Milk Program Research Articles

INFLUENCE OF SCHOOL FEEDING PROGRAM ON THE RETENTION OF LEARNERS IN PUBLIC PRIMARY SCHOOLS IN KENYA; A CASE OF MOMBASA COUNTY

Purpose: The purpose of the study was to establish the influence of school feeding program on the retention of learners in public primary schools.Methodology: This study was conducted through a descriptive survey research design. A descriptive survey is a present oriented methodology used to investigate populations by selecting samples to analyze and discover occurrences. The survey focused on 60 out of the 188 head teachers and teachers who are beneficiaries of school milk program in all the six sub counties in Mombasa i.e. Mvita, Kisauni, Likoni, Nyali, Jomvu and Changamwe.This gives 31.9 % of the total number of participants in this project. To obtain the study sample for descriptive studies 10% of the accessible population is enough. Simple random and purposive sampling procedures were used in this research.Results: School feeding program influences retention of learners in public primary schools with a reliability value of 0.8 which is considered minimal acceptable thus rejecting null hypothesis therefore meaning that school feeding program has a significant effect on retention of learners in pubic primary schools.Unique contribution to theory, practice and policy: School feeding programmes are often designed to enhance academic performance and cognitive development. Improved nutritional status of school-age children leads to better attention and cognition, and thus, better educational outcome. School feeding can improve attentiveness in class by reducing short-term hunger many children come to school on an empty stomach, yet they remain surrounded by the distracting and disturbing facets of the crisis. The study recommends that the ministry of education should review the School feeding Programme and extend it upper primary classes. They should prioritize supply of food to ensure continuous provision and adequate supply of food for pupils.

Donor milk programme for very low birth weight infants: better outcomes, lower cost

Donor milk programme for very low birth weight infants: better outcomes, lower cost

The Economic Impact of Donor Milk in the Neonatal Intensive Care Unit

To assess the cost-effectiveness of mother's own milk supplemented with donor milkvs mother's own milk supplemented with formula for infants of very low birth weight in the neonatal intensive care unit (NICU). A retrospective analysis of 319 infants with very low birth weight born before (January 2011-December 2012, mother's own milk+formula, n=150) and after (April 2013-March 2015, mother's own milk+donor milk, n=169) a donor milk program was implemented in the NICU. Data were retrieved from a prospectively collected research database, the hospital's electronic medical record, and the hospital's cost accounting system. Costs included feedings and other NICU costs incurred by the hospital. A generalized linear regression model was constructed to evaluate the impact of feeding era on NICU total costs, controlling for neonatal and sociodemographic risk factors and morbidities. An incremental cost-effectiveness ratio was calculated for each morbidity that differed significantly between feeding eras. Infants receiving mother's own milk+donor milk had a lower incidence of necrotizing enterocolitis (NEC) than infants receiving mother's own milk+formula (1.8% vs 6.0%, P=.048). Total (hospital+feeding) median costs (2016 USD) were $169 555 for mother's own milk+donor milk and $185 740 for mother's own milk+formula (P=.331), with median feeding costs of $1317 and $936, respectively (P<.001). Mother's own milk+donor milk was associated with $15 555 lower costs per infant (P=.045) and saved $1812 per percentage point decrease in NEC incidence. The additional cost of a donor milk program was small compared with the cost of a NICU hospitalization. After its introduction, the NEC incidence was significantly lower with small cost savings per case. We speculate that NICUs with greater NEC rates may have greater cost savings.

The physical activity and nutrition-related corporate social responsibility initiatives of food and beverage companies in Canada and implications for public health

