Mothers Of Malnourished Children Research Articles

Maternal Age, Nutrition and Literacy; Targeting the Root Cause for Undernutrition in Children under the Age of Two Years.

Objective: To analyze the risk factors for child undernutrition in mothers of malnourished children under the age of 2 years.
 Methods: This cross-sectional study was conducted at the Pediatric Medicine Department of The Children’s Hospital Lahore from January to December, 2019. A total of 210 malnourished children in the age bracket of 2 months to 24 months and accompanying mothers admitted in the Stabilization Center for nutritional rehabilitation were included. Demographic characteristics of children and their mothers were taken.
 Results:
 Out of a total of 210 children there was slight male preponderance 116 (55%). Mean age of children was 8.89 + 6.74 months. During first six months of life, only 31 (15%) were exclusively breast fed and in six months or older children weaning food was not started at appropriate age in 91 (43%). Illiteracy was more in mothers as compared to fathers 140 (66.7%) vs 82 (39%). Half 104 (49.5%) of the mothers had satisfactory BMI of 18.5-23 kg/m2 and remaining were either severely under nourished or overweight/obese. With advancing age significantly more mothers were obese 17% as compared to 2.4% in younger age (18-25 years) (p= 0.007). Improper weaning practice was significantly more in mother of younger age group (p=0.023). A significant number of children who were older than six months of age and in whom weaning was not started at appropriate age had WHZ score <-3SD (p=0.019). There was no association of maternal nutrition, maternal/paternal education with the nutritional status of children (p=>0.05).
 Conclusion: Maternal illiteracy and both undernutrition and overweight/obesity were prevalent among the mother of undernourished children under the age of two years. Improper weaning was the major contributing factor in child’s malnutrition and improper weaning practice was significantly more in mother of younger age group.

Determinants of Infant Young Child Feeding Among Mothers of Malnourished Children in South Punjab, Pakistan: A Qualitative Study

Inadequate feeding is one of the most critical underlying determinants of child malnutrition. In this study, we explore infant young child feeding (IYCF) and deconstruct breastfeeding barriers in mothers of severely malnourished children in one of the most marginalized districts of Punjab province of Pakistan. Using purposive sampling, 20 lactating mothers are recruited for open-ended semi-structured interviews. Results reveal that barriers to immediate and exclusive breastfeeding include the introduction of pre-lacteal, butter, and cow or formula milk by mothers and grandmothers. Birthing difficulties and ritualizing prelacteal to transfer religion and culture cause the delay of early initiation of breastmilk. The colostrum is also discarded based on its weird physical look. Moreover, household circumstances, limited diet, extra workload, and mental stress associated with marital relationships are other significant barriers. Mothers perceive their breastmilk as thin, impotent, and of bad quality and often complain against breastmilk insufficiency due to general weakness. Furthermore, poor mothers reduce breastfeeding when the fertility burden is high, especially if a female baby is in their womb. Alternatively, outer milk is recommended but washing bottles with detergents often becomes frequent. In conclusion, immediacy, exclusivity, frequency, and duration of breastfeeding are circumscribed owing to multiple social, cultural, and economic causes. Therefore, a holistic approach combining cultural and structural causes might be more relevant for successful IYCF practices in marginalized communities of Pakistan.

Impact of maternal depression and social factors on child’s nutritional status: a case–control study in Egypt

Background Malnutrition is a primary cause of child morbidity. Maternal depression affects children’s health, especially nutrition.Aim This study aimed to explore the effects of maternal depression and social factors on children’s nutrition.Patients and methods A case–control study was carried out on 100 children and their mothers: 50 malnourished children and 50 age-matched and sex-matched healthy-control children. Anthropometric measurements of children were done and transformed into weight-for-age and weight-for-height Z-scores. Screening of depression in mothers was done using Symptom’s Checklist 90-Revised (SCL90-R) Depression dimension. Mini-Mental State Examination (MMSE) was used to assess maternal cognitive functions.Results Thirty-eight percent mothers of malnourished children were depressed compared with 12% mothers of healthy children. The difference was statistically significant (P<0.05). Statistically significant differences were found regarding maternal age at marriage, education, working status, crowding index, and family income between groups (P<0.01). Mothers of malnourished children had cognitive impairment than controls (P<0.001). The Z-score of malnourished children was positively correlated with breastfeeding duration, maternal age at marriage, education, working status, family income, and other social parameters; and negatively correlated with crowding index and gastrointestinal tract (GIT) morbidity, indicating that malnutrition increases with short duration of breastfeeding, younger maternal age at marriage, low education, bad working status, low income, and high crowding index.Conclusions Mothers of malnourished children have more depressive symptoms and impaired cognitive functions than the controls. Maternal age at marriage, education, family income, and crowding index are predictive variables affecting children nutrition.

