Maternal and Child Nutrition

Exclusive breastfeeding (EBF) for the first six months of life is essential for an infant's optimal growth, immunity, and development. However, global adherence remains inadequate, particularly in developing regions. This study aimed to explore the factors influencing EBF practices among mothers of infants aged 0-6 months attending the immunization clinic at the University of Port Harcourt Teaching Hospital (UPTH) in Rivers State, Nigeria. A crosssectional approach, data were gathered from 382 mothers through structured questionnaires. Analysis was done using Pearson correlation and chi-square tests. The findings showed that social support from healthcare providers, family and breastfeeding support groups played a crucial role in encouraging EBF. A substantial portion of mothers (47.1%) receive help with breastfeeding decisions from healthcare providers, followed by 39.3% from husbands or relatives and 13.6% from friends. Encouragement from husbands or family members plays a crucial role, with 83.8% of mothers reporting support in this regard. Additionally, 26.2% of mothers participate in breastfeeding support groups, and 75.9% of healthcare providers discuss the benefits of breastfeeding with them, further supporting their decisions. A notable 68.1% of healthcare

To explore the perspectives of male caregivers involved in managing newborn illnesses at home and in healthcare facilities. Methods: An exploratory descriptive design was used, involving face-to-face semi-structured interviews with 18 male caregivers selected through purposive sampling. Thematic analysis was used for data analysis. Results: Two major themes emerged: a) Knowledge and attitudes of male caregivers toward newborn care and, b). Beliefs of male caregivers influencing newborn care. The first theme encompassed several subthemes: men's knowledge and reactions, their perceived responsibilities in newborn care, their emotional responses to their baby's illness, the support they provide during such times, and their affection towards their ill babies. The second theme included subthemes related to men's perceptions of their involvement in newborn care and how family ties influence their caregiving role. The findings underscore the essential role that male caregivers play in newborn care, especially during illness. Insights into their perspectives can inform healthcare providers in delivering targeted support and education. Policymakers in Ghana can use this information to develop interventions that promote male involvement in newborn care. Enhancing support systems and communication can improve health outcomes for newborns and strengthen family bonds.

Evidence supporting the practice of skin-to-skin contact and breastfeeding soon after birth points to physiologic, social, and psychological benefits for both mother and baby. The 2009 revision of Step 4 of the WHO/UNICEF "Ten Steps to Successful Breastfeeding" elaborated on the practice of skin-to-skin contact between the mother and her newly born baby indicating that the practice should be "immediate" and "without separation" unless documented medically justifiable reasons for delayed contact or interruption exist. While in immediate, continuous, uninterrupted skin-to-skin contact with mother in the first hour after birth, babies progress through 9 instinctive, complex, distinct, and observable stages including self-attachment and suckling. However, the most recent Cochrane review of early skin-to-skin contact cites inconsistencies in the practice; the authors found "inadequate evidence with respect to details … such as timing of initiation and d...

Food frequency questionnaires (FFQs) are less time consuming and inexpensive instruments for collecting dietary intake when compared with 24‐h dietary recalls or double‐labelled water; however, the validation of FFQ is important as incorrect information may lead to biased conclusions about associations. Therefore, the relative validity of the Block Kids Food Screener (BKFS) developed for use with children was examined in a convenience sample of 99 youth recruited from the Portland, OR metropolitan area. Three 24‐h dietary recalls served as the reference. The relative validity was analysed after natural log transformation of all variables except glycaemic index prior to correlation analysis. Daily cup equivalent totals from the BKFS and ‘servings’ from 24‐h recalls were used to compute average daily intake of fruits, vegetables, potatoes, whole grains, legumes, meat/fish/poultry and dairy. Protein grams (g), total kcalories, glycaemic index (glucose reference), glycaemic load (glucos...

Background More than one-third of all deaths in children under five are attributable to malnutrition brought on by child food poverty (CFP) practices, while proper feeding techniques are essential for enhancing nutritional status and guaranteeing child survival. There is, however, little research on inadequate feeding practices, especially in the Sidama Region. antenatal care follow-up below four times (AOR=3.52, 95% CI: (1.429-4.152), family size more than five in the household(AOR= 3.715, 95% CI: 1.974-6.993), and maternal inadequate knowledge of CFP (AOR= 5.148, 95% CI: 3.146-8.426). Conclusion The prevalence of CFP, which remains a significant public health concern, was 30% in the study area. Child age, child sex, antenatal care follow-ups, inadequate maternal knowledge to feed children, and household size greater than five were significantly associated with child food poverty. Enhancing antenatal care services and raising awareness of the best feeding practices, especially for younger infants and female children should be the main goals of nutrition interventions.

Many policy drivers have identified the importance of peer support for breastfeeding, and recent reviews have recognised that support for breastfeeding mothers can help to increase breastfeeding rates and in turn reduce health and social inequalities. Breastfeeding peer support groups offer much more to a community than is measureable in terms of money. Deprived areas of the UK are seen as having 'lost skills' in breastfeeding; they have no experience or tradition of breastfeeding to draw on and are unable to view it as an everyday activity that influences an intention to breastfeed and leads to bottle feeding. South Tyneside is one of the most deprived areas in the UK, and has integrated and implemented peer counsellor training into the support model for new mothers and the training model with other professionals. It has had a high success rate with more than a fifth moving on to nurse education.

Children of HIV-infected mothers experience poor growth, but not much is understood about the extent to which such children are affected. The Research to Improve Infant Nutrition and Growth (RIING) Project used a longitudinal study design to investigate the association between maternal HIV status and growth among Ghanaian infants in the first year of life. Pregnant women in their third trimester were enrolled into three groups: HIV-negative (HIV-N, n = 185), HIV-positive (HIV-P, n = 190) and HIV-unknown (HIV-U, n = 177). Socioeconomic data were collected. Infant weight and length were measured at birth and every month until 12 months of age. Weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) z-scores were compared using analysis of covariance. Infant HIV status was not known as most mothers declined to test their children's status at 12 months. Adjusted mean WAZ and LAZ at birth were significantly higher for infants of HIV-N compared with infants of HIV-P mothers. The prevalence of underweight at 12 months in the HIV-N, HIV-P and HIV-U were 6.6%, 27.5% and 9.9% (P < 0.05), respectively. By 12 months, the prevalence of stunting was significantly different (HIV-N = 6.0%, HIV-P = 26.5% and HIV-U = 5.0%, P < 0.05). The adjusted mean Ϯ SE LAZ (0.57 Ϯ 0.11 vs. -0.95 Ϯ 0.12; P < 0.005) was significantly greater for infants of HIV-N mothers than infants of HIV-P mothers. Maternal HIV is associated with reduce infant growth in weight and length throughout the first year of life. Children of HIV-P mothers living in socioeconomically deprived communities need special support to mitigate any negative effect on growth performance.

