Infants And Young Children Research Articles

A 10-year (2014-2023) review of complementary food development in sub-Saharan Africa and the impact on child health.

Complementary foods (CFs) commonly consumed by infants and young children (IYC) in sub-Saharan Africa (SSA) are processed using either single or multi-grain ingredients through simple technologies such as fermentation, malting and roasting. Interestingly, CFs (e.g., ogi, kunu, and dabo) are prepared and fed to infants alongside breastmilk until they are completely weaned up to the infant's second birthday. The grains used for preparing CFs can be contaminated with bacterial and chemical contaminants as a result of poor harvesting, handling or storage practices. The stage at which IYC are introduced to CFs is of utmost importance as it aids in addressing malnutrition and improving their overall health and well-being. Complementary feeding practices across SSA are influenced by socio-economic, cultural and geographical factors such that improper introduction can result in dire health consequences including immune suppression, severe foodborne diseases, poor child growth and development, and sometimes death from malnutrition. Malnutrition often occurs from inadequacies of nutrient intakes and assimilation which affect the ability to maintain normal body functions such as growth, learning abilities, resistance to and recovery from diseases. In SSA, IYC malnutrition still poses an enormous concern, therefore indicating the need for intervention strategies such as the promotion of indigenous crops and elevating traditional knowledge and technologies for formulating CFs. This paper clearly highlights the diversity of CFs in SSA, ingredients utilized, processing techniques, contamination by bacteria and chemicals, and demonstrates the consequences of consuming contaminated CFs, and their influence on IYC health as well as approaches to ensuring safety and scaling up indigenous CFs.

Dietary Exposure of Infants and Young Children to Aflatoxins and Fumonisins in the East African Region: A Review

Proper supplementary nutrition is essential for nurturing and promoting the growth and development of Infants and Young Children (IYC). Poor food quality and safety during this critical period can result in malnutrition. Complementary foods (CF) commonly provided to IYC in East African countries often contain ingredients highly susceptible to mycotoxin contamination, particularly aflatoxins (AFs) and fumonisins (FBs). This narrative review sought to explore the contamination of infant diets with AFs and FBs, as well as the exposure of IYC to these toxins. The review covers the types of CF used in infant diets, their susceptibility to AFs and FBs contamination, associated dietary exposure, and detection methods, along with regulatory and mitigation strategies in the East Africa region. Studies revealed widespread contamination of staple crops with AFs and FBs, highlighting that IYC primarily encounter these toxins through the consumption of cereal-based CF, often supplemented with legumes and oily seeds. Maize and groundnuts emerge as the predominant ingredients in CF. Despite established regulatory limits for these toxins in food intended for the general population, no specific limits exist for IYC, who are particularly vulnerable due to their high consumption of the susceptible crops and relatively small body size. Limited enforcement of existing regulations, unfortunately, allows the problem to persist in these low-resource countries. Focusing on East Africa, this review synthesizes findings from scientific studies to assess the dietary exposure of children to AFs and FBs through CFs. The findings underscore the need for further research on the magnitude and effects of AFs and FBs exposure, coupled with awareness campaigns to promote the demand for clean and safe CF within the East African Community countries.

Cognitive Interviewing to Improve Infant and Young Child Dietary Assessments in the Nepal Demographic and Health Survey