Factors Related to Malnutrition in Children Under Five at Kori Public Health Center

Malnutrition is currently an unsolved health problem in the work area of Kori Public Health Center, the incidence of malnutrition has increased from 2017-2019. This is a case-control study that aimed to determine parenting, history of infectious diseases, family income, number of family members related to malnutrition in children under five. The sample size is 51 for each case and control. The dependent variable is malnutrition and the independent variables are parenting, history of infectious diseases, family income, and the number of family members. The results show that parenting (p-value 0.004 and OR 12,583), history of infectious diseases (p-value 0.000 and OR 8.854), and family income (p-value 0.000 and OR 10,382) are related to malnutrition of children under five. Parenting is the most influential variable so that Kori Public Health Center should provide counseling to the mothers, especially the mothers of malnourished children, about health care including supplying nutritious food for children.

Prevalence of malnutrition among under-five children in Al-Nohoud province Western Kordufan, Sudan

Malnutrition remains one of the most common causes of childhood morbidity and mortality worldwide. The objective of this research was to determine the prevalence of malnutrition and related factors among Al-Nohoud children between 6-59 months of age. For the choice of parts, blocks and households, a three-stage sample design was used. Data collection was focused on anthropometric tests and structured questionnaires. The prevailing low weight, stunting and wasting of 16.7%, 13.5% and 17.6%, respectively, was shown. Two thirds (67%) %) of the affected children were 24 months. Female children were further underweight than male children. Home-wives achieved lower education levels and were higher in the mothers of malnourished children than those with healthy children. This study found that age of mothers, mother and family income have substantial malnutrition linked to children under the age of five (p= 000, X2= 57.40) (p= .004, X2= 41.00) (p= .00, X2= 32.74). The study found that under-five children were particularly malnutrition. Age ranges were significantly linked to wasting, stunting and underweight. Sex, mother's age, mother's level of education and family income differ greatly from malnutrition for children under the age of five.

The Pappa di Parma project: promoting better health and social condition in developing countries

Abstract Background Malnutrition is the primary cause of death in infants and children. Malnutrition is very common in individuals aged from 6 to 60 months due to the lack of high-quality protein and to deficiencies in the intake of vitamin A, D, thiamine, riboflavin, niacin, calcium and iron. In low-income countries, the nutritional approach to treat child malnutrition is mainly based on RUTFs (Ready-to-Use Therapeutic Foods). Being produced by donor countries, RUTFs do not solve the problem of malnutrition at source: RUTFs are expensive for low-income communities and are distant from their local tradition. The use of ingredients not locally available and the passive participation of the community are the main cause of RUTFs failure among mothers of malnourished children. Community engagement and educating the local populations represent a key element in addressing the causes and treatment of malnutrition. Results Based on these concepts, the Pappa di Parma project, developed at Department of Food and Drug of University of Parma, aims to create a hyper-energetic and nutritional balanced meal, tailored on children from 6 to 60 months suffering from severe/moderate malnutrition, including only affordable local ingredients and technologies, providing in this way a potential long-term solution to decrease malnutrition. Conclusions The Pappa di Parma approach has been applied in Sierra Leone, Zambia, Tanzania, Burundi, Senegal, Togo from 2009 adapting to the different context. The Pappa di Parma approach consists in: (a) identifying the local food and creating a nutritional database; (b) developing recipes with accessible-to-family ingredients and with local technologies; (c) testing in loco the recipes in the real setting; (d) creating educational materials aiming to enhance awareness about the importance of a balanced nutrition.

Maternal depression, a hidden predictor for severe acute malnutrition in children aged 6-59 months: a case-control study at Omdurman Paediatrics Teaching Hospital, Sudan.

