Introduction Of Bottle Feeding Research Articles

Early Nutrition and Risk of Type 1 Diabetes Mellitus - A Nationwide Case-control Study in Preschool Children

The evidence on the role of environmental factors in the development of type 1 diabetes is conflicting. Reducing potential bias and the variety of exposures we investigated the association between type 1 diabetes risk and nutritional and other environmental exposures in preschool children. This nationwide case-control study included 760 cases newly diagnosed with type 1 diabetes under five years of age during 1992-1995. 630 controls of the same age were selected from the case families' acquaintance. Information on infant diet, foetal, perinatal and socio-economic factors, and family history of diabetes was obtained by a parent-administered questionnaire. Data were analysed by multiple unconditional logistic regression. Duration of breastfeeding and age at introduction of bottle-feeding were inversely associated with type 1 diabetes risk according to a dose-response relationship (trend test p<0.05). Adjusted odd ratios (95%-CI) for a short breastfeeding period and an early introduction of formula feeding (<5 vs. > or =5 months) were 1.31 (1.01-1.69) and 1.34 (1.03-1.74), respectively. Familial type 1 diabetes was found more frequently among diabetic than among control children. Higher social status, late introduction of solid food (> or =5 month), and higher current cow's milk consumption (> or =200 ml/d) were associated with a reduced diabetes risk. A considerable proportion of the diabetic risk among preschool children was explained by modifiable exposures. Our findings indicate that infant feeding is causally associated with type 1 diabetes risk and that a considerable part of new type 1 diabetic cases is potentially preventable.

Assessment of the performance of Pastoral de Criança, a health support group, in promoting child survival and health education in Criciúma,a city in southern Brazil

Thousands of children younger than 5 years of age still die all over the world as a result of preventable diseases. Community intervention measures emphasizing primary health and nutritional care have been identified as one of the solutions to this problem. This article describes a population-based cross-sectional study of the Pastoral da Criança, a Roman Catholic health support group in Brazil. The study assesses whether mothers and children assisted by the Pastoral present better health indicators and have a better knowledge of basic child survival actions than non-assisted mothers and children. The study was carried out in 1996 in an urban area of the municipality of Criciúma, in the state of Santa Catarina, in southern Brazil. The sample was composed of 2,208 children under 3 years of age. The adjusted analysis taking into consideration possible confounding factors showed that the presence of the Pastoral was significantly associated with maternal knowledge of appropriate feeding measures during diarrheal episodes, optimal duration of exclusive breast-feeding, implications of feeding powdered milk to infants, correct interpretation of the infant growth curve, and knowledge of the proper vaccination schedule for infants. Participation in the Pastoral was positively associated with longer total breast-feeding duration, later introduction of bottle-feeding, higher frequency of growth monitoring visits in the quarter before the study, and availability in the home of measuring spoons for oral rehydration. No significant association was found between participation in the Pastoral and duration of predominant or exclusive breast-feeding, or correct diarrhea management. The results showed Pastoral actions have a positive effect and also revealed areas in which greater investments are needed. It is recommended that the Pastoral, as well as other similar institutions, give priority to educating mothers on child care and to recruiting mothers early in pregnancy, when the impact of these actions is potentially greater.

Use of pacifiers and breastfeeding duration.

Pacifiers are widely used in many developing countries. Although their use is not recommended for breastfeeding infants, there have been no published reports on the association between pacifier use and risk of early weaning. In a study of 354 infants in Brazil, mothers were asked about pacifier use at age 1 month, duration of breastfeeding, and introduction of other foods. Among 249 children still breastfed at 1 month, the risk that a child would be weaned at any age between 1 and 24 months was higher in pacifier users than in non-users (hazard ratio 3.0, 95% CI 2.0-4.6). The association remained even after adjustment for the child's age, sex, birthweight, socioeconomic status, and age at introduction of bottle-feeding.

Infant feeding practices among patients of pediatricians and general practitioners.

