Infant and young child feeding practice among mothers of children age 6 to 23 months in Debrelibanos district, North Showa zone, Oromia region, Ethiopia.

BACKGROUND: Inappropriate infant and young child feeding (IYCF) practice is the leading cause of malnutrition in children. Data is needed to identify children at risk of poor feeding practice and to target interventions to improve IYCF practices. Therefore, this study aimed to assess IYCF practice and associated factors among mothers of children age 6 to 23 months in Debrelibanos district, north Showa zone, Oromia region, Ethiopia. METHOD: A community-based cross-sectional study design was conducted among 380 mothers of children age 6 to 23 months from March 1 to April 5, 2019. A simple random sampling technique was used to select the respondents. Data was collected using a structured interviewer-administered questionnaire that had been pretested. The data was entered into Epi-Data 3.1 and then transferred to SPSS 21 for analysis. Descriptive statistical analysis was done, and an association between an outcome variable and independent variables was examined in logistic regression models. RESULT: Overall, 65.8% of mothers practiced appropriate IYCF practice. The study revealed that 70.5% of children started breastfeeding within one hour of birth, and 61.6% were breastfed exclusively for six months. Among studied mothers, 79.5% continued to breastfeed their children until 2 years, and 69.2% of the participants started complementary feeding timely at six months. Minimum dietary diversity was observed in 19.2% of children, while minimum meal frequency was found in 79.2%. The majority of mothers (77.6%) fed their babies with bottles. Mother's educational status of primary school [AOR = 4.50, 95% CI: (1.38,14.61)], husband's occupation being merchant [AOR = 6.45, 95% CI: (1.51, 27.59)]; antenatal care follows up [AOR = 3.15, % CI: (1.22, 8.12)], radio/television ownership [AOR = 7.41, 95% CI: (2.86, 19.20)], child's sex being female [AOR = 4.78, 95% CI: (2.26, 10.064) and sufficient knowledge on child feeding [AOR = 2.82, 95% CI: (1.27, 26.26)] were independent predictors for appropriate IYCF practice. CONCLUSION: The prevalence of appropriate infant and young child feeding practice indicators was found to be rather high among the mothers in this study. The use of a bottle to feed babies, in particular is very common among the mothers who were studied. To address child malnutrition, it is critical to educate families about proper IYCF practices. This study suggests that mothers be properly educated about IYCF recommendations at health care facilities during their visits, as well as the promotion of appropriate IYCF through various media.

Complementary Feeding and Overweight in European Preschoolers: The ToyBox-Study.

Complementary feeding (CF) should start between 4-6 months of age to ensure infants' growth but is also linked to childhood obesity. This study aimed to investigate the association of the timing of CF, breastfeeding and overweight in preschool children. Infant-feeding practices were self-reported in 2012 via a validated questionnaire by >7500 parents from six European countries participating in the ToyBox-study. The proportion of children who received breast milk and CF at 4-6 months was 51.2%. There was a positive association between timing of solid food (SF) introduction and duration of breastfeeding, as well as socioeconomic status and a negative association with smoking throughout pregnancy (p < 0.005). No significant risk to become overweight was observed among preschoolers who were introduced to SF at 1-3 months of age compared to those introduced at 4-6 months regardless of the type of milk feeding. Similarly, no significant association was observed between the early introduction of SF and risk for overweight in preschoolers who were breastfed for ≥4 months or were formula-fed. The study did not identify any significant association between the timing of introducing SF and obesity in childhood. It is likely that other factors than timing of SF introduction may have impact on childhood obesity.

Formula feeding practice and associated factors among mothers with infants 0-6 months of age in Addis Ababa, Ethiopia: a community-based cross-sectional study.

