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Irenso AA, Zheng M, Campbell KJ, Chamberlain D, Laws R. The influence of household structure and composition on the introduction of solid, semisolid and soft foods among children aged 6-8 months: An analysis based on Ethiopia Demographic and Health Surveys. MATERNAL & CHILD NUTRITION 2022; 19:e13429. [PMID: 36148628 PMCID: PMC9749599 DOI: 10.1111/mcn.13429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/13/2022] [Accepted: 08/20/2022] [Indexed: 12/15/2022]
Abstract
The early and late introduction of complementary food, both prevalent in Ethiopia, are associated with morbidities, growth faltering and developmental risks in children. The interhousehold network around the primary caregiver's intrahousehold network is critical in influencing the age of introducing complementary foods. This study examined the influence of household composition and structures on complementary food introduction. This is a secondary data analysis of four Ethiopian Demographic and Health Surveys conducted between 2000 and 2016. The household structure and composition variables were calculated from household members' kinship status and attribute, respectively. The introduction of solid, semisolid or soft foods was dichotomised as whether the children within 6 to 8 months have been given complementary foods. Multivariable logistic regression with adjustment for the primary caregiver and household characteristics was run to examine the associations between household structure and composition variables and the introduction of complementary foods. The marginal effects (ME) were calculated to facilitate the practical interpretation of the study findings. Large households (>3 nonredundant contacts) with extended family or unrelated people (high effective size, ME = 6.01%, 95% confidence interval [CI]: -8.53, -3.49) lowered the proportion of children starting food within the recommended 6-8 months. Households with close kins (high constraint) (ME = 7.22%, 95% CI: -13.65, 28.09) and greater age diversity (ME = 0.65%, 95% CI: 0.15, 1.15) increased the proportion of children receiving complementary food at an appropriate age. This study revealed that interhousehold structure and composition influence the age of introduction of complementary foods. These factors, therefore, need to be considered in designing interventions to improve age at the introduction of complementary foods.
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Affiliation(s)
- Asnake Ararsa Irenso
- School of Public HealthAmbo UniversityAmboEthiopia,School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Miaobing Zheng
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Karen J. Campbell
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Dan Chamberlain
- Centre for Social Impact UNSWUniversity of New South WalesSydneyNew South WalesAustralia
| | - Rachel Laws
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
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Hamer DH, Solomon H, Das G, Knabe T, Beard J, Simon J, Nisar YB, MacLeod WB. Importance of breastfeeding and complementary feeding for management and prevention of childhood diarrhoea in low- and middle-income countries. J Glob Health 2022; 12:10011. [PMID: 35916658 PMCID: PMC9344980 DOI: 10.7189/jogh.12.10011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Early and exclusive breastfeeding have been shown to protect young infants from all-cause and diarrhoea-related mortality. Ideally breastfeeding should be initiated within the first hour of birth. Despite efforts to increase rates of early and exclusive breastfeeding in low- and middle-income countries (LMICs), challenges with uptake remain. This analysis reviews trends in early and exclusive breastfeeding, and the impact of infant feeding interventions in reducing childhood diarrhoea. Methods We conducted a detailed review of articles written in English between 1990 and 2020 on the impact and efficacy of breastfeeding and complementary feeding on diarrhoea in children aged 0-2 years in LMICs. Using data from 86 countries and all WHO global regions collected from the mid-1980s through 2018 obtained from publicly available Demographic Health Surveys, we assessed trends in five-year intervals of timing of breastfeeding initiation, exclusive breastfeeding, median and mean duration of exclusive breastfeeding, and complementary feeding. Results The literature search identified ten articles that described variable rates of early initiation of breastfeeding from 20% in Pakistan to 76% in Egypt. An analysis of 288 DHS studies found that the proportion of women who reported initiating breastfeeding within an hour of birth increased from 32% in the early 1990s to 55% between 2016 and 2020. Exclusive breastfeeding increased from 20% in the late 1980s to 48% between 2016 and 2020 and the mean duration of exclusive breastfeeding of 2-to-4-month-old infants doubled. Early initiation of breastfeeding and exclusive breastfeeding was associated with reductions in diarrhoea prevalence in the South East Asian, Western Pacific, Eastern Mediterranean, and African regions. Eight studies evaluating the effectiveness of different maternal education interventions, health care worker training, and media campaigns demonstrated improvements in exclusive breastfeeding, and most resulted in reductions in the incidence or duration of diarrhoea. Conclusions During the last two decades, early and exclusive breastfeeding have increased. Nevertheless, the uptake of this basic, low-cost intervention remains suboptimal across all global regions. Given the potential benefits the in reduction of diarrhoea and diarrhoea-associated mortality, interventions for improving the uptake of early and exclusive breastfeeding in different sociological contexts need to be designed, implemented, and evaluated.
