Early initiation of weaning foods and proliferation of bacteria in Nigerian infants

Fermented Cereal Gruels: Towards a Solution of the Weanling's Dilemma

The high incidence of diarrhoeal morbidity a the onset of weaning is due in part to consumption of contaminated food. This paper discusses the possible role of fermentation as a household food preparation technology in the improvement of the microbial quality of weaning foods as well as in providing adequate nutrients for infant growth and development. It discusses the extent to which fermented foods provide adequate nutrients; the degree to which fermentation can reduce the levels of aflatoxins, hydrocyanic acid, and other toxins in foods; whether fermentation reduces contamination of weaning foods by pathogens; and the role of fermented foods in reducing diarrhoeal morbidity, severity, and duration.

Breast feeding practices in urban and rural health centres: impact of baby friendly hospital initiative in Ile-Ife, Nigeria

The present study was carried out to assess the impact of the Baby Friendly Hospital Initiative (BFHI) on breast feeding practices. The variables used to evaluate the BFHI centre included time of initiation of breastfeeding (BF) after delivery, intended duration of BF, adoption of exclusive breastfeeding (EBF) in relation to educational status, location of health centre, and knowledge and practice of positioning the child at the breast. Observation, questionnaire and interview techniques were employed to collect the data among 217 and 214 nursing mothers (NMs) from Urban and Rural Health Centres. Of the 228 NMs who initiated BF within 30 minutes after delivery, 140 (61%) were from a designated BFHI Centre and 88 (39%) were from an undesignated BFHI rural health centre. There was a significant relationship between the practice of EBF and designation of BFHI centre (P = 0.0001). The higher the level of education of the NMs, the higher the present of NMs subscribing to EBF (P = 0.0001). The present study has also confirmed that EBF which was once considered to be less than 3%, has increased significantly to 61%. The success was not unconnected with the inauguration of BFHI. The BFHI is recording huge success in the urban area but the impact is still to be felt in the rural areas.

Infant feeding practices in a deprived environment: a concern for early introduction of water and glucose D water to neonates

The main objective of this study was to inquire from lactating mothers whether they were fully or partially practising exclusive breastfeeding in the first six months postnatally. Time of initiation of breast and complementary feedings, types of feeds and reasons for giving other feeds to infants apart from breast milk were also examined. The data were collected by structured pretested questionnaire. Of the 200 nursing mothers interviewed, 103 (51.5%) and 77 (38.5%) reported to have given water and glucose D water to neonates respectively within the first week of life. Sieved cornpap was the popular weaning diet. Time of introducing complementary feeding to infants, and nursing mothers' educational levels, were highly significantly related (P = 0.005). Surprisingly, none of the nursing mothers listed infant formula as one of the complementary feeds. It is concluded that there is a strong need to correct this unnecessary practice of giving water and glucose D water to neonates to prevent thirst and Jaundice respectively. The correction should commence with health workers and then the nursing mothers.

Gastroenteritis, diarrhoea and breast feeding

In this paper we review the literature in regard to possible relationships between breast feeding and diarrhoea or gastroenteritis. We show that in the developed as well as the developing world, there is consistent evidence of a protective effect of exclusive breast feeding in the first 4-6 months of life. The odds ratios were generally in excess of 3.0 for non-breast milk feeds. The relationship was not consistent for rotavirus infections but was consistently strong for non-viral pathogens. There are a number of indicators that suggest biological plausibility, in both the developing and developed world. The triple indicators of consistency and strength of the epidemiological associations, together with biological plausibility are major arguments for believing that there is a causal sequence involved.

Immunologic benefits of breast milk in relation to human milk banking

A review of the immunologic benefits of human milk is presented, with emphasis on the antiviral properties of human milk. These properties are so important to infant health that the World Health Organization has restated its recommendation. "In all populations, irrespective of HIV infection rates, breast-feeding should continue to be protected, promoted, and supported." Infection control procedures are described for human milk banking, which should be supported as an immunologically beneficial feeding alternative for infants.

