Status of Beverages Served to Young Children in Child Care After Implementation of California Policy, 2012-2016.

INTRODUCTION: Since 2012, licensed California child care centers and homes, per state policy, are required to serve only unflavored low-fat or nonfat milk to children aged 2 years or older, no more than one serving of 100% juice daily, and no beverages with added sweeteners, and they are required to ensure that drinking water is readily accessible throughout the day. We evaluated adherence to the policy after 4 years in comparison to the adherence evaluation conducted shortly after the policy went into effect. METHODS: Licensed California child care sites were randomly selected in 2012 and 2016 and surveyed about beverage practices and provisions to children aged 1-5 years. We used logistic regression to analyze between-year differences for all sites combined and within-year differences by site type and participation in the federal Child and Adult Care Food Program (CACFP) in self-reported policy adherence and beverage provisions. RESULTS: Respondents in 2016 (n = 680), compared with those in 2012 (n = 435), were more adherent to California's 2010 Healthy Beverages in Child Care Act overall (45.1% vs 27.2%, P < .001) and with individual provisions for milk (65.0% vs 41.4%, P < .001), 100% juice (91.2% vs 81.5%, P < .001), and sugar-sweetened beverages (97.4% vs 93.4%, P = .006). In 2016, centers compared with homes (48.5% vs 28.0%, P = .001) and CACFP sites compared with non-CACFP sites (51.6% vs 27.9%, P < .001) were more adherent to AB2084 overall. DISCUSSION: Beverage policy adherence in California child care has improved since 2012 and is higher in CACFP sites and centers. Additional policy promotion and implementation support is encouraged for non-CACFP sites and homes. Other states should consider adopting such policies.

Attending Informal Preschools and Daycare Centers Is a Risk Factor for Underweight, Stunting and Wasting in Children under the Age of Five Years in Underprivileged Communities in South Africa.

The study objectives were to determine the nutritional status of children between the ages of 12-60 months and to establish the association between attending preschool and the prevalence of undernutrition. This was a cross-sectional survey conducted in health facilities in Tshwane district in South Africa, consisting of both a questionnaire and anthropometric measures of 1256 mothers and their children. Weight-for-age (WAZ), height-for age (HAZ) and BMI-for-age (BAZ) were calculated and bivariate and multivariable analysis was performed to establish association. The results showed that child-related factors, namely birthweight, age, gender, and attending preschool increased the risk of undernutrition. Children over the age of 24 months were likely to be stunted and underweight. Maternal education reduced the odds of underweight. Children who stayed at home had reduced odds of underweight and stunting. High birthweight reduced the odds of wasting and underweight. The risks for undernutrition are multifaceted, but children who attend preschool have an increased risk of undernutrition. The risk of undernutrition increased with age and coincided with the time of cessation of breast-feeding and attendance at daycare or preschool. The complementary role of quality childcare in preschools and daycare centers is vital in alleviating the problem of undernutrition in underprivileged communities.

Características cognitivas, emocionales y conductuales de niños preescolares del programa buen comienzo en el noroccidente de Medellín / Cognitive, emotional, and behavioral characteristics of preschoolers of the good start program in the northwestern area in Medellin

En el presente artículo derivado de investigación, se describen las características cognitivas, emocionales y conductuales de una muestra de 20 niños preescolares, que oscilan entren los 3 y 5 años de edad, de estrato socioeconómico bajo y que han sido beneficiados del programa estratégico de la Alcaldía de Medellín (Colombia), perteneciente a la Secretaría de Educación, denominado Buen Comienzo. El programa Buen Comienzo tiene como propósito la promoción del desarrollo integral,diverso e incluyente de niñas y niñas, desde en una perspectiva interdisciplinaria del ciclo vital, protección de los derechos y articulación interinstitucional.