BACKGROUND: Lack of exclusive breastfeeding during the first half-year of life is an important risk factor for childhood morbidity and mortality. Despite this, less than 40% of infants below 6 months are exclusively breastfed worldwide. This is because breastfeeding is declining and being replaced by formula feeding. Nowaday, formula feeding has become a more common practice in urban communities of developing countries. However, relatively little information is available regarding formula feeding practice and its associated factors in Ethiopia, particularly in Addis Ababa. Hence, this study was aimed at assessing the prevalence of formula feeding practice and its associated factors among mothers of an infant aged 0-6 months in Addis Ababa, Ethiopia. METHODS: A community-based cross-sectional study was conducted from April-1 to May 30/2020 among 494 mothers with infants 0-6 months of age. Data were collected using a pre-tested structured questionnaire. Data were entered and cleaned by using Epi data version 3.1 and analysed by SPSS software version 25. Then data were processed by using descriptive analysis, including frequency distribution, and summary measures. The degree of association was assessed using binary logistic regression analysis. P-value < 0.05 was considered statistically significant. RESULT: The prevalence of formula feeding and pre-lacteal feeding practice was 46.2 and 34.4%, respectively. Educational status with a diploma and above (AOR = 3.09, 95%CI: 1.56-6.14), delivery by cesarean section (AOR = 6.13, 95%CI: 4.01-9.37), pre-lacteal feeding practice (AOR = 7.61, 95%CI: 4.11-11.06), and delayed initiation of breastfeeding (after 1 h to 1 day (AOR = 3.43, 95% CI: 1.59-7.40), after 1 day to 3 days (AOR = 3.71, 95% CI: 1.51-9.41), and after 3 days (AOR = 5.41, 95% CI: 2.15-13.60)) were significantly associated with formula feeding practice. CONCLUSIONS: Nearly half of the participants were practiced formula-feeding for their infant. Educational status of mothers, the timing of initiation of breastfeeding, delivery by cesarean section, and pre-lacteal feeding practice were significantly associated with formula feeding practice. Therefore, early initiation of breastfeeding, educating mothers about the risks associated with pre-lacteal feeding, and supporting mothers who gave birth by cesarean section for exclusive breastfeeding should be encouraged at the community and institutional levels.

Breastfeeding Practices among Adolescent Mothers and Associated Factors in Bangladesh (2004-2014).

Optimal breastfeeding practices among mothers have been proven to have health and economic benefits, but evidence on breastfeeding practices among adolescent mothers in Bangladesh is limited. Hence, this study aims to estimate breastfeeding indicators and factors associated with selected feeding practices. The sample included 2554 children aged 0-23 months of adolescent mothers aged 12-19 years from four Bangladesh Demographic and Health Surveys collected between 2004 and 2014. Breastfeeding indicators were estimated using World Health Organization (WHO) indicators. Selected feeding indicators were examined against potential confounding factors using univariate and multivariate analyses. Only 42.2% of adolescent mothers initiated breastfeeding within the first hour of birth, 53% exclusively breastfed their infants, predominant breastfeeding was 17.3%, and 15.7% bottle-fed their children. Parity (2-3 children), older infants, and adolescent mothers who made postnatal check-up after two days were associated with increased exclusive breastfeeding (EBF) rates. Adolescent mothers aged 12-18 years and who watched television were less likely to delay breastfeeding initiation within the first hour of birth. Adolescent mothers who delivered at home (adjusted OR = 2.63, 95% CI:1.86, 3.74) and made postnatal check-up after two days (adjusted OR = 1.67, 95% CI: 1.21, 2.30) were significantly more likely to delay initiation breastfeeding within the first hour of birth. Adolescent mothers living in the Barisal region and who listened to the radio reported increased odds of predominant breastfeeding, and increased odds for bottle-feeding included male infants, infants aged 0-5 months, adolescent mothers who had eight or more antenatal clinic visits, and the highest wealth quintiles. In order for Bangladesh to meet the Sustainable Development Goals (SDGs) 2 and 3 by 2030, breastfeeding promotion programmes should discourage bottle-feeding among adolescent mothers from the richest households and promote early initiation of breastfeeding especially among adolescent mothers who delivered at home and had a late postnatal check-up after delivery.

Maternal postpartum feeding anxiety was associated with infant feeding practices: results from the mother-infant cohort study of China.

