Complementary Feeding Knowledge and Practices of Caregivers in Orphanages Improved after Nutrition Education Intervention in Ibadan, Nigeria

Malnutrition among under-5 children has been linked to inadequate complementary feeding practices. Children living without permanent parents have also been proven to have a higher risk of malnutrition, which puts their growth and development in danger. In this study, an impact evaluation of nutrition education was carried out on the knowledge and practice of complementary feeding among caregivers in orphanages. This quasi-experimental study was conducted in selected orphanage homes located within Ibadan, southwestern Nigeria. A purposive sampling technique was employed to select 50 caregivers from 8 orphanage homes. Data was collected using an adapted interviewer administered at baseline and post-intervention. The key results showed that those who had good knowledge of complementary feeding practices increased from 68.1% to 79.9% at baseline and post-intervention respectively. The WHO complementary feeding indicators that were used to measure the practice revealed that 37.5% met the minimum meal frequency (MMF), 52.5% met the minimum dietary diversity (MDD) and 35% met the minimum adequate diet (MAD) at baseline, which increased to 62.5%, 80% and 60% respectively after intervention. Conclusively, this study revealed that nutrition education improved the complementary feeding knowledge and practice of caregivers. It is recommended that such nutrition education should be introduced to new caregivers and could also be converted into policy actions at a national level.

The Effects of Different Feeding Practices on the Nutritional Status of Infants below 12 Months Old in the Kumba 1 Sub-Division

Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to 6 months of age to EBF until about 6 months of age, with the addition of complementary foods thereafter. This recommendation confirms that breast milk alone is sufficient to meet infants’ nutritional requirements for the first 6 months of life. The main objective of this study was to investigate the effect of various feeding practices on the Nutritional status of infants 0 - 12-month-old in the Kumba 1 Sub-Division. A descriptive cross-sectional study was conducted from December 2019 to August 2020. A total of 341 nursing mothers and their infants 0 - 12 months of age were recruited. Socio-demographic factors and the different feeding habits of the children were assessed using a semi-structured questionnaire. Nutritional status was assessed using anthropometric measurements. The overall proportion of infants who exclusively breastfed for 6 months was 69.2% and those who were mix-fed were 30.8% in the study area. The overall prevalence of malnutrition in the population was 61.0%. Among the malnourished children, 53.1% were underweight, 19.6% were wasted and 10.0% were stunted. Though not significant, the prevalence of wasting (21.0%) and underweight (58.3%) was higher among Mix-Fed (MF) children when compared to their EBF counterparts. Feeding practices affected the nutritional status of the infants. Underweight and wasting were observed among infants on Complementary Feeding (CF), although some exclusively breast-fed infants were stunted. Hence, nursing mothers should try as much as possible to practice EBF as recommended by WHO and can practice CF when the child is above six months.

Effect of a Nutrition Education Intervention on Mothers’ Infant and Young Child Feeding Knowledge and Practices in the Peri-Urban Areas of Bobo-Dioulasso: Before and after Study

Background: This study assessed the effect of a nutrition education intervention aiming to improve the knowledge and practices of under 5 years children’s mothers on infant and young child feeding in peri urban areas of Bobo-Dioulasso in Burkina Faso. Methods: A total of 243 mothers of children under 5 years in the peri-urban of Bobo-Dioulasso were surveyed before and after the intervention using the FAO questionnaire for infant and young child feeding (IYCF) knowledge and practices assessment in January and October 2017. The intervention included two components consisting of a theoretical phase (counselling and discussion) and cooking demonstrations implemented for ten months. To account for the before-and-after design of the study, the McNemar’s test was used to assess the effect of the intervention on mothers’ infant and young child feeding knowledge and practices. Results: The mean age of mothers was 29 ± 6.2 years and 50.6% of the mothers were between 20 and 29 years old. All indicators used to assess the mothers’ knowledge of breastfeeding and complementary feeding significantly improved after the intervention (all p-values < 0.05). In terms of child feeding practices, half of the indicators (early breastfeeding initiation, age of complementary feeding initiation, and minimum meal frequency) significantly increased (all p = 0.001) while two indicators (minimum dietary diversity, and minimum acceptable diet) did not change (p = 0.06 and 0.67) after the intervention. Finally, continued breastfeeding, significantly declined after the intervention (73.3% vs 86.0% p = 0.001). Conclusion: The intervention improved the mothers’ knowledge on breastfeeding and complementary feeding and some child feeding practices. This study provided some evidence of an effective nutrition education intervention to increase maternal knowledge and practices.