The Canada Prenatal Nutrition Program (CPNP) provides a variety of health and nutrition supports to vulnerable mothers and strongly promotes breastfeeding but does not have a formal framework for postnatal lactation support. Breastfeeding duration and exclusivity rates in Canada fall well below global recommendations, particularly among socially and economically vulnerable women. We aimed to explore CPNP participant experiences with breastfeeding and with a novel community lactation support program in Toronto, Canada that included access to certified lactation consultants and an electric breast pump, if needed. Four semistructured focus groups and 21 individual interviews (n = 46 women) were conducted between September and December 2017. Data were analysed using inductive thematic analysis. Study participants reported a strong desire to breastfeed but a lack of preparation for breastfeeding‐associated challenges. Three main challenges were identified by study participants: physical ...

Child malnutrition remains high in Ethiopia, and inadequate complementary feeding is a contributing factor. In this context, a community-based intervention was designed to provide locally made complementary food for children 6-23 months, using a bartering system, in four Ethiopian regions. After a pilot phase, the intervention was scaled up from 8 to 180 localities. We conducted a process evaluation to determine enablers and barriers for the scaling up of this intervention. Eight study sites were selected to perform 52 key informant interviews and 31 focus group discussions with purposely selected informants. For analysis, we used a framework describing six elements of successful scaling up: socio-political context, attributes of the intervention, attributes of the implementers, appropriate delivery strategy, the adopting community, and use of research to inform the scale-up process. A strong political will, alignment of the intervention with national priorities, and integration wit...

Information on fortifiable food consumption is essential to design, monitor and evaluate fortification programmes, yet detailed methods like 24‐h recalls (24HRs) that provide such data are rarely conducted. Simplified questionnaire‐based methods exist but their validity compared with 24HRs has not been shown. We compared two simplified methods (i.e., a household food acquisition and purchase questionnaire [FAPQ] and a 7‐day semiquantitative food frequency questionnaire [SQ‐FFQ]) against 24HRs for estimating fortifiable food consumption. We assessed the consumption of fortifiable wheat flour and oil using a FAPQ and, for wheat flour only, a 7‐day SQ‐FFQ and compared the results against 24HRs. The participants included children 12−18 months (n = 123) and their mothers 18−49 years selected for a study assessing child vitamin A intake and status in Mandaluyong City, Philippines. For fortifiable wheat flour, the FAPQ estimated considerably lower mean intakes compared to 24HRs for childre...

The Baby‐Friendly Hospital Initiative (BFI) is currently presented worldwide as the gold standard model of care for promoting and supporting breastfeeding. However, there is a lack of understanding about the ways in which health services, including the BFI, address the cultural change from a disembodied practice (formula feeding) to an embodied one (breastfeeding) in contexts where formula feeding is the norm. We used a qualitative case study methodology to compare the embodied experience of breastfeeding and the maternal experience of breastfeeding promotion and support services between mothers receiving care from institutions with low and high levels of BFI implementation in Québec, Canada. A total of 11 focus groups were conducted with mothers from six institutions–three with high and three with low levels of BFI implementation. We found the flexible approach to breastfeeding duration, characteristic of BFI services in our study, helped to avoid maternal guilt and shame; the shif...

Métodos: estudio transversal, mediante Búsqueda-Activa-Comunitaria (BAC) de todas las gestantes de las diecinueve comunidades indígenas de la zona, aplicación de encuesta de conocimientos-actitudes-prácticas (CAP) previo consentimiento informado y evaluación del riesgo de cada materna. Sistematización y análisis con Epi-Info 3.5.1, utilizando medidas de frecuencia y tendencia central.

Dietary intake during pregnancy plays a vital role in determining the health of both mother and baby. Maternal undernutrition affects a large proportion of women in low and lower middle income countries (LLMIC) likely influencing high maternal, infant, and child mortality in these countries. Mobile health (mHealth) interventions have been proposed as effective solutions to improve maternal and neonatal health. This paper reviews the literature to evaluate the effectiveness of mHealth interventions on improving dietary/nutrients intake of pregnant women in LLMIC. Eight electronic databases were searched from inception up to April 2018, including the MEDLINE, EMBASE, CINAHL, Cochrane, Web of Science, Scopus, Global Index Medicus, and Maternity and Infant Care. Using Covidence, two reviewers assessed articles for inclusion, assessed study quality and extracted data. Only studies published in English language were included. Data were summarised narratively. In total, 6,778 were identified of which four were included, with three randomised controlled trials and one prepost experimental study. Studies were conducted in India (n = 2),

We present an updated cost analysis to provide new estimates of the cost of providing community-based treatment for severe acute malnutrition, including expenditure shares for major cost categories. We calculated total and per child costs from a provider perspective. We categorized costs into three main activities (outpatient treatment, inpatient treatment, and management/administration) and four cost categories within each activity (personnel; therapeutic food; medical supplies; and infrastructure and logistical support). For each category, total costs were calculated by multiplying input quantities expended in the Médecins Sans Frontières nutrition program in Niger during a 12-month study period by 2015 input prices. All children received outpatient treatment, with 43% also receiving inpatient treatment. In this large, well-established program, the average cost per child treated was €148.86, with outpatient and inpatient treatment costs of €75.50 and €134.57 per child, respectivel...

Strategies for preventing undernutrition comprise a range of interventions, including education, provision of complementary food and cash transfer. Here, we compared monthly distributions of two different lipid-based nutrient supplements (LNS), large-quantity LNS (LNS-LQ) and medium-quantity LNS (LNS-MQ) for 15 months on prevention of undernutrition among children 6 to 23 months. Both groups also received cash transfer for the first 5 months of the intervention. We conducted a prospective intervention study in Maradi, Niger, between August 2011 and October 2012. Six and 11 villages were randomly allocated to LNS-LQ/Cash and LNS-MQ/Cash, respectively. Children measuring 60-80 cm were enrolled in the respective groups and followed up monthly. Poisson regression was used to assess differences between interventions and adjust for baseline characteristics, intervention periods and child-feeding practices. The analysis included 2586 children (1081 in the LNS-LQ/Cash group and 1505 in the LNS-MQ/Cash group). This study suggests that provision of LNS-LQ (reference) or LNS-MQ had, overall, similar effect on incidence of severe acute malnutrition (

Despite improvements in children's nutritional status and a commitment to early childhood development (ECD) policy developments in Ethiopia, the risk of poor ECD outcomes remains alarming. This study aimed to identify enablers and barriers to the implementation of ECD assessment and provision of nutrition-focused interventions in community settings. A qualitative case study was employed in Hawassa city and Dore Bafano district of Sidama region from November 2023 to February 2024. Fifteen key informant interviews (KIIs) and five focus group discussions (FGDs) were conducted with purposively selected key informants from the healthcare system and mothers of children under two years old, respectively. Pre-tested interview and discussion guides were used for data collection and a narrative thematic analysis was applied at different levels of the socioecological model (SEM). The existing ECD policy and strategy landscape, healthcare system, communication and trust built between the health Extension workers (HEWs) and the community, existence of different mothers groups and the HEWs positive attitudes were identified as enablers; however, gaps in ECD practical knowledge and community awareness, low commitment of HEWs and political leaders at multiple levels, as well as absence of training, facilities and standardized indicators of ECD were identified as barriers for the implementation of ECD assessment and provision of nutritioninterventions in the community settings. ECD assessments and nutrition-focused interventions can be integrated into the existing health extension program, with HEWs playing key roles. This requires raising awareness of ECD policies across all healthcare levels and providing targeted training for HEWs on ECD assessment and its targeted interventions. Building the capacity of all persons associated with health posts, and incorporating ECD indicators into HEWs' services and their supervision checklists will enhance the effectiveness and sustainability of ECD integration in the community, leading to improved child health and development outcomes. Additional research is required to develop a tailored, user-friendly and time-saving ECD assessment tool for use in the community by the HEWs to assess, classify and identify children at risk of developmental delay.