BACKGROUND: Maternal feeding anxiety (FA) was prevalent during puerperium and might affect infant feeding practices. This study was aimed to investigate the FA status in Chinese postpartum women and its relationship with infant feeding practices (FPs). METHODS: Participants were from the Mother-Infant Cohort Study of China, in which the dietary and feeding practices, physical and psychiatric health for both mothers and infants were followed up from childbirth to next 2 years. In this study the maternal feeding anxiety (FA) status at 0-3 months postpartum was assessed by Li's Self-rating Feeding Anxiety Scale (SFAS). Infant feeding practices (FPs) at 0-3 months, including breastfeeding-related behaviors, responsive feeding and infant food refusal were investigated by self-designed questionnaire. RESULTS: In total 456 mothers the average feeding anxiety scores (FAS) was 41.02 ± 8.02 (mean ± SD), and maternal FA prevalence were 61.4% (FAS>38) with severe FA being 8.6% (FAS>52) at 0-3 months postpartum. The FAS was related with infant FPs, and lower maternal FAS was significantly related with infant colostrum feeding (40.86 ± 8.02 vs 44.74 ± 11.33, P < 0.05), but higher FAS was related with bottle feeding (41.95 ± 8.28 vs 39.69 ± 7.92, P < 0.05). The mothers with severe feeding anxiety (FAS > 53) were more likely to feed infants with bottle (ORs, 95%CI: 2.41, 1.11 ~ 5.19). There were not significant association between FAS and exclusive breastfeeding and responsive feeding practices (P > 0.05). The higher FAS was associated with infant food refusal behaviors, the maternal scores whose infant "never", "rarely", "sometimes" and "often" spat out food when feeding were 39.86 ± 8.02, 41.47 ± 8.18, 41.36 ± 7.44 and 42.14 ± 12.03 increasingly (P > 0.05), and the FA prevalence was significantly different among groups (P < 0.05). The infants whose mother was identified as feeding anxiety were more likely to refuse opening the mouth when feeding (P < 0.05). Multivariate analysis indicated maternal FAS was positively related to infant bottle feeding (ßi = 2.487, P < 0.05) and outdoor sunshine exposure practice (ßi = 1.787, P < 0.05), and negatively related to household income level (ßi = - 0.118, P < 0.05). CONCLUSIONS: Maternal postpartum feeding anxiety was associated with some infant feeding practices, including bottle feeding and infant food refusal behaviors.

Prevalence of prelacteal feeding and associated risk factors in Indonesia: Evidence from the 2017 Indonesia Demographic Health Survey.

BACKGROUND: Prelacteal feeding (PLF) is a recognised challenge to optimal breastfeeding but remains common in Indonesia. Meanwhile, PLF-related epidemiological research is limited, particularly in this setting. This study examines the prevalence and determinants of overall PLF as well as common PLF types (formula, other milk, and honey) in Indonesia. METHODS: Data from 6127 mothers whose last child was ≤23-month-old were drawn from the 2017 Indonesia Demographic and Health Survey. Multivariable modified Poisson regression was used to measure the prevalence ratio (PR) for selected PLF risk factors. PLF was defined as anything to drink other than breast milk within three days after birth, before breastmilk flows. Additional analyses were performed on mothers who gave formula, other milk, and honey. RESULTS: About 45% babies in Indonesia received PLF with formula being the most frequent (25%), followed by other milk (14%), plain water (5%), and honey (3%). Factors associated with higher prevalence of any PLF were higher wealth quintiles in rural area (PR 1.07; 95% CI 1.03-1.11 per increase in quintile), baby perceived to be small at birth (PR 1.23; 95% CI 1.12-1.35), caesarean deliveries at either public (PR 1.27; 95% CI 1.13-1.44) or private facilities (PR 1.15; 95% CI 1.01-1.31), and not having immediate skin-to-skin contact after birth (PR 1.32; 95% CI 1.23-1.42). PLF was less prevalent among mothers who gave birth to second/subsequent child (PR 0.82; 95% CI 0.76-0.88) and who had an antenatal card (PR 0.89; 95% CI 0.80-0.99). These patterns did not apply uniformly across all PLF types. For example, honey was more common among home births than deliveries at health facilities, but formula and other milk were more common among caesarean deliveries. CONCLUSIONS: Mapping risk factors for PLF, especially by types, could help to design more targeted interventions to reduce PLF and improve breastfeeding practices in Indonesia.

Pre-lacteal feeding practices and associated factors among mothers of children aged less than 12 months in Jinka Town, South Ethiopia, 2018/19.

BACKGROUND: Pre-lacteal feeding is one of the major harmful practices being faced while feeding the newborns. Although it affects child health, little is known about the extent of the problem and its contributing factors in the study area. Therefore, this study aimed to figure the prevalence of pre-lacteal feeding practices and associated factors among mothers of children aged less than 12 months in Jinka Town. METHODS: A community-based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2019. A total of 430 mothers, having children less than 12 months of age, were selected by systematic sampling technique. The data were collected by using pretested and interviewer- administered structured questionnaires. The data were entered using epidata 4.2.1 and exported to SPSS version 23 for analysis. Adjusted odds ratios, 95% confidence intervals and p-values were reported. RESULTS: The prevalence of pre-lacteal feeding practice was 12.6% [95% CI (9.5-15.7)]. Having no maternal education [AOR = 4.82(95%CI 1.60-14.24)], colostrum avoidance [AOR = 4.09(95% CI 1.62-7.67)], lack of breast feeding counseling [AOR: = 2.51(95% CI 1.20-5.25)], home delivery [AOR = 3.34 (95% CI 1.52-7.33)], lack of knowledge about risks of pre-lacteal feeding [AOR = 2.86 (95% CI 1.30-6.29] and poor knowledge on breast feeding practices [AOR = 3.63(95% CI 1.62-8.11)] were factors associated with pre-lacteal feeding practices. CONCLUSION: Pre-lacteal feeding practice among mothers of children aged less than 12 months in Jinka town was found to be higher than the national prevalence. Illiterate, colostrum avoidance, lack of breastfeeding counseling, home delivery, lack of knowledge on the risk of pre-lacteal feeding, and poor knowledge on breastfeeding practice were factors associated with pre-lacteal feeding practices.

