Evaluation of nutritional status using the minimum dietary diversity for women of reproductive age (MDD-W) tool in breastfeeding mothers in Madagascar.

OBJECTIVES: Women of reproductive age in low-income countries are especially nutritionally vulnerable given the strain that pregnancy and lactation places on the body. The aim of this study was to identify dietary diversity and its associated factors among mothers with young children. METHODS: It is a cross-sectional study conducted in Ampefy, Madagascar from 1 November 2022 to 31 March 2023. Dietary diversity was determined using the minimum dietary diversity for women of reproductive age tool. Data were collected through face-to-face interviews using validated structured questionnaires, and anthropometric status was examined. Frequencies and percentages were calculated, and the comparison of variables was performed between mothers with acceptable and unacceptable dietary diversity using the chi-square test for qualitative variables. A logistic regression analysis was also conducted. RESULTS: A total of 437 mothers with young children participated in the study, resulting in a response rate of 95.0%. The mean age of the participants was 25.84 years (SD = 6.30). The study revealed that 32.95% of participants had unacceptable dietary diversity scores and the associated profile included low education, no transport, homebirth not by personal choice, not breastfeeding within the first hour of birth, not breastfeed exclusively for 6 months, no dietary changes during pregnancy or lactation, and no use of folic acid supplements. CONCLUSION: This study's findings underscore the importance of providing nutrition information to women, in order to improve dietary diversity and overall maternal and child health.

Inappropriate complementary feeding practice and associated factors among children aged 6-23 months in Shashemene, Southern Ethiopia: a community-based cross-sectional study.

BACKGROUND: Inappropriate complementary feeding is widely practiced in low and middle income countries. These contribute to undernutrition, morbidity and mortality among young children. The incidence of malnutrition in the first two years of life has been directly linked with inappropriate complementary feeding practices along with high infectious disease levels. OBJECTIVE: To assess the level of inappropriate complementary feeding practice and associated factors among children aged 6 to 23 months in Shashemene, Southern Ethiopia. METHOD: A community-based cross-sectional study was conducted from July to August 2021 among 609 children aged 6 to 23 months paired with their caregivers. Systematic random sampling was used to identify study participants. Data were analyzed by using SPSS version 25 software. Binary logistic regression analysis was used to identify predictors of inappropriate complementary feeding practice. Statistical significance was determined using Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI). RESULTS: The prevalence of inappropriate complementary feeding practice among children aged 6-23 months was 55.3%. Being a mother under the age of 25 years [AOR = 2.07, 95% CI: 1.30, 3.31], aged 25-34 years [AOR = 1.82, 95% CI: 1.14, 2.91], having an occupation [AOR = 2.73, 95% CI: 1.84, 4.05], and households where husbands' are the sole decision makers on their income [AOR = 2.41, 95% CI: 1.54, 3.77] increased the chance of inappropriate complementary feeding practice. On the other hand, mother's whose infants were aged 9-11 months [AOR = 0.30, 95% CI: 0.19-0.45] were less likely to practice inappropriate complementary feeding. CONCLUSIONS: The prevalence of inappropriate complementary feeding practice in the study area was high compared to the WHO recommendation. Child's age, maternal age, maternal occupation, and decision-making role on income were found to be associated with inappropriate complementary feeding practice. Appropriate behavioral change communication to family and community decision-makers, and involvement of husbands in infant and young child feeding practice are recommendable.

Pre-lacteal feeding practice and associated factors among mothers having children aged less than six months in Dilla town, Southern Ethiopia.

BACKGROUND: Pre-lacteal feeding, the introduction of liquids or non-breast milk foods before establishing regular breastfeeding, poses significant risks to newborns, depriving them of vital nutrients and the protective benefits of colostrum while exposing them to infection hazards. Despite breast milk being a renewable and comprehensive source of infant nutrition for the first six months of life, prevalent in many low income country are pre-lacteal feeds such as honey, sugar-water, jiggery water, castor oil, and goat's milk. These practices, widespread in such regions, carry potential risks of infection and aspiration. The objective of this study is to assess the prevalence of pre-lacteal feeding and identify associated factors among mothers with children under six months in Dilla Town, Southern Ethiopia. METHOD: A community-based cross-sectional study took place in Dilla town, southern Ethiopia, spanning from June 20 to August 20, 2022. The study included a total of 372 participants, selected through simple random sampling for kebele and systematic random sampling for individual participants. Data was collected using interviewer-administered structured questionnaires and subsequently coded, entered, cleaned, and edited using SPSS version 23.0 software. The presentation of data utilized tables and figures, followed by a logistic regression analysis to identify potential factors associated with pre-lacteal feeding. The significance level was set at a p-value less than 0.05 for the final model. RESULT: The prevalence of pre-lacteal feeding practice was 176 (47.3%) in the study area and having no maternal education (AOR = 3.68, 95% CI; [1.01-5.84] colostrum avoidance (AOR = 4.20, 95% CI; [2.03-6.86] and lack of breast feeding counseling (AOR = 2.00, 95% CI; 1.40-2.57), were factors associated with pre-lacteal feeding practices. CONCLUSION AND RECOMMENDATION: Pre-lacteal feeding practice among mothers of children aged less than 6 months in Dilla town was found to be higher than the national prevalence. No formal education, colostrum avoidance, lack of breastfeeding counseling, were factors associated with pre-lacteal feeding practices. So awareness creation activities on the risks of PLF (pre-lacteal feeding) and improving breastfeeding counseling targeted to all mothers and care givers including their families within the study area is vital.

