ABSTRACT
Infant and young child feeding practice (IYCF) by World Health Organization (WHO) strongly encourage initiation and continuation of exclusive breastfeeding (EBF) in the COVID-19 pandemic backdrop with essential counseling about the benefits of breastfeeding against risks of transmission. This study aimed to explore qualitatively the knowledge and understand the recommended practices regarding infant and IYCFs during COVID-19 pandemic among obstetricians in diverse care settings in Chennai. One-to-One telephone-interviews were conducted among sixteen obstetric practitioners from diverse care settings in Chennai during May 2021-October 2021 using a 13-item interview guide and recorded with informed consent. The transcribed data were analyzed thematically. Among the all-female study participants, the mean age was 39.7 years (SD=10.45 years) and 68.8% (11) were aged 31-40 years, 180 lactating mothers received COVID-19 counseling and 130 referred for testing in preceding month, 56.3% were aware that COVID- 19 is not passed in breast milk and 93.8% knew it is safe to feed breast milk from suspected or confirmed positive mothers. All obstetricians were aware of hygiene recommendations for lactation mothers and only 75% were aware of WHO recommendation for IYCF during-COVID-19. This qualitative study unearths the key areas to focus on during awareness and training sessions for obstetricians further strengthen the promotion of optimal breastfeeding practices during the COVID-19 pandemic.
ABSTRACT
Background & objectives: Research studies in the 1970s reported that in pre-school children, undernutrition increased the risk of infections and infections aggravated undernutrition. Over decades, there has been a reduction in prevalence of undernutrition and improvement in access to healthcare for treatment of infections. A mixed longitudinal study was undertaken to assess whether over time there were any changes from the earlier reported effect of undernutrition prior to infection on the risk of morbidity and effect of morbidity on nutritional status in pre-school children. Methods: Pre-school (0-59 months of age) children from urban low- and middle-income families whose parents were willing to allow their participation in the study were enrolled. Information on sociodemographic profile of the families was collected at enrolment. Weight of all children and length in infants were recorded every month; length/height in children 12-59 months of age was recorded once in three months. Morbidity information was collected through fortnightly visits. Results: 3888 pre-school children were followed up in 74636 home visits. Among these children, underweight and wasting were associated with a small increase in risk of infections. The odds ratio for risk of infection for underweight children was 1.09 (95% CI: 1.02 to 1.16) and for wasting was 1.18 (95% CI: 1.08 to 1.29). The deterioration in Z scores for weight-for-age and body mass index-for-age in children during illness and convalescence was small but significant (P<0.001). Interpretation & conclusions: The increased risk of infections in undernourished children living in overcrowded tenements in areas with poor environmental hygiene was not significant, perhaps because the risk of infection in normally nourished children was also high. The deterioration in nutritional status following infection was small because of the ready access to and utilization of health and nutrition care.