Stunting remains a chronic nutritional problem among children under five in Indonesia, including in Ngaliyan, Semarang, with an increasing prevalence in 2025. Contributing factors include inadequate nutrient intake, low maternal knowledge, economic limitations, and limited use of local food. This study aimed to evaluate the SEHATI Nutrition Program (Sehatkan Anak Tercinta dengan Gizi Terpenuhi/Healthy Beloved Children with Adequate Nutrition) as a local-based stunting prevention effort. A cross-sectional design was applied involving 25 mothers of children under five at the Ngaliyan Public Health Center. Interventions included nutrition education, pre-and post-tests, provision of fish-based supplementary food (lele catfish), cooking demonstrations, educational media distribution, as well as entrepreneurship and catfish farming training. Results showed improvement in mothers' knowledge (100% increased post-test scores) and good acceptance of fish-ball supplementary food. The SEHATI Program effectively improved nutrition knowledge, promoted local food utilization, and created family entrepreneurship opportunities. It has the potential to become a sustainable community-based nutrition intervention model to accelerate stunting reduction in Indonesia.

The scourge of drug usage among young people in Ghana has emerged as a significant impediment to the country's sustainable growth. Substance misuse poses a severe challenge, particularly in underdeveloped nations like Ghana, acting as a catalyst for economic woes and exerting a profound impact on the socioeconomic, public health, social, and individual facets of the nation. The alarming rise in the consumption of substances such as shisha, tramadol, alcohol, cannabis, wee (marijuana), as well as the inhalation of glue and other harmful drugs, is becoming a growing concern in northern region of Ghana and Ghana as whole with negative consequences on the world and the achievement of the sustainable development goals (SDGs) and universal health coverage (UHC). Objective: This study endeavours to gauge the prevalence of adolescent drug abuse, aiming to offer a comprehensive understanding of the issue and subsequently inform the development of effective prevention and treatment strategies within the Northern Region of Ghana. A cross-sectional study design was used. The research employed a meticulously crafted questionnaire featuring both open and closed-ended questions. The incorporation of open-ended questions provided participants with an avenue to articulate their perspectives. The findings indicate a disturbing trend of drug abuse among teenagers in schools or students in Tamale Metropolis and Sagnarigu Municipal of the northern region of Ghana, particularly involving substances like shisha and tramadol. Negative peer group influence emerged as a prominent factor leading adolescents into the realm of drug abuse. Inadequate parental supervision, coupled with parental substance use, was identified as significant contributors to adolescents adopting similar habits. Encouragingly, a noteworthy percentage of teenagers in schools or students demonstrated awareness of available resource and help centres for seeking assistance and counselling services against drug abuse. However, sadly mist this greater level of awareness it was surprising to note that a good percentage of the respondents would not seek help for substance use challenges sterming from stigma associated with mental health and limited resources. To address the burgeoning issue of adolescent drug abuse, it is imperative for the Ghana Education Service to integrate education on drug abuse into the school curriculum. This addition would equip students with a deeper understanding of the causes, effects, and potential solutions to drug abuse. Recognizing the detrimental impact of negative peer influence and insufficient parental supervision on students' susceptibility to drug abuse, it is recommended that government institutions and Civil Society Organizations (CSOs) engage in advocacy and education initiatives targeted at students to mitigate the impact of negative peer pressure and the need for positive parenting.

Background/Objectives: Maternal dietary behaviors, including meal frequency patterns, may influence fetal growth. This study examined the associations between maternal meal frequency patterns during pregnancy—categorized as structured, moderately irregular, or highly irregular—and neonatal anthropometric outcomes, including weight, length, head, chest, and abdominal circumferences, and Apgar score. A secondary objective was to assess whether maternal education and household income modify these associations. Methods: This cross-sectional study included 1025 mother–newborn pairs from a socioeconomically diverse Romanian cohort. Maternal meal frequency patterns were classified based on self-reported weekly consumption. Neonatal anthropometric outcomes were obtained from medical records. Multivariable linear regression models, adjusted for maternal and neonatal characteristics, assessed the associations between meal frequency patterns and birth outcomes. Interaction terms evaluated effect modification by maternal education and income. Results: Structured maternal meal frequency patterns were associated with a slight but significant reduction in neonatal length compared to highly irregular patterns (β = −0.36 cm; 95% CI: −0.68 to −0.04; p = 0.02). A borderline inverse association with birth weight was also observed (β = −63.82 g; 95% CI: −128.87 to 1.23; p = 0.05). No significant differences were found for other anthropometric indicators or Apgar score. Maternal education modified the association between moderately irregular patterns and chest circumference (β = 0.15 cm; 95% CI: 0.04 to 0.25; p = 0.003), while household income modified the association with abdominal circumference (β = 0.14 cm; 95% CI: 0.02 to 0.26; p = 0.02). Conclusions: Maternal meal frequency patterns were modestly associated with neonatal length, while socioeconomic factors modified specific anthropometric outcomes. These findings highlight the importance of considering social context in prenatal nutritional recommendations.

Micronutrient deficiencies (including iodine and iron deficiency) is a global health problem affecting one third of the world&#39;s population. Salt is an ideal carrier for food fortification as it is universally consumed at equal rates, independently of economic status, and it is industrially processed. Addressing iron and iodine deficiencies together is a challenge, due to interaction between iodine and iron, negating the effect of added iodine. This paper explains the development of an improved microencapsulation‐based technology to produce iron premix, which, when added to iodized salt, is stable and organoleptically indistinguishable. Ferrous fumarate was extruded, followed by cutting, sieving to achieve a size of 300–710 μm (salt grain size). Agglomerated extrudates were microencapsulated (5% hydroxypropyl methylcellulose and 5% soy stearin) to form iron premix. Microencapsulation ensures that the added micronutrients are stable without interaction or degradation. Double Forti...