BackgroundAs diet-related diseases have increased over the past decades, large food companies have come under scrutiny for contributing to this public health crisis. In response, the food industry has implemented Corporate Social Responsibility (CSR) initiatives related to nutrition and physical activity to emphasize their concern for consumers. This study sought to describe the nature and targeted demographic of physical activity and nutrition-related CSR initiatives of large food companies in Canada and to compare companies who participate in the Canadian Children’s Food and Beverage Advertising Initiative (CAI), a self-regulatory initiative aimed at reducing unhealthy food advertising to children, with non-participating companies.MethodsA cross-sectional study was conducted in 2016. Thirty-nine large food companies, including 18 participating in the CAI, were included in the study. The webpages, Facebook pages and corporate reports of these companies were surveyed to identify CSR initiatives related to nutrition and physical activity. Initiatives were then classified by type (as either philanthropic, education-oriented, research-oriented or other) and by targeted demographic (i.e. targeted at children under 18 years or the general population). Differences between CAI and non-CAI companies were tested using chi-square and Mann-Whitney U tests.ResultsOverall, 63 CSR initiatives were identified; 39 were nutrition-related while 24 were physical activity-related. Most (70%) initiatives were considered philanthropic activities, followed by education-oriented (20%), research-oriented (8%) and other (2%). Almost half (47%; n = 29) of initiatives targeted children. Examples of child-targeted initiatives included support of school milk programs (n = 2), the sponsorship of children’s sports programs (n = 2) and the development of educational resources for teachers (n = 1). There were no statistically significant differences in the number of CSR initiatives per company (CAI: Mdn = 1, IQR = 3; non-CAI: Mdn = 0, IQR = 2; p = .183) or the proportion of child-targeted initiatives (CAI: 42%; non-CAI: 54%; p = .343) between CAI and non-CAI companies.ConclusionFood companies, including many that largely sell and market unhealthy products, are heavily involved in physical activity and nutrition-related initiatives in Canada, many of which are targeted to children. Government policies aimed at protecting children from unhealthy food marketing should consider including CSR initiatives that expose children to food company branding.

Donor human milk programs in German, Austrian and Swiss neonatal units - findings from an international survey

BackgroundDonor human milk (DHM) has been recommended for premature infants if mothers’ own milk is not available. The aim of this study was to increase the knowledge about the utilization rate and handling of DHM among neonatal units in Germany, Austria und Switzerland.MethodsOnline survey of utilization rates and handling practices of DHM of all neonatal units within Germany, Austria and Switzerland providing care for premature infants less than 32 weeks of gestation.ResultsDHM utilization rate of 35% is low (50/142) within those 54% of units that responded to our survey (142/261). Only 26/50 units have DHM routinely integrated into their nutritional management protocols. Lacking access and difficult procurement were cited as the main obstacles for not using DHM. However, eight out of ten respondents currently not using DHM would like to introduce DHM in their unit if available. There were differences in most aspects of DHM handling including donor recruitment and screening, testing and treatment of milk microbiota and commencement of DHM utilization. Breastmilk feeding rates were increased in units utilizing DHM compared to those not utilizing DHM.ConclusionsDHM is underutilized in most neonatal units caring for premature infants within participating countries. Lacking access to DHM represents the main barrier for utilizing DHM for premature infants.

US NICUs and donor milk banks brace for COVID-19

Neonatal intensive care units (NICUs) and donor human milk programmes across the USA are bracing for the coronavirus disease 2019 (COVID-19) pandemic. NICU workers have tested positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes COVID-19. A worker at the Children's Hospital & Medical Center NICU in Omaha (NE) was in contact with ten patients 3–4 days before testing positive for the virus, according to a March 25 report by the Associated Press. In Alabama, at least one newborn was placed in isolation after a NICU nurse tested positive.

Prevalence and predictors of donor milk programs among U.S. advanced neonatal care facilities.

(1) Determine national prevalence and predictors of donor milk programs among levels 2-4 advanced neonatal care facilities; (2) describe characteristics of donor milk programs. We randomly selected 120 U.S. hospitals with levels 2-4 advanced neonatal care facilities among each of four U.S. regions and surveyed the medical directors from July 2017 to November 2017 regarding donor milk use. We weighted responses according to the number of birthing hospitals in each region. Response rate was 213/480 (44%). Twenty-eight percent of level 2 and 88% of levels 3 and 4 neonatal care facilities had donor milk programs. Donor milk programs occurred more often in the South vs. Northeast (aOR 3.7 [1.1, 12.5] and less often in safety-net hospitals (≥75% Medicaid patients) vs. nonsafety-net hospitals (aOR 0.3 [0.1, 0.8]). In 2017, the vast majority of levels 3 and 4 neonatal care facilities had donor milk programs but disparities existed according to the safety-net hospital status and region.

Raw milk producers with high levels of hygiene and safety.