BackgroundThe Demographic and Health Survey (DHS) is the primary source of nationally representative nutrition data for many countries and is important in shaping national nutrition policy, advocacy, and research. Without careful testing and adaptation to local contexts, findings are at risk of inaccurately representing respondents’ behaviors and key nutritional indicators. ObjectivesThis study used a cognitive interviewing approach to assess mothers’ comprehension, retrieval, judgment, and response to the infant and young child feeding (IYCF) dietary assessment module questions in the Nepal DHS-8 Woman’s Questionnaire. MethodsA cross-sectional qualitative study was conducted in December 2021, using semistructured cognitive interviews, among 54 mothers of children 6–23 mo of age across 3 regions of Nepal. Interviews were analyzed to identify issues in participant understanding of questions, as well as cognitive challenges or benefits of a longer introduction to the IYCF dietary assessment module, as compared with the original shorter introduction and challenges or benefits to using closed-ended compared with open-ended questions. ResultsCognitive challenges were identified, including issues with judgment of certain food categories resulting in misclassification, comprehension of certain concepts, and comprehension of certain instructions for the dietary assessment that resulted in the variability of food and liquids recalled by mothers. ConclusionsThese findings carry substantial implications for the measurement of the diet quality of infants and young children (IYC) in Nepal, and similar cognitive challenges may exist in other contexts. Although this current study is not able to answer the exact extent to which the accuracy and precision of IYCF indicators are affected by these cognitive challenges, these findings indicate that current measurements may be subject to over or underestimation and there is a need for further research in this area to understand the degree of measurement error related to these challenges.

Responsive Complementary Feeding Practices in Rural Muhanga District of Rwanda: A Mixed Methods Study

ABSTRACTBackgroundResponsive feeding among infants and young children (IYC) determines their food acceptance and adequate dietary intake, which enhances growth and developmental opportunities. However, little is known about responsive feeding practices among IYC in Rwanda. This study explored the status and barriers of responsive feeding practices among mothers from rural areas of Muhanga District in Rwanda.MethodThis descriptive longitudinal and exploratory mixed methods study was conducted among 29 mothers from 2 rural health centers in Muhanga District. Mothers were interviewed, and their interactions with children during lunch meals at 6, 9, and 12 months were observed. The interviews were recorded, transcribed, and thematically analyzed using Atlas.ti software.ResultsThe study shows that the number of mothers who reported to verbally encourage their children to eat during feeding increased with the child's age. Less than half of mothers, at all three time points of data collection (at 6, 9, and 12 months), reported and were observed allowing their children to self‐feed, smiling and talking to them during feeding. The perceived major barriers to mother–child interaction during feeding were lack of time due to the burden of other responsibilities, and poverty. In addition, fear of messing up and food waste were barriers to child self‐feeding opportunities.ConclusionFindings indicate that responsive feeding was less practiced among study mothers due to lack of time, poverty, and fear of food waste during child self‐feeding. Nutrition interventions in this community should consider raising awareness of responsive feeding practices through education and encouraging mothers to devote sufficient time to interact with their children during feeding episodes.

LMIC-16. PRE-IRRADIATION CHEMOTHERAPY AND DELAYED RADIATION THERAPY IN INFANTS AND YOUNG CHILDREN WITH WITH CENTRAL NERVOUS SYSTEM EMBRYONAL TUMOURS

