[Guideline 'Overweight' for child health care]. / Richtlijn 'Overgewicht' voor de jeugdgezondheidszorg.

The '5th National Growth Study' indicates that the percentage of overweight children in the Netherlands has risen from 9-12% in 1997 to 13-15% in 2009. Child Health Care is a unique setting for promotion of development, growth and behaviour of children, in which tailored prevention can be offered. Detection of overweight in children and intervention by Child Health Care takes place in a multidisciplinary setting linking general practitioners, paediatricians, dieticians, teachers, physiotherapists, pedagogues and psychologists. For overweight children, a change plan is created based on exercise, playing outside, having breakfast every day, as little as possible sweetened beverages and fast-food, and less time spent in front of the television or computer, with fewer energy-rich snacks. As recommended in the Dutch CBO guideline 'Obesity', obese children are referred to a general practitioner or paediatrician.

[Guideline 'Incontinence urine and feces' of the Dutch Preventive Youth Health Care]. / Jeugdgezondheidszorgrichtlijn 'Zindelijkheid urine en feces'.

Continence problems can occur during childhood. This guideline is for the Dutch Youth Health Care (JGZ) and gives recommendations for the prevention, early detection and treatment of these problems. As a preventative measure advices for potty training should be started in children aged 18-24 months. If incontinence is present, it is important to take a history and carry out physical examination. In children over the age of 5 who are incontinent of urine the following are recommended: taking child out of bed, calendar with reward system, bedwetting alarm or voiding diary; children over the age of 8 can follow dry bed training. Faecal incontinence is often associated with constipation. Incontinent children with constipation are given advice about normal eating and exercise patterns. If this is not successful then laxatives are prescribed. The JGZ should refer further if there are indications of an underlying condition; if children over the age of 5 are wet during the day; if children are incontinent of faeces at night; if children are incontinent of faeces but not constipated; if children persistently wet the bed; if there is faecal incontinence despite counselling, and if medication needs to be prescribed.

Ethnic variation in infant-feeding practices in the Netherlands and weight gain at 4 months.

This prospective study of 4438 infants (0-4 months) examined differences in infant-feeding patterns in relation to the ethnic origin of their mothers, based on the mother's native language: Dutch (87%), Turkish (4%), Moroccan (3%), other European languages (3%), and various other languages (4%). Breastfeeding at birth varied between 75% and 94%. Dutch and Moroccan mothers breastfed for a shorter period (32% and 37% at 4 months, respectively) than did Turkish mothers and mothers with a native European language other than Dutch (47% and 51% at 4 months, respectively; P < .001). Of all mothers, 71% started exclusive breastfeeding at birth, and 21% continued exclusive breastfeeding for at least 4 months. The reasons why mothers discontinued breastfeeding (both exclusive breastfeeding and breastfeeding) were generally infant related. The average weight gain between birth and day 133 was 3.45, 3.87, and 3.69 kg for Dutch, Turkish, and Moroccan infants, respectively. Weight gain was influenced by ethnicity of the mothers and exclusive breastfeeding.

Weight and weight gain at 4 months (The Netherlands 1998): influences of nutritional practices, socio-economic and ethnic factors.

We describe the determinants of weight gain in the first 4 months of life in a cohort of 3256 infants. The study was designed as a survey with follow-up. In the period 1 April to 1 July 1998, all infants, usually 4 weeks old but not older than 4 months, brought to a well-baby clinic for the first time were included. Nutritional practices, demographic data on mother and child, birthweight and a second weight measured between days 118 and 147 were recorded. Simple and multiple linear regression analyses were performed. The average weight gain over 4 months was 27.7 g/day for boys and 24.5 g/day for girls. Weight gain was lower with high parity and if the mother was a native Dutch speaker. Nutritional practices affected weight gain only slightly: exclusive breast feeding for 4 months lowered the weight gain by 0.06 g/day. However, because of their higher birthweight, breast-fed infants weighed a little more than formula-fed infants at 4 months. In addition, we compared the median weight at the age of 4 months with the median weight at the same age in previous Dutch growth studies. The median weight, adjusted to day 133, was higher in 1998 than in 1965, 1980 and 1997 (boys 7.15 vs. 6.85, 6.77 and 6.95 kg; girls 6.59 vs. 6.49, 6.39 and 6.45 kg respectively).