Background: Malnutrition remains a major public health challenge in Somalia, with children under five and pregnant or lactating women being the most vulnerable groups. Despite ongoing humanitarian and health interventions, challenges persist due to inadequate resources, weak referral systems, and limited training for frontline health workers. Understanding the knowledge, practices, and barriers faced by health professionals is crucial for strengthening nutrition services in the country. (33.3%), lack of trained staff (26.7%), high workload (23.3%), and cultural barriers (16.7%). Respondents recommended more training (40%), improved supplies (26.7%), and stronger referral systems (20%) as key areas for improvement. Conclusion: The study demonstrates that while nutrition services in Somalia are moderately effective, systemic barriers continue to limit their coverage and impact. Training gaps, shortages of supplies, weak referral systems, and staff insufficiency remain pressing concerns. Strengthening health worker capacity through regular training, ensuring consistent availability of screening tools, enhancing referral and follow-up systems, and engaging communities to overcome cultural barriers are critical for improving the detection and management of malnutrition. These interventions, if implemented effectively, could significantly enhance the overall quality and effectiveness of nutrition services in Somalia.

Background: Severe acute malnutrition (SAM) is one of the most common
causes of morbidity in children and accounts for 4.4% of deaths worldwide
due to severe wasting. It has been found that vitamin D levels are low in
children with SAM and in very sick children. The WHO recommendations
for the management of SAM include very modest amounts of vitamin D
that do not reliably correct deficiency.
Aims of the study: The aims of this study were to determine the effects
of vitamin D supplementation on children with severe acute malnutrition.
Methods: This randomized controlled trial was conducted in the
Department of Paediatrics, Sylhet MAG Osmani Medical College
Hospital, Sylhet, Bangladesh, from January 2021 to December 2022.
Seventy two children aged 6 to 59 months with SAM were randomized by
lottery method and enrolled as Group A and Group B. Group A received
six lakhs IU Vitamin D that was given intramuscularly on admission day
along with conventional treatment of SAM, while Group B received only
conventional management. Both groups were assessed for weight, height/
length, WHZ/WLZ scores, developmental indexes on admission and after
eight weeks of intervention. Cure rate and hospital stay duration were also
recorded.

Background: Severe acute malnutrition (SAM) is one of the most common causes of morbidity in children and accounts for 4.4% of deaths worldwide due to severe wasting. It has been found that vitamin D levels are low in children with SAM and in very sick children. The WHO recommendations for the management of SAM include very modest amounts of vitamin D that do not reliably correct deficiency. Aims of the study: The aims of this study were to determine the effects of vitamin D supplementation on children with severe acute malnutrition. Methods: This randomized controlled trial was conducted in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh, from January 2021 to December 2022. Seventy two children aged 6 to 59 months with SAM were randomized by lottery method and enrolled as Group A and Group B. Group A received six lakhs IU Vitamin D that was given intramuscularly on admission day along with conventional treatment of SAM, while Group B received only conventional management. Both groups were assessed for weight, height/ length, WHZ/WLZ scores, developmental indexes on admission and after eight weeks of intervention. Cure rate and hospital stay duration were also recorded. Results: Among the 72 randomly assigned children, 67 participants completed the 8 weeks follow-up and were included in the analysis. Group A exhibited a significantly greater mean weight gain compared to Group B (1.76 ± 0.51 kg vs. 1.26 ± 0.82 kg; p=0.003), which was statistically significant. Although the mean height gain was higher in Group A (0.63 ± 0.59 cm) than in Group B (0.44 ± 0.62 cm), this difference was not statistically significant (p=0.204). Weight-for-height/length Z scores of Group A showed a significantly greater improvement (0.74 ± 1.04 vs. 0.09 ± 1.38; p<0.05) after 8 weeks. Proportion of cured participants (97.2% vs. 88.9%; p=0.16) and the length of hospital stay (8.69 ± 2.99 vs. 10.16 ± 3.78 days; p=0.081) in Group A and Group B were not statistically significant. Neurodevelopmental assessments using Denver Developmental Screening Tool II (DDST-II), revealed lower proportions of delayed gross motor, language and personal/social development in Group A (p<0.05) which were statistically significant. The mean of serum 25(OH)D concentration at the end of study were 77.03 ± 16.64 and 28.88 ± 7.44 ng/ml in Group A and Group B respectively. Serum 25(OH)D concentration exceeded 125 ng/ml in only 1 of 35 participants in Group A without any hypervitaminosis signs. Conclusion: Vitamin D supplementation in addition to conventional treatment of SAM, significantly enhanced weight gain, improved the mean weight for height/length Z score and developmental indexes in children with uncomplicated severe acute malnutrition.
Keywords: Severe acute malnutrition (SAM); Vitamin D supplementation; WHZ/WLZ; DDST-II; Developmental index; Serum 25-hydroxyvitamin D [25(OH)D]

Infants of mothers of low educational background display consistently poorer outcomes, including suboptimal weaning diets. Less is known about the different causal pathways that relate maternal education to infants&#39; diet. The present study aimed to test the hypothesis that the relationship between maternal education and infants&#39; diet is mediated by mothers&#39; diet. The analyses included 421 mother–infant pairs from the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program. Dietary intakes were collected from mothers when infants were aged 3 months, using a validated food frequency questionnaire relating to the past year, and in infants aged 9 months using 3 × 24‐h recalls. Principal component analysis was used to derive dietary pattern scores, based on frequencies of 55 food groups in mothers, and intakes of 23 food groups in infants. Associations were assessed with multivariable linear regression. We tested the product ‘ab’ to address the mediation hypoth...

Background Underweight among women of reproductive age poses significant health risks. Despite global and national reductions, it remains a public health concern in Rwanda. Objectives This study assessed the prevalence and associated factors of underweight among Rwandan women of reproductive age. Methods A cross-sectional analysis was used on data from the 2019-2020 Rwanda Demographic and Health Survey (RDHS), involving a nationally representative sample of 6,831 women aged 15-49 years. Data was collected through questionnaires and anthropometric measurements. A weighted analysis and multivariable analysis were performed. Results The prevalence of underweight was 5.8% (95% CI: 5.26-6.46). Women aged 15-24 years had higher odds of being underweight (AOR: 1.54, 95% CI: 1.21-1.95), while those aged 25-34 years had lower odds of being underweight (AOR: 0.67, 95% CI: 0.47-0.94). Moreover, women from rural (AOR: 1.76, 95% CI: 1.25-2.49), from poor household (AOR: 1.74, 95% CI: 1.35-2.25), middle-class households (AOR: 1.42, 95% CI: 1.05-1.93) and being anemic (AOR: 1.40, 95% CI: 1.04-1.87) were more likely to be underweight. Conclusions Although underweight prevalence was low, younger women, rural residents, and those from lower socioeconomic status or with anaemia were at greater risk. These findings underscore the need for targeted interventions addressing both nutritional and broader social determinants of health.