Abstract BACKGROUND Established strategies for infants and young children(IYC) with embryonal tumours of the central nervous system(CNSET) - autologous stem-cell rescue(ASCT) and intraventricular chemotherapy(IVCT) – are not universally available. We report the outcomes of IYC with CNSET treated using the strategy of surgery, pre-irradiation chemotherapy and delayed radiation. METHODS Children <3years diagnosed with CNSET- medulloblastoma(MB), atypical teratoid/rhabdoid tumour(ATRT), embryonal tumour with multilayered rosettes(ETMR), CNS primitive neuroectodermal tumours(PNET)- and pineoblastoma(PB),underwent standard evaluation and staging, maximal safe excision, pre-irradiation chemotherapy(cyclophosphamide, etoposide and carboplatin;CEJ) upto 36months of age and either ris-adapted craniospinal with boost or focal irradiation. We performed a retrospective intention-to-treat outcome analysis. RESULTS Of 117children <3years with CNSET treated January2011- December2022, 72 were treated with this strategy.The median age was 25months (range6-35), 49males,histology medulloblastoma-42(58%), ATRT-9(12.5%), PNET-8(11.1%), ETMR-8(11.1%) and PB-5(6.8%); 23(32%) metastatic.The median chemotherapy cycles were 6(range 1-15). 36 children went on to receive RT; CSI in 33 (20standard-dose,13reduced-dose) and focal in 3. At last follow-up, 27children are in remission, 43 have relapsed/progressed (9 received salvage treatment) and 2 died due to chemotherapy toxicity. The 3-year and 5-year event-free-survival(EFS) are 35% and 3-year and 5-year overall-survival(OS) are 41.8% and 40.2%. The 3-year EFS/OS for MB are 51.1%/ 62.8%,PNET 25%/25%,ATRT 11.1%/11.1%,ETMR 12.5%/12.5% and PB 0%. Only metastasis was prognostic in medulloblastoma (HR 2;95% CI 0.86-4.6 for EFS and HR 1.7;95% CI 0.67-4.5 for OS); age, molecular group and histology were not prognostic. Long-term follow-up (n=17) documented >grade2 late effects in all (endocrine-16, neurocognitive-8, vision-3, hearing -8 and neurological-10). CONCLUSION The use of moderate-intensity pre-irradiation chemotherapy is feasible and effective in infants and young children with CNSETs. Despite inferior outcomes compared to ASCT or IVCT,this strategy could be used in resource-limited settings.

Identifying priority double-duty actions to tackle the double burden of malnutrition in infants and young children in Peru: Assessment and prioritisation of government actions by national experts.

Multiple forms of malnutrition coexist in infants and young children (IYC) in Peru. The World Health Organization has proposed double-duty actions (DDAs) to simultaneously address undernutrition and overweight/obesity. We assessed current implementation of- and priority for- government-level actions to tackle multiple forms of malnutrition in IYC in Peru. Mapping of current policy activity was undertaken against 47 indicators of good practice for five DDAs (exclusive breastfeeding, complementary feeding, food marketing, maternal nutrition, preschool nutrition; assessed by 27 indicators) and for the enabling policy environment, i.e., 'infrastructure support' (health in all policies, platforms for interactions, financing, monitoring, governance, leadership; assessed by 20 indicators). Interviews with 16 national experts explored views on the level of and barriers to implementation of DDAs and infrastructure support, as well as their prioritisation based on likely impact and feasibility. The level of implementation of actions was categorised into two groups (agenda setting/formulation vs. implementation/evaluation). Mean scores were generated for prioritisation of DDAs and infrastructure support. Deductive qualitative analysis was undertaken to identify barriers that influence policy implementation. Only 5/27 DDA indicators were reported as fully implemented by all national experts (international code that regulates the marketing of breastmilk substitutes, iron supplementation for IYC, micronutrient powders in IYC, iron/folic acid supplementation in pregnant women, paid maternity leave). Only 1/20 infrastructure support indicator (access to nutrition information) was rated as fully implemented by all experts. Barriers to implementing DDAs and infrastructure support included: legal feasibility or lack of regulations, inadequate monitoring/evaluation to ensure enforcement, commercial influences on policymakers, insufficient resources, shifting public health priorities with the COVID-19 pandemic and political instability. The experts prioritised 12 indicators across all five DDAs and eight infrastructure support indicators. Experts highlighted the need to improve implementation of all DDAs and identified ways to strengthen the enabling policy environment.

Designing intervention prototypes to improve infant and young child nutrition in Peru: a participatory design study protocol

IntroductionNutrition during the complementary feeding period (6–23 months) is critical to ensure optimal growth and reduce the risk of diet-related disease across the life course. Strategies to reduce multiple forms...

Benchmarking the nutrient composition and labelling practices of commercially produced ready-to-eat purées and meals for older infants and young children across seven Southeast Asian countries.