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Affiliation(s)
- Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.,Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.,Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Hiwote Solomon
- Doctor of Public Health Program, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Gopika Das
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Tanner Knabe
- College of Engineering, Boston University, Massachusetts, USA
| | - Jennifer Beard
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Jon Simon
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Yasir B Nisar
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - William B MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
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Aiga H, Nomura M, Langa JPM, Mahomed M, Marlene R, Alage A, Trindade N, Buene D, Hiraoka H, Nakada S, Arinde E, Varimelo J, Chivale AJ. Spectrum of nutrition-specific and nutrition-sensitive determinants of child undernutrition: a multisectoral cross-sectional study in rural Mozambique. BMJ Nutr Prev Health 2020; 3:320-338. [PMID: 33521543 PMCID: PMC7841811 DOI: 10.1136/bmjnph-2020-000182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/07/2020] [Accepted: 11/15/2020] [Indexed: 11/04/2022] Open
Abstract
BackgroundDespite an increasing need for multisectoral interventions and coordinations for addressing malnutrition, evidence-based multisectoral nutrition interventions have been rarely developed and implemented in low-income and middle-income countries. To identify key determinants of undernutrition for effectively designing a multisectoral intervention package, a nutrition survey was conducted, by comprehensively covering a variety of variables across sectors, in Niassa province, Mozambique.MethodsA cross-sectional household survey was conducted in Niassa province, August–October 2019. Anthropometric measurements, anaemia tests of children under 5 years of age and structured interviews with their mothers were conducted. A total of 1498 children under 5 years of age participated in the survey. We employed 107 background variables related to possible underlying and immediate causes of undernutrition, to examine their associations with being malnourished. Both bivariate (χ2 test and Mann-Whitney’s U test) and multivariate analyses (logistic regression) were undertaken, to identify the determinants of being malnourished.ResultsPrevalence rates of stunting, underweight and wasting were estimated at 46.2%, 20.0% and 7.1%, respectively. Timely introduction of solid, semi-solid or soft foods to children of 6–8 months of age was detected as a determinant of being not stunted. Mother–child cosleeping and ownership of birth certificate were a protective factor from and a promoting factor for being underweight, respectively. Similarly, availability and consumption of eggs at the household level and cough during the last 2 weeks among children were likely to be a protective factor from and a promoting factor for being wasted, respectively.ConclusionTimely introduction of solid, semi-solid or soft foods could serve as an entry point for the three sectors to start making joint efforts, as it requires the interventions from all health, agriculture and water sectors. To enable us to make meaningful interprovincial, international and inter-seasonal comparisons, it is crucially important to develop a standard set of variables related to being malnourished.
