Suboptimal Feeding Research Articles

Trends and Influencing Factors of Complementary Feeding Practices in Niger: An Analysis of National Surveys From 2000 – 2018

ObjectivesTo examine the trends and influencing factors of suboptimal complementary feeding (CF) practices among children aged 6–23 months in Niger using national data from 2000 to 2018. MethodsUsing data from the 2000 Multiple Indicator Cluster Survey, 2012 Demographic and Health Surveys (DHS), and 2018 Standardized Monitoring and Assessment of Relief and Transitions survey in Niger, the trends and predictors of WHO-UNICEF CF indicators including timely introduction of complementary foods (INTRO), minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD) were estimated. Using the most completed data in CF and influencing factors (available from 2012 DHS), multilevel logistic regression models were applied to identify factors at the individual, household and community levels that were associated with meeting INTRO, MMF, MDD, and MAD. ResultsThe weighted proportion of children aged 6–8 months meeting INTRO increased from 56.0% in 2000 to 84.4% in 2018. The weighted proportion of children meeting MMF (51.3% to 77.9%), MDD (9.8% to 14.2%), and MAD (5.6% to 10.9%) also increased between 2012 - 2018. At the individual level, children with mothers who were employed had higher odds of meeting all four indicators as compared to those whose mothers were unemployed. Older child age and maternal exposure to media were significantly associated with higher odds of meeting MMF, MDD, and MAD. Maternal education and child birth weight greater or smaller than average (reference) were positively associated with the odds of meeting MMF and MAD, and antenatal iron supplementation and currently breastfeeding were positively associated with the odds of achieving MDD and MAD. At the household level, the odds of meeting MMD and MAD were higher among children from wealthier households. At the community level, the odds of meeting INTRO and MMF were higher among children from communities with greater access to health services. ConclusionsDespite the improvement in CF practices since 2000, only 10% of children from 6–23 months received minimum acceptable diets. Factors associated with CF were distributed across individual, household and community levels, suggesting the need for multi-level strategies to improve child nutrition in Niger. Funding SourcesUNICEF West and Central Africa Regional Office (Grant # 43279190).

Pre-breeding Diets in the Seahorse Hippocampus reidi: How Do They Affect Fatty Acid Profiles, Energetic Status and Histological Features in Newborn?

Seahorses (Hippocampus spp.) are exceptional marine species considering their reproductive patterns and other features. Due to the iconic characteristics of these fishes, aquarium trade, and research efforts have increased in the last years. Consequently, novel rearing techniques have been developed; however, there is a need for improvements on a series of issues, namely reproduction success enhancement. The tropical species Hippocampus reidi is the most traded seahorse but many aspects of breeding and its impact on the quality of neonates are still poorly understood. In the present study, we assessed the effects of two pre-breeding diets on newborn quality and viability considering biochemical characteristics, energetic status, and ultrastructural aspects of muscular tissue. During the whole pre-breeding season (5 months), the breeders were fed on one of the following diets: M0 (adult non-enriched Artemia) and M5 (adult non-enriched Artemia + mysidaceans). From the onset of the reproduction period, all breeders were fed for 6 months on diet M5. Breeding success and energetic status (ATP, total adenylic nucleotides, AEC, and NAD) of newborns resulted considerably enhanced in treatment M5. However, initial differences in neonates quality did not affect further newborn performance (survival and growth until day 7 after male’s pouch release) while gaining access to high-quality preys (copepods). Besides, morphological alterations in muscle tissue were not observed. The reproduction in the species followed a capital–income continuum pattern characterized by an initial mixed capital-income period (until 70–100 days since the onset of the breeding season) followed by an income breeding period with progressive exhaustion of body reserves, especially in M0-newborns. Interestingly, the effects of pre-breeding diets were also noticed in the second half of the breeding period. Our results seemed to indicate that the requirements in essential fatty acids in H. reidi are lower than in other seahorse species (e.g., Hippocampus guttulatus). Globally, the results achieved revealed that high-quality pre-breeding diets enhanced reproduction success and would likely result advantageous to improve newborn endurance in conditions of moderate starvation or sub-optimal feeding.