Commercially produced complementary foods (CPCF), including ready-to-eat CPCF purées and meals, are gaining popularity among caregivers of older infants and young children (IYC) as a convenient alternative to home-prepared foods in low and middle-income countries. However, there is growing concern regarding the suitability of these products for older IYC, as they can contain high levels of sugar and/or sodium. Given the rapidly evolving market in Southeast Asia, it is crucial to monitor the appropriate composition and promotion of CPCF in the region. This study examined the nutrient composition and labelling practices of CPCF purées and meals sold in 2021 in the capital cities of seven Southeast Asian countries: Phnom Penh (Cambodia), Jakarta (Indonesia), Manila (Philippines), Bangkok (Thailand), Vientiane (Lao PDR), Hanoi (Viet Nam), Kuala Lumpur (Malaysia). The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older IYC. The proportion of CPCF purées and meals that would require a high sugar front-of-pack warning based on the percentage energy from total sugar was also determined. Of the 459 CPCF purées/meals assessed, only 37.7% of the products met all nutrient composition requirements and none met all labelling requirements. In addition, most CPCF purées and meals were identified as having high total sugar content. To ensure that older IYC consume appropriate CPCF products, Southeast Asian countries need to implement and enforce regulations concerning the nutrient composition and labelling practices of CPCF purées and meals.

Benchmarking the nutrient composition and labelling practices of finger foods and snacks for older infants and young children across seven Southeast Asian countries.

Ensuring consumption of nutrient-dense, safe and appropriate complementary foods among older infants and young children (IYC) 6-36 months of age is critical for enabling optimal growth and development. The ubiquitous availability of and high demand for commercially packaged snack foods has culminated in a growing trend of snack food products specifically produced and promoted for older IYC. Commercially produced complementary foods (CPCF) that are finger foods/snacks often contain added sugars, excessive sodium content and high total sugar content, making them inappropriate for this young population. This study benchmarked the nutrient composition and labelling practices of CPCF finger foods/snacks available for purchase in seven countries in Southeast Asia. The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older IYC. Of the total 606 products identified, 8.2% were automatically categorized as not suitable because they were confectionery items. Of the remaining 556 products assessed, over 85% failed to meet all nutrient composition requirements, with the presence of added sugars/sweeteners and excessive sodium and total sugar contents the primary reasons for failure. Products also demonstrated concerning labelling practices, with all of the products (98.6%) displaying an inappropriate claim on the label. These findings reveal major concerns with the nutrient composition and labelling practices of CPCF finger foods/snacks in the SEA region and should serve as an alarm bell for regulatory action. National binding legal measures, such as mandatory standards for composition and labelling are urgently needed.

Sensory panel results of a dried fish powder supplement among caregivers and young children in Zambia.

To evaluate the acceptability of traditional Zambian dishes fortified with Complementary Food for Africa+Dried Fish Powder (ComFA+Fish), a locally sourced protein/micronutrient blend designed to impact nutrient deficiencies among infants and young children (IYC) and improve pregnancy and birth outcomes among women of reproductive age (WRA). During two sensory panels, caregivers evaluated: (1) the acceptability of four ComFA+Fish dishes for household consumption, including fortified chibwabwa fisashi, savory Kapenta chutney, fortified complementary maize porridge and fortified bean-vegetable soup and (2) whether their IYC found the fortified complementary maize porridge acceptable. Lake Kariba, Southern Province, Zambia. Women of reproductive age (n 42) and their IYC aged 6-11 months (n 16) and 12-23 months (n 26) were recruited from fishing villages in Gwembe, Siavonga and Sinazongwe District. A majority of caregivers extremely liked/liked the: (1) fortified chibwabwa fisashi's sensory attributes (94·7 %), convenience (92·8 %) and overall acceptability (100 %); (2) savory Kapenta chutney's sensory attributes (81·8 %), convenience (92·8 %) and overall acceptability (100 %); (3) fortified complementary porridge's sensory attributes (83·5 %), convenience (90·5 %) and overall acceptability (88·1 %) and (4) fortified bean-vegetable soup's sensory attributes (66·8 %), convenience (87·5 %) and overall acceptability (87·5 %). Further, a majority of caregivers evaluated the fortified complementary porridge as highly acceptable to their IYC. Results suggest that ComFA+Fish is strategically well placed to fill nutritional gaps among IYC and WRA in Zambia and has the potential to be scaled across sub-Saharan Africa.