Individual characteristics and environmental factors influencing preschoolers' emotional eating.

Emotional eating, which refers to eating in response to emotional states, is prevalent in early childhood. Executive function (EF) and sleep problems are related to preschoolers' self-regulatory abilities during the day and night and have been reported to be associated with their emotional eating. These associations can be stronger in emotionally stressful situations, such as controlling feeding practices. This study explored the role of preschoolers' EF and sleep problems as child characteristics, as well as maternal feeding practices as environmental factors influencing emotional eating during the preschool period. Participants included 363 Korean mothers with preschoolers aged 3- to 5-years old (190 boys, 173 girls). Mothers reported on their own feeding practices, and preschoolers' EF, sleep problems, and emotional eating. Results indicated that preschoolers' EF was negatively associated with emotional over- and undereating, and this association was stronger when mothers applied more pressure to eat. Maternal monitoring had a similar effect, with emotional overeating exerting a greater impact with low levels of maternal monitoring. Finally, maternal pressure to eat moderated the influence of preschoolers' sleep problems on emotional overeating, with higher pressure to eat predicting a stronger relationship between sleep problems and emotional overeating. These findings suggest that maternal feeding practices, which are relatively modifiable, should be considered an important element in intervention programs aimed at preventing emotional eating in preschool children.

Factors associated with infant and young child feeding practices in children aged 6-23 months in Indonesia: A nationwide study.

INTRODUCTION: Children-related nutrition raises significant attention due to the low implementation of infant and young child feeding (IYCF) practices. However, the factors affecting the low implementation of IYCF remains limited globally. This study aimed to identify factors influencing IYCF in children aged 6-23 months in Indonesia. METHODS: We conducted a cross-sectional study using data from the 2017 Indonesian Demographic and Health Survey. A total of 4943 responses were included. We employed binary logistic regression to determine the factors affecting IYCF practices in children aged 6-23 months. The results are reported as odds ratios (OR) with a 95% confidence interval (CI) and a significance level of p < 0.05. RESULTS: Several factors significantly influenced IYCF practices among children aged 6-23 months, including the age of the child (OR: 0.42; 95% CI: 0.27-0.65), middle wealth index (OR: 1.85; 95% CI: 1.12-3.08), regional disparities (OR: 0.43; 95% CI: 0.23-0.77), place of residence (OR: 1.77; 95% CI: 1.17-2.68), and a history of childhood diseases like fever (OR: 1.65; 95% CI: 1.05-2.58). CONCLUSION: This study highlights the significance of various factors related to IYCF practices among children aged 6-23 months. These factors include maternal aspects such as wealth index, child-related factors like age, a history of childhood illnesses such as fever, and environmental factors such as regional disparities and place of residence. PRACTICE IMPLICATIONS: Paediatric nurses can contribute to enhancing maternal knowledge by providing education on the importance of infant and child feeding practices, beginning early in the child's life.

The Association of Parental Feeding Practices, Parental Control Over children's Eating Behavior, and Sociodemographic Characteristics with Childhood Overweight and Obesity in Türkiye.

Parents both respond to and influence their child's weight. This study aimed to investigate the association of parental feeding practices, parental control over children's eating behavior, and sociodemographic characteristics with childhood overweight and obesity. This descriptive cross-sectional study was conducted with 405 parents of children aged 7-11 years. Predictors that decreased the risk of childhood overweight/obesity were increase in child age (27.9%), high maternal education (61.7%), upper socioeconomic status (38.9%), increase in parental covert control (30.4%), and increase in parental pressure to eat (46.2%). Examining both parental attitudes and practices regarding child feeding and parental approaches to child food choices can benefit early intervention programs to prevent overweight and obesity in children.