There is world-wide increasing interest in the consumption of unprocessed, natural food commodities including fresh (unpasteurised) milk and milk products. Consumers are actively seeking out raw milk, partly due to health reasons, but also for taste, freshness, closeness to the producer and to support local agriculture. The need for high levels of hygiene and safety in farms producing raw milk for direct consumption has long been recognised and has led to federal and industry-initiated systems for safe raw milk production. Raw milk producers in North America and Europe have demonstrated that raw milk, intended for direct consumption, can be produced safe and hygienic. The aim of this paper is to describe practices that have been developed for safe raw milk production. The German Vorzugsmilch is a federally regulated programme for legal raw milk production that was established already in the 1930s to provide raw milk with high hygienic standards controlled for zoonotic diseases to consumers. The Raw Milk Institute is a non-profit organisation established in California that has developed a voluntary safe raw milk programme in North America. RAWMI has developed a risk analysis and management system for raw milk dairy farmers to assist farmers in making individually tailored solutions for various production systems. In British Colombia, Canada, small herd share farms have employed good manufacturing practices, a risk management approach and performed monthly samples for pathogens and indicator bacteria to demonstrate safety and consistency. The major components of the raw milk systems applied, and the results of regular milk microbial indicator bacteria are presented. For the German system, the results from standard monthly pathogen tests are compared to zoonotic pathogen tests from other milk sources. The overall results indicate that raw milk can be produced with a high level of hygiene and safety in various systems.

Disparities in Donor Human Milk Supplementation Among Well Newborns.

Donor human milk supplementation for healthy newborns has increased. Racial-ethnic disparities in supplementation have been described in the neonatal intensive care unit but not in the well newborn setting. The aim of this study was to identify maternal characteristics associated with donor human milk versus formula supplementation in the well newborn unit. This retrospective cohort study includes dyads of well newborns and their mothers (N = 678) who breastfed and supplemented with formula (n = 372) or donor human milk (n = 306) during the birth hospitalization at a single hospital in the midwestern United States. Maternal characteristics and infant feeding type were extracted from medical records. Chi-square and logistic regression were used to examine associations between maternal characteristics and feeding type. Nonwhite women were less likely to use donor human milk. Compared to non-Hispanic white women, the largest disparity was with Hispanic (adjusted odds ratio [OR] = 0.28, 95% CI [0.12, 0.65]), then non-Hispanic black (adjusted OR = 0.32, 95% CI [0.13, 0.76]) and Asian women (adjusted OR = 0.34, 95% CI [0.16, 0.74]). Lower donor human milk use was associated with primary language other than English and public versus private insurance. The goal of improving public health through breastfeeding promotion may be inhibited without targeting donor human milk programs to these groups. Identifying the drivers of these disparities is necessary to inform person-centered interventions that address the needs of women with diverse backgrounds.

Call to action for equitable access to human milk for vulnerable infants

Call to action for equitable access to human milk for vulnerable infants

Participation in the School Milk Program Contributes to Increased Milk Consumption and Dietary Nutrient Intake by Middle School Students in South Korea.

Milk is considered to be one of the main food sources of calcium for promoting growth and bone health in children and adolescents. This study investigated whether or not participation in a school milk program affected milk consumption and nutrient intake by middle school students in South Korea. In total, 692 middle school students aged 13–16 years old were enrolled in two groups: the school milk program participant group (n = 346) and the non-participant group (n = 346). The survey examined normal milk consumption status in both groups. The diet record method was applied to analyze the amount of nutrient intake levels. Milk/dairy product consumption was significantly higher in the school milk program participant group for both boys and girls (p < 0.001). The school milk program participant group also generally showed higher energy and dietary nutrient intake levels as compared to the non-participant group for both genders (p < 0.05). No differences were observed in milk consumption at home or outside school, and calcium intake from animal-derived foods was higher in the school milk program participant group (p < 0.001). Therefore, it can be assumed that participating in the school milk program directly resulted in higher calcium intake. Hence, we can report that participating in the school milk program contributes to increased milk consumption and improved the overall nutrient intake.