Assessment of Nutritional Status and Associated Factors in Infants Aged 6 to 23 Months in Rural Burundi

This study was carried out in the Health districts of Kayanza and Gahombo. Its aim was to assess the nutritional status and associated factors of infants aged between 6 and 23 months. This descriptive and cross-sectional study was carried out in the health centers of the action zone during medical consultations in community medicine from 13 to 22 February 2023. For this purpose, 53.0% of a sample of 398 mothers of infants aged 6 - 23 months were male, and the most represented age group was 12 - 23 months with 53.8%. Mothers were asked about the diet of their children. All the children involved in this study were vaccinated, whereas 99.2% were given vitamin A supplements. The most frequent illnesses in this age group were acute respiratory infection (ARI) (73.4%), fever (66.6%), diarrhea (53.8%), and vomiting (40.5%). Analysis of nutritional status showed that infants had severe (8.3%) and moderate (70.4%) acute malnutrition. Factors associated with infant nutritional status comprised the occupation of mother (P = 0.009), level of education of mother (P = 0.0625), and prolonged diarrhea (P = 0.004). To remedy this problem, concrete nutritional and educational interventions are needed to promote optimal infant nutrition during the first two years of life.

Parental Stress and Sensory Integration Disorder as Risk Factors for Eating Disorders Poor Nutrition and Growth Delay Among Toddlers

Selective eating among toddlers is a well-known phenomenon which is characterized by varied factors including nutritional deficits and a unique and challenging sensory profile.Our clinical experience in a multidisciplinary feeding and eating clinic,in Hadassah Medical Center of Jerusalem binds specific feeding and eating patterns with high levels of parental stress ll.Parental stress is combined by three domains:parental general approach of satisfaction,the quality of interaction with child and child’s temperament,as perceived by parent.Our cross-sectional research includes 42 pairs of parents and their children,referring the clinic due to selective eating and suspected sensory integration disorder.Our study includes a broad nutritional assessment,questionnaires testing parental stress(PSI-4)and questionnaires testing sensory integration(Toddler Sensory Profile-2)and anthropometric indices.Our study’s results are relevant family physicians and pediatricians working in the community,who address diagnosis like autistic spectrum disorder,attention deficit hyperactive disorder,developmental delay,and learning disabilities that interface with domains of parental stress and experience of parenting interaction and child temperament,as well as sensory integration and limited eating and nutrition.Research results are significant in the field of locating babies and families needing early intervention and as a base of promoting intervention programs of prevention and treatment of toddlers and their parents.It is important to apply suitable intervention programs based on a reflective manner about dyadic and triadic eating and feeding relations,in the family unit,considering the cultural context.

Knowledge, Attitudes and Practices of Caregivers of Children 0 - 23 Months in Eastern and Central Uganda

Introduction: Appropriate feeding and consequently good nutritional status of young children largely depends on their caregivers. Aim: The current study aimed at assessing maternal/caregivers’ current knowledge, attitudes, practices, and beliefs regarding different aspects of infant and young child feeding in Eastern and Central Uganda. Methodology: A cross-sectional survey design with mixed methods employing both qualitative and quantitative methods was used for data collection. Results: The study participants included 556 caregivers and 572 children. Results indicate that most caregivers (77%) were knowledgeable about key infant and young child feeding practices such as breastfeeding, complementary feeding and meal frequency. However, culture and economic hardships were a major barrier to the applicability of this knowledge. Nearly all (98%) children were ever breastfed with 41% having been initiated on breast milk in the first hour after birth and 68% of all the children below 6 months exclusively breastfed. Three percent of the children aged 6 - 23 months were classified as having either Moderate (2%) or Severe (1%) Acute malnutrition. The median birth weight was 3.2 Kgs with nine percent of the children classified as underweight at birth. The majority (78%) of the children consumed foods from at least four food groups however only 44% consumed heme-rich animal flesh food such as meat, poultry, organ meats and fish, 29% consumed milk and milk products while only 11% consumed eggs. The barriers to improved nutritional status and health-seeking behaviour in children from both regions were largely similar. Some of these included cultural practices which prohibit children from eating certain foods and lack of drugs in the health facilities. Lack of male involvement was a key barrier to health-seeking behaviour and the nutritional well-being of children. Males were, however, more knowledgeable about the key childcare practices that are critical to positive outcomes because they listen to radios, have access to social media and usually congregate at bars where this information is disseminated and exchanged. Conclusion: There should be continuous sensitization of mothers on the benefits of breastfeeding with special focus on early initiation and exclusive breastfeeding as well as child feeding practices during illness. To increase protein intake in children 6 - 23 months, interventions aimed at increasing consumption of these vital nutrients such as promotion of nutrition-sensitive agricultural enterprises like rearing of small livestock and chickens should be emphasized. Consumption of these foods is critical, especially during pregnancy and infancy. Finally, male involvement in maternal and child feeding should be encouraged.