Malnutrition remains one of the main disabling issues in child health, especially in developing countries. Maternal depression by its related disabilities has been linked with children undernutrition in the studies abroad. Unfortunately, not much is known regarding this issue in Sudan, so this study aims to examine the association between maternal depression and severe acute malnutrition (SAM) in children under 5 years of age. A matched case-control study was conducted in Omdurman Paediatrics Teaching Hospital. Children admitted with SAM were assigned as cases, whereas controls were age- and sex-matched children with normal weight and height admitted in the same hospital. Mothers of both cases and controls were assessed for depression utilising the Patient Health Questionnaire-9 tool. The prevalence of depression among mothers of malnourished children was high (41.5%) compared to the mothers of controls (19.1%). In multivariate logistic regression analyses, the adjusted odds ratio (AOR) of maternal depression were markedly higher in cases than in controls (AOR = 3.09, p = 0.002), as was the odds of below 1-year breastfeeding weaning (AOR = 18.60, p = 0.006) and mother illiteracy (AOR = 2.42 p = 0.031). Furthermore, the analysis found a significant negative association between the occurrence of malnutrition and exclusive breastfeeding (AOR = 0.43, p = 0.015). Maternal depression carries a significant burden in the mothers of children hospitalised with SAM. We strongly recommend routine screening and treatment for depression in childbearing age mothers in the available relative maternal and child health clinics.

A qualitative exploration of behavioral factors affecting mothers of malnourished children under 5 years old in Kiribati.

Background: In Kiribati, malnutrition is the leading cause of death for children aged less than 5 years. The purpose of this study was to explore contributing behavioral factors among mothers of malnourished children under 5 years old in Kiribati. Methods: This qualitative study was conducted in an urban area of South Tarawa among mothers of malnourished children aged less than 5 years in 11 public health centers in 2016. The study included 9 focus group discussions, with a sub sample of 3 to 4 in each group, having a total of 35 participants. Using a semi-structured questionnaire, data was collected and thematic analysis was applied to analysis the data. Results: Seven main themes were identified including; knowledge, behaviors, perceived severity, perceived benefits to action, perceived barriers and cultural related issues. These encompassed a variety of reasons which could explain the malnutrition in children of those particular mothers. Conclusion: In order to tackle malnutrition in Kiribati, it is crucial to identify the main factors that are hindering this preventable disease. This study provides information essential to enhanced decision making, health care delivery planning and has policy implications for the improvement of quality of health care in Kiribati.

A qualitative exploration of behavioral factors affecting mothers of malnourished children under 5 years old in Kiribati

Background: In Kiribati, malnutrition is the leading cause of death for children aged less than 5 years. The purpose of this study was to explore contributing behavioral factors among mothers of malnourished children under 5 years old in Kiribati. Methods: This qualitative study was conducted in an urban area of South Tarawa among mothers of malnourished children aged less than 5 years in 11 public health centers in 2016. The study included 9 focus group discussions, with a sub sample of 3 to 4 in each group, having a total of 35 participants. Using a semi-structured questionnaire, data was collected and thematic analysis was applied to analysis the data. Results: Seven main themes were identified including; knowledge, behaviors, perceived severity, perceived benefits to action, perceived barriers and cultural related issues. These encompassed a variety of reasons which could explain the malnutrition in children of those particular mothers. Conclusion: In order to tackle malnutrition in Kiribati, it is crucial to identify the main factors that are hindering this preventable disease. This study provides information essential to enhanced decision making, health care delivery planning and has policy implications for the improvement of quality of health care in Kiribati.

A qualitative exploration of factors affecting mothers of malnourished children under 5 years old in Kiribati.

Background: In Kiribati, malnutrition is the leading cause of death for children aged less than 5 years. The purpose of this study was to explore contributing factors among mothers of malnourished children under 5 years old in Kiribati. Methods: This qualitative study was conducted in an urban area of South Tarawa among mothers of malnourished children aged less than 5 years in 11 public health centers in 2016. The study included 9 focus group discussions, with a sub sample of 3 to 4 in each group, having a total of 35 participants. Using a semi-structured questionnaire, data was collected and thematic analysis was applied to analysis the data. Results: Seven main themes were identified including; knowledge, behaviors, perceived severity, perceived benefits to action, perceived barriers and cultural related issues. These encompassed a variety of reasons which could explain the malnutrition in children of those particular mothers. Conclusion: In order to tackle malnutrition in Kiribati, it is crucial to identify the main factors that are hindering this preventable disease. This study provides information essential to enhanced decision making, health care delivery planning and has policy implications for the improvement of quality of health care in Kiribati.

