Anemia in Breastfeeding Women and Its Impact on Offspring's Health in Indonesia: A Narrative Review.

Anemia in breastfeeding women is a neglected global health issue with significant implications for maternal and child health. Despite its widespread occurrence and adverse effects, this problem remains largely unknown and overlooked on the global health agenda. Despite efforts to improve health access coverage and provide iron and folic acid supplementation, anemia persists. This underscores the need for a comprehensive approach to address the problem. Urgent action must be taken to prioritize education and awareness campaigns, ensure access to nutritious food, and enhance healthcare services. Education programs should focus on promoting iron-rich diets, dispelling cultural myths, and providing practical guidance. Improving healthcare services requires increasing availability, ensuring a consistent supply of iron supplements, and providing adequate training for healthcare providers. A successful implementation relies on a strong collaboration between the government, healthcare providers, and community. It is crucial that we acknowledge that high coverage alone is insufficient for solving the issue, emphasizing the importance of targeted interventions and a strategic implementation. By adopting a comprehensive approach and addressing the underlying causes of anemia, Indonesia can make significant progress in reducing its prevalence and improving the overall health of its population, particularly among breastfeeding women.

Lactose Intolerance versus Cow's Milk Allergy in Infants: A Clinical Dilemma.

Due to its very early introduction, cow's milk is one of the first foods that can cause adverse reactions in human beings. Lactose intolerance (LI) and cow's milk allergy (CMA) are the most common adverse reactions to cow's milk. While LI is due to insufficient small intestinal lactase activity and/or a large quantity of ingested lactose, CMA is an aberrant immune reaction to cow's milk proteins, particularly casein or ß-lactoglobulin. However, the clinical manifestations of LI and CMA, particularly their gastrointestinal signs and symptoms, are very similar, which might lead to misdiagnosis or delayed diagnosis as well as nutritional risks due to inappropriate dietary interventions or unnecessary dietary restriction. Formula-fed infants with LI should be treated with formula with reduced or no lactose, while those with CMA should be treated with formula containing extensive hydrolyzed cow's milk protein or amino acids. This review is therefore written to assist clinicians to better understand the pathophysiologies of LI and CMA as well as to recognize the similarities and differences between clinical manifestations of LI and CMA.

Disease-Related Malnutrition in Pediatric Patients with Chronic Disease: A Developing Country Perspective.

Malnutrition is widely known to affect growth in children. There are many studies focusing on malnutrition globally in relation to limited food access; however, there is only limited research on disease-related malnutrition, especially in chronic conditions and particularly in developing countries. This study aims to review articles on the measurement of malnutrition in pediatric chronic disease, especially in developing countries where there are resource limitations in identifying nutritional status in pediatric chronic disease with complex conditions. This state-of-the-art narrative review was conducted through search of literatures through 2 databases, and identified 31 eligible articles published from 1990 to 2021. This study found no uniformity in malnutrition definitions and no consensus regarding screening tools for the identification of the malnutrition risk in these children. In developing countries where resources are limited, instead of focusing on finding the best tools to identify the malnutrition risk, the approach should be directed toward developing systems that work best according to capacity and allow for a combination of anthropometry assessment, clinical evaluation, and observation of feeding access and tolerance on a regular basis.