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1.
BMC Public Health ; 19(1): 1437, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675943

RESUMO

BACKGROUND: The period from birth to two years is the "critical window" for achieving optimal growth and development. An inadequate quality and quantities of complementary foods, poor child-feeding practices and infection negatively impact the growth of under-twos. Approximately one-third of under-fives in developing countries are stunted; many are also micronutrient deficient. An estimated 6% of mortalities among under-fives can be prevented by ensuring optimal complementary feeding. The objective of the study was to assess the ability of a 12-month integrated nutrition intervention to improve the nutritional status (length-for-age Z-score) of 6 to 12-month-old children in rural Bangladesh. METHODS: In this community-based randomized controlled trial, the intervention group received a package of interventions that includes, food vouchers; to prepare egg-based nutritious snacks (suji firni for < 1-year-olds, suji halwa for > 1-year-olds), micronutrient powder to fortify children's food at home, child feeding counselling and water, sanitation and hygiene (WASH), behaviour change communication. The control group received routine health messages provided by the government. Baseline and endline surveys were conducted; Data collection was performed monthly on children's growth, food voucher utilization, child feeding and morbidity. In addition, we assessed the cognitive development of the children after 12 months of intervention. CONCLUSION: This trial aims to explore whether an integrated nutrition intervention can mitigate childhood stunting during the critical window of opportunity in rural Bangladesh. The results may provide robust evidence to improve the linear growth of children in developing countries. TRIAL REGISTRATION: The study was retrospectively registered on August 17, 2018 and is available online at ClinicalTrials.gov (ID: NCT02768181).


Assuntos
Transtornos do Crescimento/prevenção & controle , Promoção da Saúde/métodos , Fenômenos Fisiológicos da Nutrição do Lactente , Estado Nutricional , População Rural/estatística & dados numéricos , Bangladesh , Humanos , Lactente , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa
2.
Lima; Perú. Ministerio de Salud; 5 ed; 20191100. 32 p. ilus.
Monografia em Espanhol | LILACS, LIPECS | ID: biblio-1026279

RESUMO

El manual consta de tres disposiciones legales y/o reglamentos referentes a: 1. La alimentación de la niña y niño de cero (0) a veinticuatro (24) meses de edad, con énfasis en la promoción, protección y apoyo a la lactancia materna., 2. La responsabilidad del sistema de atención de salud, farmacias y otros puntos de venta, fabricantes y personal de comercialización de los productos a que se refiere el presente reglamento., y 3. Los procedimientos de comercialización de los sucedáneos de la leche materna para lactantes, niñas y niños hasta los veinticuatro (24) meses de edad.


Assuntos
Programas e Políticas de Nutrição e Alimentação , Aleitamento Materno , Agentes Comunitários de Saúde , Substitutos do Leite Humano , Nutrição do Lactente , Promoção da Saúde , Fenômenos Fisiológicos da Nutrição do Lactente
4.
Wei Sheng Yan Jiu ; 48(5): 745-750, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31601324

RESUMO

OBJECTIVE: To investigate the current situation of the utilization of infant and young child health services in pool rural areas where minorities gathered in Sichuan and Gansu Province and analyze its effect on infant nutrition and growth. METHODS: We choosed 1065 infants and young children aged≤24 months with their mother as the subjects by multistage cluster random sampling in October to November 2014 in poor rural areas where ethnic minorities gathered in Sichuan and Gansu Province. Questionnaires were used to obtain the data of demography and utilization of maternal and child health services, physical examination to obtain the data of growth status, and hemoglobin detection to obtain the hemoglobin level. The relationship between the nutrition and growth status and maternal and child health service utilization was analyzed by the unconditioned Logistic regression analysis. RESULTS: Among the surveyed infants and young children, the underweight rate was 3. 38%, the stunting rate was 10. 52%, and the wasting rate was 2. 25%, the malnutrition prevalence was 12. 58%, and the anemia prevalence was 52. 68%. The children's physical examination rate was 37. 09%, and the systematic management( frequency of physical examination reached the standard) rate of children was 12. 68%. The rate of prophylactic inoculation was 92. 30%, and the rate of reaching the standard of vaccination frequency was 48. 73%. After adjusting the confounding factors, the result showed that utilization of vaccination( OR = 0. 41, 95% CI0. 23-0. 74) and vaccination frequency reaching the standard( OR = 0. 58, 95%CI 0. 36-0. 92) were protective factors for infant malnutrition. Children 's physical examinations frequency reaching the standard( OR = 0. 52, 95%CI 0. 35-0. 79) was a protective factor for infant anemia. CONCLUSION: Reasonable utilization of health services can reduce the poor result of nutrition and growth of infants in poor rural areas where ethnic minorities gather in Sichuan and Gansu provinces.