Trends and determinants of prelacteal feeding in Turkey: analysis of 2003-2018 demographic and health surveys.

OBJECTIVE: The aim of the current study is to analyse the trends, determinants of prelacteal feeding (PLF) and its relations with the mode of delivery among infants <24 months over the years 2003-2018. DESIGN: We pooled data from Turkey Demographic and Health Surveys (TDHS). The key outcome variable was PLF. Factors associated with PLF were analysed by using complex sample multiple logistic regression analysis, separately and merged database. SETTING: TDHS in 2003, 2008, 2013 and 2018. PARTICIPANTS: Mother-infant dyads (n 4942). RESULTS: PLF rates fluctuated between 29·3 and 41·4 %. The most common types of PLF were infant formula (61·1 %) followed by sugar/glucose water (24·9 %) and plain water (9·3 %). PLF rate was 1·51 times higher (95 % CI 1·28, 1·78) in cases delivered by caesarean section as compared with those delivered by vaginal route. According to the initiation time of breast-feeding after delivery, the most significant absolute change in PLF rate was observed within 1 h (10·9 % increase). Delayed initiation of breast-feeding was associated with significantly higher odds of PLF compared with the first hour (1 to < 2 h: adjusted OR (AOR) 1·29, 95 % CI 1·04, 1·61; 2-23 h: AOR 1·73, 95 % CI 1·42, 2·11; ≥24 h: AOR 11·37, 95 % CI 8·81, 14·69). CONCLUSIONS: To eliminate suboptimal breast-feeding practices, counselling on breast-feeding and delivery type during antenatal visits, postnatal breast-feeding support and social support should be provided to all mothers and families.

Cultural adaptation of Infant Feeding Intentions Scale (IFI) for pregnant women in Brazil.

OBJECTIVES: to translate and culturally adapt the Infant Feeding Intentions Scale for pregnant women in Brazil. METHODS: methodological study that included stages of translation, synthesis, face and content validation, back translation and semantic assessment. In the face and content and semantic validation stages, we used the Content Validity Index for individual items and for the overall scale for clarity and representativeness. RESULTS: nine (100.0%) experts participated in face and content validation, and the average index obtained was 85.0% for representativeness. In the semantic assessment, performed with 31 (100.0%) pregnant women, the tool was considered clear, obtaining an average index of 91.0%. CONCLUSIONS: the Brazilian version of the scale was considered representative and clear. After assessing psychometric properties, the scale is expected to be valid and reliable to assess maternal intention to breastfeed exclusively until the infant's six months of life in different Brazilian settings.

Milk-free diet followed by breastfeeding women.

BACKGROUND: Breastfeeding is the most common way of feeding infants. Human milk contains nutrients which are necessary to provide proper growth of a child. Nowadays there aren't any recommendations to follow elimination diet in order to decrease the risk of allergy or baby colic. Only the occurrence of health problems such as lactose intolerance or cow's milk protein allergy in breastfeeding mother or infant should be a reason for eliminating dairy products from diet. It seems to be important to explore the reasons and the frequency of following milk-free diet by breastfeeding women. OBJECTIVES: The main purpose of the study was to find the reasons for following milk-free diet by breastfeeding women and making an assessment of their nutrition knowledge and food habits. MATERIAL AND METHODS: Thirty-three breastfeeding women following milk-free diet took part in the project. The women were interviewed by the Computer Assisted Web Interview (CAWI) method with an original questionnaire. The results were developed with Spearman's rank correlation, Chi2 test and the gamma coefficient. The statistical significance level for the p-value was <0.05. RESULTS: The main reason for following milk-free diet by the breastfeeding women was the occurrence of hypersensitivity reactions of the children's gastrointestinal system after consuming milk by mother (72% responses). After excluding milk from diet only 42% respondents declared consuming new food products or dietary supplements in order to refill the potential deficiency of nutrients. The majority of respondents also eliminated from diet highly processed food products, fast-food and the carbonated drinks. The most often declared source of information about lactation was Internet (85%). Only 12% respondents asked a nutritionist in order to get the information about breastfeeding. CONCLUSIONS: It's necessary to promote a specific nutritional advice about following milk-free diet in breastfeeding women group in order to decrease the health risk connected with low calcium diet.