Availability, Accessibility and Contribution of Infant Flours to the Diet of Children Aged 6-59 Months in Benin

This study assesses the nutritional composition as well as the availability and affordability of infant flour found on the market and in the households of Benin. To do that assessment, a two-step cross-sectional survey based on food ethnography methods was used. A total of 61 marketplaces were visited in seven towns and rural districts as part of the availability and affordability survey, while 400 children (aged 6 to 59 months) were surveyed to track the uses of infant flours at the household level. The results obtained reveal that pre-manufactured infant flour is sold more in urban areas (Cotonou, Porto-Novo and Parakou) than in rural ones. The average infant flours price did not vary (p = 0.985) in any given year (regardless of abundance or lean periods) nor does it vary (p = 0.133) from one point of sale to another (drugstore or supermarkets). However, the average price is found to be expensive considering the purchasing power of the households surveyed. On the other hand, the amount of ingredients used in the production of the flour types found on the market complies with the recommendations of the Codex Alimentarius, unlike the homemade ones. Pre-manufactured infant flour is found to be outside of the economic reach of most households (92%) who rely heavily on the homemade ones to feed their children. In light of the above, public authorities should help improve geographic access and pricing affordability to quality infant flour for low-income households in urban and remote areas. Moreover, awareness should be raised among mothers relative to the importance of complementary feeding through education on good nutrition practices.

Key Determinants of Optimal Breastfeeding Practices in Laos

This paper provides information on optimal breastfeeding practices in the People’s Democratic Republic of Lao from data collected in the2011 Lao Social Indicator Survey. Results: Early initiation of breastfeeding within the first hour of life occurred among 39.6% of Laotian infants. After controlling for the effects of wealth, early initiation of breastfeeding was found to be most prevalent among mothers with higher education, those who received antenatal services, and those who delivered in a health facility. Avoidance of prelacteal feeds within the first three days of life occurred among 65% of Laotian infants, and was highest among ethnic Hmong and Khmer infants, and among those born in public versus private health facilities. Avoidance of prelacteal feeds was lowest after deliveries in which a traditional birth attendant was present. Exclusive breastfeeding through the first 5 months of age was reported among 40.8% of infants nationally. Ethnicity again played a role with the highest levels of exclusive breastfeeding found to occur among ethnic Khmer infants (69.4%, OR 2.8, CI: 1.5 - 5.1). Discussion: These results highlight the role that health care workers can have on early breastfeeding practices at the point of both antenatal counseling and in the delivery setting. Strengthening the quality of counseling on infant feeding can have a significant impact on early initiation of breastfeeding. Ethnic difference significantly impact both early and exclusive breastfeeding practices. Conclusion: A complexity of factors at different levels of care impact breastfeeding practices. A synergy of strategic approaches are needed to target antenatal counseling as well as post-delivery practices, all which account for the unique social and cultural attitudes towards infant feeding. Stronger community-based interventions that account for cultural attitudes and practices are most likely to be successful in promoting exclusive and continued breastfeeding practices.