Associations of parental feeding practices with children's eating behaviors and food preferences: a Chinese cross-sectional study.

BACKGROUND: Childhood inadequate eating behaviors contribute to the epidemic of obesity. Previous research suggests that parental feeding practices are partially associated with development of eating behaviors among children, but the results are inconsistent. The present study was to investigate whether parental feeding practices were associated with eating behaviors and food preferences among Chinese children. METHODS: A cross-sectional study was conducted to collect data from 242 children (ages 7-12) in six-primary schools in Shanghai, China. A series of questionnaires including parental feeding practices and children's eating behaviors have been validated, and were completed by one of parent who has responded for child's daily diet and living. In addition, researchers instructed children to complete the questionnaire of food preference. After adjustment for children's age, sex and BMI status, as well as parental education and family income, the linear regression analysis was used to evaluate relationships of parental feeding practices with children's eating behaviors and food preferences. RESULTS: Parents with boys had higher level of control overeating practice than those with girls. Mothers who responded to child's daily diet and living and completed feeding practices questionnaire used a greater level of emotional feeding practices than fathers. Boys had higher levels of food responsiveness, emotional overeating, enjoyment of food and desire to drink than girls. Boys had different preferences for meat, processed meat products, fast foods, dairy foods, eggs, and snacks and starchy staples & beans from girls. In addition, scores of instrumental feeding practice and preference for meat significantly differed among children with different weight status. Furthermore, parental emotional feeding practice was positively associated with children's emotional undereating (ß 0.54, 95% CI 0.16 to 0.92). There were also positive associations of parental encouragement to eat with children's preference for the processed meat (ß 0.43, 95% CI 0.08 to 0.77). Moreover, instrumental feeding practice was negatively associated with children's fish liking (ß -0.47, 95% CI -0.94 to -0.01). CONCLUSION: The current findings support associations of emotional feeding practice with some children's emotional undereating, as well as parental encouragement to eat and instrumental feeding practice related to preference for processed meat and fish, respectively. Further studies should continue to ascertain these associations using longitudinal designs, and to evaluate efficacy of parental feeding practices impacting developments of healthy eating behaviors and preferences for healthy foods among children by interventional studies.

Survey on human milk feeding and enteral feeding practices for very-low-birth-weight infants in NICUs in China Neonatal Network.

BACKGROUND: The breastfeeding rate in China is lower than that in many other countries and the extent of adoption of the "Feeding Recommendations for Preterm Infants and Low Birth Weight Infants" guideline in NICUs remains unclear. METHOD: A web-based survey about the current status of human milk feeding and enteral feeding practices at NICUs was sent to all China Neonatal Network's cooperation units on September 7, 2021, and the respondents were given a month to send their responses. RESULTS: All sixty NICUs responded to the survey, the reply rate was 100%. All units encouraged breastfeeding and provided regular breastfeeding education. Thirty-six units (60.0%) had a dedicated breastfeeding/pumping room, 55 (91.7%) provided kangaroo care, 20 (33.3%) had family rooms, and 33 (55.0%) routinely provided family integrated care. Twenty hospitals (33.3%) had their own human milk banks, and only 13 (21.7%) used donor human milk. Eight units (13.3%) did not have written standard nutrition management guidelines for infants with body weight < 1500 g. Most units initiated minimal enteral nutrition with mother's milk for infants with birth weight ˂1500 g within 24 h after birth. Fifty NICUs (83.3%) increased the volume of enteral feeding at 10-20 ml/kg daily. Thirty-one NICUs (51.7%) assessed gastric residual content before every feeding session. Forty-one NICUs (68.3%) did not change the course of enteral nutrition management during drug treatment for patent ductus arteriosus, and 29 NICUs (48.3%) instated NPO for 1 or 2 feeds during blood transfusion. CONCLUSION: There were significant differences in human milk feeding and enteral feeding strategies between the NICUs in CHNN, but also similarities. The data obtained would be useful in the establishment of national enteral feeding guidelines for preterm infants and quality improvement of cooperation at the national level.

Determinants of dietary diversity among children 6-23 months: a cross-sectional study in three regions of Haiti.