In this current article, derived from a piece of research, the cognitive, emotional, and behavioral characteristics, of a sample of 20 preschoolers, are described and whose ages range between 3 and 5 years. They belong to a low socio-economic level and they have benefited from the strategic program at the Mayor’s Office in Medellin (Colombia), belonging to the Secretariat of Education program called theGood Start. Such a program aims the promotion of comprehensive, diverse, and inclusive development of children, from an interdisciplinary perspective of the life cycle, the protection of rights and the inter-institutional coordination.

Fatores associados à interrupção do aleitamento materno exclusivo antes dos seis meses em crianças matriculadas em creches públicas e filantrópicas do Município de São Paulo, Brasil / Factors associated with the interruption of exclusive breastfeeding before six months for children enrolled in public and philanthropic daycare centers in Sao Paulo, Brazil

Breastfeeding meets ideal nutritional characteristics of children. The aim of this study was to describe the prevalence of exclusive breastfeeding and evaluate the factors described by mothers for early weaning among children attending public and philanthropic daycare centers in Sao Paulo. The study, which applies a qualitative and quantitative sample methodology, was based on two cross-sectional surveys; statistical analyses were performed using Kaplan Meier curves and Cox proportional hazards model. The average duration of exclusive breastfeeding was 87.2±61.36, median of 90 days. The following variables for exclusive breastfeeding were considered in the adjusted final model: mother's age <20 years (HR=1.43, 95% CI=1.09 to 1.88), use of the pacifier <3 months (HR=1.87, 95% CI=1.57 to 2.24) and prematurity (HR=1.36, 95% CI=1.04 to 1.77). Results show that there are many factors that can negatively influence breastfeeding duration; and that, as the daycare center is a place of education since the early age of those children; it can also be a place of education for the mothers, once it informs them about the importance of breastfeeding.

La lactancia materna exclusiva reúne las características adecuadas de la alimentación infantil. El objetivo de este estudio fue describir la prevalencia de la lactancia materna exclusiva y evaluar los factores asociados a su duración entre los niños que asisten a guarderías públicas y filantrópicas de São Paulo. Este estudio, que aplicó metodología de muestreo cuantitativo, fue realizado a partir de dos observaciones transversales, y los análisis estadísticos se realizaron utilizando las curvas de Kaplan Meier y el modelo de riesgos proporcionales de Cox. El tiempo medio de lactancia materna exclusiva fue de 87,2±61,36 y mediana de 90 días. En el análisis multivariado, entraron en el modelo final las siguientes variables: edad de la madre < de 20 años (HR=1,43, 95% CI=1,09- 1,88), uso de chupete < de 3 meses (HR=1,87, 95% CI=1,57-2,24) y prematuridad (HR=1,36, 95% CI=1,04-1,77). Los resultados mostraron que muchos factores influyen negativamente en la duración de la lactancia materna y que las guarderías, instituciones educativas que ocupan un lugar desde el inicio de la vida de los niños, pueden ser efectivas para educar a las madres al informar sobre los beneficios de la lactancia materna.

O aleitamento materno exclusivo faz parte de uma alimentação adequada das crianças. O objetivo deste trabalho foi descrever as prevalências de aleitamento materno exclusivo e avaliar os determinantes associados à sua duração entre crianças frequentadoras de creches públicas e filantrópicas do Município de São Paulo. Este estudo, que aplica metodologia amostral de natureza quantitativa, foi feito a partir de duas observações do tipo transversal, e as análises estatísticas foram feitas utilizando as curvas de Kaplan Meier e modelo de riscos proporcionais de Cox. O tempo médio de aleitamento materno exclusivo foi de 87,2±61,36, mediana de 90 dias. Na análise multivariada, entraram para o modelo final as seguintes variáveis: idade da mãe <20 anos (HR=1,43, 95% CI=1,09- 1,88), uso de chupeta com <3 meses (HR=1,87, 95% CI=1,57-2,24) e prematuridade (HR=1,36, 95% CI=1,04-1,77). Os resultados mostram muitos fatores que influenciam negativamente na duração do aleitamento materno exclusivo e que a creche, sendo um local de educação desde o início da vida destas crianças, pode ser um local de educação também das mães ao informar os benefícios da amamentação.

