Introduction Of Complementary Foods Research Articles

Introduction of complementary feeding: analysis of practices and factors that influence parental decisions

The World Health Organization (WHO) recommends that mothers exclusively breastfeed their infant for the first six months to achieve optimal growth and development. In addition, children should receive nutritious complementary foods and continue to breastfeed until age two years or older. Several factors still greatly influence the introduction of complementary feeding (ICF). Thus, this research aimed to analyze whether parents perform the appropriate ICF for their children. This survey used a questionnaire prepared via Google Forms®, with 58 participants, 100% women with 28 years old on average. Exclusive breastfeeding (EBF) until the sixth month was reported by 51.7% of the interviewees. Based on feeding characteristics, 69% started introducing food at six months old. Regarding early ICF, infant formula was the most offered food (36.2%). Foods such as crackers, stuffed biscuits, sugar, fruit juice, and cow's milk were offered early to children younger than 24 months. The lack of information, the economic factor, time concerning work, and practicality were the factors that interfered with the introduction of food to children. The importance of professional nutritionists in raising awareness among parents is highlighted, transmitting confidence and aiming at an adequate introduction of complementary foods.

The association between complementary feeding practice and linear growth faltering among Cambodian children: an analysis of the 2014 Cambodia Demographic and Health Survey

Background Inappropriate complementary feeding is a factor contributing to linear growth faltering in early childhood. We aimed to assess complementary feeding practice and investigate its association with linear growth faltering among children aged 6 to 23 months among children aged 6-23 months in Cambodia. Methods This study is a secondary data analysis of the 2014 Cambodia Demographic and Health Survey (CDHS). Multivariable linear regression analysis was used to investigate associations between complementary feeding practice and linear growth faltering as length-for-age z-scores (LAZ), adjusted for all covariates. Results This study included 1381 children aged 6 to 23 months. The prevalence of age-appropriate complementary feeding practice was low in Cambodia. Only 23% of the children met all three criteria of minimum dietary diversity, minimum meal frequency, and age-appropriate breastfeeding. Approximately 30% of children aged 6 to 11 months met the minimum dietary diversity requirements and less than 40% of children aged 18 to 23 months were provided breastfeeding after the introduction of complementary food. This study found that there is no relationship between food diversity and feeding frequency and child linear growth. However, the provision of both complementary food and breast milk was independently and negatively associated with linear growth (β-Coefficient=-0.38, 95% confidence interval, CI=-0.60, -0.16). Positive effects on child linear growth, after controlling for all covariates, included the richer (β-Coefficient=0.36, 95% CI=0.07, 0.66) and richest (β-Coefficient=0.50, 95% CI=0.20, 0.79) quintiles of households, as well as appropriate water treatment before drinking (β-Coefficient=0.22, 95% CI=0.05, 0.40). Conclusions Most Cambodian young children aged 6 to 23 months received inappropriate complementary feeding. This study suggests that from the time of conception there is a necessity to improve maternal and child nutrition educational intervention for mothers, including feeding and hygiene practices.

Feeding Practices and Dietary Diversity in the First Year of Life: PreventADALL, a Scandinavian Randomized Controlled Trial and Birth Cohort Study