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Affiliation(s)
- Hirotsugu Aiga
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Human Development, Japan International Cooperation Agency, Tokyo, Japan
| | - Marika Nomura
- Department of Human Development, Japan International Cooperation Agency, Tokyo, Japan
- Center for International Collaboration and Partnership, The National Institute of Health and Nutrition, Tokyo, Japan
| | - José Paulo M Langa
- Endemic and Epidemic Disease Program, National Institute of Health, Maputo, Mozambique
| | - Mussagy Mahomed
- Health System Program, National Institute of Health, Maputo, Mozambique
| | - Rosa Marlene
- Public Health Directorate, Ministry of Health, Maputo, Mozambique
| | - Albertina Alage
- Training Documentation and Technology Transfer Directorate, Ministry of Agriculture and Food Security, Maputo, Mozambique
| | - Nilton Trindade
- Water Resource Directorate, Ministry of Public Works, Housing and Water Resources, Maputo, Mozambique
| | - Dino Buene
- Technical Secretariat for Food Security and Nutrition, Maputo, Mozambique
| | - Hiroshi Hiraoka
- Department of Rural Development, Japan International Cooperation Agency, Tokyo, Japan
| | - Shunichi Nakada
- Department of Rural Development, Japan International Cooperation Agency, Tokyo, Japan
| | - Edgar Arinde
- Niassa Provincial Health Department, Lichinga, Mozambique
| | - José Varimelo
- Niassa Provincial Agriculture and Food Security Department, Lichinga, Mozambique
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Hitachi M, Honda S, Kaneko S, Kamiya Y. Correlates of exclusive breastfeeding practices in rural and urban Niger: a community-based cross-sectional study. Int Breastfeed J 2019; 14:32. [PMID: 31384285 PMCID: PMC6668169 DOI: 10.1186/s13006-019-0226-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 07/21/2019] [Indexed: 11/10/2022] Open
Abstract
Background Exclusive breastfeeding (EBF) can prevent death and disease among young children. The proportion of EBF is low in Niger. This study aimed to identify the prevalence and correlates of exclusive breastfeeding. Methods We conducted a community-based cross-sectional study in urban and rural areas of Niger among mothers of infants under 7 months old. We used a structured questionnaire to investigate breastfeeding practices, sociodemographic factors, and health service use. We used multivariate analysis to explore the correlates of EBF since birth. Results The study involved 234 urban and 283 rural mothers. Colostrum was almost universally given to newborns (98.7% [231/234] urban and 97.9% [277/283] rural) and many mothers started breastfeeding within an hour of giving birth (69.2% [162/234] and 90.5% [256/283]). The proportion of EBF since birth in urban and rural areas was 15.8% (37/234) and 54.4% (154/283), respectively. Among mothers who had ceased EBF, proportion of prelacteal feeding was 85.3% (168/197) in urban areas and 62.0% (80/129) in rural areas, while 93.4% (183/196) and 72.7% (88/121) had stopped EBF within 1 week after birth respectively. The median duration of EBF was 1 week in urban and 2 months in rural areas. In urban areas, EBF was more likely in mothers with infants 3 months old or younger (Adjusted Odds Ratio [AOR] 2.78; 95% Confidence Interval 95% [CI] 1.07, 7.21) and problems with delivery including Caesarean section (AOR 3.60; 95% CI 1.17, 11.01). In rural areas, lower socioeconomic status (AOR 1.89; 95% CI 1.12, 3.18), early initiation of breastfeeding (AOR 4.04; 95% CI 1.50, 10.83) and delivery assisted by a traditional birth attendant (AOR 3.49; 95% CI 1.37, 8.89) were correlated with exclusive breastfeeding. Conclusions Exclusive breastfeeding was uncommon. Most mothers ceased EBF within 1 week after birth. Adequate information about EBF by health professionals around delivery seems to encourage its use. To encourage EBF in Niger, it is important to educate health professionals, including traditional birth attendants, and enable them to discuss the practice with mothers through individual counselling or group education. Electronic supplementary material The online version of this article (10.1186/s13006-019-0226-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mami Hitachi
- 1Leading Program Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan
| | - Sumihisa Honda
- 2Department of Nursing Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Satoshi Kaneko
- 3Department of Eco-epidemiology Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Yasuhiko Kamiya
- 4School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan
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Carducci F, Biscotti MA, Canapa A. Vitellogenin gene family in vertebrates: evolution and functions. EUROPEAN ZOOLOGICAL JOURNAL 2019. [DOI: 10.1080/24750263.2019.1631398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- F. Carducci
- Dipartimento di Scienze della Vita e dell’Ambiente, Università Politecnica delle Marche, Ancona, Italy
| | - M. A. Biscotti
- Dipartimento di Scienze della Vita e dell’Ambiente, Università Politecnica delle Marche, Ancona, Italy
| | - A. Canapa
- Dipartimento di Scienze della Vita e dell’Ambiente, Università Politecnica delle Marche, Ancona, Italy
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Reda EB, Teferra AS, Gebregziabher MG. Time to initiate complementary feeding and associated factors among mothers with children aged 6-24 months in Tahtay Maichew district, northern Ethiopia. BMC Res Notes 2019; 12:17. [PMID: 30642371 PMCID: PMC6332614 DOI: 10.1186/s13104-019-4061-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 01/09/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE In Ethiopia, only 51% of the infants start complementary feeding on time. Therefore this study is aimed to determine the time to initiate complementary feeding and associated factors among mothers with children aged 6-24 months in Tahtay Maichew district, northern Ethiopia. A retrospective follow up study was conducted among 639 mothers who had children aged 6-24 months. Bi-variable and multi-variable Cox regressions were conducted and statistical significance was declared at P-value < 0.05 and 95% confidence level. RESULTS The median age for the initiation into complementary feeding was 6.00 months. Being government employee [AHR = 1.67, 95% CI 1.10-2.53], having educated husband [AHR = 2.08, 95% CI 1.22-3.86], birth preparedness [AHR = 3.74, 95% CI 1.49-9.94], growth monitoring [AHR = 5.79, 95% CI 2.60-12.88], ability to know exact time to introduce complementary feeding [AHR = 4.93, 95% CI 1.94-12.50], and paternal support [AHR = 4.99, 95% CI 2.02-12.34] were significantly associated with the time to initiate into complementary feeding. Therefore, establishing breast feeding centres at work place and extending maternity leave for reasonable months are important to improve timely initiation into complementary feeding.