Provider-reported illness and absence due to illness among children attending child-care homes and centers in San Diego, Calif.

PURPOSE: To compare the incidence of provider-reported illness and absence due to illness among children attending small child-care homes, large child-care homes, and child care centers in a large metropolitan area. METHODS: From July 6, 1992, through January 28, 1994, we collected information from child-care providers on illness and absence due to illness at 64 small and 58 large child-care homes and 41 child-care centers. This included 113 446 child-weeks of information on 5360 children. RESULTS: Providers reported 14 474 illness episodes (6.6 episodes per child-year) and 8593 days of absence due to illness (3.9 days per child-year). The incidence of illness episodes was greatest in children who were younger than 1 year, white, or enrolled in small child-care homes. The incidence of absence due to illness was greatest in children who were 1 year of age, Hispanic, or enrolled in child-care centers. Respiratory symptoms were most commonly associated with illness episodes and absence due to illness. CONCLUSIONS: Children in child-care homes had a greater incidence of provider-reported illness than did those in centers. This risk varied by the type of facility and was greatest in small child-care homes. The increased risk for absence due to illness among children in child-care centers reflects exclusion and attendance patterns. It may be possible to reduce the incidence of absence due to illness and subsequent economic impact of child-care-associated illness by educating providers on exclusion guidelines.

Day-care centers and diarrhea: a public health perspective.

OBJECTIVE: To assess the relation between morbidity from acute diarrhea and the form of day care. STUDY DESIGN: The design was a retrospective cohort study. The setting was the city of Espoo, an urban-suburban municipality in southern Finland with a population of 170,000. The study population comprised 2568 randomly selected children aged 1 to 7 years. The main outcome measure was the occurrence of diarrhea. RESULTS: Children in day-care centers (DCCs) had an increased risk for acute diarrhea compared with children in home care. In the whole group of children in DCCs, the relative risk was 1.20 (95% confidence interval [CI], 1.08 to 1.34). The risk was greatest in 1- and 2-year-old children, for whom the estimated relative risks were 1.76 (95% CI, 1.28 to 2.43) and 1.56 (95% CI, 1.16 to 2.09), respectively. The proportion of diarrhea episodes attributable to DCC care in 1-year-old children was 49% (95% CI, 18% to 91%), in 2-year-old children 37% (95% CI, 11% to 73%), and in the whole group 17% (95% CI, 7% to 29%). The infection risk did not differ between children in home and family care. CONCLUSIONS: The results provide quantitative evidence that the care in DCCs is a major determinant of acute diarrhea in children, whereas family day care does not increase the infection risk.

Effects of age of entry, day-care quality, and family characteristics on preschool behavior.

Teachers evaluated 155 4-5-year-old children attending Montréal day-care centers of excellent (N = 51), average (N = 60), or low (N = 44) quality using behavioral scales. Age of entry to day-care was also considered. Center quality was assessed by two observers using the Early Childhood Environment Rating Scale. Results point to the positive effects of longer exposure to high-quality group day-care (increased interest-participation), and the negative effects of longer exposure to low-quality centers (increased anger-defiance). Positive or negative family characteristics contributed further to these effects.