Assuntos
Serviços de Saúde da Criança/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente , População Rural , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Estado Nutricional , Prevalência
5.
Wei Sheng Yan Jiu ; 48(5): 780-784, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31601325

RESUMO

OBJECTIVE: To study the introducing time of complementary food in poor rural areas and its association with the growth of infants and young children. METHODS: In total of 1802 infants and young children aged 6-12 months from 11 poverty counties in southern Shaanxi Province were selected by stratified random cluster sampling. These infants were surveyed four times, and once every 6 months. Data on complementary feeding for children were collected through the questionnaires. Cognitive development was measured by BSID. Body weight and length for them were measured using standard gauges to generate height for age Z score( HAZ), weight for age Z score( WAZ) and weight for height Z score( WHZ). The analysis of variance was used to identify the association between the introducing time of complementary food and growth of children. RESULTS: at baseline, only 32. 93% of children were introduced complementary food at the age of 6 months. This study indicated that the introducing time of complementary food was significantly associated with the cognitive development in the longer run. The third and fourth survey showed that children with introducing complementary food after 6 months of age( mental development index were 81. 24 and78. 40 respectively) had significantly lower cognitive development ability( F = 11. 86, P<0. 05; F = 4. 24, P< 0. 05). There were no long-term significant correlation between the introducing time of complementary food and WAZ, HAZ and WHZ. CONCLUSION: There are still lots of children that were not feeding reasonably in poor rural China. The introducing time of complementary food is related to growth of infants and young children.


Assuntos
Alimentos Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Peso Corporal , Criança , Pré-Escolar , China , Humanos , Lactente , População Rural
6.
Lakartidningen ; 1162019 Oct 08.
Artigo em Sueco | MEDLINE | ID: mdl-31593285

RESUMO

The recently documented high survival of extremely preterm infants in Sweden is related to a high degree of centralization of pre- and postnatal care and to recently issued national consensus guidelines providing recommendations for perinatal care at 22-24 gestational weeks. The prevalence of major neonatal morbidity remains high and exceeded 60 % in a recent study of extremely preterm infants born at < 27 gestational weeks delivered in Sweden in 2014-2016 and surviving to 1 year of age. Damage to immature organ systems inflicted during the neonatal period causes varying degrees of functional impairment with lasting effects in the growing child. There is an urgent need for evidence-based novel interventions aiming to prevent neonatal morbidity with a subsequent improvement of long-term outcome.


Assuntos
Lactente Extremamente Prematuro , Doenças do Prematuro , Nascimento Prematuro , Displasia Broncopulmonar/epidemiologia , Displasia Broncopulmonar/fisiopatologia , Displasia Broncopulmonar/prevenção & controle , Serviços Centralizados no Hospital , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/epidemiologia , Hemorragia Cerebral/fisiopatologia , Hemorragia Cerebral/prevenção & controle , Ventrículos Cerebrais/irrigação sanguínea , Ventrículos Cerebrais/diagnóstico por imagem , Enterocolite Necrosante/epidemiologia , Enterocolite Necrosante/fisiopatologia , Enterocolite Necrosante/prevenção & controle , Feminino , Humanos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Doenças do Prematuro/epidemiologia , Doenças do Prematuro/fisiopatologia , Doenças do Prematuro/prevenção & controle , Assistência Perinatal/organização & administração , Gravidez , Nascimento Prematuro/mortalidade , Retinopatia da Prematuridade/sangue , Retinopatia da Prematuridade/epidemiologia , Retinopatia da Prematuridade/fisiopatologia , Retinopatia da Prematuridade/prevenção & controle , Taxa de Sobrevida , Suécia/epidemiologia
7.
Lakartidningen ; 1162019 Oct 07.
Artigo em Sueco | MEDLINE | ID: mdl-31593288

RESUMO

Late and moderately preterm infants, born between 32+0/7 and 36+6/7 gestational weeks, comprise more than 80 % of all preterm infants and account for almost 40 % of all days of neonatal care. While their total number of days of care has not changed, an increasing part of their neonatal stay (from 29 % in 2011 to 41 % in 2017) is now within home care programmes. Late and moderate preterm birth is often complicated by respiratory disorders, hyperbilirubinemia, hypothermia and feeding difficulties. These infants also have an increased risk of perinatal death and neurologic complications. In the long run, they have higher risks of cognitive impairment, neuropsychiatric diagnoses and need for asthma medication. As young adults, they have a lower educational level and a lower average salary than their full-term counterparts. They also have an increased risk of long-term sick leave, disability pension and need for economic assistance from society.