Effects of fasting and water temperatures during transition from freshwater to seawater on juvenile chum salmon growth and metabolism

We examined the combined effects of fasting in freshwater and water temperature during the transition from freshwater to seawater on growth/metabolic parameters in juvenile chum salmon Oncorhynchus keta. Juveniles of 1 g in freshwater were first subjected to a 5-day fasting period at 10 or 5 °C, acclimated to either 10 or 5 °C seawater and fed ad libitum for 30 days. Control fish were transferred from 10 °C freshwater to 10 °C seawater and fed ad libitum throughout the experimental period. Serum insulin-like growth factor (IGF)-I was measured to evaluate growth status/potential and liver glycogen as an index of energy storage. Fasting in freshwater for 5 days negatively affected body size. Growth of juveniles kept at colder temperatures was retarded in seawater for at least 20 days, which may partly be explained by a lower feeding rate in cold seawater. Serum IGF-I levels were lower in fasted fish in freshwater at both temperatures and colder seawater had a negative effect on restoring serum IGF-I levels after refeeding for 20 days. Liver glycogen content was low in fish fasted in freshwater for 5 days. After refeeding in seawater for 10 days, liver glycogen content increased significantly in juveniles kept at colder temperatures. Colder water temperatures in both salinities positively affected glycogen content for 30 days after transfer to seawater, suggesting that juveniles allocated energy stores to the liver rather than growth under suboptimal feeding and temperature conditions. The findings of the present study suggested that relatively cold freshwater could negatively affect juvenile chum salmon growth soon after sea entry.

Maturation of the digestive system of Downs herring larvae (Clupea harengus, Linnaeus, 1758): identification of critical periods through ontogeny

Digestive system functionality is a key process linked to larval recruitment and survival. However, little is known about organ development and enzyme maturation of the digestive system of North Sea Atlantic herring (Clupea harengus). In this study, herring larvae were reared at 13 °C from hatching to 69 day post hatch, covering four developmental stages: (1) yolk sac (8–9 mm), (2) pre-flexion (9–14 mm), (3) flexion (12–18 mm) and (4) post-flexion stages (15–30 mm). Combined histological (semi-quantitative scoring) and enzyme analyses (pancreatic and intestinal) showed that developmental stages are strongly linked to physiological changes. The larvae lack a functional stomach and use the intestine as the primary site of digestion which is mainly supported by pancreatic enzyme activity. The intestine acquired adult enzymatic digestive features with a functional brush border at the end of the flexion stage and pyloric ceca started to develop during the post-flexion stage. The transition from pre-flexion to flexion stage and the end of the post-flexion stage are energetically taxing periods as indicated by a reduced number and size of liver vacuoles. Based on these findings, we consider these moments as critical periods, where herring larvae could be dramatically affected by suboptimal feeding conditions in the field. This implies that pre-flexion stage larvae with low or no liver reserves may not be able to proceed to the next developmental stage. Hence, the level of energy storage in first-feeding larvae needs to be examined for its use as a field indicator of survival and development.

A multi-center longitudinal study on responsive breastfeeding in China from the perspective of health equity: research protocol

BackgroundSocio-economic inequities can strongly influence suboptimal infant feeding outcomes. Factors such as lack of knowledge about breastfeeding, low family income, low educational attainment, social and economic status, cultural norms and ethnicity may negatively affect success with offering breastfeeding following a responsive feeding approach (ie. responsive breastfeeding). Such inequities can indeed shorten breastfeeding duration, and negatively affect behavioral and cognitive infant outcomes. In China, there is a dearth of studies focusing on breastfeeding from the responsive and health equity perspective.ObjectiveThe aim of this article is to present a protocol of an ongoing longitudinal cohort study investigating factors associated with responsive breastfeeding behaviors, and the child’s behavioral and cognitive development from birth to12 months post-partum in five centers in China. The study seeks to identify breastfeeding barriers and facilitators from a health equity perspective.MethodsWe are enrolling 700 women and their singleton full term infants in Chongqing, Huizhou and Guangzhou urban and rural areas. The study questionnaires will be administrated within 72 h, 30 days, 3, 6, 9, and 12 months post-partum during the baby’s vaccination visits. We will investigate the difference between urban and rural areas sociodemographic characteristics, breastfeeding knowledge, attitudes and practice, postnatal depression, maternal emotion regulation and parenting stress, and anthropometric and cognitive development indicators of the infants at each time-point.ConclusionOur article illustrates how a cohort study can be designed to understand the barriers and facilitators of responsive breastfeeding taking equity principles into account to help promote infants’ growth and development in China.