Spatial variation and determinants of inappropriate complementary feeding practice and its effect on the undernutrition of infants and young children aged 6 to 23 months in Ethiopia by using the Ethiopian Mini-demographic and health survey, 2019: spatial and multilevel analysis.

Inappropriate complementary feeding practices (IACFPs) are major public health issues in Ethiopia, which usually result in stunting and becoming an intergenerational cycle. However, the spatial patterns and determinants of IACFP and its effect on undernutrition are not well understood in Ethiopia. Therefore, the aim of this study was to explore the spatial patterns and determinants of IACFPs and their effects on the undernutrition of infants and young children (IYC) in Ethiopia. This was a nationwide community-based survey study among 1,463 mothers of IYC aged 6-23 months in Ethiopia. The global spatial autocorrelation was assessed using the global Moran's-I to evaluate the spatial clustering of IACFPs. Significant clusters with high and low rates of IACFPs were explored. A multilevel mixed-effect logistic regression with cluster-level random effects was fitted to identify determinants of IACFPs with an AOR and 95% CI. The prevalence of IACFPs was 90.22%. The spatial pattern of IACFP in Ethiopia was clustered across regions (Global Moran's I = 0.63, Z-score = 12.77, value of p ≤0.001). Clusters with a high rate of IACFP were detected in southern, northwest, and eastern Ethiopia. Individual and community-level variables accounted for 63% of IACFP variation. Mothers with no education were 3.97 times (AOR = 3.97; 95% CI: 1.64-9.60) more likely to have IACFPs than those with higher education. The poorest HHs had 4.80 times the odds of having IACFPs as the richest HHs (AOR = 4.80, 95% CI: 1.23-18.71). The odds of having IACFPs were 2.18 times (AOR = 2.18; 95% CI: 1.28-3.72) higher among babies with no postnatal checkup. Non-breastfed IYC were 2.8 times (AOR = 2.80; 95% CI: 1.29-6.10) more likely to have IACFP when compared with breastfed ones. IYC with the inadequate introduction of solid, semi-solid, and soft foods, inadequate minimum dietary diversity, and inadequate minimum acceptable diet were more likely to have wasting, underweight, and stunting. This study showed the prevalence of IACFPs was very high, which had an effect on undernutrition and showed spatial variation in Ethiopia. Therefore, the government of Ethiopia and stakeholders should focus on women with no education and the poorest HHs, encourage PNC checkups, and encourage breastfeeding in the hotspot areas to minimize IACFPs in Ethiopia.

Changing maternal, infantand young child nutrition practices through social and behaviour change interventions implemented at scale: Lessons learned from Alive & Thrive.

Alive & Thrive (A&T) is an initiative designed to advance the implementation of maternal, infantand young child nutrition (MIYCN) social and behaviour change (SBC) at a large scale. The aims of this research were to: (1) describe A&T's SBC implementation processes and their impact based on a review of programme documents and peer-reviewed publications and (2) gather lessons learned from key informant interviews (N = 23) with A&T staff and stakeholders in Bangladesh, Burkina Faso, Ethiopia, India, Nigeriaand Vietnam. A&T's SBC approach used interpersonal communication, community mobilizationand mass media to address knowledge gaps, strengthen self-efficacyand shift social norms. The initiative used data for designand evaluation and facilitated scale and sustainability through close collaboration with governments and other stakeholders. A&T's approach increased exclusive breastfeeding, minimum meal frequency of childrenand use of iron and folic acid tablets by pregnant women, but had mixed impacts on early initiation of breastfeeding and maternal and child dietary diversity. Multiple SBC channels and frequent contacts strengthened the impact of SBC on MIYCN practices. Lessons learned included: using existing large-scale platforms for interpersonal communication, improving counselling skills of health workers, delivering timely tailored messages, engaging key influencers to take specific actions, using research to address underlying behavioural concerns and maximize mass media reach and frequency, using simple memorable messagesand employing additional channels to reach low media coverage areas. A&T developed and implemented at-scale MIYCN SBC in multiple countries, providing lessons learned about intervention strategies, engagement of influencersand mass media campaign development, which governments and other implementers can adapt and replicate.