BackgroundBreastmik is considered the optimal source of nutrition in early infancy. However, recommendations and practices for when and how complementary food should be introduced in the first year of life vary worldwide. Early introduction of allergenic foods may prevent food allergies, but if early food introduction influences infant feeding practices is less known. ObjectivesWe sought to assess infant feeding practices in the first year of life and to determine if early interventional food introduction influences breastfeeding and dietary diversity. MethodsDietary intake was assessed in infants from the population-based clinical trial Preventing Atopic Dermatitis and ALLergies (PreventADALL) in children study. A total of 2397 infants were cluster-randomized at birth into 4 different groups: 1) control, 2) skin intervention, 3) introduction to 4 allergenic foods between 3 and 4 mo of age: peanut, cow milk, wheat, and egg, as small tastings until 6 mo, and 4) combined skin and food interventions. Dietary data were available from at least one of the 3-, 6-, 9-, and 12-mo questionnaires in 2059 infants. In the present analysis, groups 1 and 2 constitute the No Food Intervention group, whereas groups 3 and 4 constitute the Food Intervention group.We used the log-rank test and Cox regression to assess the impact of food intervention on age of breastfeeding cessation. Mixed effects logistic regression was used to compare dietary diversity, defined as the number of food categories consumed, between intervention groups. ResultsAt 3, 6, 9, and 12 mo, 95%, 88%, 67%, and 51% were breastfed, respectively, and breastfeeding duration was not affected by the food intervention. In the No Food Intervention group, mean age of complementary food introduction was 18.3 wk (confidence interval [CI]: 18.1, 18.5). In the Food Intervention group, the dietary diversity score was 1.39 units (CI: 1.16, 1.62) higher at 9 mo (P < 0.001) and 0.7 units (CI: 0.5, 0.9) higher at 12 mo (P < 0.001) compared to the No Food Intervention group. ConclusionsEarly food intervention did not affect breastfeeding rates and increased dietary diversity at 9 and 12 mo.

Maasai mother's knowledge on complementary feeding practices and nutritional status of children aged 6-24 months in Monduli District, Arusha, Tanzania: A case study of Naitolia village.

Despite Tanzania's achievement in reducing childhood problems, undernutrition is still a problem. Little is known about how mothers' knowledge on complementary feeding practice affects their children nutritional status. Therefore, the study determined how nutritional status of Maasai children aged 6-24 months is related to their mothers or caregivers' knowledge on complementary feeding. A semistructured questionnaire was used in analytical cross-sectional study including 286 Maasai mothers and their 6-24-month-old children. A convenient and snowball sampling were employed in choosing households and mothers. Using SPSS version 20 and ENA for SMART software, demographic variables, mother's complementary feeding knowledge and practices, and anthropometric data were examined. Respondents were mostly young female aged 29 ± 9.5 years, married (89.2%), housewives (88.8%), with no formal education (39.1%). Maasai mothers (51.1%) introduced complementary foods at 4 months. Of all children, 75.2% did not attain minimum acceptable diet, whereas 66.1% and 57.3% did not meet minimum number of meals per day and recommended variety of foods, respectively. Based on complementary feeding practices, underweight was associated with timely introduction of complementary foods (p = .000), minimum dietary diversity (p = .001), and minimum acceptable diet (p = .001). Stunting was associated with minimum acceptable diet (p = .0027). Regarding mother's knowledge, underweight was associated with breastfeeding duration (p = .000) and meals adequacy (p = .014). Wasting was associated with breastfeeding duration (p = .027). Maasai mothers' weaning practices were unsatisfactory and children's nutritional status was poor. Children's nutritional status was significantly associated with mother's understanding on complementary feeding, which was only somewhat adequate.

Effects of early introduction of solid foods on nutrient intake in preterm infants during their 1st year of life: a secondary outcome analysis of a prospective, randomized intervention study.

ClinicalTrials.gov: NCT01809548.

Breastfeeding practices in Northeast China in 2008 and 2018: cross-sectional surveys to explore determinants over a decade