Maternal depression and child severe acute malnutrition: a case-control study from Kenya

BackgroundDepression is the leading cause of disease-related disability in women and adversely affects the health and well-being of mothers and their children. Studies have shown maternal depression as a risk factor for poor infant growth. Little is known about the situation in Sub-Saharan Africa. The aim of our study was to examine the association between maternal depression and severe acute malnutrition in Kenyan children aged 6–60 months.MethodsA matched case-control study was conducted in general paediatric wards at the Kenyatta National Hospital. The cases were children admitted with severe acute malnutrition as determined by WHO criteria. The controls were age and sex-matched children with normal weight admitted in the same wards with acute ailments. Mothers of the cases and controls were assessed for depression using the PHQ-9 questionnaire. Child anthropometric and maternal demographic data were captured. Logistic regression analyses were used to compare the odds of maternal depression in cases and controls, taking into account other factors associated with child malnutrition status.ResultsThe prevalence of moderate to severe depression among mothers of malnourished children was high (64.1%) compared to mothers of normal weight children (5.1%). In multivariate analyses, the odds of maternal depression was markedly higher in cases than in controls (adjusted OR = 53.5, 95% CI = 8.5–338.3), as was the odds of having very low income (adjusted OR = 77.6 95% CI = 5.8–1033.2).ConclusionsKenyan mothers whose children are hospitalized with malnutrition were shown in this study to carry a significant mental health burden. We strongly recommend formation of self-help groups that offer social support, counseling, strategies to address food insecurity, and economic empowerment skills for mothers of children hospitalized for malnourishment.

Energy Intake in Socially Vulnerable Women Living in Brazil: Assessment of the Accuracy of Two Methods of Dietary Intake Recording Using Doubly Labeled Water

BackgroundDiet is related to the prevention of chronic diseases, but assessing dietary intake is a complex task, especially in socially vulnerable populations. ObjectivesTo assess the accuracy of the 24-hour food recall (24HFR) and the food frequency questionnaire (FFQ) methods in socially vulnerable women in Brazil and compare these methods against doubly labeled water (DLW). DesignCross-sectional study. Energy intake (EI) was measured using 3 24HFRs and 1 FFQ. Total energy expenditure (TEE) was measured using DLW. Cutoff points were calculated to assess underreporting and overreporting using both the difference and the ratio between the EI and TEE. Participants/settingSixty-seven socially vulnerable, nondieting adult women with stable body weight and mothers of malnourished children. Main outcome measuresEI, in kilocalories, derived from 24HFR and FFQ. Statistical analysesRepeated measures analysis of variance was used to compare EI and TEE and Bland-Altman graphs were plotted to assess the agreement between these variables. Spearman correlation coefficient between the ratio of EI to TEE and socioeconomic or anthropometric variables was calculated. ResultsMean TEE was 2,186 kcal (95% CI 2,063 to 2,309 kcal). EI obtained through 24HFR (mean=1,848.6 kcal [95% CI 1,737.5 to 1,959.7 kcal]) was significantly lower than TEE (P=0.01), and significantly lower than the EI obtained through FFQ (mean=2,084.5 [95% CI 1,929.0 to 2,240.0 kcal]; P<0.01). There were no statistically significant differences between the EI values of FFQ and TEE (P=0.89). The distribution of underreporters, nonunderreporters, and overreporters were more homogenous in the FFQ method. There was a positive correlation between body fat percentage and underreporting in the FFQ method (r=0.245; P=0.046). ConclusionsThe methods of assessing dietary intake in our study showed poor agreement with TEE obtained by DLW. These may, therefore, not be the most suitable methods for assessing EI in this population.