Associations between Bottle-Feeding during Infancy and Obesity at Age 6 Years Are Mediated by Greater Infancy Weight Gain.

Objective: To explore whether the association between bottle-feeding during the first year and childhood obesity at age 6 years is mediated by change in weight-for-age z-score (ΔWAZ) during infancy. Methods: Participants were 1062 mother-child pairs who participated in the Infant Feeding Practices Study II and Year 6 Follow-Up. Mothers completed 1 prenatal questionnaire, 10 postpartum questionnaires during the first year, and 1 follow-up questionnaire at 6 years. Child weights were reported by mothers and used to determine ΔWAZ from birth to later infancy. Causal mediation analysis was used to determine the average direct effect of bottle-feeding on obesity at age 6 years and the average causal mediation effect of bottle-feeding through ΔWAZ. Results: Infants who experienced rapid increases in bottle-feeding frequency during the first 6 months had significantly greater ΔWAZ compared with infants who had consistently low bottle-feeding frequency until 12 months of age [ß = 0.45, 95% confidence interval (CI) 0.11-0.80]. Significant predictors of obesity at age 6 years were larger birth weight [adjusted odds ratio (AOR) = 4.27, 95% CI 2.42-7.64] and larger ΔWAZ (AOR = 1.59, 95% CI 1.29-1.98). An indirect effect of bottle-feeding, mediated via ΔWAZ, accounted for 59% of the total effect of bottle-feeding on obesity at age 6 years. Conclusions: Rapid increases in bottle use during the first 6 months postpartum predicted greater risk for obesity at age 6 years via an indirect mediation effect of larger ΔWAZ from birth to later infancy.

Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: a systematic review and critical analysis.

BACKGROUND: Early reports of COVID-19 in pregnancy described management by caesarean, strict isolation of the neonate and formula feeding. Is this practice justified? OBJECTIVE: To estimate the risk of the neonate becoming infected with SARS-CoV-2 by mode of delivery, type of infant feeding and mother-infant interaction. SEARCH STRATEGY: Two biomedical databases were searched between September 2019 and June 2020. SELECTION CRITERIA: Case reports or case series of pregnant women with confirmed COVID-19, where neonatal outcomes were reported. DATA COLLECTION AND ANALYSIS: Data were extracted on mode of delivery, infant infection status, infant feeding and mother-infant interaction. For reported infant infection, a critical analysis was performed to evaluate the likelihood of vertical transmission. MAIN RESULTS: Forty nine studies included information on mode of delivery and infant infection status for 655 women and 666 neonates. In all, 28/666 (4%) tested positive postnatally. Of babies born vaginally, 8/292 (2.7%) tested positivecompared with 20/374 (5.3%) born by Caesarean. Information on feeding and baby separation were often missing, but of reported breastfed babies 7/148 (4.7%) tested positive compared with 3/56 (5.3%) for reported formula fed ones. Of babies reported as nursed with their mother 4/107 (3.7%) tested positive, compared with 6/46 (13%) for those who were reported as isolated. CONCLUSIONS: Neonatal COVID-19 infection is uncommon, rarely symptomatic, and the rate of infection is no greater when the baby is born vaginally, breastfed or remains with the mother. TWEETABLE ABSTRACT: Risk of neonatal infection with COVID-19 by delivery route, infant feeding and mother-baby interaction.

Maternal Infant-Feeding Attitudes, Infant Eating Behaviors, and Maternal Feeding Choice at 3 and 6 Months Postpartum: A Comparative Multicenter International Study.