The rapid decline in fertility is a crucial driver of population ageing worldwide. In India, the Total Fertility Rate (TFR) has decreased from 2.9 (NFHS-2) to 2.0 (NFHS-5). Sikkim, however, has an alarmingly low TFR of 1.1, significantly below the national average of 2.0 and far below the replacement rate of 2.1 needed to maintain population stability. Given these trends, understanding the factors influencing fertility in Sikkim is critical. This study, a communitybased cross-sectional analysis covering all districts of Sikkim, examines various sociodemographic, economic, and marital factors affecting fertility in the state. The analysis of fertility in Sikkim highlights critical influencing factors. Urban residence significantly lowers fertility by 41% (OR=0.59, p=0.02), while caste has no notable impact (OR=0.81, p=0.30). Education shows an inverse relationship with fertility; illiterate women are 2.08 times more likely to have children than their educated counterparts (OR=2.08, p=0.012). Financial stability also reduces fertility, with higher-income women 44.4% less likely to have children (OR=0.55, p=0.0002). Early marriage (ages 0-18) strongly increases fertility, making women 4.1 times more likely to have children (OR=4.09, p<0.0001). The length of marriage has a strong negative correlation with fertility (r=-0.91), explaining 81.98% of fertility variation (p<0.0001). Coital frequency has a substantial positive effect, with women engaging in weekly sexual activity being 3.9 times more likely to have children (OR=3.9, p<0.0001). Family planning significantly reduces fertility (OR=0.6, p=0.008), while contraceptive use shows a

Dietary adequacy and diversity during the lactation period are necessary to ensure good health and nutrition among women and children. Behavioral interventions pertaining to health and nutrition counselling during pregnancy and lactation are critical for awareness about dietary diversity. The issue assumes salience for marginalized communities because of the Covid-19 pandemic and associated economic and societal disruptions. This paper assesses the dietary patterns among 400 lactating mothers in the tribal-dominated district of Palghar in Maharashtra, India in 2020. The study is based on primary data regarding consumption of 10 food groups among women across 10 food groups based on 24-hour recall period. The primary outcome variable was binary information regarding Minimum Dietary Diversity defined as consumption from at least 5 food groups. Econometric analysis based on multilevel models and item-response theory is applied to identify food groups that were most difficult to be received by mothers during the early and late lactation period. We find that the daily diet of lactating mothers in Palghar primarily consists of grains, white roots, tubers, and pulses. In contrast, the intake of dairy, eggs, and non-vegetarian food items is much lower. Only Half of the lactating women (56.5 percent; 95% CI: 37.4; 73.8) have a minimum diversified diet (MDD). The prevalence of lactating women with MDD was higher among households with higher income (73.1 percent; 95% CI: 45.2; 89.9) than those in lower income group (50.7 percent; 95% CI: 42.3; 58.9). Lactating Women (in early phase) who received health and nutrition counseling services are more likely (OR: 2.37; 95% CI: 0.90; 6.26) to consume a diversified diet. Food groups such as fruits, meat, poultry, fish, nuts, and seeds were among the rare food items in daily diet. The dietary pattern lacking in fruits, nuts, and heme (iron) sources indicates more significant risks of micronutrient deficiencies. The findings call for improving dietary diversity among lactating mothers, particularly from the marginalized communities, and are driven by low consumption of dairy products or various fruits and vegetables. Among the different food items, the consumption of micronutrient-rich seeds and nuts is most difficult to be accessed by lactating mothers.

Dietary intake is a fundamental determinant of maternal and child nutrition. This paper presents evidence on whether maternal and child dietary diversity can be improved with systemic improvements focused on strengthening training, capacity building, and behavior change communication among frontline workers to encourage improved nutritional practices among mothers and children in the intervention area. The evidence is derived from Project Spotlight intervention that was jointly implemented by Department of Women and Child Development, Government of Maharashtra and Tata Trusts in tribal dominated Gadchiroli and Chandrapur districts in Maharashtra. Based on a pre-post comparison of baseline ( ) and endline (2021) household survey data it is confirmed that there is a significant association between maternal and child dietary diversity in the study area. Notably, dietary diversity in mother-child dyads is marked with a higher consumption of fruits and vegetables as well as eggs and flesh foods. Econometric analysis further reveals that the association between maternal and child dietary diversity has improved after the systems strengthening interventions. The paper concludes that local interventions such as Project Spotlight for strengthening counselling services and coverage by frontline workers and enhancing knowledge and awareness on maternal and child dietary diversity among communities are important for improving maternal and child nutrition.

ObjectivesTo assess the relevance, effectiveness, efficiency, impact, sustainability, learning and replicability of the transition from mass vitamin A supplementation to a routine six monthly contact point, integrated with complementary feeding and family planning counselling.Study designProgram performance was assessed taking into consideration the knowledge, attitudes and practices of both healthcare providers and caregivers to understand barriers and enablers to service uptake. A cross sectional qualitative survey with 63 key informant interviews with stakeholders and implementation staff and focus group discussions with 60 caregivers. Data was transcribed then coded through a framework analysis (developing themes from specific objectives) and thematic analysis (developing emerging themes not identified by the objectives). MethodsThe ‘routine six-monthly contact point’ included vitamin A, Albendazole, growth monitoring plus the promotion of optimal infant and young child feeding ...

Adolescent birth is a major global concern owing to its adverse effects on maternal and child health. We assessed trends in adolescent birth and examined its associations with child undernutrition in Bangladesh using data from seven rounds of Demographic and Health Surveys (1996–2017, n = 12,006 primiparous women with living children &lt;5 years old). Adolescent birth (10–19 years old) declined slowly, from 84% in 1996 to 71% in 2017. Compared with adult mothers (≥20 years old), young adolescent mothers (10–15 years old) were more likely to be underweight (+11 pp), have lower education (−24 pp), have less decision‐making power (−10 pp), live in poorer households (−0.9 SD) with poorer sanitation (−15 pp), and have poorer feeding practices (10 pp), and were less likely to access health and nutrition services (−3 to −24 pp). In multivariable regressions controlled for known determinants of child undernutrition, children born to adolescents had lower height‐for‐age Z‐scores (−0.29 SD fo...

Anaemia has serious effects on human health and has multifactorial aetiologies. This study aimed to determine putative risk factors for anaemia in children 6–59 months and 15‐ to 49‐year‐old non‐pregnant women living in Ghana. Data from a nationally representative cross‐sectional survey were analysed for associations between anaemia and various anaemia risk factors. National and stratum‐specific multivariable regressions were constructed separately for children and women to calculate the adjusted prevalence ratio (aPR) for anaemia of variables found to be statistically significantly associated with anaemia in bivariate analysis. Nationally, the aPR for anaemia was greater in children with iron deficiency (ID; aPR 2.20; 95% confidence interval [CI]: 1.88, 2.59), malaria parasitaemia (aPR 1.96; 95% CI: 1.65, 2.32), inflammation (aPR 1.26; 95% CI: 1.08, 1.46), vitamin A deficiency (VAD; aPR 1.38; 95% CI: 1.19, 1.60) and stunting (aPR 1.26; 95% CI: 1.09, 1.46). In women, ID (aPR 4.33; 9...