Assuntos
Nascimento Prematuro , Corticosteroides/administração & dosagem , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos Cognitivos/epidemiologia , Educação Especial/estatística & dados numéricos , Feminino , Humanos , Lactente , Mortalidade Infantil , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido Prematuro , Tempo de Internação , Pneumopatias/epidemiologia , Masculino , Transtornos Mentais/epidemiologia , Gravidez , Nascimento Prematuro/economia , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/mortalidade , Nascimento Prematuro/prevenção & controle , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Fatores de Risco , Tempo
8.
Br J Nurs ; 28(17): 1150-1151, 2019 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-31556739

RESUMO

Emeritus Professor Alan Glasper, of the University of Southampton, discusses a new report published by the Dutch multinational company Philips, which in addition to its electronic portfolio has a prime mission to improve people's health and enable better outcomes across the health continuum.


Assuntos
Aleitamento Materno , Fenômenos Fisiológicos da Nutrição do Lactente , Humanos , Lactente
9.
Bratisl Lek Listy ; 120(9): 658-662, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31475549

RESUMO

AIM: To analyse the dynamics of macronutrients in breast milk in Slovakian women and compare the dynamics between mothers of hospitalized newborns and donors of human breast milk relative to the gestational age of their babies. METHODS: Human milk samples were collected from 101 breastfeeding women and analysed once or repeatedly from September 2017 to August 2018. Group A consisted of 79 mothers of newborns hospitalized at the Neonatal Department of Intensive Medicine (NDIM) of whom 69 were mothers of premature newborns (subgroup A1) and 10 were mothers of term babies (subgroup A2). Group B consisted of 22 breast milk donors registered at the Human Milk Bank at National Institute of Children's Diseases (NICHD). Of these, 4 were mothers of premature newborns (subgroup B1) and 18 were mothers of term newborns (subgroup B2). From subgroup A1, we chose two mothers, one with a hypotrophic newborn and another with a eutrophic newborn. The results were obtained by using the MIRIS breast­milk analyzer. RESULTS: The overall dynamics of macronutrients correspond with other studies, however, we demonstrated that the level of macronutrients in individual cases were different. CONCLUSION: The determination of macronutrients in human milk is essential in neonatal care. It provides information about the nutritional value of breast milk and helps to optimise nutrition according to the individual needs of newborns (Fig. 10, Ref. 16).


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente , Leite Humano/química , Nutrientes/análise , Aleitamento Materno , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Bancos de Leite
10.
BMC Public Health ; 19(1): 1034, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370827

RESUMO

BACKGROUND: Inappropriate complementary feeding practices significantly contribute to undernutrition among children under 2 years of age in India. However, there is limited up-to-date evidence on the prevalence and factors associated with complementary feeding practices to guide policy actions at the subnational level in India. We investigated the regional prevalence and factors associated with complementary feeding practices in India. METHODS: This study used a sample of 69,464 maternal responses from the 2015-16 National Family Health Survey in India. The prevalence of complementary feeding indicators was estimated using data for each administrative region, namely: North (n = 8469), South (n = 12,828), East (n = 18,141), West (n = 8940), North-East (n = 2422) and Central (n = 18,664). Factors associated with complementary feeding by region in India were investigated using logistic regression Generalized Linear Latent and Mixed Models (GLLAMM) with a logit link and binomial family that adjusted for clustering and sampling weights. RESULTS: The study showed a wide variation in the prevalence of introduction of solid, semi-solid or soft foods (complementary foods) among infants aged 6-8 months in regional India; highest in the South (61%) and lowest in the Central and Northern regions (38%). Similarly, minimum dietary diversity (MDD) was highest in the South (33%) and lowest in the Central region (12%). Both minimum meal frequency (MMF) and minimum acceptable diet (MAD) varied substantially across the regions. The factors associated with complementary feeding practices also differed across Indian regions. Significant modifiable factors associated with complementary feeding practices included higher household wealth index for the introduction of complementary foods in the North and Eastern India; higher maternal education for MMF and MDD in the North and Central regions; and frequent antenatal care visits (≥4 visits) for all indicators but for different regions. CONCLUSION: Our study indicates that there are wide differences in regional prevalence and factors associated with complementary feeding practices in India. The improvement of complementary feeding practices in India would require national and sub-national efforts that target vulnerable mothers, including those with no education and limited health service contacts.