BACKGROUND: The prenatal, perinatal, postnatal and nutritional (A3PN) support study was a 4-year initiative aimed to reduce maternal mortality in Haiti. A cross-sectional study was developed to collect the baseline data for evaluation purposes of the A3PN. This study aimed to determine the factors contributing to dietary diversity (DD) in Haitian children aged 6-23 months. METHODS: A cross-sectional study during two seasons (the lean season and the harvest season) was carried out in Haiti to assess the DD of children and their mothers using non-quantitative 24-h recalls. Indicators of DD were minimum dietary diversity for children (MDD-C) and minimum dietary diversity for women (MDD-W). Mid-upper arm circumference was measured in women and children, and food security was assessed using the Household Hunger Scale. Focus groups were also conducted to gain a better understanding of the quantitative findings. RESULTS: Only 7.3% of the children included in this study met the MDD-C. Factors associated with MDD-C were the season (odds ratio [OR]: 0.141 [0.039-0.513]), land ownership or rental (OR: 4.603 [1.233-17.188]), maternal education (OR: 0.092 [0.011-0.749]), the mother's responsibility for the main or secondary source of income for the household (OR: 2.883 [1.030-8.069]) and her DD (OR: 5.690 [1.916-16.892]). Focus groups revealed the existence of various food restrictions. CONCLUSIONS: The results indicated that the low prevalence of MDD-C in three regions of study in Haiti is indicative of a serious public health concern that might be further aggravated by local food taboos. They also suggest that to fight against hunger, it is necessary to focus on women's well-being.

The association between parents' stress and parental feeding practices and feeding styles: Systematic review and meta-analysis of observational studies.

In the extended UNICEF framework of early childhood nutrition, parents' stress is associated with parental feeding style. However, no comprehensive review has examined the association between parents' stress and feeding styles and practices. The objective of our review was to synthesise the current literature examining the association between parents' stress and their feeding practices and/or styles, among parents of children ≤ 5 years old. We searched; MEDLINE, EMBASE, PSYCHINFO and CINAHL from 2019 to 2021. Two investigators independently extracted relevant data and assessed the study quality and the certainty of evidence. Data were pooled using generic inverse variance with fixed effects (<5 comparisons) or random effects (≥5 comparisons) and expressed as correlation coefficients with 95% confidence intervals (CI). Between study heterogeneity was assessed using Cochran's Q and quantified with I2 . We identified 6 longitudinal and 11 cross-sectional studies, of which 4 studies provided sufficient data to be pooled. A very small correlation between general stress and restrictive feeding practices was observed (r = 0.06 [95% CI: 0.01-0.12]; no substantial heterogeneity (I2 = 0.00%, PQ < 0.85, very low certainty). No correlation between general stress and feeding pressure was identified (r = 0.06 [95% CI: -0.02 to 0.15]). Results showed that both general and parenting stress were associated with suboptimal breastfeeding practices and unresponsive feeding styles. Conclusion: This study demonstrated a low-to-moderate quality of literature for the inclusion of parents' stress in the extended UNICEF care model of child nutrition. Future research needs to explore this relationship longitudinally and in ethnic diverse populations to inform tailored interventions that promote responsive feeding practices.

Infant and preschooler feeding behaviors in Chinese families: A systematic review.

A systematic review was conducted on the literature on feeding behaviors in Chinese families of children under 6 years old. Forty relevant publications were identified, of which 33 were published in Chinese, 7 in English. All studies were questionnaire-based and used a cross-sectional research design. Approximately half of the studies reported a score for each feeding practice/style, based on a Likert scale; the other half dichotomized these scores into a percentage of the population that reported frequent use of the behaviors. The most commonly reported feeding style of Chinese caregivers was a locally defined "active response" style that somewhat resembled authoritative parenting. The most commonly reported feeding practices were praise, encouraging trying new foods, encouragement of balanced diet and encouragement of healthy eating. Some behaviors showed a great deal of variance in prevalence between studies, which may be at least partially due to differences in methodology and how behaviors were defined. Some feeding behaviors varied in frequency depending on the child's age, although longitudinal studies are needed to better understand how these evolve over time. Child body composition was also associated with feeding behaviors use, although the direction of the association cannot be determined due to the cross-sectional nature of the research. There is still an important gap in the literature regarding the feeding behaviors of non-maternal caregivers, as grandparents often play an important role in childcare in China.

Optimal complementary feeding practices and associated factors among mothers having children 6 to 23 months, south WOLLO zone, Dessie ZURIA, Ethiopia.

