and genotypes of rs1965211, rs3760675, and rs7814359 showed an area under the receiver operating characteristic curve of 0.824. Functional polymorphisms can change women's susceptibility to GDM and the predictive nomogram model based on genetic and environmental factors can effectively distinguish individuals with different GDM risks in early stages of pregnancy.

Development and validation of the Cannabis Exposure in Pregnancy Tool (CEPT): a mixed methods study

BackgroundEvidence of associations between prenatal cannabis use (PCU) and maternal and infant health outcomes remains conflicting amid broad legalization of cannabis across Canada and 40 American states. A critical limitation of existing evidence lies in the non-standardized and crude measurement of prenatal cannabis use (PCU), resulting in high risk of misclassification bias. We developed a standardized tool to comprehensively measure prenatal cannabis use in pregnant populations for research purposes.MethodsWe conducted a mixed-methods, patient-oriented tool development and validation study, using a bias-minimizing process. Following an environmental scan and critical appraisal of existing prenatal substance use tools, we recruited pregnant participants via targeted social media advertising and obstetric clinics in Alberta, Canada. We conducted individual in-depth interviews and cognitive interviewing in separate sub-samples, to develop and refine our tool. We assessed convergent and discriminant validity internal consistency and 3-month test–retest reliability, and validated the tool externally against urine-THC bioassays.ResultsTwo hundred fifty four pregnant women participated. The 9-item Cannabis Exposure in Pregnancy Tool (CEPT) had excellent discriminant (Cohen’s kappa = -0.27–0.15) and convergent (Cohen’s kappa = 0.72–1.0) validity; as well as high internal consistency (Chronbach’s alpha = 0.92), and very good test–retest reliability (weighted Kappa = 0.92, 95% C.I. [0.86–0.97]). The CEPT is valid against urine THC bioassay (sensitivity = 100%, specificity = 82%).ConclusionThe CEPT is a novel, valid and reliable measure of frequency, timing, dose, and mode of PCU, in a contemporary sample of pregnant women. Using CEPT (compared to non-standardized tools) can improve measurement accuracy, and thus the quality of research examining PCU and maternal and child health outcomes.

Environmental policies and infant health: Evidence from China

Environmental policies and infant health: Evidence from China

Insulinemic and inflammatory dietary patterns show enhanced predictive potential for gestational diabetes mellitus risk.

The putative association between proinflammatory and hyperinsulinemic dietary patterns and susceptibility to gestational diabetes mellitus (GDM) remains unclear. We aimed to compare the risk associated with the Mediterranean diet, as well as insulinemic and proinflammatory dietary patterns, in relation to the occurrence of GDM, and evaluate their predictive value. We prospectively followed 8, 495 women from the Maternal and Infant Health cohort in Hefei, China (2015-2021). Using a food frequency questionnaire, we calculated the Empirical Dietary Inflammatory Pattern (EDIP), the Empirical Dietary Index for Hyperinsulinemia (EDIH) score, and the Mediterranean diet (MD) score. GDM was diagnosed based on a 2-hour 75-gram oral glucose tolerance test conducted between 24 to 28 weeks of gestation. Logistic regression was used to estimate the risk of GDM, while Receiver Operating Characteristic (ROC) curves were constructed to evaluate the predictive performance of the empirical dietary index for GDM. Participants who followed hyperinsulinemic or proinflammatory dietary patterns to the greatest extent had a higher risk of developing GDM. The OR for the highest quartile compared to the lowest quartile were 1.39 (95% CI: 1.30-1.49) for EDIH and 2.40 (95% CI: 1.88-3.01) for EDIP. The OR for the lowest quartile compared to the highest quartile was 1.33 (95% CI:1.14-1.55)for MD. The ROC curve analysis indicated that the combination of EDIP and EDIH (AUC = 0.81, 95% CI: 0.78-0.82, P = 0.003) can effectively predict the occurrence of GDM. Utilizing both empirical dietary indexes, EDIP and EDIH, might offer a potentially more effective approach in preventing GDM when compared to solely focusing on adherence to the Mediterranean diet pattern.

Nutrition in immune defence, the role of milk and its natural components, a systematic review

Introduction: the World Health Organisation (WHO) stresses the fundamental importance of exclusive breastfeeding. This approach helps prevent diseases that cause infant mortality, while decreasing the risk of breast and ovarian cancer, diabetes, and heart disease and hypertension in women.Objective: to analyse the importance of maternal nutrition by studying the components of milk in order to prevent pathologies in the short term.Methodology: a systematic search was carried out by reviewing the literature in scientific databases such as Pubmed, Elsevier, Springer, Scopus, Scielo published in the last 5 years, considering significant contributions in the areas of paediatrics and neonatology, as well as theoretical approaches, with the aim of reflecting the controversies that arise around avoidable pathologies in exclusive breastfeeding.Results: breastfeeding provides essential nutrients and immunological components that strengthen infant health and protect against disease by offering benefits such as protection against infectious diseases and allergies, and promotes optimal cognitive development. Although breastmilk substitutes have improved, they cannot match its unique benefits. Conclusion: exclusive breastfeeding for the first six months is critical to the health of the newborn, providing essential nutrients and strengthening the immune system. Although breast substitutes have advanced, they cannot match the benefits of breastfeeding. The importance of promoting breastfeeding to improve infant health and prevent disease is emphasized