BackgroundThis study was conducted to investigate the prevalence and determinants of breastfeeding in 2008 and 2018, respectively, in Northeast China, where health service efficiency is at the lowest national level and regional data on breastfeeding are lacking. The influence of early initiation of breastfeeding on later feeding practices was specifically explored.MethodsData from the China National Health Service Survey in Jilin Province in 2008 (n = 490) and 2018 (n = 491) were analysed. Multistage stratified random cluster sampling procedures were used to recruit the participants. Data collection was conducted in the selected villages and communities in Jilin. Early initiation of breastfeeding was defined as the proportion of children born in the last 24 months who were put to the breast within one hour after birth in both the 2008 and 2018 surveys. Exclusive breastfeeding was defined as the proportion of infants 0–5 months of age who were fed exclusively with breast milk in the 2008 survey; while defined as the proportion of infants 6–60 months of age who had been fed exclusively with breast milk within the first six months of life in the 2018 survey.ResultsThe prevalence of early initiation of breastfeeding (27.6% in 2008 and 26.1% in 2018) and exclusive breastfeeding during the first six months (< 50%) were low in two surveys. Logistic regression revealed that exclusively breastfeeding at six months was positively associated with early initiation of breastfeeding (OR 2.65; 95% confidence interval (CI) 1.65, 4.26) and negatively associated with caesarean section (OR 0.65; 95% CI 0.43, 0.98) in 2018. Continued breastfeeding at one year and timely introduction of complementary foods were associated with maternal residence and place of delivery, respectively, in 2018. Early initiation of breastfeeding was associated with mode and place of delivery in 2018 but residence in 2008.ConclusionBreastfeeding practices in Northeast China are far from optimal. The negative effect of caesarean section and positive effect of early initiation of breastfeeding on exclusive breastfeeding suggest that an institution-based approach should not be substituted by the community-based one in the formulation of breastfeeding strategies in China.

Дитина-малоїжка на прийомі в педіатра

The review article provides data from modern approaches to diagnosis and correction of behavioral eating disorders, that tend to occur in preschool children. Purpose - to consider the algorithm of pediatrician’s actions in the case of preschool children eating difficulties; to point out the main ways to prevent from development of child’s health negative consequences. Basic principles of eating behaviour disturbances were analyzed. The main factors, that affect the establishment of child eating behaviour are pregnant woman nutrition, influence of genetic factors and breastfeeding in early childhood. Malnutrition and loss of appetite among the preschool children with a lack of timely detection and due correction lead to negative consequences for children’s health and development, associated with chronic nutriet deficiency. Pediatrician algorithm of actions to manage preschool children eating difficulties includes the estimation of physical development, excluding of internal organs pathology, central nervous system and neuropsychiatric disease. Nutritional anamnesis should comprise information about child’s nutrition from the moment of birth: composition and method of feeding, age of complementary food introduction, food tolerance and manifestation of unusual eating behaviour at this time. Conclusions. When parents visit a pediatrician with complaints about difficulties in feeding a preschool child, it is necessary to calmly and thoroughly analyze the child’s behaviour, general physical condition and eating habits, and, based on this, determine the possible reasons why the child has no appetite. This will determine what to do with the “starving” child, and whether it is need to do anything at all. The main rules that will help to form healthy eating behaviour in children are the formation of healthy eating habits and the development of healthy lifestyle skills in the child’s family, a full and varied diet, nutrition, regular exercise and outdoor walks. Treatment should be comprehensive and focus primarily on the psychological side of the problem, with nutritional correction as needed. No conflict of interests was declared by the authors.

Are Complementary Feeding Practices Aligned with Current Recommendations? A Narrative Review.

The complementary feeding introduction period (introduction of solid foods alongside breastmilk or formula) is defining in children's health; however, it appears that many parents do not follow complementary feeding guidelines. Our aim was to describe current parental feeding practices during complementary feeding in relation to current recommendations and explore determinants of adherence to guidelines. We included any relevant studies published within the last decade in French or English and summarized findings by recommendation category. The timing of complementary food introduction varied widely across and within continents (earlier in North America and often delayed in Asia). The introduction of allergenic foods tended to be delayed globally. Although some parents now begin complementary feeding with solid foods (i.e., baby-led weaning), delayed introduction of lumpy textures was still prevalent in the United States and in Europe. The consumption of iron-rich foods was predominantly low in Africa. Added sugars were globally introduced early, especially in America. Evidence for the prevalence of responsive feeding practices among parents is unclear due to the small number of studies. Determinants of complementary feeding practices included parental characteristics, such as age, education, socio-economic status, and race/ethnicity. Interventions aiming to increase adherence to complementary feeding guidelines must account for parental characteristics.