Assuntos
Comportamento Alimentar , Fenômenos Fisiológicos da Nutrição do Lactente , Mães/psicologia , Feminino , Humanos , Índia/epidemiologia , Lactente , Masculino , Mães/estatística & dados numéricos , Gravidez , Prevalência , Fatores de Risco , Fatores Socioeconômicos
11.
Cochrane Database Syst Rev ; 8: CD002972, 2019 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-31452191

RESUMO

BACKGROUND: Artificial formula can be manipulated to contain higher amounts of macro-nutrients than maternal breast milk but breast milk confers important immuno-nutritional advantages for preterm or low birth weight (LBW) infants. OBJECTIVES: To determine the effect of feeding preterm or LBW infants with formula compared with maternal breast milk on growth and developmental outcomes. SEARCH METHODS: We used the standard strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 9), and Ovid MEDLINE, Ovid Embase, Ovid Maternity & Infant Care Database, and CINAHL to October 2018. We searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials that compared feeding preterm or low birth weight infants with formula versus maternal breast milk. DATA COLLECTION AND ANALYSIS: Two review authors planned independently to assess trial eligibility and risk of bias, and extract data. We planned to analyse treatment effects as described in the individual trials and report risk ratios and risk differences for dichotomous data, and mean differences for continuous data, with 95% confidence intervals. We planned to use a fixed-effect model in meta-analyses and to explore potential causes of heterogeneity in subgroup analyses. We planned to use the GRADE approach to assess the certainty of evidence. MAIN RESULTS: We did not identify any eligible trials. AUTHORS' CONCLUSIONS: There are no trials of formula versus maternal breast milk for feeding preterm or low birth weight infants. Such trials are unlikely to be conducted because of the difficulty of allocating an alternative form of nutrition to an infant whose mother wishes to feed with her own breast milk. Maternal breast milk remains the default choice of enteral nutrition because observational studies, and meta-analyses of trials comparing feeding with formula versus donor breast milk, suggest that feeding with breast milk has major immuno-nutritional advantages for preterm or low birth weight infants.


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Recém-Nascido de Baixo Peso/crescimento & desenvolvimento , Recém-Nascido Prematuro/crescimento & desenvolvimento , Leite Humano , Humanos , Lactente , Fórmulas Infantis , Recém-Nascido , Ensaios Clínicos Controlados Aleatórios como Assunto , Ganho de Peso
12.
Nutrients ; 11(7)2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31373314

RESUMO

Optimal nutrition improves child development, and impaired development is associated with maternal depression symptoms, in particular in low resource settings. In this follow-up of an open cluster-randomized education trial, we examined its effects among mothers in rural Uganda on their depression symptoms and the association of these symptoms to child development. The education comprised complementary feeding, stimulation, and hygiene. We assessed 77 intervention mothers and 78 controls using Beck Depression Inventory-II (BDI-II) and Center for Epidemiologic Studies Depression Scale (CES-D) scores. Child development was assessed with Bayley Scales of Infant and Toddler Development-III (BSID-III) composite scores for cognitive, language and motor development. Compared to controls, the intervention reduced depression symptoms' scores with mean (95% CI) differences: -8.26 (-11.49 to -1.13, p = 0.0001) and -6.54; (-8.69 to -2.99, p = 0.004) for BDI II at 20-24 and 36 months, respectively. Similar results were obtained with CES-D. There was a negative association of BDI-II scores and BSID-III cognitive and language scores at 20-24 (p = 0.01 and 0.008, respectively) and 36 months (p = 0.017 and 0.001, respectively). CES-D associations with BSID-III cognitive and language scores showed similar trends. BSID-III motor scores were associated with depression scores at 36 months for both BDI-II and CES-D (p = 0.043 and 0.028, respectively). In conclusion, the group education was associated with reduced maternal depression scores. Moreover, the depression scores were inversely associated with child cognitive and language development outcomes.