Comparison of Determinants of Clinical Recovery from Acute Watery Diarrhea of Well-nourished and Malnourished Children in an Urban Hospital

A hospital based cross sectional study was carried out among the under-five children admitted to the longer stay wards (LSU) of the hospital of ICDDR,B to investigate the relationship between children’s nutritional status and clinical recovery as well as sock, economic condition. Nutritional status was determined by anthropometric measurements. The study conducted on 94 children of 6-59 months, of whom 49 were malnourished and 49 were well nourished 64 of them were male and 35 were female. (It means that boy’s are more sufferers in diarrhea than girls.) (Children’s age come within a range of 6-59) month. Mother’s education level was lower, 32.6% mothers were illiterate and 40% mothers of malnourished children were illiterate where, 25% mothers having well nourished child were illiterate. Most of the malnourished children’s Family income was below TK. 5,000 per month for majority of the parents whereas, most of the well nourished children’s family income was 8,000tk. It shows that, children having low family income are more likely malnourished than well nourished children. Family member was within 4 persons for majority of the well nourished children’s households’. On the other hand family member was more than 5 in out of the malnourished households. Within their limited income; it was difficult to maintain a medium size family properly. Our study reveals that knowledge, attitude and practices of dietary pattern, health, sanitation and immunization of the malnourished children’s family were lower than well-nourished children’s family. Their nutritional knowledge was too low, compared with well nourished children’s parents. In our study, Most of the parents of well-nourished children used to feed colostrums (80.6%) but Parents having malnourished children discarded colostrums (93.6%). Our study reveals that 64.4% malnourished children’s mother has started complementary food in &lt;2 months of age ,on the other hand majority of well-nourished children’s mother gave their child complementary food at the age of 6-9 months. It has been seen that, the majority of well nourished children (62%) were immunized by taking all doses of vaccines. where as most of the malnourished children (49%) has not taken all doses as a result there immunity was lesser than well-nourished children. Most of the caregivers of well-nourished children (43.5%) knows that diarrhea causes by not giving immunization, on the other hand majority of caregiver of malnourished patients (31.9%) knows that main cause of diarrhea is infection by germs. The immunization status of well nourished children was quite satisfactory. 62% well nourished children and only 40% Mal nourished children was completely immunized. It has been seen that, ORS intake was higher in well-nourished children (172.2lml-on the 1st day of hospitalization, compare to malnourished children. Stool output was higher in malnourished children 235.48 ml-on the 1st day after admission. It shows that there is a co-relation between ORS intake, stool output and recovery period. It has been seen that, mean duration of diarrhea before hospitalization was lower in well-nourished children group, but duration of fever, vomiting and abdominal pain rate was higher in this group compared to malnourished group. DOI: http://dx.doi.org/10.3329/bjnut.v24i0.14039 Bangladesh J. Nutr. Vol. 24-25 Dec 2011-2012 pp.83-92

Crianças desnutridas: percepção da família quanto ao cuidado

This is a descriptive-exploratory study, carried out at the Center for Integrated Medical Care - NAMI and the Dendê community from January to June 2005. The purpose was to investigate maternal knowledge on care and information about malnutrition. The informants were six mothers of malnourished children. Data collection was developed through semi- structured interviews and participant observation. Research was approved by the Ethics Committee of the University of Fortaleza on the advice of Report N. 023/2005. The analysis was performed through classification and comprehension, resulting in the emerging themes: Behavior and feeding of malnourished children; Perception and feelings of the family in relation to the malnourished child; and the care and knowledge of families regarding malnutrition. The results showed that in a social group, apparently homogeneous, there is heterogeneity among children and families belonging to the same social strata, as well as different behaviors. It was concluded that despite the complexity of the approach on the intervention, these factors represent inequalities on health and enables search for strategies to overcome them.

PENANGGULANGAN GIZI BURUK MELALUI ANALISIS SIKAP DAN KEBIASAAN IBU DALAM PENGATURAN MAKANAN KELUARGA

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Learning From the Community to Improve Maternal–Child Health and Nutrition: The Positive Deviance/Hearth Approach

The "traditional" use of the Positive Deviance approach to behavior change involves studying children who thrive despite adversity, identifying uncommon model behaviors among Positive Deviant families, and then designing and implementing an intervention to replicate these behaviors among mothers of malnourished children. This article presents the results of a literature review designed to gather information on the role of the Positive Deviance/Hearth methodology in social and behavior change. Examples of how the methodology has been applied beyond infant and child malnutrition to address other health areas, such as improving pregnancy outcomes, are explored. An analysis of Positive Deviance programming being carried out by Project Concern International in Guatemala and Indonesia is conducted. The role of cultural context in the design and implementation of Positive Deviance/Hearth, as well as the role of Positive Deviance in affecting social and behavior change, require further exploration. The issues related to cultural context and the challenges for monitoring and evaluation of program outcomes are presented.