Ocurrence of Giardia lamblia in children of municipal day-care centers from Botucatu, Sao Paulo state, Brazil

Foi realizado um levantamento parasitologico em tres creches da rede municipal: duas na area urbana, uma no centro da cidade e a outra na periferia, e a terceira na zona rural. Tres amostras de fezes, coletadas com intervalo de 7 dias, foram obtidas de 147 criancas com idade variando de 0 a 6 anos e de 20 funcionarios. Cada amostra foi processada pelos metodos de sedimentacao espontanea e centrifugo - flutuacao com sulfato de zinco. Os resultados demonstraram que das 147 criancas examinadas, 93 (63,3 por cento) apresentaram cistos de G. lamblia. O uso de 3 amostras de fezes aumentou a positividade do exame para o diagnostico deste parasita, uma vez que dos 93 casos positivos, 24 (25,5 por cento) e 8 (8,5 por cento) foram diagnosticados somente apos o exame da segunda e terceira amostra, respectivamente. Outros parasitas e comensais intestinais como Ascaris lumbricoides (20,4 por cento), Trichuris trichiura (19,0 porcento), Hymenolepis nana (8,8 por cento), Entamoeba coli (22,4 por cento) e Blastocystis hominis (32,0 por cento) foram diagnosticados...

Secondary dengue infection in schoolchildren in a dengue endemic area in the state of Rio de Janeiro, Brazil

Apos um periodo de epidemias sequenciais pelos virus dengue tipo 1 e 2 (DEN-1 e DEN-2), foi realizado um estudo soroepidemiologico e uma amostra de escolares da rede publica de ensino do municipio de Niteroi; 450 amostras de sangue foram obtidas atraves de puncao da polpa digital, coletadas sobre discos de papel de filtro e testadas para a deteccao de anticorpos inibidores da hemaglutinacao (IHA) para DEN-1 e DEN-2. Das amostras testadas, 66,0 por cento (297/450) apresentaram titulos de anticorpos IHA e as medias geometricas dos titulos de anticorpos foram de 1/182 e 1/71, para DEN-1 e DEN-2, respectivamente. Cerca de 61,0 por cento (181/297) daqueles com anticorpos IHA tiveram infeccao secundaria. Destes, 75 por cento (135/181) tinham idade igual a ou menor do que 15 anos...

[Criteria for the hygienic evaluation of the state of preschool institutions and their classification]. / Kriterii gigienicheskoi otsenki sostoianiia doshkol'nykh uchrezhdenii i ikh klassifikatsiia.

Significant factors of enterobiasis spreading in preschool institutions in Rostov-on-Don were: water supply conditions, staff number, number of children in groups (above 25 per group). Classification of those institutions was given.

[The level of enterobiasis infectivity in children in relation to the sanitary status of preschool institutions]. / Uroven' porazhennosti detei énterobiozom v zavisimosti ot sanitarnogo sostoianiia detskikh doshkol'nykh uchrezhdenii.

Nursery schools and kindergartens have been examined in Rostov-on-Don. Five most essential factors based on the determination of signs informativeness and prognostic coefficients and responsible for possible enterobiasis determination have been identified: the state of water supply, staffing with personnel, presence (absence) of the round-the-clock groups, overcrowded groups, location of bedrooms. An attempt is made to classify kindergartens according to these indexes.

A prospective study of infectious morbidity and antibiotic consumption among children in different forms of municipal day-care.

During the 9-month period September 1986-May 1987, reasons for absence and antibiotic consumption were investigated among children cared for in day-care center(s) (DCC) and Swedish town. family day-care (FDC) within a limited geographical area of a medium-sized Swedish town. All 352 children in 11 DCC in this area and 199 children in FDC were included in this prospective study, which intended to elucidate the infectious morbidity. The investigation period comprised 55,760 and 26,019 expected days' attendance for the DCC and FDC children, respectively. A higher absence attributable to infection was evident at all ages in DCC children than in those in FDC. This difference tended to diminish with age. No difference in antibiotic consumption was evident between the 2 categories, and the diagnostic pattern was almost identical. In the DCC, overall absence figures, and absence due to infection, were considerably lower than in earlier comparable studies. Appreciable differences in absence due to infection and antibiotic consumption were also found between different "departments" in the DCC; both low and high-absence groups could be identified. There was an indication of differences between the groups both socially and in the environment at the DCC.