Sleep Pattern and Problems in Young Children Visiting Outpatient Department of a Tertiary Level Hospital in Kathmandu, Nepal.

BACKGROUND: Sleep is an important parameter of a child's growth and development. The pattern and duration of sleep varies with age. Sleep problems are a common occurrence during childhood days, and these problems that establish in childhood are presumed to continue later in life. Many times, parental concerns regarding their child's sleep problems like difficulty in putting to sleep, frequent night time awakening, and waking up early are overlooked during their visits to the hospital. OBJECTIVE: The aim of this study was to find out the sleep patterns and problems of children aged six to thirty-six months. Methodology. A cross-sectional study was conducted at the pediatric outpatient department of Kathmandu Medical College Teaching Hospital from October, 2019 till March, 2020. Two hundred and forty-nine respondents were chosen purposively and were given questionnaires to be filled out. Research instrument was a standard, Nepali version of a structured questionnaire called Brief Infant Sleep Questionnaire (BISQ) which contained questions related to sleep parameters and sleep problems existing among young children of 6-36 months. Mean, standard deviation, frequencies, and Kruskal Wallis test were used for statistical analysis. RESULTS: The mean duration of total sleep was 12.12 ± 2.00 hours, while that of night sleep was 9.22 ± 1.19 hours and mean daytime nap was 2.90 ± 1.66 hours. Most of the children (96%) coslept with their parents, and 55% of the children had feeding as a bedtime ritual. Overall, 19.6% of the children had sleep problems as identified by BISQ although only 5.6% of the parents perceived that their children had it. CONCLUSIONS: Sleep problems were present among young Nepalese children included in our study, and sleep assessment should be a part of every health checkup for children.

Parental child feeding practices and their relationship with children's dietary intake and weight status in Nepal.

Background: Small children have less control over their dietary intake and parents have a major role to play in it. The aim of our study was to determine parental child feeding practices and their association with the weight status and dietary intake of the child. Design and methods: A cross-sectional study was conducted among 138 parents and preschool children attending two private schools in Kathmandu Valley, Nepal using a structured questionnaire. Parents filled in a self-report questionnaire to assess child feeding practices, perceived activity level of the child, and dietary intake at home. Child's height and weight was measured using a standard height scale and a digital weighing scale. A digital food scale was used for measuring dietary intake. Results: Eight percent of the children were overweight and another 8% were obese. On bivariate analysis, the BMI of parents had weak, positive, and significant correlation (r=0.206, p=0.016 for fathers; r=0.307, p≤0.001 for mothers) with child's weight status. Similarly, concern about child's overweight had a significant, positive correlation (r=0.232, p=0.006) with the weight status of the child. Furthermore, these three independent variables were found to be significant predictors of a child's weight status on multivariate analysis. None of the studied independent variables was associated with dietary intake. Conclusion: The study concludes that parental BMI and parental concern about the child being overweight is significantly associated with the weight status of the child.

Perceived Burden in Caregivers of Children with Autism Spectrum Disorder.

BACKGROUND: Autism Spectrum Disorder is a lifelong developmental disorder that affects children and results in deficit in social interaction, communication and display of unusual pattern of behavior. Though caregiving is a normal parental duty, providing intensive care to a child with long-term problem is burdensome and impacts both physical and mental health of caregivers. The aim of this study was to obtain a picture of burden among caregivers raising children with Autism Spectrum Disorder. METHODS: We conducted a descriptive cross-sectional study to assess the burden of caregiving among sixty one parents of children with Autism Spectrum Disorder in the Kathmandu Valley, Nepal, using purposive sampling technique. The burden perceived by caregivers was assessed using standard tool Zarit Burden Interview-22. RESULTS: Average burden score was 41.49±12.25 which indicates that caregivers experienced moderate to severe range of burden. Level of education, anxiety and depression was found to be significantly associated with burden of caregiving. CONCLUSIONS: The study concluded that the burden of caregiving is most remarkably associated with emotional status and social life of the caregivers.