In an attempt to document the infant feeding practices among patients of pediatricians and general practitioners, a study was carried over a period of one month and data of 10,374 infants were recorded using a pre-printed proforma marked by a simple 'tick' for each patient. The results showed: (i) initiation of breastfeeding was delayed in nearly half of the cases beyond 24 hours; (ii) introduction of bottle feeding in more than half of infants by the age of 4 months and (iii) introduction of solid foods later than eight months in almost half of infants. While breastfeeding is practised by 78% of women, only one in five practice exclusive breastfeeding till 4-6 months, and very few avoid bottle feeds. Much education and change in behaviour is needed if optimal benefit of breastfeeding in India is to be realised.

Determinants for Breast Feeding and Bottle Feeding in Botswana

In the Botswana Primary Health Care Survey 1983-84 data on breast and bottle feeding were collected as well as characteristics of households, mothers, and children. The country-wide median breast-feeding duration was 1 year and 7 months, with a tendency towards shorter duration in the urban areas. Better hygienic conditions, higher education of the mother, and wage employment of the mothers were associated with shorter breast-feeding duration. Similarly, the risk of starting bottle feeding was higher in households with better hygienic conditions. However, a substantial proportion of the bottle feeding took place in households lacking piped water indoors. These data may indicate a current shift from traditional feeding patterns towards shorter breast feeding and introduction of bottle feeding, starting among well-off families, but also threatening the health of children in less privileged conditions. The association with maternal factors such as type of occupation calls for breast feeding promotion including improved conditions for the salary employed mothers.

Socio-economic, dietary, and cultural factors associated with diarrhoeal disease in Trinidad and Tobago.

A survey was conducted in Trinidad among mothers with children hospitalized with diarrhea and matched controls (30 in each group) to investigate socioeconomic dietary and knowledge attitude-practice factors relating to diarrhea. Anthropometric measurements showed that 10% of children of both groups were below normal limits for weight for length. There were consistent trends to lower birth weight and earlier introduction of bottle feeding among these cases. Over 1/2 the mothers withheld some or all food from the child during an episode of diarrhea and 1/3 also reduced fluid intake. Both practices need to be strongly discouraged. Immediate measures are needed to protect young children at risk of diarrheal disease in Trinidad and Tobago. Priority should be given by both the public and the medical profession to the following health education practices: protection via the strong encouragement of breastfeeding and discouraging of bottle feeding; and early treatment through provision of oral rehydration therapy in the community to prevent serious dehydration and quickly restore the childs appetite. (authors modified)

Infant Feeding and Health in Ibadan

Infant feeding and health in Ibadan Nigeria is examined. Money is being wasted in Nigeria by the introduction of bottle feeding during the early months when breastfeeding is in most cases adequate. The infant is exposed to diarrheal diseases through artificial feeding under conditions of poor sanitation in the home. There are few comprehensive studies of milk feeding in Nigeria. A study undertaken in Ibadan by the Food and Science and Applied Nutrition Unit of the University showed the differences in practice between middle class and illiterate mothers in infant feeding. The following were among the study findings: 1) breastfeeding has declined markedly as the exclusive method of feeding young infants with only 25% of Ibadan mothers feeding their children entirely on the breast; 2) only 1 mother out of the 500 studied used bottle feeding exclusively; 3) 95% of the mothers who combine breast and bottle feeding believed that they were advised to do so by nurses midwives or physicians; 4) the price of packaged milks set against low incomes led many mothers to use milks far below the recommended quantities for each feed; 5) most mothers stopped bottle feeding by 12 months but breastfeeding tended to continue for 18 months to 2 years; 6) most of the children even up to age 4 were being given pap daily and up to age 1 year there was virtually no usage of animal proteins; 7) the father played a major role in the choice and purchase of food and medicine for the child; and 8) the introduction of a protein rich packaged food is under consideration by commercial companies. Weaning has now become more gradual with solids being introduced from the age of about 6 months. The poorly nourished child of 6 months and older has a lower growth rate and a lowered resistance to infectious diseases. Children who are poor in Ibadan are undernourished although there is no evidence of widespread starvation in the community. The primary causes of infant malnutrition are poverty ignorance and too ready acceptance of bottle feeding in partial replacement of breastfeeding.