Background: Ghana has achieved significant progress in breastfeeding practices in the past two decades. Further progress is, however, limited by insufficient government funding and declining donor support for breastfeeding programs. The current study pretested feasibility of the Becoming Breastfeeding Friendly (BBF) toolbox in Ghana, to assess the existing enabling environment and gaps for scaling-up effective actions. Methods: Between June 2016 and April 2017, a 15-person expert country committee drawn from government and non-government agencies was established to implement the BBF toolbox. The committee used the BBF index (BBFI), comprising of 54 benchmarks and eight gears of the Breastfeeding Gear Model (advocacy; political will; legislation and policy; funding and resources; training and program delivery; promotion; research and evaluation; and coordination, goals and monitoring). Available evidence (document reviews, and key informant interviews) was used to arrive at consensus-scoring of benchmarks. Benchmark scores ranged between 0 (no progress) and 3 (major progress). Scores for each gear were averaged to estimate the Gear Total Score (GTS), ranging from 0 (least) to 3.0 (strong). GTS's were aggregated as a weighted average to estimate the BBFI which ranged from 0 (weak) to 3.0 (outstanding). Gaps in policy and program implementation and recommendations were proposed for decision-making. Results: The BBFI score was 2.0, indicating a moderate scaling-up environment for breastfeeding in Ghana. Four gears recorded strong gear strength: advocacy (2.3); political will (2.3); legislation and policy (2.3); and coordination, goals and monitoring (2.7). The remaining four gears had moderate gear strength: funding and resources (1.3); training and program delivery (1.9); promotion (2.0); and research and evaluation (1.3). Key policy and program gaps identified by the committee included sub-optimal coordination across partners, inadequate coverage and quality of services, insufficient government funding, sub-optimal enforcement of policies, and inadequate monitoring of existing initiatives. Prioritized recommendations from the process were: 1) strengthen advocacy and empower breastfeeding champions, 2) strengthen breastfeeding regulations, including maternity protection, 3) strengthen capacity for providing breastfeeding services, and 4) expand and sustain breastfeeding awareness initiatives. Conclusions: The moderate environment for scaling-up breastfeeding in Ghana can be further strengthened by addressing identified gaps in policy and programs.

Background Micronutrient deficiencies affect many children in low-income settings due primarily to over-reliance on complementary foods low in nutrients. Home-fortification (HF) could improve children’s diet quality in these settings. The Ghana Health Service, supported by UNICEF, integrated the pilot Micronutrient Powder Initiative (MPI) into Child Welfare Clinic (CWC) services in four districts (Tain, Tolon, Talensi, and Ho West), whereby micronutrient powder (MNP) is supplied for HF for children aged 6–23 months attending CWCs. This study’s main aim was to identify the facilitators, barriers and “lessons learned” after 2 years of program implementation. Methods This was a qualitative cross-sectional study. MNP distributed and children enrolled were obtained from program records. Primary data were collected from November to December 2019 and included, by district: interviews with senior program staff; key informant interviews and focus group discussion with caregivers in each of 6...

Background Voices of under-resourced communities are recognised as important yet are often unheard in decisions about healthcare resource allocation. Deliberative public engagement can serve as an effective mechanism for involving communities in establishing nutrition priorities. This study sought to identify the priorities of community members of a South African township, Soweto, and describe the underlying values driving their prioritisation process, to improve nutrition in the first 1000 days of life. Methods We engaged 54 community members (28 men and 26 women aged &gt; 18 years) from Soweto. We conducted seven group discussions to determine how to allocate limited resources for prioritising nutrition interventions. We used a modified public engagement tool: CHAT (Choosing All Together) which presented 14 nutrition intervention options and their respective costs. Participants deliberated and collectively determined their nutritional priorities. Choices were captured quantitative...

M S I with data on all delive oi: 10.1016/j.ajog.2009.05.032 ia) occurred in 1209 women (12.2%). Its prevalence increased with evels of TG—from 7.2% in the group with low TGs ( 25th percentile djusted for the gestational month) to 19.8% in the group with high Gs ( 75th percentile), but was not associated with high-density lioprotein levels. In multivariate analysis higher TGs levels, but not low igh-density lipoprotein, were associated with the primary endpoint.

In Kamonyi District, the prevalence of stunting was reported as 23% according to the Demographic and Health Survey of 2019-2020. Different interventions have been implemented in the framework of fighting stunting in Kamonyi District. However, despite all these interventions, stunting still persists. Studies have affirmed that several factors influence the stunting situation of the children. However, the situation of such practices is not known in Kamonyi District. Therefore, identifying the factors associated to stunted growth is crucial for setting up adequate strategies to address malnutrition in regions with a high prevalence of stunting. The objective of this study is to determine the prevalence of stunted growth and to establish the factors related to stunted growth among children aged between 6 and 59 months in Kamonyi District. The study used a cross-sectional analytical study design to get data from mothers who have under five children residing in Kamonyi District. The sample size of 395 respondents was obtained from the target population using Yamane's formula. A questionnaire was used as data collection instrument. Data was analyzed using descriptive statistics of frequencies, percentages, and simple regression analysis at 95% level of significance in evaluating significant relationship between different factors and the stunting situation of the children. A descriptive statistic; bivariate and multivariate analyses was carried out to evaluate the significant factor in regard to the stunting situation of the children. The findings demonstrated that 25.3% of the children presented stunted growth while 74.7% were not stunted. In addition, children born to unmarried couples were twice as likely to experience stunted growth compared to those from married couples (AOR=2.6, 95% CI: 1.475, 4.788, P=0.001). Similarly, children from larger families (more than 7 persons) faced double the odds of stunting compared to those from smaller families (AOR 2.1 95% CI: 1.296, 3.403, p=0.003). Maternal headship of families also doubled the likelihood of stunting among children (AOR= 1.9, 95% CI: 1.244, 3.193, P=0.0049), while inadequate breastfeeding (less than 6 months) tripled the risk (AOR= 3.6, 95% CI: 2.272, 5.992, P=0.008). Children receiving only milk as supplementary food had a 2.6-fold higher odds of stunting compared to those receiving a balanced diet (AOR 1 6.9, 95% CI: 1.338, 5.271, p=0.005). Lack of enriched supplementary food increased the odds of stunted growth by 1.9 time (AOR=1.9, 95%CI: 1.208, 3.025, P=0.006). Moreover, children eating only one meal a day were three times more likely to be stunted than those eating three meals (AOR=3.6, 95%CI: 1.663, 8.096, P=0.002). Additionally, maternal education, household wealth index, maternal employment status, and maternal visits to nutritional centers were found significantly associated with child stunting, emphasizing the complex interplay of socioeconomic factors in child nutrition outcomes. These findings underscore the need for targeted interventions addressing maternal education, household income, feeding practices, and access to nutritional support to combat child stunting effectively.