Assuntos
Desenvolvimento Infantil , Depressão/psicologia , Relações Mãe-Filho/psicologia , Mães/educação , Mães/psicologia , Adulto , Atitude Frente a Saúde , Pré-Escolar , Depressão/epidemiologia , Feminino , Seguimentos , Educação em Saúde/métodos , Inquéritos Epidemiológicos , Humanos , Higiene/educação , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Pobreza , Escalas de Graduação Psiquiátrica , População Rural , Uganda/epidemiologia , Adulto Jovem
13.
Nutrients ; 11(8)2019 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-31382632

RESUMO

(1) Background: Undernutrition and micronutrient deficiency have been consistently linked to cognitive impairment among children and young adults. As a primary source of dietary animal protein, beef consumption holds the potential to improve diet quality and positively influence cognitive function. This study systematically reviewed evidence linking beef intake to cognition among children and young adults. (2) Methods: A literature search was conducted in seven electronic bibliographic databases for studies assessing the impact of beef consumption on cognition. (3) Results: We identified eight studies reporting results from five unique interventions. Two interventions were conducted in Kenya, two in the U.S. and one in four countries including Guatemala, Pakistan, Democratic Republic of the Congo and Zambia. Only one intervention employed a non-feeding control arm and found beef consumption to improve cognitive abilities compared to the control. However, the other interventions comparing beef consumption to other food types found no consistent result. (4) Conclusions: Evidence pertaining to the impact of beef consumption on cognition remains limited due to the small and heterogeneous set of studies. Future research should adopt a population representative sample and longer follow-up period, employ a non-feeding control arm and comprehensively measure nutrient intakes among study participants.


Assuntos
Comportamento do Adolescente , Comportamento Infantil , Fenômenos Fisiológicos da Nutrição Infantil , Cognição , Valor Nutritivo , Carne Vermelha , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Comportamento do Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Estado Nutricional , Recomendações Nutricionais , Adulto Jovem
14.
Nutrients ; 11(8)2019 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-31382653

RESUMO

Poverty adversely affects child development through multiple pathways in low- and middle-income countries. Relationships between diet and child development are poorly understood. In this study, we aimed to explore these associations in a longitudinal cohort of 305 children in rural Nepal (baseline mean age 14 months), evaluating dietary diversity and the consumption of specific food groups at three timepoints over 1.5 years. Child development was assessed using the Ages and Stages questionnaire-version 3 (ASQ-3). Associations between the number of days that children consumed minimum dietary diversity (MDD) (≥4/8 items) and specific food groups over time (range 0-3) and total and subscale ASQ scores at age 23-38 months were estimated using multiple linear and logistic regression, dichotomizing scores at the lowest quartile. After adjusting for confounders, each additional day of consuming MDD was associated with a 35% reduction in the odds of low total ASQ score [OR 0.65, 95% CI (0.46, 0.92)]. The consumption of animal source foods [OR 0.64, (0.46, 0.89)], and vegetables/fruits [OR 0.60, (0.41, 0.90), but not processed foods [OR 0.99, (0.62, 1.59)] was associated with lower odds of low total development. Vegetables, fruits and animal source foods may be important for child development in this setting.


Assuntos
Desenvolvimento Infantil , Fenômenos Fisiológicos da Nutrição Infantil , Dieta , Estado Nutricional , Valor Nutritivo , Fatores Etários , Pré-Escolar , Dieta/efeitos adversos , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Estudos Longitudinais , Masculino , Nepal , Ensaios Clínicos Controlados Aleatórios como Assunto , Recomendações Nutricionais , Saúde da População Rural , Inquéritos e Questionários
15.
Cochrane Database Syst Rev ; 7: CD012412, 2019 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-31339557