INTRODUCTION: Optimal complementary feeding practice is a child feeding practice that fulfills the minimum dietary diversity, the minimum meal frequency, continuing breastfeeding with complementary feeding, and initiation of complementary feeding from 6 to 8 months. METHOD: A community-based comparative cross-sectional study was conducted on a total of 732 randomly selected mothers having children 6 to 23 months of age from March 10 to April 21 /2021.Data were collected using a pre-tested interviewer-administered questionnaire. Data entry was performed by using Epi data version 3.1 and was exported to Stata version 14.1. Descriptive statistics were done. Multivariable Logistic regression was used to predict the role of independent variables on optimal complementary feeding. Findings with a p-value <0.05 at a 95% confidence interval (CI) were considered statistically significant in the final model. RESULT: The overall proportion of mothers with optimal complementary feeding practice was 18.1% (95% C I 15.3% - 21.0). Only 90 (25.1%, 95% CI = 20.6-29.7) of mothers were found to have optimal complementary feeding practice in NGO supported kebeles but only 37 (10.8%, 95% CI = 7.5-14.1) practiced optimal complementary feeding is not NGO-supported kebeles. Mothers from Kebeles with no NGO support were 46% (AOR = 0.54, 95% CI 0.31, 0.96) less likely to practice optimal complementary feeding. On the other hand, mothers of children aged20-23 months were four times (AOR = 4.47, 95% CI 2.02-9.91) more likely to practice optimal complementary feeding than mothers having children 6-8 months of age. PRACTICE IMPLICATIONS: Different interventions have been implemented by governmental and non-governmental organizations to improve this condition in Dessie Zuria District. But, there is limited data on the extent to which intervention by governmental and non-governmental organizations reduces this improving condition. The aim of this study was to assess the Optimal Complementary Feeding Practice and Associated Factors among Mothers Having Children Aged 6-23 Months, Ethiopia 2021. CONCLUSION: Optimal complementary feeding practices among mothers in NGO-supported kebeles were higher than not supported kebeles. Therefore, strengthening and scaling up the program to not-supported kebeles is recommended to improve the optimal complementary feeding practiced.

Dental caries and associated risk factors in 13- to 18-month-old infants receiving breast or formula milk feeding: A cross-sectional study.

BACKGROUND: The association between breast milk feeding and dental caries risk in children remains controversial. Moreover, it is unclear whether risk factors for caries differ between breast milk-fed and formula milk-fed infants. AIM: To investigate dental caries in 13- to 18-month-old infants receiving breast milk or formula milk feeding and associated risk factors. DESIGN: One hundred and sixty-six 13- to 18-month-old infants were recruited from a tertiary hospital in Bangkok, Thailand. Information on feeding practices, demographics, and potential risk factors was collected using a caregiver questionnaire. Carious lesions were identified by visual and tactile examination. The Chi-squared test, Mann-Whitney U test, and logistic regression model were used for statistical analysis. RESULTS: The prevalence of caries in breast milk- and formula milk-fed infants was 31.8% and 36.0%, respectively, with no statistically significant difference (p = .579). Among all children, having dental plaque deposition on more than one third of the crown (adjusted OR (aOR): 15.11%; 95% CI: 6.11-37.35) and sleeping while milk feeding (aOR: 2.20%; 95%CI: 1.01-4.77) were associated with dental caries. In subgroup analysis, however, sleeping while milk feeding increased caries risk in the formula milk-fed group only (aOR: 2.95%; 95%CI: 1.07-8.12). CONCLUSIONS: The type of milk feeding was not associated with dental caries, whereas dental plaque and sleeping while milk feeding increased the odds of having dental caries in this population.

Women empowerment and minimum daily meal frequency among infants and young children in Ghana: analysis of Ghana demographic and health survey.

BACKGROUND: The nutritional quality of food has an important impact on the health and well-being of families, especially children whose bodies need to grow, develop and reach their full physical and mental potential. Traditionally, women in Ghana provide care and nourishment for their children and families if they have the means to do so or if they are financially, legally and socially empowered. Women's empowerment is not only important for women's human rights, but also improves nutrition and health outcomes of both mothers and their children. Women's empowerment is concerned with increasing ability to make strategic life choices in situations where the ability was hitherto denied. This study sought to investigate the association between women's empowerment and minimum daily meal frequency (minimum number of meals to be consumed in a day) in Ghana. METHODS: The study used data from the 2014 Ghana Demographic and Health Survey (GDHS). A sample of 1640 mother-child dyad was used. Mothers ages ranged from 15 to 49 while children's ages ranged from 6 to 23 months. Univariate and multiple linear regression techniques were applied to identify women empowerment (economic, socio-familial and legal) and sociodemographic factors associated with minimum daily meal frequency scores. Data was analyzed by the STATA statistical package software version 13.0. Statistical significance level was set at P < 0.10. RESULTS: Data from decisions on large household purchases (ß = 0.351, p < 0.01) family visits (ß = 0.743, p < 0.01), home ownership (ß = - 0.245, p < 0.10), age of child (ß = 1.387, p < 0.01), mother's educational attainment (ß = 0.496, p < 0.10) and place of residence (ß = - 0.298, p < 0.10) showed significant positive association with minimum daily meal frequency in Ghana. CONCLUSION: Minimum daily meal frequency was largely influenced by economic and socio-familial factors that contribute to empowerment of women. as decisions on large household purchases and family visits showed significant positive association with minimum daily meal frequency. Interventional programs should target households and mothers with lower socio-demographic characteristics such as lower educational levels and low economic status to improve minimal daily meal frequency in their children thereby ensuring better child health and well-being.