Objective: The aim of this study was to compare mothers' attitudes toward infant feeding and infant eating behavior in different countries, and their associations with infant feeding at 3 and 6 months. Methods: Data from 164 mothers with healthy term infants recruited for a randomized trial comparing breast pumps from the UK (n = 68), Russia (n = 51), and China (n = 45) were included in this analysis. Feeding practices were assessed using questionnaires at 3 and 6 months. Maternal attitudes toward infant feeding and infant eating behaviors were measured by Iowa Infant Feeding Attitudes Scale (IIFAS) and Baby Eating Behavior Questionnaire (BEBQ) at 5-6 weeks postpartum; scores were compared between countries and associations with infant feeding at 3 and 6 months were examined. Results: IIFAS score was significantly different between countries; mean scores in Chinese and Russian mothers (China 64.6 ± 4.88 and Russia 61.5 ± 6.15) lay in the range of "neutral breastfeeding attitudes," while British mothers had more positive attitudes (70.6 ± 6.47, post hoc p < 0.001). Russian infants had higher scores for "general appetite" (mean = 4.8 ± 0.41, p < 0.05) and "satiety responsiveness" (mean = 8.7 ± 1.08, p < 0.01) than Chinese or British infants. Longer duration of full-time education was associated with more positive attitudes toward breastfeeding in the whole sample (p < 0.001) and in the United Kingdom (p < 0.05). The majority of mothers were exclusively breastfeeding (EBF) at 3 months. Total IIFAS and BEBQ scores were not significant predictors of EBF at 3 and 6 months (p > 0.05), although greater agreement with the IIFAS statement "Formula feeding is more convenient than breastfeeding" was associated with lower EBF at 3 months (OR = 0.47, 95% CI: 0.29-0.78, p < 0.01). Conclusions: Maternal attitudes toward infant feeding and perceptions of infant eating behavior differed between countries, but were not associated with EBF at 6 months. Mothers with a greater baseline perception that formula feeding is more convenient than breastfeeding were less likely to EBF at 3 months; this could be a potential target for education.

Association of Infant and Child Feeding Index with Undernutrition in Children Aged 6-59 Months: A Cross-Sectional Study in the Maldives.

Adequate dietary intake is critically important for child growth and development. This study aimed to analyze the prevalence of undernutrition and its association with infant and child feeding index (ICFI). This cross-sectional study was conducted among children (younger than5 years) and their mothers from Lhaviyani Atoll, Maldives. The data were obtained by interviewing the children's mothers via pretested questionnaires. Infant and child feeding index scores were calculated from the dietary information. Weight-for-age z-scores (WAZ), length/height-for-age z-scores (LAZ/HAZ), and weight-for-length/height z-scores were calculated from anthropometric data taken according to the WHO criterion. Linear regression tests were used to find the association of nutritional status with ICFI scores. A total of 800 children and their mothers participated in this study. The prevalence of underweight, stunting, and wasting was 24.6%, 32.4%, and 16.3%, respectively. The mean ICFI scores (13.0) of children aged 6-8 months were better than those of children in other age-groups. In food groups, the intake of fish was higher among the respondents, whereas the consumption of vegetables and fruits was lower. Infant and child feeding index scores were significantly associated (P < 0.05) with WAZ and LAZ/HAZ after adjustment for confounders. Overall, the findings showed that Maldivian children consumed the limited number of food items that resulted in an inadequate intake of nutrients which further resulted in the high prevalence of malnutrition.

Associations between infant and young child feeding practices and acute respiratory infection and diarrhoea in Ethiopia: A propensity score matching approach.

BACKGROUND: Acute respiratory infection (ARI) and diarrhoea are the leading causes of childhood morbidity and mortality in Ethiopia. Understanding the associations between infant and young child feeding (IYCF) and ARI and diarrhoea can inform IYCF policy interventions and advocacy in Ethiopia. This study aimed to investigate the relationship between IYCF practices and ARI and diarrhoea in Ethiopian children. METHODS: This study used the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n = 3680), 2005 (n = 3528), 2011 (n = 4037), and 2016 (n = 3861). The association between IYCF practices and (i) ARI and (ii) diarrhoea were investigated using propensity score matching and multivariable logistic regression models. The IYCF practices include early initiation of breastfeeding, exclusive breastfeeding (EBF), predominant breastfeeding, introduction of complementary foods, continued breastfeeding at two years and bottle feeding. RESULTS: Infants and young children who were breastfed within 1-hour of birth and those who were exclusively breastfed had a lower prevalence of ARI. Infants who were exclusively and predominantly breastfed had a lower prevalence of diarrhoea. Early initiation of breastfeeding (Odds ratio [OR]: 0.81; 95% confidence interval [CI]: 0.72, 0.92) and EBF (OR: 0.65; 95% CI: 0.51, 0.83) were associated with lower risk of ARI. Bottle-fed children had higher odds of ARI (OR: 1.36; 95% CI: 1.10, 1.68). Early initiation of breastfeeding and EBF were associated with lower odds of diarrhoea (OR: 0.88; 95% CI: 0.79, 0.94 for Early initiation of breastfeeding and OR: 0.51; 95% CI: 0.39, 0.65 for EBF). Infants who were predominantly breastfed were less likely to experience diarrhoea (OR: 0.69; 95% CI: 0.53, 0.89). CONCLUSION: The recommended best practices for preventing ARI and diarrhoeal diseases in infants and young children namely: the early initiation of breastfeeding, EBF and avoidance of bottle feeding should be institutionalized and scale-up in Ethiopia as part of implementation science approach to cover the know-do-gaps.