A Call for Action to Address Food Insecurity by Strengthening Child Nutrition Programs

When on schedule, the United States Congress reauthorizes the existing child nutrition programs every 5 years. These child nutrition programs include the National School Lunch and School Breakfast Programs; the Child and Adult Care Food Program; Summer Food Service Program; Special Milk Program; Fresh Fruit and Vegetable Program; Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and Farm to School grant program. The last reauthorization, the Healthy Hunger-Free Kids Act (HHFKA), was passed in 2010. Consequently, the aforementioned programs have not been updated in nearly a decade. E. Campbell is senior director, Policy Initiatives and Advocacy, Academy of Nutrition and Dietetics, Washington, DC. S. Crulcich is an intern, Academy of Nutrition and Dietetics, Houston, TX. J. Folliard is a family and community health field specialist, SDSU Extension, and Academy CNR Workgroup member, Sioux Falls, SD.

The consumption pattern of milk and calcium sources of the middle school students depending on the participation of school milk program in Gyeonggi, Korea

The consumption pattern of milk and calcium sources of the middle school students depending on the participation of school milk program in Gyeonggi, Korea

Assessing the relationship between water and nutrition knowledge and beverage consumption habits in children.

To examine the relationship between knowledge and beverage consumption habits among children. Cross-sectional analysis. Linear regression was used to identify sociodemographic, dietary and behavioural determinants of beverage consumption and knowledge, and to describe the relationships between children's knowledge and water and sugar-sweetened beverage (SSB) consumption. Seventeen elementary schools in London, Ontario, Canada. A total of 1049 children aged 8-14 years. Knowledge scores were low overall. Children with higher knowledge scores consumed significantly fewer SSB (β = -0·33; 95 % CI -0·49, -0·18; P < 0·0001) and significantly more water (β = 0·34; 95 % CI 0·16, 0·52; P = 0·0002). More frequent refillable water bottle use, lower junk food consumption, lower fruit and vegetable consumption, female sex, higher parental education, two-parent households and not participating in a milk programme were associated with a higher water consumption. Male sex, higher junk food consumption, single-parent households, lower parental education, participating in a milk programme, less frequent refillable water bottle use and permission to leave school grounds at lunchtime were associated with a higher SSB consumption. Water was the most frequently consumed beverage; however, 79 % of respondents reported consuming an SSB at least once daily and 50 % reported consuming an SSB three or more times daily. Elementary-school children have relatively low nutrition and water knowledge and consume high proportions of SSB. Higher knowledge is associated with increased water consumption and reduced SSB consumption. Interventions to increase knowledge may be effective at improving children's beverage consumption habits.

Consumption of Mother's Own Milk by Infants Born Extremely Preterm Following Implementation of a Donor Human Milk Program: A Retrospective Cohort Study

To compare mothers' own milk (MOM) consumption by infants born extremely preterm before and after implementation of a donor human milk (DHM) program and determine healthcare provider's knowledge and practices regarding DHM. One hundred fifty-seven infants born at <30weeks of gestation were enrolled during 3 time-periods. Group 1: before DHM program implementation, Group 2: the year following implementation, and Group 3: the second year after implementation. The proportion of feeds consisting of MOM for 6weeks following birth was analyzed using a generalized linear mixed model. The study's second phase surveyed healthcare providers regarding knowledge and practices concerning DHM. Group 1 consumed feeds with a greater proportion of MOM than Group 3 during weeks 1 (P<.001) and 3 (P=.007) and more than both Group 2 (P=.033) and 3 (P=.021) in week 4. During the first 14days, Group 1 consumed feeds with 23.6% more MOM than Group 3 (P=.002) and had a greater odds of consuming feeds with > 90% MOM (P<.001) than Group 3. During days 1-28, Group 1 consumed feeds with 22% more MOM than Group 3 (P=.003) and had greater odds of consuming feeds with >90% MOM than Group 2 (P=.020) and 3 (P=.004). Knowledge regarding DHM was inconsistent among providers and they were unlikely to communicate potential risks and benefits of DHM to mothers. Following implementation of a DHM program, MOM consumption decreased over 2years. Strategies focused on lactation success are necessary to increase MOM consumption.