Complementary feeding practice and associated factors among internally displaced mothers of children aged 6-23 months in Amhara region, Northwest Ethiopia: a cross-sectional study.

BACKGROUND: Internally displaced populations are susceptible to food deprivation. Specifically, children aged 6-23 are commonly vulnerable to poor complementary feeding. Proper complementary feeding is of paramount importance to the healthy growth and survival of a children. Therefore, this study aimed to assess the level of appropriate complementary feeding practices and associated factors among internally displaced children aged 6-23 months in northwest Ethiopia, 2020. METHODS: A community-based cross-sectional study was conducted from June to July 2020 among 264 internally displaced mothers of children 6-23 months in northwest Ethiopia. A systematic random sampling technique was used to reach the study subjects and data were collected using a structured and pre-tested interviewer-administered questionnaire. Data were entered into the Epi Data version 4.1 and analyzed using SPSS version 23. Binary and multivariable analyses with a 95% confidence level were performed. In the final model, variables with P < 0.05 were considered statistically significant. RESULTS: The overall level of appropriate complementary feeding practice was 26.8%. Only 14% of the mothers provided a diversified diet for their 6-23 months children. Child aged 6-11 months (AOR = 0.11, 95%; CI: 0.04-0.27), 12-17 months (AOR = 0.35, 95%; 95% CI: 0.17-0.70) and not having harmful culture on complementary feeding (AOR = 2.04; 95% CI: 1.06-3.96) were independent predictors of appropriate complementary feeding practices. CONCLUSION: The level of appropriate complementary feeding practice was found to be low, which would have negative implications on the health and nutritional status of infants and young children. Additional rations for breastfeeding mothers and children aged 6-23 months at refugee camps and nutritional counseling on child feeding practices are recommended.

Associations between the infant and young child feeding index and nutritional status.

BACKGROUND: The infant and child feeding index (ICFI) is a single summary World Health Organization influenced index to assess feeding quality in infants and young children aged 6-36 months. This study aimed to demonstrate any associations between ICFI and nutritional status in a single Thai center. METHODS: The demographic data and feeding practices of healthy infants and children aged 6-36 months were collected from questionnaires given to 304 parents/caregivers; anthropometric measurements were taken. Associations between ICFI and weight-for-age Z scores (WAZ), length/height for age Z scores (LAZ/HAZ), weight-for-length/height Z scores (WLZ/WHZ), and body mass index-for-age Z scores (BAZ) were examined. RESULTS: The mean ICFI was 6.14 ± 1.63 and was lowest in the 6-8 months age group. Breastfed infants had significantly higher ICFI scores than those not breastfed. Factors influencing ICFI were infant age and milk volume intake. The ICFI was negatively associated with WAZ, WLZ/WHZ, and BAZ (ß = -0.13, P = 0.037; ß = -0.17, p = 0.01; ß = -0.15, P = 0.026, respectively). Breastfeeding was also negatively associated with WAZ, LAZ/HAZ, WLZ/WHZ, and BAZ. CONCLUSIONS: This study demonstrated a negative association between the ICFI and nutritional status. Breastfeeding may have obscured some positive effects from appropriate feeding practices, while dairy consumption may have hidden negative outcome from inappropriate ones. Despite the ICFI appearing to reflect infant and young child feeding behaviors, using the ICFI alone may not accurately reveal nutritional status.

The Association of Feeding Practices and Sociodemographic Factors on Underweight and Wasting in Children in Ethiopia: A Secondary Analysis of Four Health Surveys from 2000 to 2016.