Introduction of Complementary Foods and the Risk of Sensitization and Allergy in Children up to Three Years of Age.

Allergy is known to be influenced by both diet and the immune system. In addition, the time of first exposure to food allergens and their type appear to play a particularly important role in the development of allergies. To determine the influence of the time of exposure, and the type, degree of processing, and frequency of supply of complementary foods and the development of sensitization and allergies in children up to three years of age. Materials and metods: The study was conducted prospectively in two stages. The first stage included 106 children aged 6-18 months, while the second stage included 86 children selected from the first stage, after a further 12 months. A questionnaire based on validated FFQ sheets was created for the purpose of the study. The following were assessed: nutrition in the first year of life (time, type, degree of processing), frequency of supply of complementary foods and allergic symptoms, sIgE concentration against 10 foods and 10 inhalant allergens. Four groups of patients were formed. This paper presents the results of the second stage of the study. For all participants, allergenic products, viz. hen's egg, milk, peanuts, wheat, soybean, fish, tree nuts and shellfish were typically introduced at an age of 7 to 12 months. During this period, egg white was introduced in 47 (85.5%) children with allergy (p = 0.894), in 29 (82.9%) with allergy and sensitization (p = 1.00), and in 38 (82.6%) children with sensitization alone (p = 0.533). Milk was introduced at 7 to 12 months in 35 (64.8%) children with allergy (p = 0.64), 22 (64.7%) with both allergy and sensitization (p = 0.815), and 26 (57.8%) children with sensitization alone (p = 0.627). For other foods, the time of introduction appeared not to significantly influence the presence of allergies or sensitization. Heat-treated peanuts were introduced significantly more often to children without allergies and without sensitization (n = 9; 56.2%) than those without allergies but with sensitization (n = 6; 54.5%) (p = 0.028). Fish was consumed significantly more often by children with allergies, i.e., 1-3x/week (n = 43; 79.6%) than children without allergies, i.e., 1-3x/month (n = 9; 30%) (p = 0.009). No relationship was observed between the introduction time of complementary foods, including allergenic ones, or their type, and the development of allergies and sensitization in children up to three years of age. The degree of processing and the frequency of supply of products may affect the development of allergies and sensitization.

The Influence of Applying the Baby-Led Weaning (BLW) Method in the Feeding of Complementary Feeding in Infants

Baby-Led Weaning is a method to introduce complementary foods to babies aged 6 months or older. Weaning or the introduction of complementary foods of breast milk can be a major role in the future growth and health of the baby. This research design uses the Literature Review method. The articles were obtained from keyword searches in the Google Scholar, Pubmed and Scient Direct databases with publications ranging from 2018-2022 in English. The results of the study which are in accordance with the inclusion state that the Baby-Led Weaning method is very influential in giving MP-ASI from an early age to infants. The results of the analysis of 5 journals found that the use of the baby Led Weaning method affects nutritional intake, oral motor development, and body weight, besides that it affects the duration of feeding and even affects the incidence of choking.

Antenatal and perinatal service delivery associations with breastfeeding outcomes in Nepal: Analysis of the 2016 Nepal Demographic and Health Survey