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Affiliation(s)
- Ermyas Brhane Reda
- Department of Public Health, College of Health Sciences, Aksum University, P.O. Box: 298, Aksum, Ethiopia
| | - Alemayehu Shimeka Teferra
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, The University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Measho Gebreslassie Gebregziabher
- Department of Health Service Management and Health Economics, Institute of Public Health, College of Medicine and Health Sciences, The University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Cresswell JA, Ganaba R, Sarrassat S, Cousens S, Somé H, Diallo AH, Filippi V. Predictors of exclusive breastfeeding and consumption of soft, semi-solid or solid food among infants in Boucle du Mouhoun, Burkina Faso: A cross-sectional survey. PLoS One 2017. [PMID: 28640900 PMCID: PMC5480894 DOI: 10.1371/journal.pone.0179593] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Exclusive breastfeeding is among the most effective interventions for preventing child mortality. The objectives of this paper are to describe infant feeding knowledge and practices in Boucle du Mouhoun, Burkina Faso; to identify predictors of exclusive breastfeeding among infants <6 months, and consumption of soft, semi-solid or solid food among infants 6-11 months; to describe mothers' sources of information regarding breastfeeding. METHODS A cross-sectional survey (n = 2288) of a representative sample of women aged 15-49 years with at least one live birth in past year took place during June and July 2015. Crude and multivariable random-effects logistic regressions were used to identify factors predictive of exclusive breastfeeding and consumption of soft, semi-solid or solid food. RESULTS 30% of infants <6 months were exclusively breastfed; 67% of infants age 6-11 months consumed soft, semi-solid or solid food the day and night before the interview. 2% of infants age 6-11 months had a minimum acceptable diet. There was strong evidence of a positive association between knowledge and practice of exclusive breastfeeding, nonetheless 60% of mothers who correctly identified that an infant should be exclusively breastfed for 6 months did not breastfeed their infant exclusively. Only 42% of mothers reported receiving advice on breastfeeding from a health worker, despite all mothers having contact with a health worker at least once during pregnancy or postpartum. CONCLUSION Given poor practices and low levels of knowledge, targeted interventions are needed to improve infant nutrition in Boucle du Mouhoun during antenatal, delivery and postnatal care. Most women now deliver in a facility in Burkina Faso; increased attention should be paid to ensuring that existing guidelines relating to support and counselling for infant feeding are adhered to. Factors such as social norms are also important and these should be investigated in more detail using qualitative methods.
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Affiliation(s)
- Jenny A Cresswell
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Sophie Sarrassat
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Simon Cousens
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Henri Somé
- AFRICSanté, Bobo-Dioulasso, Burkina Faso
| | | | - Veronique Filippi
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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Zhao A, Zheng W, Xue Y, Li H, Tan S, Zhao W, Wang P, Zhang Y. Prevalence of premastication among children aged 6-36 months and its association with health: A cross-sectional study in eight cities of China. MATERNAL AND CHILD NUTRITION 2017; 14. [PMID: 28382711 DOI: 10.1111/mcn.12448] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/16/2017] [Accepted: 02/18/2017] [Indexed: 12/22/2022]
Abstract
Premastication is thought to be an adaptive behavior in the introduction of complementary plant-bassed food to infants. It arouses controversy, however, because of the potential for transmitting saliva-born infectious diseases. The aim of this study was to explore whether premastication by healthy caregivers was associated with children's health and behavior. The data were collected as part of the Maternal and Infant Nutrition and Growth study. From 8 cities in China, 1341 pairs of infants/toddlers and their caregivers were recruited. An interviewer-administrated questionnaire collected data on sociodemographic characteristics, feeding behaviors, and self-reported health status. Anthropometric measurements were taken and blood samples were collected for analysis of hemoglobin levels. The overall prevalence of premastication was 26.9% and varies from 14-43% among the 8 cities. Premastication was not associated with occurrences of illness or with the nutritional indicators of height-for-age Z score, weight-for-age Z score, weight-for-height Z score, head circumference Z score and hemoglobin (P all >.05). Premastication occurred more often among infants who were raised by their parents (P = .005), whose mothers' education was lower (P < .001), who were subject to more concern from their parents (P = .022), and whose parents thought their children had an obesity problem (P = .001). Presmastication was not associated with food picky behaviors. Premastication is still a common feeding practice in China. More studies are needed to determine the biological, economic, and cultural benefits or harm from premastication.