Evaluation of Small and Medium-Sized Enterprises Operating in Short Supply Chains Within Slovak School Programmes

Abstract Despite of reduction of its share on the gross domestic product, agriculture remains a branch generating job opportunities in rural areas. However, through more intensive farming procedures, it puts a pressure on environment and sustainability of agricultural production and prolongs the distance of distributed goods. Reduction of the mentioned impacts is possible through shortening the food supply chain subsequently resulting in increase of local sale, demand for local services and increase of labour market, putting an emphasis on support of small and medium – sized enterprises and their economic viability improvement. This paper evaluates the performance of small and medium enterprises and micro-enterprises which applied for the support and supplied and distributed fruits, vegetables, milk and milk products to kindergartens and primary schools within the School Fruits and Vegetables and the School Milk programme. We suppose that through supplying local schools they contributed to the food supply chain shortening.

Evaluation of a Free Milk in Schools Program in New Zealand: Effects on Children's Milk Consumption and Anthropometrics.

ABSTRACTBACKGROUNDWhile dietary sources of calcium are important for bone health, the intake of milk and milk products decreases as children get older. A free milk in schools program may mitigate this decrease in milk consumption. We evaluated the Fonterra Milk for schools program (a free milk initiative) by determining changes in children's milk consumption and anthropometric measures over a 2‐year period.METHODSThe evaluation was conducted in children aged 7‐9 years in a representative sample of primary schools participating in the free milk program, in Auckland, New Zealand. The primary outcome was the proportion of children meeting the New Zealand guidelines for dairy and milk product consumption over 7 days (≥2 servings per day). Changes in anthropometric measures were also assessed as secondary outcomes.RESULTSNine schools (N = 511 children) participated in the evaluation. The proportion of children meeting the New Zealand guidelines for milk and milk product consumption over 7 days increased significantly from baseline to 2 years' follow‐up (72% vs 94%; p < .001). Body mass index z scores did not change significantly between baseline and 2 years' follow‐up.CONCLUSIONSThe Fonterra Milk for Schools initiative appears to be an effective way of increasing milk/milk product consumption behaviors in school‐aged children.

The Impact of a Donor Milk Program on Breast Milk Consumption, Infection Rates, and Necrotizing Enterocolitis in Hospitalized Neonates

Purpose: Expressed mother’s own colostrum and transitional preterm milk (EMOM), produced during early lactation, contain high amounts of protective bioactive proteins and growth factors which imbue significant gut barrier protection and affect immunomodulatory and nutritional programming. Commensal bacteria specific to the mother are prevalent in EMOM. Donor breast milk (DBM), although recommended as a safe alternative to EMOM, contains lower amounts of protective factors and non-specific commensal bacteria due to pasteurization and processing. Our Donor Breast Milk Program (DBMP) was implemented August 2014 to increase neonates’ consumption of human milk and optimize health outcomes. DBM was provided to neonates < 35 weeks gestational age (GA) as a substitute for formula, and with education …

The Impact of a Donor Milk Program on Breast Milk Consumption, Infection Rates, and Necrotizing Enterocolitis in Hospitalized Neonates

The Impact of a Donor Milk Program on Breast Milk Consumption, Infection Rates, and Necrotizing Enterocolitis in Hospitalized Neonates

Facing the State: Everyday Interactions throughout Regime Change: Chile’s State Milk 1954–2010

This article uses Chile’s state milk program as a prism to map the trajectory of Chile’s social state through three combinations of political, economic, and welfare regimes. It traces the informal strategies deployed by citizens and local service providers and presents a historical typology of these encounters between 1954 and 2010, examining what commodification and decommodification mean to families in their everyday lives and discussing the implications of these findings to the literature on welfare regimes. The most important finding of this article is that regime type shapes but does not determine levels of provision. Welfare provision occurs in everyday interactions between state workers and citizens, and changes in regime type are filtered through and resisted through practices and strategies deployed in face-to-face encounters between local state representatives and citizens. There is often a large gap between central policy and these informal institutions that are created in everyday on-the-ground encounters between local state workers and citizens. Therefore, a second main conclusion of this article is that the informal institutions created at the local provision level coexist, compete, and clash with formal rules. A third conclusion of this article is that, to some extent, people who are regulated by the state also have some capacity to regulate their exchanges with the state, and, at the same time, state workers who organize and are organized by the state to distribute resources exercise discretionary power when implementing social programs.