婴幼儿辅助食品分阶喂养体系的现状与前景

婴幼儿辅助食品是指适于6~36月龄婴幼儿食用的婴幼儿谷类辅助食品、婴幼儿罐装辅助食品以及辅食营养补充品。文章总结了婴幼儿食品的国家标准现状、婴幼儿配方食品的分阶喂养体系现状,以及婴幼儿辅助食品的产品现状,讨论了婴幼儿辅助食品的特点,并结合国际吞咽障碍食物标准行动委员会(IDDSI)的分级标准,按食品质构提出适合婴幼儿分阶喂养的5个阶段“中度稠、高度稠/细泥型、细馅型、软质型、常规型(容易咀嚼)”,进一步从胃容量、吞咽咀嚼能力、均衡营养等方面定量讨论了婴幼儿辅食分阶喂养体系的建立,并提出婴幼儿零辅食的生产只需适度强化必要的营养素。

中国儿童生长发育现状和趋势分析

依据 1 990～ 1 998年营养监测数据 ,分析了 1 998年我国 5岁以下儿童生长发育情况和 1 990～ 1 998年我国儿童生长发育的变化趋势 ,并分析了影响儿童生长发育的相关因素的变化。结果表明 ,1 990～ 1 998年间 ,我国儿童的低体重患病率城市由 8.0 %降为 2 .7% ,农村由 2 2 .0 %降为 1 2 .6% ;生长迟缓患病率城市由 9.4%降为 4.1 % ,农村由 41 .4%降为 2 2 .0 %。1 990～ 1 995年 ,儿童体重增长较快 ,身高没有同速增长 ;而 1 995～ 1 998年 ,儿童身高则出现加速的增长。与营养不良患病率有关的因素 :腹泻、安全饮水、母乳喂养率、母亲文化程度、家庭膳食等因素在这几年改善也非常明显。通过对 1 998年不同月龄儿童生长发育状况的分析 ,提出目前改善儿童营养关键是年龄段 6～ 1 8个月的儿童 ,应将辅食添加与母乳喂养放在同等重要位置。以进一步降低我国城乡儿童营养不良患病率。

婴幼儿生长发育与辅食添加的关系

应用 1 998年 6岁以下儿童营养监测现场调查资料分析 4至 2 4个月以内婴儿辅助食品添加对婴幼儿生长发育的影响 ,以便为农村特别是贫困农村合理添加辅助食品提供参考。统计分析采用了描述性、相关回归分析及 Logistic回归分析。结果表明贫困农村婴幼儿各类辅助食品添加率低于一般农村和城市。贫困农村婴幼儿在 2 4个月以内平均添加动物性食物只占 42 %、乳类 30 .5%、淀粉类 57.8%、蔬菜水果类 48.6% ,相当于城市添加比例的一半。通过相关分析表明 ,在 4至 6个月 ,6至 1 2个月 ,1 2至 1 8个月 ,1 8至 2 4个月几个年龄段的按年龄身高和体重与动物性食物和蔬菜水果类食物的添加率呈显著的正相关关系 ,但淀粉类食物在各个年龄段相关都不显著。通过回归分析 ,估算了如果每个营养监测点动物性食物添加率提高 1 0 %时 ,1 8至 2 4个月的婴幼儿生长迟缓率可下降 2 .6个百分点 ,低体重下降 1 .2个百分点。Logistic回归分析表明 ,没有添加动物性食物时 ,发生生长迟缓的危险度 OR=2 .2 1 (4～ 6个月 )、1 .73(6～ 1 2个月 )、2 .81(1 2～ 1 8个月 )和 2 .58(1 2～ 2 4个月 )。未添加蔬菜水果类食物发生生长迟缓的危险度与动物性食物类似。

蚕蛹蛋白的生产与应用的研究

本文报导了蚕蛹蛋白分离提取技术及其产品的营养评价与动物和儿童喂养试验的研究结果。该技术已用于工业生产,具有简易高效无三废排放等优点,得率为鲜蛹的16.7％,干物质回收65.4％。该产品微黄色无蛹臭含蛋白质80％以上,必需氨基酸最高、质好,依FAO评分模式氨基酸分为0.94。此外,产品中还富含核黄素、尼克酸及锌、铁、铜等微量元素,用该产品制成食品或饲料进行儿童与动物喂养试验证明,具有促进生长、增进健康的显著功效。