Delayed breast feeding initiation increases the odds of colostrum avoidance among mothers in Northwest Ethiopia: a community-based cross-sectional study

BackgroundColostrum is a yellowish and sticky breast milk produced in late pregnancy. Annually, 60% of 10.9 million under-five deaths globally are due to malnutrition. Of these, over two-thirds of the deaths are accounted by sub-optimal feeding practices in the first year of life, including colostrum discarding. However, evidence on the magnitude of colostrum avoidance and its associated factors at the community level is very limited in Ethiopia, particularly in the study area.Thus, this study aimed to assess the magnitude of colostrum avoidance and associated factors among mothers who gave birth in the last six months in Gozamen district, northwest Ethiopia, 2019.MethodsA community-based cross-sectional study was conducted among 741 (741) mothers who gave birth in the last six months in Gozamen district from August 1 to September 12, 2019. A stratified cluster sampling technique was used to select the study participants. Data were collected by face-to-face interviewer-administered, pretested, and semi-structured questionnaire. Binary logistic regressions (bi-variable and multivariable) were fitted to identify statistically significant variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to declare statistically significant variables on the basis of p-value < 0.05 in the multivariable binary logistic regression.ResultsThis study indicated that the magnitude of colostrum avoidance was 22.1% (95% CI, 19.0, 25.2%).Mothers who did not get counseling on timely initiation of breast feeding (AOR = 3.91[95% CI, 1.98, 7.72]), not participate in pregnant woman forum (AOR = 2.59[95% CI, 1.30, 5.14]), initiate breast-feeding lately (more than 1 h) (AOR 2.27[95% CI, 1.18, 4.34]), and those having unfavorable attitude towards colostrum feeding (AOR = 7.35[95% CI, 3.89, 13.91]) were factors associated with the increased likelihood of colostrum avoidance. However, institutional delivery (AOR; 0.06[95% CI, 0.02, 0.19]) and prelacteal feeding (AOR; 0.10[95% CI, 0.05, 0.21]) were predictors associated with reduced likelihood of colostrum avoidance.ConclusionColostrum avoidance is a common practice in the study area. Therefore, in order to reduce this practice, strengthening infant feeding counseling, promoting institutional delivery, timely initiation of breastfeeding, health education, and community advocating are recommended interventions. In addition, creating awareness on the benefits of colostrum feeding is very instrumental to tackle the practice of colostrum avoidance.

Survey on Colostrum Management by Dairy Farmers in the Netherlands.

Colostrum feeding is essential for the transfer of passive immunity and health of newborn calves. Information on current colostrum management practices to reduce calf morbidity and mortality is important but lacking for Dutch dairy herds. We therefore conducted a survey to investigate colostrum management strategies on Dutch dairy farms. The survey was specifically focused on the most recently born calf and was returned by 107 respondents (response rate of 13.4%). The mean amount of colostrum fed at first feeding was 2.9 liters. Overall, 79% of farmers provided the calf with at least 6 liters of colostrum in up to three feedings. The majority of respondents (84%) claimed to provide the calf with colostrum for the first time within 2 h post-partum. Using ordinal logistic regression and Wilcoxon rank sum test, we found no differences in time to first colostrum feeding or total amount of colostrum fed between bull calves and heifer calves, respectively. Ordinal logistic regression showed no significant differences in time to first colostrum feeding or time between calving and removing the calf from the dam between AMS and conventional milking herds. Two sample T-test comparing the total volume of colostrum showed no significant difference between AMS and conventional milking herds. Time of day at which a calf was born affected both volume fed at first colostrum feeding and time until first colostrum feeding. Calves born between 00.00 and 06.00 were significantly at risk of receiving the first colostrum later as compared to calves born at other times. Calves born in the evening received on average a lower amount of colostrum at first feeding. Survey results on colostrum management on most Dutch dairy farms are in agreement with the advice to feed as soon as possible after parturition and to provide at least 6 liters within 24 h of age. The current study points at time of calving as a potential risk factor for sub-optimal colostrum feeding. Further research is necessary to determine the consequences of this observation.