Influence of various environmental factors on the growth of children and adolescents in Jeddah, Kingdom of Saudi Arabia.

OBJECTIVES: To evaluate the association between various environmental factors and the anthropometric measurements of children and adolescents. METHODS: This retrospective studywasperformed from September 2017 to April 2018 and included 393 children aged 2-18 years. Data were extracted through patient and/or parentinterviews and from medical records of endocrine ambulatory clinics. RESULTS: Among underweight children,the proportion of mixed-fed children was the highest, and among normal weight children, most were either bottle-fed or mixed-fed. Most overweight children were mixed-fed, and most obese children were breastfed. Underweight status was noted most commonly in children playing videogames for <2 hours/day, followed by those playing>4 and 2-4 hours/day. Normal weight was noted most commonly in those playing for >4 hours/day, followed by those playing <2 and 2-4 hours/day. Overweight status was noted most commonly in those playing videogames for >4 hours/day, followed by those playing 2-4 and <2 hours/day. Most children playing videogames for <2 hours/day were obese. Mean BMIs were the highest in those who exercised 1-2 times/week. P-values for the association between passive smoking indoors and BMI, weight, and height were 0.045, 0.150, and 0.854, respectively. Regarding socioeconomic status, log BMI values were 1.22, 1.23, and 1.26 in low-, medium-, and high-income families, respectively (P-value, 0.001). CONCLUSION: Children who were bottle-fed in their first year of life, played video games >2 hours/day, did not exercise regularly, were exposed to indoor passive smoking, and had a high socioeconomic status had a higher BMI and weight than their counterparts. (www.actabiomedica.it).

[Factors associated with dietary patterns in the second half of life]. / Fatores associados aos padrões alimentares no segundo semestre de vida.

The aim of this paper is to identify eating patterns of children aged 6, 9 and 12 months and their association with socioeconomic, behavioral, birth and nutrition variables. Cross-sectional study with children from a cohort in Viçosa-MG, with 112 children at 6 months, 149 at 9 months and 117 at 12 months. Food intake was assessed by a 24-hour recall and patterns extracted by cluster analysis. Breast milk was identified in at least one dietary pattern every month. There was a low participation of ultra-processed foods in the identified dietary patterns. At month 6, children with lower family income were less likely to belong to the dietary pattern composed of milk formulas. Already overweight/obesity was 3.69 times higher in children who made up the pattern 2 (dairy formulas, vegetables, vegetables, beef and pear). At 12 months height deficit (PR = 3.28) and bottle use (PR = 4.51) were associated with the dietary pattern composed of milk formulas and cow's milk. The dietary patterns identified reflected the important participation of breast milk in children's diets. Dietary patterns with the presence of other types of milk were associated with nutritional deviations and bottle feeding.

O objetivo deste artigo é identificar padrões alimentares de crianças com 6, 9 e 12 meses e sua associação com variáveis socioeconômicas, comportamentais, de nascimento e nutrição. Estudo transversal com crianças de uma coorte em Viçosa-MG, sendo 112 crianças com 6 meses, 149 com 9 meses e 117 com 12 meses. O consumo alimentar foi avaliado por um recordatório de 24 horas e os padrões extraídos por análise de agrupamentos. O leite materno foi identificado em pelo menos um padrão alimentar em todos os meses. Houve baixa participação de alimentos ultraprocessados nos padrões alimentares identificados. No 6º mês, crianças com menor renda familiar tiveram menos chance de pertencer ao padrão alimentar composto por fórmulas lácteas. Já o sobrepeso/obesidade foi 3,69 vezes maior em crianças que compunham o padrão 2 (fórmulas lácteas, verduras, legumes, carne bovina e pera). Aos 12 meses o déficit de estatura (RP = 3,28) e o uso de mamadeira (RP = 4,51) estiveram associados ao padrão alimentar composto por fórmulas lácteas e leite de vaca. Os padrões alimentares identificados refletiram a importante participação do leite materno na alimentação das crianças. Padrões alimentares com a presença de outros tipos de leite, foram associados a desvios nutricionais e uso de mamadeiras.