Overweight and obesity among mothers of malnourished children--Brazil--PNSN--1989.

To evaluate the relationship between the nutritional status of the youngest child under 48 months of age (in families with the biological mother present) and their mothers among 3906 children selected from a sample of a national survey in 1989 (PNSN). Malnutrition was present in 5.8% of the children. From these, 21.8%, 60.9% and 17.3% had overweight/obese, eutrophic and malnourished mothers, respectively. Stratified analyses taking into account the regions, situation, income distribution and mother's educational level demonstrated that a lower proportion of malnourished children was concurrent with a higher proportion of overweight/obese mothers. The Kappa test evidenced a poor agreement between the nutritional conditions of the child-mother pairs (K < = 0.048). When the proportion of malnourished children decreased within the analyzed groups, the proportion of overweight/obese mothers increased. Such an epidemiological pattern indicates that within groups in which malnutrition is less prevalent, the proportion of children for whom a lack of food in the household is the main determinant factor for malnutrition is lower.

Growth Charts Only Marginally Improved Maternal Learning from Nutrition Education and Growth Monitoring in Lesotho

A study done in Lesotho in 1985–1986 assessed whether growth charts increased the impact of nutrition education and growth monitoring on maternal learning about weaning practices and diarrhea. Seven hundred and seventy six mothers were given three monthly sessions of group nutrition education along with growth monitoring of children and individual counseling. Growth charts, which were taught to one of two groups, fostered learning but only on issues related to diarrhea and only among new clinic attendants, mothers with less than secondary schooling and mothers of malnourished children. These benefits, however, were small (differences <10%) compared with the overall impact of the nutrition education and growth monitoring intervention (increases between baseline and post-intervention were >50% for some questions). Our findings suggest that well-designed clinic-based nutrition education and growth monitoring can have a significant impact on maternal nutrition knowledge. Teaching growth charts to mothers may not be necessary for obtaining such results in programs conducted under ideal conditions. More research is needed to determine under what circumstances, for what purposes and for whom growth charts may be beneficial.

Protein-energy malnutrition in northern Sudan: prevalence, socio-economic factors and family background

The socio-economic and family background and the nutrition of 145 children with kwashiorkor admitted to hospital in Khartoum over a 2-year period were compared with 113 marasmic kwashiorkor, 158 marasmic, and 186 nutritionally normal controls of similar age. Peak admissions for kwashiorkor were in the wet and post-wet season and the mean (SD) age was 1.6 (0.6) months. Mothers of malnourished children were more likely to be pregnant, and had poorer housing, sanitation and water supply, a lower income and food expenditure and less education than controls. Mothers of controls breastfed their children longer, introduced mixed feeding earlier, offered a wider variety of foods, and were more likely to have had their infants immunized. Neither family instability nor cultural practices which result in separation of children from their mothers appear to have an important role in protein-energy malnutrition in the Sudan. Families of kwashiorkor children had a higher food expenditure and better maternal education than marasmic children. There was no significant difference between the two groups in duration of breastfeeding or in the age of introduction of mixed diet. However, kwashiorkor children appeared to be offered more meat. Differences in food availability could account for the relative retardation of growth and lack of subcutaneous fat in marasmus compared to kwashiorkor.

Current Outlook for Children Around the World

The most tragic impact of the deep economic recession of the 1980s is falling on the 1.8 billion children less than 15 years of age who represent 40% of the 4.5 billion inhabitants of this earth. Two fifths of the world population still lacks the comfort of even minimally adequate housing and one third of the world's work force is unemployed or underemployed. The result is that 100 million children stay hungry every day. Most of the nutritional education programs of the World Health Organization have turned out to be useless in improving protein diet. Sixty percent of the mothers of malnourished children are unaware of the fact that their children are underdeveloped and suffering from inadequate nourishment; due to a high rate of illiteracy, infantile malnutrition passes unobserved in one fourth of the population of developing countries.