Innovative approach to mitigate aflatoxin and micronutrient problems in complementary foods (CFs) for health and economic wellbeing

Complementary foods (CFs) provided to infants and young children (IYC) in sub-Saharan Africa contain ingredients that are susceptible to aflatoxin contamination. Chronic dietary exposure to aflatoxins is associated with serious health consequences. CF for thin porridge was developed by combining seven ingredients namely, finger millet, soya beans, orange fleshed sweet potato, cassava, breadfruit, baobab and moringa aiming to produce a nutrient dense and aflatoxin safe CF. The developed formulation was evaluated for safety with a focus on total aflatoxin and aflatoxin B1 and microbiological parameters, fibre and micronutrients especially iron and zinc. After passing safety test, the formulations (normal and instant porridge types) were evaluated for acceptability, cookability preference and market performance. The formulated product passed safety and overall quality tests. Market response was very good suggesting that more work should be undertaken in the direction of scale up and dissemination for wider availability and use. Children and persons of other ages can now use a highly nutritional quality and guaranteed aflatoxin safe product.

Infant and young child feeding practices and associated socioeconomic and demographic factors among children aged 6-23 months in Ghana: Findings from Ghana Multiple Indicator Cluster Survey, 2017-2018.

Association between poor infant and young child feeding (IYCF) practices and malnutrition in infants and young children (IYC) is well established. Furthermore, appropriate IYCF practices are important during the first 1,000 days of life to ensure optimal health and development. Understanding IYCF practices and associated socioeconomic and demographic factors will inform interventions to achieve the UN 2030 Sustainable Development Goal (SDG) target to end malnutrition in all forms. This study estimates the prevalence of Minimum Dietary Diversity (MDD), Minimum Meal Frequency (MMF), and Minimum Acceptable Diet (MAD), and examines their association with socioeconomic and demographic characteristics among children aged 6-23 months in Ghana. We used data from the Ghana Multiple Indicator Cluster Survey 6 (GMICS6) conducted in 2017-18. Participants were recruited through multi-stage stratified cluster sampling. Information on caregiver's self-reported breastfeeding status and 24-hour dietary recall of foods IYC were fed with were collected through face-to-face interviews. We estimated the prevalence of MDD, MMF and MAD with a 95% confidence interval (CI). We investigated the socioeconomic and demographic determinants of MDD, MMF and MAD using univariate and multivariable logistic regression analyses. Among 2,585 IYC aged 6-23 months, MDD, MMF and MAD were estimated as 25.46%, 32.82% and 11.72% respectively. Age of the IYC, educational status of the mothers/primary caregivers, and resident regions were found to have positive associations with MDD, MMF and MAD. In addition, the richest household wealth index and urban area of residence were found to have significant positive associations with MDD. We report a low prevalence of MDD, MMF and MAD. Efforts to improve IYCF practices among children aged 6-23 months in Ghana should focus on multi-sectorial approaches including increasing access to formal education, income-generating activities and addressing regional and rural-urban inequity.

Yingyangbao Reduced Anemia among Infants and Young Children Aged 6-23 Months When Delivered through a Large-Scale Nutrition Improvement Program for Children in Poor Areas in China from 2015 to 2020.