Infant and Young Child Feeding (IYCF) breastfeeding guidelines of the World Health Organization (WHO) have been promoted in Nepal since the early 1990s. This study investigated whether antenatal and perinatal service delivery in Nepal are associated with early initiation of breastfeeding and age-appropriate feeding practice (exclusive breastfeeding to six months; introduction of complementary foods at six months with continued breastfeeding to two years). Data from the 2016 Nepal Demographic and Health Survey (NDHS) were analysed using multivariable logistic regression. The unit of analysis was an interviewed woman and her last-born child aged 0-23 months. We examined number of antenatal visits, place and type of delivery, infant-mother skin-to-skin contact post-delivery, and breastfeeding observation and counselling by a healthcare provider within two days post-delivery. Of 1938 mother-infant dyads, 1073 (55.4%) commenced breastfeeding within one hour of delivery and 1665 (85.9%) were engaged in age-appropriate feeding. Breastfeeding within one hour of delivery was associated with infants delivered vaginally (aOR: 4.76, 95% CI: 2.96-7.65), infant-mother skin-to-skin contact post-delivery (aOR:2.10, 95% CI: 1.63-2.72) and observation of breastfeeding by a healthcare provider within two days post-delivery (aOR: 1.58, 95% CI: 1.20-2.08). Age-appropriate feeding was lowest amongst mothers with infants aged 4-5 months (40.8%) compared to those with infants aged 0-1 month (aOR: 0.158, 95% CI: 0.083-0.302). Antenatal and perinatal service delivery were not significantly associated with age-appropriate feeding. Further promotion of infant-mother skin-to-skin contact post-delivery (including after caesarean delivery) and observation of early breastfeeding may increase the rate of breastfeeding within one hour of delivery. Promotion of exclusive breastfeeding in antenatal and perinatal services and additional postnatal support should be considered to increase exclusive breastfeeding of infants to six months. These improvements may be achieved through enhanced implementation of the Baby Friendly Hospitals Initiative and effective training and sufficient practice for skilled birth attendants.

The big squeeze: a product content and labelling analysis of ready-to-use complementary infant food pouches in Australia

BackgroundEncouraging the early development of healthy eating habits prevents diet-related chronic disease. It is well understood that highly processed foods with high amounts of sugars, salt and fats are a risk factor for non-communicable diseases. Commercial baby foods in ready-to-use squeeze pouches emerged in the global food market around 2012. The long-term effects of this now ubiquitous packaging on the quality of infant diets, baby food consumption and marketing are unknown. This study aimed to conduct a rigorous mixed-methods audit of squeeze pouches in Australia to inform product regulation and policy.MethodsNutritional and marketing data were sourced from products available in Australian retailers. Analysis of nutritional content, texture and packaging labelling and serving size was conducted. Pouches were given a Nutrition Profile Index (NPI) score and compared with the Australian Infant Feeding Guidelines. Marketing text was thematically analysed and compared to existing infant nutrition policy around regulation of marketing claims.Results276 products from 15 manufacturers were analysed, targeting infants from 4 + to 12 + months. Total sugar content ranged 0.8-17.5 g/100 g, 20% (n = 56) of products had added sugars, 17% (n = 46) had added fruit juice, 71% (n = 196) had added fruit puree. Saturated fat content ranged from 0.0 to 5.0 g/100 g, sodium 0.0-69 mg/100 g and dietary fibre 0.0-4.3 g/100 g. Only two products were nutritionally adequate according to a nutrient profiling tool. Marketing messages included ingredient premiumisation, nutrient absence claims, claims about infant development and health, good parenting, and convenience. Claims of ‘no added sugar’ were made for 59% of pouches, despite the addition of free sugars.ConclusionsSqueeze pouch products available in Australia are nutritionally poor, high in sugars, not fortified with iron, and there is a clear risk of harm tothe health of infant and young children if these products are fed regularly. The marketing messages and labelling on squeeze pouches are misleading and do not support WHO or Australian NHMRC recommendations for breastfeeding or appropriate introduction of complementary foods and labelling of products. There is an urgent need for improved regulation of product composition, serving sizes and labelling to protect infants and young children aged 0–36 months and better inform parents.