RESUMO

BACKGROUND: When human milk is not available for feeding preterm infants, protein hydrolysate, rather than standard cow's milk formulas (with intact proteins), is often used because it is perceived as being tolerated better and less likely to lead to complications. However, protein hydrolysate formulas are more expensive than standard formulas, and concern exists that their use in practice is not supported by high-quality evidence. OBJECTIVES: To assess the effects of feeding preterm infants hydrolysed formula (vs standard cow's milk formula) on risk of feed intolerance, necrotising enterocolitis, and other morbidity and mortality. SEARCH METHODS: We used the standard Cochrane Neonatal search strategy including electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 1), in the Cochrane Library; Ovid MEDLINE (1966 to 28 January 2019); Ovid Embase (1980 to 28 January 2019); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (28 January 2019), as well as conference proceedings and previous reviews. SELECTION CRITERIA: Randomised and quasi-randomised controlled trials that compared feeding preterm infants protein hydrolysate versus standard (non-hydrolysed) cow's milk formula. DATA COLLECTION AND ANALYSIS: Two review authors assessed trial eligibility and risk of bias and extracted data independently. We analysed treatment effects as described in the individual trials and reported risk ratios and risk differences for dichotomous data, and mean differences for continuous data, with respective 95% confidence intervals (CIs). We used a fixed-effect model in meta-analyses and explored potential causes of heterogeneity in sensitivity analyses. We assessed quality of evidence at the outcome level using the GRADE approach. MAIN RESULTS: We identified 11 trials for inclusion in the review. All trials were small (total participants 665) and had various methodological limitations including uncertainty about methods to ensure allocation concealment and blinding. Most participants were clinically stable preterm infants of less than about 34 weeks' gestational age or with birth weight less than about 1750 g. Fewer participants were extremely preterm, extremely low birth weight, or growth restricted. Most trials found no effects on feed intolerance, assessed variously as mean pre-feed gastric residual volume, incidence of abdominal distension or other gastrointestinal signs of concern, or time taken to achieve full enteral feeds (meta-analysis was limited because studies used different measures). Meta-analysis showed no effect on the risk of necrotising enterocolitis (typical risk ratio 1.10, 95% CI 0.36 to 3.34; risk difference 0.00, 95% CI -0.03 to 0.04; 5 trials, 385 infants) (low-certainty evidence; downgraded for imprecision and design weaknesses). AUTHORS' CONCLUSIONS: The identified trials provide only low-certainty evidence about the effects of feeding preterm infants protein hydrolysate versus standard formula. Existing data do not support conclusions that feeding protein hydrolysate affects the risk of feed intolerance or necrotising enterocolitis. Additional large, pragmatic trials are needed to provide more reliable and precise estimates of effectiveness and cost-effectiveness.


Assuntos
Fórmulas Infantis , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Hidrolisados de Proteína/administração & dosagem , Humanos , Lactente , Recém-Nascido , Hidrolisados de Proteína/metabolismo , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
Cien Saude Colet ; 24(7): 2387-2397, 2019 Jul 22.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31340258

RESUMO

OBJECTIVE: To verify the association of maternal and anthropometric factors with consumption of ultra-processed foods in children between 4 to 24 months. METHODS: cross-sectional study with 300 children hospitalized in a tertiary hospital and their mothers. The interview took place during the first 72 hours of hospitalization to avoid interference in the responses about the child's diet. Maternal factors investigated: age, schooling, income, parity, BMI and guidance on complementary feeding. Variables related to the child investigated: age, breastfeeding, infant school, BMI/age, height/age, weight/age and introduction of ultra-processed food. The association between the factors studied and introduction of ultra-processed food was tested by linear regression. The significance level considered was 0.05. RESULTS: . It was verified that only 21% of the children had not yet received any type of ultra-processed food, and 56.5% received any of these foods before 6 months. In the multivariate analysis, maternal schooling, family income, maternal age and parity were associated with ultra-processed food supply. CONCLUSIONS: The feeding practices of children between 4 and 24 months are inadequate when compared to the recommendations for the age group.


Assuntos
Fast Foods/estatística & dados numéricos , Comportamento Alimentar , Hospitalização , Fenômenos Fisiológicos da Nutrição do Lactente , Adulto , Aleitamento Materno/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Lactente , Entrevistas como Assunto , Masculino , Mães/estatística & dados numéricos , Adulto Jovem
17.
BMC Res Notes ; 12(1): 390, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31296262

RESUMO

OBJECTIVE: Individuals from low-income countries often migrate abroad for employment. The association between such migration and investment in education as well as other societal and familial outcomes has previously been examined. However, we have a limited understanding of the association between migration and children's nutrition. We aim to determine the extent to which migration of household members influences children's diet in a semi-urban region of Nepal. RESULTS: In our study setting, children in households with a migrant had higher dietary diversity scores, 0.69 on average, than their counterparts in households without a migrant. These children were approximately 43% points more likely to meet a minimum requirement for dietary diversity. These differences originated primarily from higher consumption of meat (41% points) and eggs (20% points). Approximately 37 percent of children in the sample consumed processed food during the 24 h preceding the survey. However, we found no evidence that migration was associated with the consumption of processed foods or with reduced frequency of breastfeeding. Our finding that migration is associated with higher consumption of meat and eggs is particularly encouraging, given that the protein deficiency in Nepal is estimated to be nearly 43 percent.