Literacy is power: structural drivers of child malnutrition in rural Liberia

BackgroundIn Liberia, an estimated 32% of children under 5 are stunted. Malnutrition and hunger worsened during the country’s civil war and were further exacerbated by the 2014–2016 outbreak of Ebola...

Prevalence and factors associated with malnutrition among under 5-year-old children hospitalised in three public hospitals in South Africa.

BackgroundMalnutrition is a significant risk factor for ill health among children under 5 years of age and the consequences are significant.AimThe aim of this study was to determine the prevalence and factors associated with malnutrition among under-5-year-old hospitalised children.SettingThis study was set at Sebokeng, Kopanong and Heidelberg hospitals, Sedibeng district, South Africa.MethodsThis was a cross-sectional study comprising 306 hospitalised under-5-year-old children. Information on socio-demography, feeding practices, immunisation and clinical problems was obtained from caregivers and medical records. Anthropometric measurements were also performed.ResultsMost participants were male (59.8%), had normal birth weights (80.0%), come from a household with a monthly income R2000 (about 150 US dollars) (50.3%), up-to-date immunisation (97.4%), breastfed for 6 months (57.4%) and were fed 3–4 meals/day (66.7%) and, at most, one snack/day (63.4%). Acute malnutrition accounted for 9.5% (n = 29) of admissions. Among these, 82.8% (n = 24) had severe acute malnutrition. On test of association, monthly household income (p = 0.01), mother’s and father’s employment status (p = 0.01; p = 0.01), breastfeeding history (p = 0.01) and having diarrhoea in index admission (p = 0.01) were significantly associated with malnutrition admission. In multivariate regression analyses, not being breastfed (odds ratio [OR] = 3.9; 95% confidence interval [CI]: 1.23–12.29; p = 0.02) and diarrhoea at index admission were independently associated with malnutrition (OR = 23.3; 95% CI: 6.85–79.43; p = 0.01).ConclusionA significant proportion of participants had malnutrition and were subjected to suboptimal feeding practices. Healthcare providers in primary care need to entrench dietary education and anthropometric screening in all clinic visits for children 5 years old, particularly when they present with diarrhoea or are not being breastfed.

Minimum Acceptable Diet and its Predictors among Children Aged 6-23 Months in Mareka District, Southern Ethiopia: Community Based Cross-Sectional Study

Background: Optimal infant and young child feeding practices are essential for normal growth, better health, and mental and physical development. Even though there are a lot of nutrition intervention programs in Ethiopia, still suboptimal feeding practices are prevalent. This study was devised to assess a level of minimum acceptable diet (MAD) and predictors among children aged 6-23 months in Mareka District, south Ethiopia. Method: A community-based cross-sectional study was employed on 662 study participants from August 15 to September 15/ 2015. They were selected by a multi-stage sampling technique. Data were collected by interviewer-administered semi-structured questionnaires. Statistical significance was declared at p-value &lt;0.05 at multivariable logistic regression. Result: The study showed that 35.5 % of the children aged 6-23 months met the recommended MAD. Maternal primary and secondary education (AOR: 1.90; 95% CI: 1.15-3.16 and AOR: 2.06, 95% CI: 1.12-3.77), Media exposure (AOR: 2.16; 95% CI: 1.46-3.29), health facility delivery (AOR:2.52; 95% CI: 1.54-4.13), child age of 9-11 and 12-23 months (AOR:2.73; 95% CI: 1.41-5.49 and AOR:2.55; 95% CI: 1.39-4.69) and GMP service utilization (AOR: 4.09; 95% CI: 2.51-6.65) were associated with MAD of children. Conclusion: The level of MAD among children was low. Maternal educational status, media exposure, institutional delivery, child age, and GMP service utilization were associated with MAD. Increasing utilization of GMP service, health facility delivery, maternal education, and media promotion was recommended to increase the level of MAD.