The purpose of this study was to assess the effectiveness of intervention with Yingyangbao (YYB) on hemoglobin (Hb) and anemia status among infants and young children (IYC) aged 6-23 months (mo) through a large-scale Nutrition Improvement Program for Children in Poor Areas (NIPCPA) in China from 2015 to 2020. Five rounds of cross-sectional surveys were conducted using a stratified and multi-stage probability proportional to size sampling of IYC in 2015, 2017, 2018, 2019 and 2020. Multivariable regression analyses were fitted to determine the effectiveness of the YYB intervention on Hb and anemia, respectively. A total of 36,325, 40,027, 43,831, 44,375 and 46,050 IYC aged 6-23 mo were included, and the prevalence of anemia was 29.7%, 26.9%, 24.1%, 21.2% and 18.1% in 2015, 2017, 2018, 2019 and 2020, respectively. Compared with the results in 2015, the Hb concentrations significantly improved and anemia prevalence significantly decreased among IYC in 2017, 2018, 2019, and 2020 (p < 0.001). Regression analysis showed that higher YYB consumption was significantly associated with the increment in Hb concentration and reduction in anemia stratified by age group (p < 0.001). The most significant increment in Hb concentration of 2.189 mg/L and the most significant reduction in odds of anemia were observed among IYC aged 12-17 mo who consumed 270 to 359 sachets of YYB (OR: 0.671; 95% CI: 0.627, 0.719; p < 0.001). This study suggests that YYB intervention is a successful public health strategy for reducing the risk of anemia among IYC when delivered through a large-scale NIPCPA in China. It is necessary to continue to advance the program and increase the adherence of YYB.

Feeding Homemade Sugar Sweetened Beverages in Addition to Breastfeeding: Survey Results from Caregivers of Infants and Young Children in Peri-Urban Lima, Peru.

Consumption of sugar sweetened beverages (SSB) is associated with childhood obesity and other negative health conditions. Feeding SSB to infants and young children (IYC) under 2years may displace consumption of breastmilk and nutrient rich foods critical for optimal growth and development. The World Health Organization (WHO) recommends avoiding added sugar (e.g. SSB) for IYC under 2years. We sought to describe the variety of homemade and commercial SSB as well as breastmilk and beverages without added sugar fed to IYC aged 4-23months living in a low-income, populous peri-urban area of Lima, Peru. A cross-sectional survey was conducted with 181 households with IYC aged 4-23months. A list of common local homemade and commercial beverages was used to investigate what caregivers had fed to the child in the past 24h. A total of 93.9% of caregivers reported feeding at least one beverage to their child other than breastmilk in the past 24h. This included a variety of homemade SSB (73.5%), commercial SSB (18.2%) and homemade beverages without added sugar (70.2%). A high percentage (83.4%) of children were also breastfed. Our findings suggest that interventions toaddress feeding homemade SSB to IYC within householdsare needed to support WHO recommendations and complement current commercial SSB policy regulations in Peru.

Yingyangbao Intervention Was Associated with the Improvement of Body Growth and Nutrition Status of Infants and Young Children in Poor Rural Areas of China: The Annual Comparison from 2012 to 2020.

Yingyangbao (YYB) is a soy-based micronutrient-fortified powder used in the Nutrition Improvement Project on Children in Poor Areas of China. After the baseline study in 2012, YYB intervention gradually spread to 21 provinces in China. From 2015 to 2020, a secular trend study was carried out to evaluate the body growth and nutritional status of 6-23-month-old infants and young children (IYC) under YYB intervention. The aim of this research was to investigate whether YYB intervention was associated with the improvement of body growth and development in large populations from broad areas with national and multi-year survey results. The anthropometric data collected in the baseline study and cross-sectional surveys were compared, and the correlation between YYB intake amount and body growth were analyzed. Compared with the results of the baseline study, the 6-23-month-old IYC under YYB intervention showed a significant increase in body weight, body length and Z scores since 2015, and the stunting rate decreased from 9.7% in 2012 to 5.3% in 2020. Significantly positive correlations were observed between the YYB intake amount and the body growth indicators. Therefore, YYB intervention was associated with the improvement of body growth and nutrition status of Chinese IYC. In the future, long-term and continuous efforts are still needed to further reveal the health benefits of YYB in depth.