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Affiliation(s)
- Ai Zhao
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Wei Zheng
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yong Xue
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Hao Li
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Shengjie Tan
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Wenzhi Zhao
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Peiyu Wang
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yumei Zhang
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China.,Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing, China
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Aakre I, Lilleengen AM, Lerseth Aarsand M, Strand TA, Barikmo I, Henjum S. Infant feeding practices in the Saharawi refugee camps Algeria, a cross-sectional study among children from birth to six months of age. Int Breastfeed J 2017; 12:8. [PMID: 28149322 PMCID: PMC5273854 DOI: 10.1186/s13006-016-0098-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 12/26/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Appropriate breastfeeding and infant feeding practices are crucial to a child's growth and development. The objective of this paper is to describe breastfeeding and general feeding practices and the nutrition status among children from birth to 6 months of age, in the Saharawi refugee camps located in Algeria. METHODS A cross-sectional study was carried out among 111 lactating mothers with infants from birth to 6 months of age. Data regarding breastfeeding practices and a 24 h dietary recall for the infants were collected to assess the World Health Organization's (WHO) indicators for infant and young child feeding. For exclusive and predominant breastfeeding, age disaggregation for each month was applied to the data. Background characteristics from the mothers and infants were collected, together with anthropometrical measures. We explored predictors for breastfeeding and nutrition status in multiple regression models. RESULTS In total 13.8%, 8.2% and 16.5% of the infants were stunted, wasted and underweight, respectively. Approximately 65% initiated breastfeeding within 1 h after birth and 11.7 and 21.6% were exclusively or predominantly breastfed less than 6 months. The most commonly given solid foods were dates (27.0%) and bread (10.8%). In multiple regression models, initiation of breastfeeding within 1 h after birth gave increased probability of exclusive or predominant breastfeeding. Giving birth at home as opposed to in a hospital and increasing number of children gave increased probability of initiating breastfeeding early. Exclusive or predominant breastfeeding seemed to protect against underweight and wasting. CONCLUSIONS Exclusively or predominant breastfeeding was low among Saharawi refugee infants. Wasting and underweight was common and more likely to occur if the infants were not exclusively or predominantly breastfed. These findings support the current international breastfeeding recommendations, and suggest that there is an urgent need for promoting infant feeding practices in the Sahara refugee camps.