Maternal Race Trends in Early Infant Feeding Patterns in Hawai'i Using Newborn Metabolic Screening-Birth Certificate Linked Data 2008-2015.

Breastfeeding provides optimal nutrition for infants, including short- and longterm health benefits for baby and mother. Maternity care practices supporting breastfeeding after delivery increase the likelihood of exclusive breastfeeding. This study explores trends in early infant feeding practices by maternal race and other characteristics in Hawai'i. Data from a linked 2008-2015 Hawai'i Newborn Metabolic Screening and Birth Certificate file for 128 399 singleton term infants were analyzed. Early infant feeding occurring 24-48 hours after delivery and before discharge was categorized: Early formula feeding; early mixed feeding; and early exclusive breastfeeding. Differences were assessed over time by maternal race and other socio-demographic characteristics. Further assessment of maternal race included a generalized logit model adjusting for maternal age, marital status, county of residence, type of birth attendant, and birth year. Statewide, early exclusive breastfeeding increased from 58.8% in 2008 to 79.1% in 2015 (relative increase=+35%); early mixed feeding declined from 31.1% to 16.0% (relative decrease=-49%) and early formula feeding declined from 10.1% to 4.9% (relative decrease=-51%). Most maternal race subgroups experienced increases in early exclusive breastfeeding and decreases in mixed and formula. Japanese mothers were 2.15 (95%CI=1.90-2.42) and Korean mothers were 1.73 (95%CI=1.37-2.18) times more likely to practice early exclusive breastfeeding compared with white mothers. Several subgroups were less likely to practice early exclusive breastfeeding compared with white mothers. Substantial increases in early exclusive breastfeeding in Hawai'i occurred across all subgroups. Development of culturally appropriate hospital practices, particularly in those with persistently lower estimates, could help improve early exclusive breastfeeding.

Fatores associados aos padrões alimentares no segundo semestre de vida / Factors associated with dietary patterns in the second half of life

Resumo O objetivo deste artigo é identificar padrões alimentares de crianças com 6, 9 e 12 meses e sua associação com variáveis socioeconômicas, comportamentais, de nascimento e nutrição. Estudo transversal com crianças de uma coorte em Viçosa-MG, sendo 112 crianças com 6 meses, 149 com 9 meses e 117 com 12 meses. O consumo alimentar foi avaliado por um recordatório de 24 horas e os padrões extraídos por análise de agrupamentos. O leite materno foi identificado em pelo menos um padrão alimentar em todos os meses. Houve baixa participação de alimentos ultraprocessados nos padrões alimentares identificados. No 6º mês, crianças com menor renda familiar tiveram menos chance de pertencer ao padrão alimentar composto por fórmulas lácteas. Já o sobrepeso/obesidade foi 3,69 vezes maior em crianças que compunham o padrão 2 (fórmulas lácteas, verduras, legumes, carne bovina e pera). Aos 12 meses o déficit de estatura (RP = 3,28) e o uso de mamadeira (RP = 4,51) estiveram associados ao padrão alimentar composto por fórmulas lácteas e leite de vaca. Os padrões alimentares identificados refletiram a importante participação do leite materno na alimentação das crianças. Padrões alimentares com a presença de outros tipos de leite, foram associados a desvios nutricionais e uso de mamadeiras.

Abstract The aim of this paper is to identify eating patterns of children aged 6, 9 and 12 months and their association with socioeconomic, behavioral, birth and nutrition variables. Cross-sectional study with children from a cohort in Viçosa-MG, with 112 children at 6 months, 149 at 9 months and 117 at 12 months. Food intake was assessed by a 24-hour recall and patterns extracted by cluster analysis. Breast milk was identified in at least one dietary pattern every month. There was a low participation of ultra-processed foods in the identified dietary patterns. At month 6, children with lower family income were less likely to belong to the dietary pattern composed of milk formulas. Already overweight/obesity was 3.69 times higher in children who made up the pattern 2 (dairy formulas, vegetables, vegetables, beef and pear). At 12 months height deficit (PR = 3.28) and bottle use (PR = 4.51) were associated with the dietary pattern composed of milk formulas and cow's milk. The dietary patterns identified reflected the important participation of breast milk in children's diets. Dietary patterns with the presence of other types of milk were associated with nutritional deviations and bottle feeding.