Antimicrobial effect of fermented Ghanaian maize dough

Unhygienic conditions of a typical rural community in a developing country were simulated in the laboratory by inoculating fermented maize dough porridge with Shigella flexneri and enterotoxigenic Escherichia coli (ETEC). The antimicrobial effects of the different processes involved in the preparation of fermented maize dough porridge were assessed. The soaking process reduced the pH but no antimicrobial effect against shigella and ETEC was noted. Unfermented maize dough did not inhibit any of the test strains. When the fermentation process had become established, half of the strains tested were inhibited by the fermented maize dough when examined 8 h after inoculation. Cooking the fermented maize dough into porridge reduced the antimicrobial effect but there was still significant inhibition of pathogens. This suggests that the antimicrobial effect of fermented maize dough is not due to pH per se. Fermentation of maize dough appears to be a useful strategy for reducing contamination of weaning foods by Sh. flexneri and ETEC. The possible nature of the antimicrobial agent(s) produced during the fermentation of maize dough is discussed.

Use of soya-beans for the dietary prevention and management of malnutrition in Nigeria

Protein-energy malnutrition is still highly prevalent in the developing countries due to the decline in breast-feeding and early introduction of overdiluted and often contaminated commercial milk products, use of weaning foods which are low in energy and nutrients, a high prevalence of diarrhoea and infections. An ideal food for the prevention and management of malnutrition should be of high nutritive value, acceptable to the children and their mothers, readily available at a cheap rate, easy to prepare and well tolerated both in health and disease. Soya-beans fulfill these conditions. It is furthermore easily processed and can be combined with a variety of foods to increase nutritive value and make them ideal both as a staple and as a weaning food. Soy-milk as well as a combination of soya-beans with maize pap "soyogi", have been found to be valuable in the management of malnutrition. In our preliminary results, home made "soyogi" was found to be as good as the more expensive commercial soy-milk product in the dietary management of acute diarrhoea in children. The children on "soyogi" tended to have a shorter duration of diarrhoea, decreased number of stools, and increased weight gain. The use of soya-beans both as soy-milk and as "soyogi" among other formulations in the homes is recommended for prevention and management of malnutrition.

Fermentation of cereals for reduction of bacterial contamination of weaning foods in Ghana

Unfermented and fermented maize dough weaning foods prepared by mothers in a Ghanaian village were examined for gram-negative bacilli (GNB) immediately after preparation and during storage to assess the antimicrobial effect of fermentation. GNB were cultured from all samples of unfermented dough (51) and from 16 of 51 samples of fermented dough. The extent of contamination was significantly higher in the unfermented dough than in fermented dough (5.9 [SEM 0.1] vs 4.0 [0.4] log10 colony forming units/g). After 6 h and 12 h storage, a higher proportion of samples of porridge made from unfermented dough contained GNB than did those made with fermented dough (45/51 vs 22/55; 49/51 vs 20/51, respectively) and levels of GNB were significantly higher in the porridge made from unfermented dough after 6 h (4.2 [0.2] vs 3.8 [0.2]). Fermentation of maize dough is an effective method to reduce contamination of maize dough weaning foods with GNB.

Partnership with nursing mothers: an interim strategy for combating childhood enteric diseases in Nigeria

Five hundred and fifteen homes of nursing mothers in Ile-Ife, Nigeria, who had earlier brought their children for treatment of diarrhoeal diseases at the IUTHC infant child welfare clinics were visited between January 1982 and June 1984. The mothers' perceptions as to causes, prevention and control of childhood enteritis were elicited: 49.7% of the mothers attributed the cause of the disease to evil spirits; and 9.5% believed enteritis in children to be due to contamination of children's feeds. Modern medicine was perceived to be the ideal method for treating this disease by only 7.4% of the mothers, while 88.8% opted for any of the traditional methods. In order to reduce the devasting effects of enteric diseases among children born to mothers in tropical countries of Africa and Asia, it is imperative that all health workers understand the cultural and social perceptions of their clients towards the disease in question. Illiteracy, and unsanitary and unhygienic environmental conditions were found to be the main factors precipitating enteritis. Implications and strategies for minimizing diarrhoea and other childhood enteric diseases are discussed in the text.