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Affiliation(s)
- Inger Aakre
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College, PB 4 St. Olavs plass, 0130 Oslo, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, PB 7804, N-5018 Bergen, Norway
| | - Anne Marie Lilleengen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College, PB 4 St. Olavs plass, 0130 Oslo, Norway
| | - Marie Lerseth Aarsand
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College, PB 4 St. Olavs plass, 0130 Oslo, Norway
| | - Tor A. Strand
- Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, PB 7804, N-5018 Bergen, Norway
- Medical Microbiology, Department of Laboratory Medicine, Medical Services Division, Innlandet Hospital Trust, Anders Sandvigs gate 17, 2609 Lillehammer, Norway
| | - Ingrid Barikmo
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College, PB 4 St. Olavs plass, 0130 Oslo, Norway
| | - Sigrun Henjum
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College, PB 4 St. Olavs plass, 0130 Oslo, Norway
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Yalçin SS, Berde AS, Yalçin S. Determinants of Exclusive Breast Feeding in sub-Saharan Africa: A Multilevel Approach. Paediatr Perinat Epidemiol 2016; 30:439-49. [PMID: 27259184 DOI: 10.1111/ppe.12305] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The study aimed to provide an overall picture of the general pattern of exclusive breast feeding (EBF) in sub-Saharan Africa (SSA) by examining maternal sociodemographic, antenatal and postnatal factors associated with EBF in the region, as well as explore countries variations in EBF rates. METHODS We utilised cross-sectional data from the Demographic Health Surveys in 27 SSA countries. Our study sample included 25 084 infants under 6 months of age. The key outcome variable was EBF in the last 24 h. Due to the hierarchical structure of the data, a multilevel logistic regression model was used to explore factors associated with EBF. RESULTS The overall prevalence of EBF in SSA was 36.0%, the prevalence was highest in Rwanda and lowest in Gabon. In the multilevel regression model, factors that were associated with increased likelihood of EBF included secondary and above maternal education, mothers within the ages of 25-34 years, rural residence, richer household wealth quantile, 4+ antenatal care visit, delivering in a health facility, singleton births, female infants, early initiation of breast feeding (EIBF), and younger infants. However, countries with higher gross national income per capita had lower EBF rates. CONCLUSIONS To achieve a substantial increase in EBF rates in SSA, breast-feeding interventions and policies should target all women but with more emphasis to mothers with younger age, low educational status, urban residence, poor status, multiple births, and male infants. In addition, there is a need to promote antenatal care utilisation, hospital deliveries, and EIBF.
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Affiliation(s)
| | - Anselm S Berde
- Institute of Public Health, Hacettepe University, Ankara, Turkey
| | - Suzan Yalçin
- Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
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Zhao A, Gao H, Li B, Zhang J, Win NN, Wang P, Li J, Zhang Y. Inappropriate Feeding Behavior: One of the Important Causes of Malnutrition in 6- to 36-Month-Old Children in Myanmar. Am J Trop Med Hyg 2016; 95:702-8. [PMID: 27481057 DOI: 10.4269/ajtmh.16-0019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/20/2016] [Indexed: 02/02/2023] Open
Abstract
The complementary feeding period is an important time for children's growth and development. This study was conducted to 1) determine the feeding behaviors of 6- to 36-month-old children in Myanmar, 2) explore health effects of feeding behaviors, and 3) determine factors associated with feeding behaviors. A total of 807 children and their mothers (N = 642) were recruited from nine villages in Kachin, Shan, and Kokang, Myanmar. Feeding behaviors and sociodemographic characteristics were investigated using a validated questionnaire. Hemoglobin and anthropometric indicators were measured during the fieldwork. In our sample, 18.6%, 72.7%, and 9.8% of children were introduced to complementary foods (CFs) earlier than 4 months of age, between 4 and 8 months of age, and later than 8 months of age, respectively. For different types of CFs, up to the age of 24.1-36 months, there were still 6.5% and 4.1% of the children who had never been introduced to eggs and meat. Introduction of CFs earlier than 4 months of age was a risk factor for being underweight (age-adjusted odds ratio (ORadjust-age) = 1.7, 95% confidence interval (CI) = 1.2-2.5) and for stunting (ORadjust-age = 1.6, 95% CI = 1.1-2.3), whereas introduction of CFs later than 8 months of age was a risk factor for anemia (ORadjust-age = 3.5, 95% CI = 1.7-7.2). Mothers who had anemia (OR = 3.7, 95% CI = 2.0-6.9) tended toward early introduction of CFs. Women with a lower family income tended toward later introduction of CFs (OR = 2.0, 95% CI = 1.3-3.3). This study demonstrated that inappropriate feeding behavior was one of the important causes of malnutrition.
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Affiliation(s)
- Ai Zhao
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, Peopl's Republic of China
| | - Hongchong Gao
- School of Basic Medical Sciences, Capital Medical University, Beijing, People's Republic of China
| | - Bo Li
- Health Poverty Action Eastern Asia Program Office, Kunming, Yunnan, People's Republic of China
| | - Jun Zhang
- Health Poverty Action Eastern Asia Program Office, Kunming, Yunnan, People's Republic of China
| | - Naing Naing Win
- Health Poverty Action Eastern Asia Program Office, Rangoon, Myanmar
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, Peopl's Republic of China
| | - Jiayin Li
- Health Poverty Action Eastern Asia Program Office, Rangoon, Myanmar
| | - Yumei Zhang
- Science Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, People's Republic of China. Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing, People's Republic of China.
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