Quality of systematic reviews on timing of complementary feeding for early childhood allergy prevention

BackgroundOnly rigorously prepared analyses can provide the highest level of evidence to inform decision-making. Several recent systematic reviews (SRs) examined the hypothesis that the early introduction of specific allergenic complementary foods (CFs) to infants may lead to a lower incidence of one or more allergic outcomes. However, the methodological rigour and quality of reporting of SRs in this area has not yet been systematically evaluated.MethodsWe comprehensively searched PubMed, Medline (Ovid), and Web of Science Core Collection on 13th January 2022, using a pre-specified and tested search syntax for SRs with RCT evidence on the early introduction of allergenic CFs as a means for allergy prevention in infants and children. We examined the quality and risk of bias (RoB) using AMSTAR-2 and ROBIS tools, examined adherence to the Preferred Reporting Items for SRs and Meta-Analyses (PRISMA), and checked whether certainty of the evidence was assessed.ResultsTwelve SRs were included. Application of both tools resulted in similar overall judgements in terms of direction and extent for nine of the 12 SRs. Nine SRs were found to be of critically low to low quality according to AMSTAR-2 and to be at high RoB according to ROBIS. One SR received a moderate quality rating (AMSTAR-2) and high RoB rating (ROBIS). However, for two SRs, judgements between AMSTAR-2 and ROBIS were at stark variance. Only two SRs fully adhered to the PRISMA checklist. Six SRs evaluated the certainty of the body of RCT evidence. Several SRs failed to consider unpublished studies either by an explicit a priori exclusion or by inadequate search strategies.ConclusionsWell-conducted SRs are important for decision-making and informing guideline development, the quality of their methodology should therefore be considered. The methodological rigour and the reporting quality of SRs on the timing of CF for allergy prevention must be improved.Registrationhttps://osf.io/7cs4b.

EVALUATING OF SUPPLEMENTARY FEEDING IN BREASTFED INFANTS

The aim of the study: to assess supplementary feeding in breastfed neonate, evaluate infant and maternal indications for supplementation in healthy infants. Methods. An anonymous voluntary survey about supplementary feeding of 50 women who has breastfed children and visited the hospital for various reasons, not related to breastfeeding. According to the results of survey, the main reason for starting supplementary feeding was the insufficient amount of breast milk in the mother (63,20%). Other reasons included: low body weight of the child, illness of the mother, difficulties in applying to the breast, restlessness of the child. After the introduction of supplementary food, only 3,80% of children were returned to exclusively breastfeeding, 22,20% - remained on mixed feeding until the introduction of complementary food, and 29,60% had artificial feeding. The majority of women (74,10%) did not use any methods to improve lactation. Half of the surveyed mothers (56,00%) who introduced supplementary feeding gave milk formula to feed their child and used bottle feeding (32,60%) and spoon feeding (21,30%). Conclusions: the majority of interviewed women had a shortage of breast milk, which was the main reason for the introduction of supplementary food; the best supplementary food product is mother's or donor's milk; a third part of the surveyed women used bottle feeding; the decision to introduce supplementary food should be made by the doctor individually to every child.

Formulation and Sensory Evaluation of Complementary Foods from Millet and Oyster Mushroom

Timely introduction of complementary foods is essential for nutrition as well as growth and development of child at the age of six month of life. locally available millets were used for formulation of complementary foods as control sample and value addition was done with dry mushroom powder. The sensory evaluation trials were conducted for consecutive three days for panel of ten judges and 76 mothers of the child between six to 12 months at the aganwadi center of the slums of Amravati city. The sensory quality of control and experimental complementary food were acceptable by judges as well as mothers. The value addition of oyster mushroom powder was found effective to improve protein content of the experimental complementary foods.