In Kamonyi District, the prevalence of stunting was reported as 23% according to the Demographic and Health Survey of 2019-2020. Different interventions have been implemented in the framework of fighting stunting in Kamonyi District. However, despite all these interventions, stunting still persists. Studies have affirmed that several factors influence the stunting situation of the children. However, the situation of such practices is not known in Kamonyi District. Therefore, identifying the factors associated to stunted growth is crucial for setting up adequate strategies to address malnutrition in regions with a high prevalence of stunting. The objective of this study is to determine the prevalence of stunted growth and to establish the factors related to stunted growth among children aged between 6 and 59 months in Kamonyi District. The study used a cross-sectional analytical study design to get data from mothers who have under five children residing in Kamonyi District. The sample size of 395 respondents was obtained from the target population using Yamane's formula. A questionnaire was used as data collection instrument. Data was analyzed using descriptive statistics of frequencies, percentages, and simple regression analysis at 95% level of significance in evaluating significant relationship between different factors and the stunting situation of the children. A descriptive statistic; bivariate and multivariate analyses was carried out to evaluate the significant factor in regard to the stunting situation of the children. The findings demonstrated that 25.3% of the children presented stunted growth while 74.7% were not stunted. In addition, children born to unmarried couples were twice as likely to experience stunted growth compared to those from married couples (AOR=2.6, 95% CI: 1.475, 4.788, P=0.001). Similarly, children from larger families (more than 7 persons) faced double the odds of stunting compared to those from smaller families (AOR 2.1 95% CI: 1.296, 3.403, p=0.003). Maternal headship of families also doubled the likelihood of stunting among children (AOR= 1.9, 95% CI: 1.244, 3.193, P=0.0049), while inadequate breastfeeding (less than 6 months) tripled the risk (AOR= 3.6, 95% CI: 2.272, 5.992, P=0.008). Children receiving only milk as supplementary food had a 2.6-fold higher odds of stunting compared to those receiving a balanced diet (AOR 1 6.9, 95% CI: 1.338, 5.271, p=0.005). Lack of enriched supplementary food increased the odds of stunted growth by 1.9 time (AOR=1.9, 95%CI: 1.208, 3.025, P=0.006). Moreover, children eating only one meal a day were three times more likely to be stunted than those eating three meals (AOR=3.6, 95%CI: 1.663, 8.096, P=0.002). Additionally, maternal education, household wealth index, maternal employment status, and maternal visits to nutritional centers were found significantly associated with child stunting, emphasizing the complex interplay of socioeconomic factors in child nutrition outcomes. These findings underscore the need for targeted interventions addressing maternal education, household income, feeding practices, and access to nutritional support to combat child stunting effectively.

This study aimed to assess the knowledge, attitudes and practices on nutrition among mothers with under five years undernourished children in Kicukiro District of Rwanda. Malnutrition constitutes a big threat to the public health especially among children less than five years and it is a burden in developing countries. The study used across sectional design with quantitative and qualitative approaches. A sample of 255 mothers living in Kicukiro District who have undernourished children below 5years were chosen using a convenience sampling process, whereby every mother that had an undernourished child was give equal chance to be enrolled in the study. Data analysis was done using SPSS version 22. Qualitative data were treated using Atlas. Univariate, bivariate and multivariate analysis were applied. The significance was set at p-value less than 0.05.The findings on knowledge level revealed that 51% of mothers knew the types of food, 55.3% were not able to give examples of each type of food and 52.2% did not know the composition of a balanced diet. Concerning attitude on nutrition among mothers,85.1% had no food restrictions. Concerning practices, 52.2% prepare a balanced diet for their children, 54.9% practiced exclusive breastfeeding until six months; 52.2% respected hygiene measures before feeding their children and 43.5% and 26.3% gave their children two and three meals a day respectively. Concerning the factors associated with nutrition practices, the bivariate analysis showed that the mother being aged under 21 years old presented a positive relationship with poor nutritional practices with 73.3%, X 2 =14.274, p<0.006; Also, the mother being single presented a positive relationship with poor nutritional practices with 77.6%, X 2 =16.860, p<0.014. The mother having not done any formal education presented a positive relationship with poor nutritional practices with 83.3%, X 2 =21.643, p<0.003. Also, wealth index presented a positive relationship with nutritional practices with 75.6%, X 2 =20.151, p<0.001; religion presented a positive relationship with nutritional practices with 65.9%, X 2 =11.129, p<0.011. Also, multivariate analysis showed that mothers aged under 21 years old were threefold less likely to be associated with good nutritional practices compared to mature mothers with AOR 0.389 95% CI (0.195-0.774), p<0.007. Also, being married was twice more likely than being a widow/ separated associated to good nutritional practices with AOR 2.119 95% CI (1.053-4.264), p<=0.035. Having not done any formal education was 0.133 times more likely than having done tertiary education associated to good nutritional practices, AOR 1.133 95% CI (0.048-0.0.378), p<=0.026. Being poor was 0.237 times more likely than being rich associated with good nutritional practices, AOR 0.237 95% CI (0.123-0.458), p<=0.004. The study recommends the reinforcement of the functioning of nutritional centers, the organization of outreach campaign programmers constantly in order to educate the mothers more on the effects and prevention of malnutrition in children, and the emphasis on exclusive breastfeeding from 0-6 months.

In Kamonyi District, the prevalence of stunting was reported as 23% according to the Demographic and Health Survey of 2019-2020. Different interventions have been implemented in the framework of fighting stunting in Kamonyi District. However, despite all these interventions, stunting still persists. Studies have affirmed that several factors influence the stunting situation of the children. However, the situation of such practices is not known in Kamonyi District. Therefore, identifying the factors associated to stunted growth is crucial for setting up adequate strategies to address malnutrition in regions with a high prevalence of stunting. The objective of this study is to determine the prevalence of stunted growth and to establish the factors related to stunted growth among children aged between 6 and 59 months in Kamonyi District. The study used a cross-sectional analytical study design to get data from mothers who have under five children residing in Kamonyi District. The sample size of 395 respondents was obtained from the target population using Yamane's formula. A questionnaire was used as data collection instrument. Data was analyzed using descriptive statistics of frequencies, percentages, and simple regression analysis at 95% level of significance in evaluating significant relationship between different factors and the stunting situation of the children. A descriptive statistic; bivariate and multivariate analyses was carried out to evaluate the significant factor in regard to the stunting situation of the children. The findings demonstrated that 25.3% of the children presented stunted growth while 74.7% were not stunted. In addition, children born to unmarried couples were twice as likely to experience stunted growth compared to those from married couples (AOR=2.6, 95% CI: 1.475, 4.788, P=0.001). Similarly, children from larger families (more than 7 persons) faced double the odds of stunting compared to those from smaller families (AOR 2.1 95% CI: 1.296, 3.403, p=0.003). Maternal headship of families also doubled the likelihood of stunting among children (AOR= 1.9, 95% CI: 1.244, 3.193, P=0.0049), while inadequate breastfeeding (less than 6 months) tripled the risk (AOR= 3.6, 95% CI: 2.272, 5.992, P=0.008). Children receiving only milk as supplementary food had a 2.6-fold higher odds of stunting compared to those receiving a balanced diet (AOR 1 6.9, 95% CI: 1.338, 5.271, p=0.005). Lack of enriched supplementary food increased the odds of stunted growth by 1.9 time (AOR=1.9, 95%CI: 1.208, 3.025, P=0.006). Moreover, children eating only one meal a day were three times more likely to be stunted than those eating three meals (AOR=3.6, 95%CI: 1.663, 8.096, P=0.002). Additionally, maternal education, household wealth index, maternal employment status, and maternal visits to nutritional centers were found significantly associated with child stunting, emphasizing the complex interplay of socioeconomic factors in child nutrition outcomes. These findings underscore the need for targeted interventions addressing maternal education, household income, feeding practices, and access to nutritional support to combat child stunting effectively.