Nutrient Profiles of Commercially Produced Complementary Foods Available in Burkina Faso, Cameroon, Ghana, Nigeria and Senegal.

The nutritional quality of commercially produced complementary food (CPCF) varies widely, with CPCF in high-income settings often containing excessive levels of sugar and sodium. Little is known about the nutritional quality of CPCF available in the West Africa region, despite their potential to improve the nutrition of infants and young children (IYC). This study evaluated the nutritional quality of CPCF available in five West African countries using the WHO Europe nutrient profiling model (NPM) and assessed their suitability for IYC based on label information. The proportion that would necessitate a "high sugar" warning was also determined, and the micronutrient (iron, calcium, and zinc) content was assessed against IYC-recommended nutrient intakes. Of the 666 products assessed, only 15.9% were classified as nutritionally suitable for promotion for IYC. The presence of added sugar and excessive sodium levels were the most common reasons for a product to fail the nutrient profiling assessment. Dry/instant cereals contributed the highest percentage of recommended nutrient intake (RNI) per serving. This highlights the need for policies to improve the nutritional quality of CPCF in West Africa, including labeling standards and the use of front-of-pack warning signs to promote product reformulation and clearly communicate nutritional quality to caregivers.

Sustainability and scalability of egg consumption in Burkina Faso for infant and young child feeding.

Malnutrition is a significant challenge to the health of women and children in Burkina Faso. Given the critical role of animal source food on the health of infants and young children (IYC), interventions continue to explore the potential for eggs to prevent malnutrition. Using data from the Un Oeuf intervention, which significantly increased IYC egg consumption, combined with quantitative and qualitative data from endline and 3-month follow-up, we explore the barriers and facilitating factors to IYC egg consumption and the sustainability and scalability of the intervention. Child egg consumption was high at follow-up in the Control, Partial, and Full Intervention arms (83.3, 88.2%, and 100, respectively). The Full Intervention arm had the highest mean number of eggs consumed (2.9, 2.6, and 5.7), which reflected a slight reduction from endline (6.2). All participants owned chickens at follow-up (100%), however, flock size varied. The Full Intervention arm had more chickens (mean 8.8) than the Control (5.1) or Partial Intervention (6.2) arms, which was a 50% reduction in below endline (18.5 chickens). Qualitative results indicate that chicken ownership, education about the nutritional value of eggs, and spousal support facilitated IYC egg consumption. Barriers included egg production, cultural taboos, and animal health. Motivational factors reported included the observed improvement in child health, increased availability of mothers' time, and mothers' financial independence. Knowledge sharing within the Full and Partial Intervention groups was widely reported, and the sustainability of IYC egg consumption was reinforced by accountability among mothers and to community leaders, flipbooks distributed during the project, and high motivation. Main findings indicate that mothers who received the full Un Oeuf intervention were able to overcome barriers to feeding their child an egg daily, were able to improve their livelihood, were motivated to continue feeding their child eggs, and saw the addition of eggs into the child's diet as sustainable. Future nutrition sensitive agriculture interventions should consider tailoring this approach for other LMIC contexts. Future research is needed to explore a possible threshold in the number of household chickens necessary to continuously feed a child an egg a day.

Missing data and other challenges in assessing inappropriate marketing of baby foods in the Russian Federation: a cross-sectional study

ObjectivesWe used the WHO draft nutrient profile model (NPM) to evaluate baby foods targeted at infants and young children (IYC) aged 6–36 months in the Russian Federation to assess their...