Assuntos
Dieta , Emigração e Imigração/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Estado Nutricional , Migrantes/estatística & dados numéricos , Pré-Escolar , Características da Família , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Nepal , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos
18.
Cochrane Database Syst Rev ; 7: CD002971, 2019 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-31322731

RESUMO

BACKGROUND: When sufficient maternal breast milk is not available, alternative forms of enteral nutrition for preterm or low birth weight (LBW) infants are donor breast milk or artificial formula. Donor breast milk may retain some of the non-nutritive benefits of maternal breast milk for preterm or LBW infants. However, feeding with artificial formula may ensure more consistent delivery of greater amounts of nutrients. Uncertainty exists about the balance of risks and benefits of feeding formula versus donor breast milk for preterm or LBW infants. OBJECTIVES: To determine the effect of feeding with formula compared with donor breast milk on growth and development in preterm or low birth weight (LBW) infants. SEARCH METHODS: We used the Cochrane Neonatal search strategy, including electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 5), Ovid MEDLINE, Embase, and the Cumulative Index to Nursing and Allied Health Literature (3 May 2019), as well as conference proceedings, previous reviews, and clinical trials. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials (RCTs) comparing feeding with formula versus donor breast milk in preterm or LBW infants. DATA COLLECTION AND ANALYSIS: Two review authors assessed trial eligibility and risk of bias and extracted data independently. We analysed treatment effects as described in the individual trials and reported risk ratios (RRs) and risk differences (RDs) for dichotomous data, and mean differences (MDs) for continuous data, with respective 95% confidence intervals (CIs). We used a fixed-effect model in meta-analyses and explored potential causes of heterogeneity in subgroup analyses. We assessed the certainty of evidence for the main comparison at the outcome level using GRADE methods. MAIN RESULTS: Twelve trials with a total of 1879 infants fulfilled the inclusion criteria. Four trials compared standard term formula versus donor breast milk and eight compared nutrient-enriched preterm formula versus donor breast milk. Only the five most recent trials used nutrient-fortified donor breast milk. The trials contain various weaknesses in methodological quality, specifically concerns about allocation concealment in four trials and lack of blinding in most of the trials. Most of the included trials were funded by companies that made the study formula.Formula-fed infants had higher in-hospital rates of weight gain (mean difference (MD) 2.51, 95% confidence interval (CI) 1.93 to 3.08 g/kg/day), linear growth (MD 1.21, 95% CI 0.77 to 1.65 mm/week) and head growth (MD 0.85, 95% CI 0.47 to 1.23 mm/week). These meta-analyses contained high levels of heterogeneity. We did not find evidence of an effect on long-term growth or neurodevelopment. Formula feeding increased the risk of necrotising enterocolitis (typical risk ratio (RR) 1.87, 95% CI 1.23 to 2.85; risk difference (RD) 0.03, 95% CI 0.01 to 0.05; number needed to treat for an additional harmful outcome (NNTH) 33, 95% CI 20 to 100; 9 studies, 1675 infants).The GRADE certainty of evidence was moderate for rates of weight gain, linear growth, and head growth (downgraded for high levels of heterogeneity) and was moderate for neurodevelopmental disability, all-cause mortality, and necrotising enterocolitis (downgraded for imprecision). AUTHORS' CONCLUSIONS: In preterm and LBW infants, moderate-certainty evidence indicates that feeding with formula compared with donor breast milk, either as a supplement to maternal expressed breast milk or as a sole diet, results in higher rates of weight gain, linear growth, and head growth and a higher risk of developing necrotising enterocolitis. The trial data do not show an effect on all-cause mortality, or on long-term growth or neurodevelopment.