Nearly one in three children is suffering from sub-optimal feeding practice in Gibe District, Hadiya zone, South Ethiopia

BackgroundAlthough infant and young child feeding practices play an important role, children in Ethiopia suffer from poor infant and young child feeding. To date, there is a limited study which addresses factors that influence infant and young child feeding practices. The aim of the study was to determine the predictors of infant and young child feeding practices in Gibe District, Hadiya Zone, Ethiopia.MethodsA community-based cross-sectional study was employed on 418 randomly selected mothers with children under the age of 24 months from March 13 to April 13, 2017. The pre-tested structured questionnaire was used to collect the data. Multiple logistic regressions were applied to determine the predictors of infant and young child feeding practices.ResultsA total of 284 (67.9%) infant and young child suffered from the sub-optimal infant and young child feeding practices. The husband being a government employee [adjusted odds ratio (AOR) = 4.08 (1.65, 10.04)], lower household income [(AOR) = 3.11 (1.36, 7.07)], not attending antenatal care (AOR = 2.03 (1.22, 3.36)], child age 0–5 months [AOR = 2.42 (1.02, 5.72)], negative attitude towards infant and young child feeding practices [AOR = 2.35 (1.44, 3.84)], and the number of children 3–4 [AOR = 1.99 (1.08, 3.64)] were predictors of the sub-optimal infant and young child feeding practices.ConclusionSub-optimal infant and young child feeding practices were very high as compared to the WHO infant and child feeding recommendation. The husband being a government employee, lower household income, not attending antenatal care, child age 0–5 months, negative attitude towards infant and young child feeding practices, and the number of children 3–4 were the predictors of the sub-optimal infant and young child feeding practices. Nutritional interventions should emphasize the predictors of sub-optimal infant and young child feeding practices to improve optimal infant and young child feeding practices in Ethiopia.

Persistent Malnutrition and Associated Factors among Children under Five Years Attending Primary Health Care Facilities in Limpopo Province, South Africa.

Despite years of interventions intended to reduce child malnutrition in South Africa, its negative effects, stunting in particular, persist mainly among children under five years old living in under-resourced regions. A cross-sectional study was conducted to determine the prevalence of malnutrition and associated factors among 404 children under age five attending childcare services with their mothers in selected healthcare facilities of Limpopo Province, South Africa. Anthropometry, socio-demographics and obstetric history were collected. Height-for-age, weight-for-age and body mass index-for-age Z-scores were used to determine stunting, underweight and thinness among children, respectively. Logistic regression analyses were performed to generate the factors associated with malnutrition. Stunting (45.3%) was the prevalent form of malnutrition among children under age five, affecting boys (51.7%) more than girls (38.8%) and children aged 12–23 months (62.4%) more than those <11 months old (40.1%), in addition to the overall prevalence of underweight (29.0%) and thinness (12.6%). Boys had increased odds of stunting (adjusted odds ratio, AOR = 2.07, 95% CI: 1.26–3.41, p = 0.004) and underweight (AOR = 2.17, 95% CI: 1.32–3.57, p = 0.002) than girls. Children aged 12–23 months were more likely to be stunted (AOR = 4.79, 95% CI: 2.36–9.75, p ≤ 0.0001) than children aged ≤11 months. Delayed introduction of solid foods increased the odds of stunting (AOR = 5.77, 95% CI: 2.63–12.64, p ≤ 0.0001) and underweight (AOR = 2.05, 95% CI: 1.08–3.89, p = 0.028). Children with normal birth weight were less likely to be thin (AOR = 0.42, 95% CI: 0.19–0.92, p = 0.029) and underweight (AOR = 0.34, 95% CI: 0.17–0.68, p = 0.003) than children who had low birth weight. Children whose mothers had obtained secondary school education (AOR = 0.39, 95% CI: 0.16–0.97, p = 0.044), and Grade 12 or post-Grade 12 education (AOR = 0.32, 95% CI: 0.12–0.83, p = 0.020) were less likely to be stunted than were children of mothers who had only primary school education. Suboptimal complementary feeding predisposed children to stunting and underweight. National nutrition programs should be context-specific to improve the introduction of complementary foods among children, especially in the remote and poor areas.