BACKGROUND: Feeding practices highly influence the nutritional status of children between 6 and 23 months of age in developing countries, including Ethiopia. Therefore, this study was conducted to investigate the association of feeding practices and sociodemographic factors on underweight and wasting of children aged 6-23 months in Ethiopia. METHODS: Data on 8003 children 6-23 months of age from four Ethiopia demographic and health surveys (EDHS) from 2000 to 2016 were analyzed using complex sample crosstabs for multivariate analysis. The association of feeding practices and sociodemographic factors on underweight and wasting was assessed via multiple logistic regression analyses adjusting the covariates. The outcomes were reported based on the adjusted odds ratios (ORs) with 95% confidence interval (CI). RESULTS: Male children, very small at birth size children, diarrhea and fever, and short stature mother were risk factors for underweight and wasting (p < 0.05-0.001). Also, minimum dietary diversity, rich and middle-income families, vitamin A in the previous 6 months and antenatal care visits during pregnancy were protective factors for both underweight and wasting (p < 0.05-0.001). Minimum meal frequency was significantly related to lower odds of wasting (p < 0.001). Higher age of the child was significantly associated with underweight (p < 0.05-0.001); however, it was less likely wasted (p < 0.05-0.01). CONCLUSION: The present study depicted that among infant young children feeding core indicators except breastfed, all the other indicators did not met the required standard; however, sociodemographic factors on four health surveys from 2000 to 2016 were associated with underweight and wasting in children in Ethiopia. LAY SUMMARY: • Over the years the prevalence of underweight in children aged 6-23 months in the country has shown a significant improvement from 40.2% in 2000 to 34.7% in 2005, then further reduced to 28.9% and 20.0% in 2011 and 2016 EDHS, respectively.• In the same manner, the prevalence of wasting in children aged 6-23 months in Ethiopia also observed improvement from 18.9% in 2000 to 16.7% in 2005, then further reduced to 15.4% and 13.9% in 2011 and 2016 EDHS, respectively.• Male children, very small at birth size children, diarrhea and fever (for the last 2 weeks), and short stature mother were risk factors for underweight and wasting.• Minimum dietary diversity, rich and middle-income families, vitamin A in the previous 6 months and antenatal care visits during pregnancy were protective factors for both underweight and wasting.• Minimum meal frequency was significantly related to lower odds of wasting.• Higher age of the children was significantly associated with underweight; however, less likely wasted.

Infant and Young Child Feeding Practices among Mothers of Children 6-23 Months Old Attending the Immunisation Clinic of a Private Tertiary Health Institution in Nigeria.

BACKGROUND: Globally, childhood malnutrition remains a major public health issue. It is thus imperative to contextually analyse Infant and Young Child Feeding (IYCF) practices in resource-poor settings like Nigeria. STUDY OBJECTIVES: This study assessed key complementary feeding indicators among 6-23-month-old children attending the immunization clinic of Bowen University Teaching Hospital, Ogbomoso, Nigeria. METHODOLOGY: Cross-Sectional design was employed, and Systematic Random Technique used to recruit 198 consenting caregivers. Validated interviewer-administered, semi-structured questionnaire was used for data collection. Both descriptive and inferential statistics were carried out. RESULTS: Mean±SD age of the children was 11.27±5.16 months. Only 57.6% of the infants had breastfeeding within 1-hour of life. Not less than 91.4% of the infants had Exclusive breastfeeding (EBF) but Infant formula was the main breastmilk substitute among children without EBF. In all, 83.0% of the infants had Minimum Meal Diversity, 90.4% had Minimum Meal Frequency but only 57.6% had Minimum Acceptable Diet (MAD). The significant predictors of MAD were early commencement of breastfeeding, reception of complementary feeding counselling during pregnancy, EBF practice and whether the child had MUAC which was at least 11cm. CONCLUSION: IYCF practices was sub-optimal in the studysetting. There is urgent need for policy makers to design evidence-informed strategic framework for effective implementation and evaluation of the existing IYCF policy in Nigeria. Emphasis should be placed on complementary feeding education/counselling using relevant Information, Education and Communication (IEC) channels/materials. Good IYCF practices ensure optimum child growth/ development, prevent childhood diseases, and can ultimately help Nigeria to attain SDG-3 by 2030.