Assuntos
Fórmulas Infantis , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Recém-Nascido de Baixo Peso/crescimento & desenvolvimento , Recém-Nascido Prematuro/crescimento & desenvolvimento , Leite Humano , Humanos , Lactente , Recém-Nascido , Ensaios Clínicos Controlados Aleatórios como Assunto , Ganho de Peso
19.
Nutrients ; 11(7)2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31331065

RESUMO

The current study aimed to investigate growth, safety and tolerance of partially hydrolysed infant formulae in healthy full-term infants. Fully formula-fed infants were randomised ≤14 days of age to receive a partially hydrolysed whey formula with 2.27 g protein/100 kcal (pHF2.27) or the same formula with 1.8 g or 2.0 g protein/100 kcal (pHF1.8 and pHF2.0) until 4 months of age. The primary outcome was equivalence in daily weight gain within margins of ± 3 g/day; comparison with WHO Child Growth Standards; gastrointestinal tolerance parameters and number of (serious) adverse events were secondary outcomes. A total of 207 infants were randomised, and 61 (pHF1.8), 46 (pHF2.0) and 48 (pHF2.27) infants completed the study per protocol. Equivalence in daily weight gain was demonstrated for the comparison of pHF1.8 and pHF2.27, i.e., the estimated difference was -1.12 g/day (90% CI: [-2.72; 0.47]) but was inconclusive for the comparisons of pHF2.0 and pHF2.27 with a difference of -2.52 g/day (90% CI: [-4.23; -0.81]). All groups showed adequate infant growth in comparison with the World Health Organization (WHO) Child Growth Standards. To conclude, the evaluated partially hydrolysed formulae varying in protein content support adequate growth and are safe and well tolerated in healthy infants.


Assuntos
Dieta com Restrição de Proteínas , Fórmulas Infantis/análise , Ganho de Peso , Proteínas do Soro do Leite/química , Bélgica , Peso ao Nascer , Método Duplo-Cego , Feminino , Humanos , Hidrólise , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Masculino , Valor Nutritivo , Estudos Prospectivos , Soro do Leite , Proteínas do Soro do Leite/administração & dosagem
20.
Nutrients ; 11(7)2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31319554

RESUMO

In view of continuing reports of high prevalence of severe vitamin D deficiency and low rate of infant vitamin D supplementation, an alternative strategy for prevention of vitamin D deficiency in infants warrants further study. The aim of this randomized controlled trial among 95 exclusively breastfeeding mother-infant pairs with high prevalence of vitamin D deficiency was to compare the effect of six-month post-partum vitamin D3 maternal supplementation of 6000 IU/day alone with maternal supplementation of 600 IU/day plus infant supplementation of 400 IU/day on the vitamin D status of breastfeeding infants in Doha, Qatar. Serum calcium, parathyroid hormone, maternal urine calcium/creatinine ratio and breast milk vitamin D content were measured. At baseline, the mean serum 25-hydroxyvitamin D (25(OH)D) of mothers on 6000 IU and 600 IU (35.1 vs. 35.7 nmol/L) and in their infants (31.9 vs. 29.6) respectively were low but similar. At the end of the six month supplementation, mothers on 6000 IU achieved higher serum 25(OH)D mean ± SD of 98 ± 35 nmol/L than 52 ± 20 nmol/L in mothers on 600 IU (p < 0.0001). Of mothers on 6000 IU, 96% achieved adequate serum 25(OH)D (≥50 nmol/L) compared with 52%in mothers on 600 IU (p < 0.0001). Infants of mothers on 600 IU and also supplemented with 400 IU vitamin D3 had slightly higher serum 25(OH)D than infants of mothers on 6000 IU alone (109 vs. 92 nmol/L, p = 0.03); however, similar percentage of infants in both groups achieved adequate serum 25(OH)D ≥50 nmol/L (91% vs. 89%, p = 0.75). Mothers on 6000 IU vitamin D3/day also had higher human milk vitamin D content. Safety measurements, including serum calcium and urine calcium/creatinine ratios in the mother and serum calcium levels in the infants were similar in both groups. Maternal 6000 IU/day vitamin D3 supplementation alone safely optimizes maternal vitamin D status, improves milk vitamin D to maintain adequate infant serum 25(OH)D. It thus provides an alternative option to prevent the burden of vitamin D deficiency in exclusively breastfeeding infants in high-risk populations and warrants further study of the effective dose.


Assuntos
Aleitamento Materno , Colecalciferol/administração & dosagem , Colecalciferol/farmacologia , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Fenômenos Fisiológicos da Nutrição Pré-Natal , Adulto , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Prevalência , Catar , Fatores de Risco , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/prevenção & controle
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