STUDY OF FEEDING PRACTICES IN CHILDREN WITH SEVERE ACUTE MALNUTRITION (SAM) OF MUMBAI, MAHARASHTRAAGED 9 – 24 MONTHS

BACKGROUND: Malnutrition is a public health concern in India. Suboptimal feeding practices reflect the development of severe acute malnutrition in children. The purpose of the study was to determine the feeding practices in children with severe acute malnutrition (SAM) aged 9 – 24 months. METHODS: A cross-sectional study was conducted in the Nutrition Rehabilitation Research and Training Centre (NRRTC) in Mumbai, Maharashtra including children aged 9 – 24 months. Children were included in the study as per WHO classification of severe acute malnutrition. The information on anthropometric measurements and feeding practices were recorded in a structured questionnaire. Correlation between the feeding practices and anthropometry was examined. Descriptive and bivariate analysis was carried out. RESULTS: 84% of SAM children were found to be severely underweight and 52 % were severely stunted. Only 40% of children were exclusively breastfed. The introduction of complementary feeds at 6 months of age was practiced in 25% of children. 44 % of children were introduced to semi-solid feeds beyond six months of age. Minimum Dietary Diversity was adequate in only 28% of SAM children. There was the least consumption of vitamins and iron-rich food groups among the SAM children. CONCLUSION: Improving maternal awareness about child feeding practices which are preventable risk factors is a key for reducing the burden of severe acute malnutrition.

Breastfeeding but not Exclusively: Exploration of Chinese American Mothers' Infant Feeding Practices.

Previous qualitative researchers have shown that Chinese American mothers experienced high rates of suboptimal breastfeeding, especially early introduction of other foods before the recommended 6-month period of exclusive breastfeeding. (1) To explore attitudes that Chinese American mothers have about the meaning and practice of exclusive breastfeeding; (2) to evaluate the extent of family pressure and support to maintain exclusive breastfeeding; and (3) to examine the influence of breastfeeding self-efficacy and the intention to continue exclusive breastfeeding. Guided by the theory of planned behavior, this descriptive cross-sectional prospective online survey was conducted with Chinese American breastfeeding mothers (N = 401). Participants' attitudes, subjective norms, and perceived behavioral control for exclusive breastfeeding behaviors were measured. The M (SD) age of participants was 29.14 (SD = 6.90). Just over 50% reported receiving family support for exclusive breastfeeding. While participants had positive attitudes about exclusive breastfeeding and the value of colostrum, 64% (n = 257) had already introduced foods other than mother's own milk before their infant was 6-months old. Participants also expressed concern that their infants did not receive enough nutrition from exclusive mother's milk. Participants with more than one child had significantly greater intention to continue exclusive breastfeeding compared to participants with only one child. Perception of approval by others for exclusive breastfeeding and breastfeeding self-efficacy were significantly related to behavioral intention to continue exclusive breastfeeding. Suboptimal infant feeding is a problem for Chinese American women and may also be a problem for mothers in other ethnic groups. We found a lack of adherence with standard recommendations for sustaining 6-months of exclusive breastfeeding.

1200 high-quality metagenome-assembled genomes from the rumen of African cattle and their relevance in the context of sub-optimal feeding

BackgroundThe Boran (Bos indicus), indigenous Zebu cattle breed from sub-Saharan Africa, is remarkably well adapted to harsh tropical environments. Due to financial constraints and low-quality forage, African livestock are rarely fed at 100% maintenance energy requirements (MER) and the effect of sub-optimal restricted feeding on the rumen microbiome of African Zebu cattle remains largely unexplored. We collected 24 rumen fluid samples from six Boran cattle fed at sub-optimal and optimal MER levels and characterised their rumen microbial composition by performing shotgun metagenomics and de novo assembly of metagenome-assembled genomes (MAGs). These MAGs were used as reference database to investigate the effect of diet restriction on the composition and functional potential of the rumen microbiome of African cattle.ResultsWe report 1200 newly discovered MAGs from the rumen of Boran cattle. A total of 850 were dereplicated, and their uniqueness confirmed with pairwise comparisons (based on Mash distances) between African MAGs and other publicly available genomes from the rumen. A genome-centric investigation into sub-optimal diets highlighted a statistically significant effect on rumen microbial abundance profiles and a previously unobserved relationship between whole microbiome shifts in functional potential and taxon-level associations in metabolic pathways.ConclusionsThis study is the first to identify 1200 high-quality African rumen-specific MAGs and provides further insight into the rumen function in harsh environments with food scarcity. The genomic information from the rumen microbiome of an indigenous African cattle breed sheds light on the microbiome contribution to rumen functionality and constitutes a vital resource in addressing food security in developing countries.