CONTEXTE: À l'échelle mondiale, la malnutrition infantile reste un problème de santé publique majeur. Il est donc impératif d'analyser contextuellement les pratiques d'alimentation du nourrisson et du jeune enfant (ANJE) dans les milieux pauvres en ressources comme le Nigéria. OBJECTIFS DE L'ÉTUDE: Cette étude a évalué les principaux indicateurs d'alimentation complémentaire chez les enfants de 6 à 23 mois fréquentant la clinique de vaccination de l'hôpital universitaire de Bowen, Ogbomoso, Nigéria. MÉTHODOLOGIE: Une conception transversale a été utilisée et la technique aléatoire systématique a été utilisée pour recruter 198 soignants consentants. Un questionnaire semi-structuré et administré par un intervieweur a été utilisé pour la collecte des données. Des statistiques descriptives et inférentielles ont été réalisées. RÉSULTATS: L'âge moyen ± écart-type des enfants était de 11,27 ± 5,16 mois. Seulement 57,6% des nourrissons ont été allaités dans l'heure suivant la vie. Pas moins de 91,4% des nourrissons avaient l'allaitement maternel exclusif (EBF), mais les préparations pour nourrissons étaient le principal substitut du lait maternel chez les enfants sans EBF. En tout, 83,0% des nourrissons avaient une diversité minimale des repas, 90,4% avaient une fréquence minimale des repas, mais seulement 57,6% avaient un régime minimum acceptable (MAD). Les prédicteurs significatifs de la MAD étaient le début précoce de l'allaitement maternel, la réception de conseils d'alimentation complémentaire pendant la grossesse, la pratique de l'EBF et si l'enfant avait un PB d'au moins 11 cm. CONCLUSION: Les pratiques d'ANJE étaient sous-optimales dans le cadre de l'étude. Il y a un besoin urgent pour les décideurs politiques de concevoir un cadre stratégique fondé sur des données factuelles pour une mise en œuvre et une évaluation efficaces de la politique d'ANJE existante au Nigéria. L'accent doit être mis sur l'éducation /le conseil en alimentation complémentaire en utilisant les canaux /matériels d'information, d'éducation et de communication (IEC) pertinents. Les bonnes pratiques en ANJE garantissent une croissance/ un développement optimal de l'enfant, préviennent les maladies infantiles et peuvent finalement aider le Nigéria à atteindre l'ODD-3 d'ici 2030. MOTS CLÉS: Pratique d'alimentation des nourrissons, alimentationcomplémentaire, Fréquence minimale des repas, diversité minimaledes repas, Régime minimum acceptable, allaitement maternel exclusif.

Association of gestational diabetes with child feeding practices: A secondary analysis using data from mother-child dyads in the deep south.

BACKGROUND: The purpose of this study was to examine whether mothers with prior gestational diabetes (GDM) used different feeding practices for their children compared to those without prior GDM. We hypothesized that mothers with prior GDM would express a greater concern for their child's weight, and greater monitoring and restrictive feeding practices compared to non-diabetic mothers. METHODS: Data for this secondary analysis came from studies examining body composition and metabolism in children (aged 4-10 years) born to women with (N = 41) and without (N = 71) GDM. A Child Feeding Questionnaire (CFQ) was used to assess maternal perception of the child's weight and her feeding practices. Analysis of covariance was used to assess group differences in feeding practices, after adjusting for parent study code, maternal education, child BMI-z, and maternal age. RESULTS: In fully adjusted models, mothers with prior GDM did not express greater concern about their children's body weight as compared to those without prior GDM (P = 0.50). Restriction and pressure to eat also did not differ by group, and women with prior GDM reported less monitoring of their children's intake as compared to those without prior GDM (P < 0.05). CONCLUSION: There is no evidence from this study that women with prior GDM are more concerned about their children's body weight or endorse more restrictive feeding practices than do those without prior GDM. Future research should investigate whether women with prior GDM are aware that their children have greater risk for obesity and comorbid health problems, and develop interventions to support parents in efforts to mitigate this risk.

Nutrition education in Southeast Sulawesi Province, Indonesia: A cluster randomized controlled study.

This study evaluated the impact of a nutrition education intervention on child feeding practices and children's nutritional status. Using a randomized controlled trial, we conducted an intervention for 6 months among caregivers with children aged 6-17 months in two subdistricts of Kendari, SE Sulawesi Province, Indonesia. In all, 22 integrated health posts were randomly assigned to an educational intervention or control group with 266 participants in both groups. Participants in the intervention group attended four nutrition classes and received a monthly home visit by cadres (community volunteers), whereas participants in the control group only received standard monthly health care at the health post. The primary study outcome was children's dietary diversity scores (DDSs). Mixed model analysis was conducted to examine the intervention effects on DDS and children's growth adjusting for clustering within subvillages. The study showed the educational intervention had a significant effect on children's DDS. Children in the intervention group had a larger DDS compared with children in the control group (Beta [mean difference] = 0.34, 95% CI: 0.02 to 0.66, P = 0.038). The intervention effect on height-for-age z-score (HAZ) could not be shown (Beta = 0.24, 95% CI: -0.06 to 0.56, P = 0.112). However, stunting prevalence remained stable in the intervention group but increased in the control group. These results indicated nutrition education delivered through nutrition classes combined with regular home visits by cadres as influencers provided a great potential to be adopted to complement other nutrition programmes in community health centres.