Parental food selection questionnaire - Infant version

PurposeComplementary feeding practices (CFPs) are associated with health outcomes (e.g., obesity and food allergies). Understanding how parents select foods for their infant is limited. This study's purpose was to develop a psychometrically sound measure of parents' food selection motives for their infant during the complementary feeding period. MethodsDevelopment and testing of the Parental Food Slection Questionnaire-Infant Version (PFSQ-I) occurred in three phases. English-speaking, U.S. mothers of healthy infants, aged 6–19 months old participated in a semi-structured, face-to-face interview (Phase 1) or a web-based survey (Phases 2 & 3). Phase 1 was a qualitative study of maternal beliefs and motives surrounding complementary feeding. Phase 2 involved adaptation and exploratory factor analysis of the original Food Choice Questionnaire (Steptoe et al., 1995). Phase 3 involved validity testing of the relationships among PFSQ-I factors and CFPs (timing/type of complementary food introduction, frequency of feeding method, usual texture intake, and allergenic food introduction) using bivariate analyses, and multiple linear and logistic regression analyses. ResultsMean maternal age was 30.4 years and infant age was 14.1 months (n = 381). The final structure of the PFSQ-I included 30 items and 7 factors: Behavioral Influence, Health Promotion, Ingredients, Affordability, Sensory Appeal, Convenience, and Perceived Threats (Cronbach's α = 0.68–0.83). Associations of factors with CFPs supported construct validity. DiscussionThe PFSQ-I demonstrated strong initial psychometric properties in a sample of mothers from the U.S. Mothers who rated Behavioral Influence as more important were more likely to report suboptimal CFPs (e.g., earlier than recommended complementary food introduction, delayed allergenic food introduction, and prolonged use of spoon-feeding). Additional psychometric testing in a larger, more heterogenous sample is needed, along with examination of relationships between PFSQ-I factors and health outcomes.

Skin care interventions and early complementary food introduction for the prevention of atopic dermatitis in infants

аtopic dermatitis and food allergy are common diseases that usually begin in early childhood and can occur together in the same individuals. The aim of this study was to assess the significance of interventions such as skin care products for the skin barrier improvement, breastfeeding and early complementary foods introduction for the primary prevention of atopic dermatitis and food allergy in infants by building logistic regression models. We performed a survey of 97 parents of children. The survey was conducted with the help of Google forms and distributed on the Internet. Method of building and analysing logistic regression models was used to analyse the association of the risk of atopic dermatitis in children with the factor characteristics. Characteristics were as follows: "Skin care 1: application moisturizers to the infant's skin", "Skin care 2: bathing infants with water containing moisturizing substances or moisturizing oils", "Skin care 3: usage of less soap, bathing the child less often", "paternal history of atopy", "duration of breastfeeding less than 1 year", "early introduction of supplementary food (up to the 6th month of life)". We obtained the following results: 42.2% of respondents reported about the application of moisturizing cream, parents of 16.5% of children were using moisturizing oil for bathing the child, 12.4% of parents used less soap and bathed the child less often, 28.9% reported that they were not using any interventions. It was established that when applying care method 1, namely applying moisturizing agents to the infant’s skin, the risk of developing atopic dermatitis increases, OR=12.8 (95% CI 3.89 - 42.3) (p&lt;0.0001). When constructing a three-factor logistic regression model for predicting the risk of food allergy, no dependence was found between the development of food allergy and the presence of allergic diseases in parents, the period of introduction of complementary foods, and the duration of breastfeeding. Thus, this study did not reveal the protective role of skin care products, breastfeeding, and early introduction of complementary foods for the development of atopic dermatitis and food allergies in children. Multivariate analysis showed that atopic dermatitis is associated with emollients application to the infant’s skin. The use of moisturizing creams for the treatment of already existing atopic dermatitis or the path of percutaneous sensitization to allergens could have influenced the data.

Association of feeding patterns in infancy with later autism symptoms and neurodevelopment: a national multicentre survey