Stunting of children under two from repeated pregnancy among young mothers

Repeated pregnancy leaves young mothers nutritionally deprived which may in turn lead to poor infant growth. We measure the occurrence and persistence of stunting among offspring of young mothers who experienced repeated pregnancies using data from the Cebu Longitudinal Health and Nutrition Survey. We selected mothers aged 14–24 years (n = 1,033) with singleton birth. We determined the length-for-age z scores (LAZ) at 12 and 24 months of the index child using the World Health Organisation 2007 growth standard. We fitted LAZ, stunting occurrence (i.e. LAZ < − 2) and persistence from 12 to 24 months into regression models and tested for the mediating effect of low birthweight and feeding practices. In these models, repeated pregnancy was analysed in an ordinal approach using number of past pregnancies of young mothers at birth of the index child. Compared to infants born to young mothers aged 14–24 years who had no previous pregnancies, those born to young mothers with repeated pregnancies have at least 0.15 (95% CI − 0.23, − 0.08) LAZ lower and are at higher chance of stunting by at least 40% (95% CI 1.19, 1.67) at 12 and 24 months. Similar cohorts of infants showed an elevated risk of persistent stunting from 12 through 24 months with a relative risk ratio of 1.51 (95% CI 1.21, 1.88). Optimal feeding practices substantially mediated stunting outcomes by further reducing the effects of repeated pregnancy to stunting occurrence and persistence by 19.95% and 18.09% respectively. Mediation tests also showed low birthweight in the causal pathway between repeated pregnancy and stunting. Repeated pregnancy in young mothers is a predictor of stunting among children under 2 years. Secondary pregnancy prevention measures and addressing suboptimal feeding practices are beneficial to mitigate the negative impact of repeated adolescent pregnancy on children.

Complementary feeding practices among infants and young children in Abu Dhabi, United Arab Emirates

BackgroundOptimal complementary feeding (CF) promotes health and supports growth and development in children. While suboptimal feeding practices are reported for many countries, very limited information exists about such practices in the United Arab Emirates (UAE). The present study describes CF practices in Abu Dhabi, UAE, and evaluates them using the United Nations Children’s Fund (UNICEF) Programming Guide: Infant and Young Child Feeding.MethodsIn this cross-sectional study, participating mothers of children below the age of two reported on their children’s CF introduction and practices via a structured questionnaire. The study received ethical approval (ZU17_006_F) from Zayed University.ResultsOut of 1822 participating mothers, 938 had initiated complementary feeding for their children, who had a mean age of 7.1 ± 5.9 months. Three quarters of the children (72.2%) were introduced to CF in a timely manner between the ages of 6 and 9 months. A majority (71.4%) consumed ≥4 food groups, i.e. the recommended minimum diet diversity. In total, less than half (47.3%) of the children met the requirements for minimum meal frequency, with the non-breastfed, 6–23 month old children being the least compliant (21.9%) (p < 0.001). Many children were fed with sugar-containing snack items. Overall, 36.2% of the children aged ≥6 months had a minimum acceptable diet.ConclusionThe gap between the suboptimal CF practices and the recommendations may be attributable to poor knowledge about feeding practices rather than food availability problems. Effective intervention programs can facilitate improvements in the feeding practices to better support a healthy upbringing among Abu Dhabi infants and toddlers.

Low food quality hinders male height growth more than female’s in Burkina Faso

As in many developing countries, stunting is a public health problem in Burkina Faso. More than one in four children does not reach his or her growth potential. In addition, all nutrition surveys conducted in the country reveal that boys are more affected. This stunting gender bias is supported by the Trivers-Willard theory that there is a natural discriminating investment in reproduction according to sex through sociodemographic characteristics, behaviour and biology. The present study is intended to investigate the role of food quality in the occurrence of this phenomenon.&#x0D; This cross-sectional and explanatory study of children under five years of age is based on data from Burkina Faso’s latest 2010 Demographic and Health Survey. Analyses were carried out on only the subsample of 6994 under-five year old children on which the anthropometric measures were taken. The assessment of child growth is based on the anthropometric index height-for-age z-score and the food quality assessment is based on the joint WHO/Unicef standard. The explanatory model used to examine the effect of the food quality is based on logistic regression.&#x0D; The prevalence of balanced diets among the children was 7.2% and there was no gender difference. On the other hand, stunting prevalence was significantly higher for boys (37.7% versus 32.6%). Children who were subjected to suboptimal feeding practices had three times more adjusted risk of stunting for both sexes. In addition, poor feeding practices led to a significantly higher growth deficit in boys compared to girls. However, when the diet was adequate, this risk gap dwindled. The higher prevalence of stunting of boys in the absence of food discrimination led us to single out behaviour and biology effects as the likely explanatory variables. Girls' natural resilience to certain infections and nutritional deficiencies could explain this difference in risk.&#x0D; Improved under-five year old child feeding practices contribute to improving overall growth stature and contribute also to bridging the gender gap in stunting.