Severe wasting is the most widespread form of severe acute malnutrition, affecting an estimated 17 million children globally. This analysis assesses the effectiveness of Pakistan&#39;s community management of acute malnutrition (CMAM) programme. We conducted a retrospective case series analysis of 32,458 children aged 6–59 months who were admitted to the programme with a mid‐upper arm circumference (MUAC) &lt; 115 mm (January 1–December 31, 2014). We found that at admission, 59.6% of the children were girls and 87.4% were in the age group 6–23 months old. While in the programme, 120 children (0.4%) died, 3,456 (10.6%) defaulted, and 28,882 (89.0%) were discharged after a mean length of stay of 69.3 ± 25.7 days. Children&#39;s mean weight gain while in the programme was 3.2 ± 2.7 g/kg body weight/day. At discharge, 28,499 children (98.7% of discharged) had recovered (MUAC ≥ 125 mm). The odds of death were significantly higher among children with weight‐for‐height (WHZ) &lt; −3 and/or...

Adding amylase to Super Cereal plus (SC+A) improves energy and nutrient intakes as porridge energy density reaches 1.0 kcal/g, meeting the recommended ≥0.8 kcal/g for prepared foods for young children. Caregiver response to SC+A in terms of adjusting porridge preparation using printed pictogram instructions was not yet investigated. The study assessed: a) porridge preparation by caregivers; b) porridge energy density; c) sensory porridge acceptability, and; d) understanding of preparation instructions. An 8 day follow up intervention study was conducted among caregivers of children aged 6-23 months (n=238) in Rwanda. Caregivers prepared porridge using SC+A while referring to printed pictogram instructions at the study site on days 1 and 8 and received flour for preparation at home on days 2-7. At the site, data were collected on porridge preparation procedures, energy density, consistency, acceptability, and interviews (n=12) and focus group discussions (n=6) were conducted. Mean po...

Pregnancy is a crucial phase as it affects the health and wellbeing of the mother and infant. The objective of this systematic review is to examine studies on the dietary quality of pregnant women across different states of India, as available on PubMed.Twelve papers were found that fitted the inclusion criteria; 3 studies from the states of UP and Pune calculated the macro and micro nutrient as well as the DDS; 6 studies focused just on the DDS and 4 studies focused on the macronutrient intake. The mean energy, protein and fat intake of the PW ranged from 1281 Kcal/ day to 2051.5 Kcal/ day, 30.5 g/ day to 69.6 g/day and 35.1 g/day to 59.6g/day respectively. Energy intake was below the EAR in all the states, protein intake was deficit among the rural PW but urban PW met the EAR for protein and some studies reported high intake up to 60g/day, high fat intake in PW from all Indian states. The diet of PWs were deficit in all the micronutrient except for niacin. Severe deficiency of folic acid, calcium and iron in the diet of Indian PW is a topic of concern. The mean dietary diversity score ranged from 3.3 to 6, with lowest DDS in Uttar Pradesh and highest DDS in Delhi. There is a need of improved ANC care with mandatory counselling of PW and multi nutrient supplementation.

Background: Breastmilk only is enough for milestone of a child because it contains all necessary nutrients. Because of its benefits World Health Organization recommends that lactating mothers must give their infants only breastmilk for six months and continue up to two years with appropriate complementary food. Despite its benefits breastfeeding is not well practiced in developing countries, South Africa included. Objective: This study aimed to investigate enabling, reinforcing and predisposing factors influencing exclusive breastfeeding interruption among lactating mothers in Limpopo Province. Methods and materials: This study was cross sectional which employed quantitative measures. Data was collected from 399 lactating mothers during immunization in the selected birthing facilities of Limpopo Province and analysed using SPSS version 26. The findings indicate that breastfeeding mothers were likely to stop breastfeeding completely when their babies were three months old. The findings were that the majority 72.9% of the mothers practised mixed feeding and the minority, only 27.1% practised EBF. It was also found that 38.5% mothers gave water to the infants, 30.2% were given soft porridge and 26.1% formula. The study revealed that the factors that affect exclusive breastfeeding include: influence from the Parents/in-laws Insufficient breastmilk, religious and cultural beliefs, illness of the mothers and young mothers and going back to work/school.

Background: Breastmilk only is enough for milestone of a child because it contains all necessary nutrients. Because of its benefits World Health Organization recommends that lactating mothers must give their infants only breastmilk for six months and continue up to two years with appropriate complementary food. Despite its benefits breastfeeding is not well practiced in developing countries, South Africa included. Objective: This study aimed to investigate enabling, reinforcing and predisposing factors influencing exclusive breastfeeding interruption among lactating mothers in Limpopo Province. Methods and materials: This study was cross sectional which employed quantitative measures. Data was collected from 399 lactating mothers during immunization in the selected birthing facilities of Limpopo Province and analysed using SPSS version 26. Results: The findings indicate that breastfeeding mothers were likely to stop breastfeeding completely when their babies were three months old. T...

Food is essential to be alive, no one can pretend when a natural disaster will sweep out all crop area, which perhaps by flood, drought and other irregularities in weather leads to loss of production, therefore, food is necessary to feed the population during these conditions. The present study was conducted in two districts of Rohtak division and data were collected in September, 2016-April, 2017. Two districts viz. Sonipat and Karnal were selected randomly and by selecting one block from each selected district and two villages from each of the selected blocks at random. From the selected four villages a sample of 300 respondents, i.e. 75 small and marginal farm families from each village was drawn at random to assess the status of food and nutrition security of small and marginal farm families. From 300 (150, i.e. small-87, marginal-63 from Sonipat district and 150, i.e. small-116, marginal-34 from Karnal district) were selected randomly. Results of the study revealed that 69.7per cent of farm families had food mainly from their own farm production, majority (67.0%) of farm families never faced any food scarcity. Regarding nutrition security, cereals and milk and milk products consumed on daily basis in both the districts and majority (81.3%) of children and more than half (56.0%) of women had normal body mass index.

Background Poor child growth and development outcomes stem from complex relationships encompassing biological, behavioral, social, and environmental conditions. However, there is a dearth of research on integrated approaches targeting these interwoven factors. The Grandi Byen study seeks to fill this research gap through a three-arm longitudinal randomized controlled trial which will evaluate the impact of an integrated nutrition, responsive parenting, and WASH (water, sanitation and hygiene) intervention on holistic child growth and development. Methods We will recruit 600 mother-infant dyads living in Cap-Haitien, Haiti and randomize them equally into one of the following groups: 1) standard well-baby care; 2) nutritional intervention (one egg per day for 6 months); and 3) multicomponent Grandi Byen intervention (responsive parenting, nutrition, WASH + one egg per day for 6 months). Primary outcomes include child growth as well as cognitive, language, motor, and social-emotional d...