BackgroundWe aimed to compare differences in infant feeding patterns (breastfeeding and complementary food supplementation) between children with the autism spectrum disorder (ASD) and typically developing (TD) children through a multicentre study. The relationship between these patterns and later core symptoms and neurodevelopment in children with ASD was also investigated.MethodsWe analysed breastfeeding and complementary feeding patterns in 1389 children with ASD and 1190 TD children. The Children Neuropsychological and Behavior Scale-Revision 2016 (CNBS-R2016) was used to assess neurodevelopmental levels. The Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), Childhood Autism Rating Scale (CARS), and ASD Warning Behavior Subscale of the CNBS-R2016 were used to assess ASD symptoms.ResultsChildren with ASD had a shorter breastfeeding duration in infancy (8 (3–12) months vs. 10 (6–14) months, P < 0.001), later introduction of complementary foods (P < 0.001), and poorer acceptance of complementary foods (P < 0.001) than TD children. Total ABC and CARS scores were lower in the group of children with ASD who had been breastfed for 12 months or more than in the group who had been breastfed for less than 6 months. Children with ASD who were given complementary food after 6 months had lower general quotient (GQ), adaptive ability, fine motor and language scores than those who were given complementary food within 4–6 months. Children with ASD with poor acceptance of complementary foods had higher ABC and SRS scores and lower gross motor scores than those who had good acceptance.ConclusionsChildren with ASD have a shorter duration of breastfeeding, a later introduction of complementary foods, and poorer acceptance of complementary foods than TD children. These feeding patterns may be related to the symptoms and growth of children with ASD. The research suggests that continued breastfeeding for longer than 12 months may be beneficial in reducing ASD symptoms and that infants who have difficulty introducing complementary foods should be followed up for neurodevelopment.Trial registrationThe ethics committee of the Children’s Hospital of Chongqing Medical University approved the study. Approval Number: (2018) IRB (STUDY) NO. 121, and registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000031194, registered on 23/03/2020).

RISK FACTORS AND OUTCOMES OF ACUTE LOWER RESPIRATORY TRACT INFECTION IN CHILDREN AGED 2 MONTHS TO 5 YEARS

Background: Acute Lower Respiratory Tract Infection (ALRI) is the leading cause of under-5 childhood morbidity in the world, with nearly 156 million new episodes each year, of which India accounts for a bulk of 43 million. The mortality burden is 1.9 million per year, out of which India accounts for around four hundred thousand deaths per year. Objective: To study the various risk factors, clinical prole and outcome of acute lower respiratory tract infections (ALRI) in children aged 2 months to 5 years. Methods: 100 ALRI cases fullling WHO criteria for pneumonia, in the age group of 2 month to 5 years were evaluated for potential risk factors, clinical prole and outcome as per a predesigned proforma in a rural medical college. Results: Socio-demographic risk factors like parental illiteracy, overcrowding, partial immunization and low socioeconomic status were potential risk factors. Nutritional risk factors like early and late introduction of complementary foods, anemia and malnutrition were associated with ALRI. Environmental risk factors were use of biomass fuels, inadequate ventilation at home, and lack of separate kitchen. Conclusion: The present study has identied various socio-demographic, nutritional and environmental risk factors for ALRI which can be tackled by effective health education of the community and effective training of peripheral health personnel.

Functional constipation symptoms and complementary feeding methods: A randomized clinical trial

IntroductionThe aim of the study was to investigate the impact of different complementary feeding methods on the prevalence of functional constipation symptoms in infants at 12 months of age. Material and methodsRandomized clinical trial in mother–infant dyads that underwent the intervention at 5.5 months post birth, randomly allocated to one of three complementary food introduction methods: PLW (parent-led weaning), Baby-led Introduction to SolidS (BLISS) and a mixed approach. The symptoms of constipation were assessed at 12 months with an online questionnaire based on the Rome IV diagnostic criteria and adapted to our sample. The data were summarised as absolute frequencies and percentages and compared by means of the χ2 test. The project was approved by the ethics committee of the Hospital de Clínicas de Porto Alegre under number 2019-0230. ResultsWe analysed data corresponding to 135 infants, 45 allocated to PLW, 48 to BLISS and 42 to the mixed approach. The prevalence of constipation symptoms was 49.6% in the overall sample (n = 67), 60% (n = 27) in the PLW group, 47.9% (n = 23) in the BLISS group and 40.5% (n = 17) in the mixed approach group. We found no association between functional constipation symptoms and the method used to introduce complementary foods (P = .183). ConclusionsThe prevalence of functional constipation symptoms was high in the study population. The presence of constipation symptoms was not associated with the complementary feeding approach.