Increasing picocyanobacteria success in shelf waters contributes to long-term food web degradation.

Continental margins are disproportionally important for global primary production, fisheries and CO2 uptake. However, across the Northeast Atlantic shelves, there has been an ongoing summertime decline of key biota-large diatoms, dinoflagellates and copepods-that traditionally fuel higher tropic levels such as fish, sea birds and marine mammals. Here, we combine multiple time series with in situ process studies to link these declines to summer nutrient stress and increasing proportions of picophytoplankton that can comprise up to 90% of the combined pico- and nanophytoplankton biomass in coastal areas. Among the pico-fraction, it is the cyanobacterium Synechococcus that flourishes when iron and nitrogen resupply to surface waters are diminished. Our field data show how traits beyond small size give Synechococcus a competitive edge over pico- and nanoeukaryotes. Key is their ability to grow at low irradiances near the nutricline, which is aided by their superior light-harvesting system and high affinity to iron. However, minute size and lack of essential biomolecules (e.g. omega-3 polyunsaturated fatty acids and sterols) render Synechococcus poor primary producers to sustain shelf sea food webs efficiently. The combination of earlier spring blooms and lower summer food quantity and quality creates an increasing period of suboptimal feeding conditions for zooplankton at a time of year when their metabolic demand is highest. We suggest that this nutrition-related mismatch has contributed to the widespread, ~50% decline in summer copepod abundance we observe over the last 60years. With Synechococcus clades being prominent from the tropics to the Arctic and their abundances increasing worldwide, our study informs projections of future food web dynamics in coastal and shelf areas where droughts and stratification lead to increasing nutrient starvation of surface waters.

Understanding Complementary Feeding Practices in Children 6–23 Months in the West and Central Africa Region: A Mixed Methods Regional Analysis of 24 Countries

Abstract Objectives 1) To describe the trends of complementary feeding since 2010; 2) to understand the factors influencing the sub-optimal feeding practices; and 3) to generate recommendations to inform future interventions. Methods Mixed methods study with an iterative, two phase design. Phase 1: quantitative data analysis of 13 key complementary feeding indicators reported in 68 national survey reports from 2010 to 2018. Phase 2: semi-structured qualitative interviews with 14 regional informants (UN, Government, NGO, and donor communities). We conducted a literature review of grey and peer-reviewed publications in 2010–2019 to contextualize the results. Results Phase 1. Across 24 WCAR countries, mean continued breastfeeding at 1y was 89%, but halved to 44% by 2y. Introduction of complementary foods occurred in 64% of children 6–8 mos. Minimum meal frequency in children 6–23 mos increased over time from 27% to 38% while minimum dietary diversity and minimum acceptable diet were stagnant (22% and 10%, respectively) since 2010. Intake of nutrient rich foods (vitamin A, animal source, iron-rich) were reported in about half of children, respectively. The proportion of children (only reported for &amp;lt; 5 y) receiving vitamin A (66%), or iron supplements (15%), or iodized salt (79%) varied. Phase 2. Regionally, we identified policy, community, institutional, household, interpersonal, and individual level barriers. Additionally, non-modifiable factors including environmental shocks/hazards and security issues (i.e., violence), were said to disrupt food systems. From a systems perspective, major facilitators to optimal complementary feeding fell within the ‘health and nutrition’ or ‘food system’ sectors; fewer were ascribed to ‘WASH’ or ‘social protection’. Preliminary recommendations from key informants and supported by the literature review were largely multi-sectorial, yet a strong emphasis was placed on the policy level. Conclusions Since 2010, complementary feeding practices in WCAR have remained nearly unchanged. Inter-related factors influencing complementary feeding distribute across levels and sectors, suggesting the need for more multi-sectorial, integrated intervention strategies to improve child nutrition in WCAR. Funding Sources Bill &amp; Melinda Gates Foundation funding to UNICEF-WCARO.