不同喂养方式婴儿体格发育水平

目的了解安徽省阜阳市某县农村婴儿的营养状况,并进一步探讨不同喂养方式与婴儿生长发育的关系。方法以安徽省某县农村地区所有3～12月婴儿作为研究对象进行普查。制定统一调查表,现场调查由经培训的乡村或社区医生承担,被调查乡村或社区领导协助,由课题负责人对调查员进行统一培训。调查员对婴儿的身高与体重进行测量,并对婴儿的监护人进行询问,了解婴儿一般情况、母乳喂养情况等以及监护人自身的情况,逐一填写调查表。结果本次有效调查1490人,男921人,女569人。其中纯母乳喂养532人,占35.7%,混合喂养748人,占50.2%,人工喂养210人,占14.1%,不同性别间喂养方式差异没有显著性。1490名婴儿的WAZ值平均为1.0436±1.2819,HAZ值为0.3947±1.4837,Kaup指数为18.2937±2.8879,母乳喂养和混合喂养组婴儿的WAZ、HAZ值均高于人工喂养组;1490名婴儿中,低体重者21人,占1.4%;生长迟缓者100人,占6.7%,以人工喂养组婴儿的发育迟缓率最高;不同喂养方式婴儿的Kaup指数差异无显著性意义。结论母乳喂养与混合喂养组婴儿的生长发育好于人工喂养组,应大力提倡母乳喂养。

小学生智力发展因素的分析研究

本文采用中国韦克斯勒儿童智力测试、个人生活学习与健康问卷调查与逐步回归多因素分析等方法,查明了学业成绩、性别、父母文化、母孕龄及婴儿期喂养方式等5个因素与学龄期儿童智力发展具有高度关联性;单因素相关系数表明独生、胎次二因素与智商亦有明显的依存关系。发挥以上诸因素的联合作用可获得促进儿童智力发展之效。

婴幼儿喂养指数应用于儿童营养评估的研究进展

通过阐述婴幼儿喂养指数的相关概念、评价内容、评价标准等,归纳婴幼儿喂养的影响因素,指出近年来国内外婴幼儿喂养指数研究的主要进展,以期为后期婴幼儿营养状况的评估提供信息。

母乳喂养和辅食添加与儿童亚临床VitA缺乏的关系

目的：探讨母乳喂养和辅食添加与儿童亚临床VitA缺乏的关系。方法：对于6—71个月儿童VitA营养状况进行横断面研究，荧光法测定血清VitA含量。半定量频率问卷收集调查前2周内儿童辅食情况，同时调查儿童的家庭经济、围生期保健及疾病情况等。结果：单因素分析表明母乳喂养为亚临床VitA缺乏的危险因素（OR=3．52，95％CI为2．02-6．12）；多因素Logistic回归在控制性别、月龄、儿童排行、母亲文化水平、母亲职业、VitA增补剂、腹泻等因素后，仍然有显著意义（OR=2．39，95％CI为1．22—4．69）。单因素分析添加鲜奶或奶制品、蛋类、豆类及豆制品、蔬菜以及鱼虾等辅食对亚临床VitA缺乏有保护作用，伽均小于1；在控制已知协变量和混杂变量后，只有豆类及豆制品辅食添加有统计学意义（OR=0．41，95％CI为0．18—0．94）。结论：6个月以后母乳喂养不能成为亚临床VitA缺乏的保护因素，辅食添加不足与亚临床VitA缺乏关系有待进一步研究。

我国西部农村地区婴幼儿营养和儿童早期教育状况调查

目的了解西部地区贫困农村的6～24个月婴幼儿的体格发育状况和膳食营养状况，为之后制定营养改善对策提供依据；了解农村学龄前儿童（36—72个月）的早期教育状况，为改善学前教育提供依据。方法在云南省会泽县、贵州省盘县和陕西省洛南县3个国家级贫困县各随机抽取两个乡镇，每个乡镇抽取约40名6～24个月的幼儿进行体格测量和24小时膳食回顾调查；抽取约40名学龄前儿童（36～72个月）进行早期教育状况调查。将收集的数据进行统计分析。结果本次调查的6～24个月婴幼儿低体重率、生长迟缓率和消瘦率分别为10．4％、14．9％和8．8％；6～11、12～24个月的婴幼儿贫血率分别为29％和25％；满6个月的幼儿有78．1％继续坚持母乳喂养，87．5％开始添加谷类和薯类食物，肉类和鱼、蛋类的添加率分别只有21．9％和15．6％，水果、蔬菜和豆类和添加率分别只有12．5％、21．9、3．1％。36—72个月的儿童上幼儿园的比例只有63．8％，其中在盘县和会泽分别只有46．3％和53．8％。结论幼儿母乳喂养不足和辅食添加不合理是导致该地儿童营养缺乏的重要原因．应该通过培训，更新幼儿家长的育儿观念和知识。另外，农村儿童的早期教育状况改善刻不容缓。

二胎早产儿的喂养方式及营养状况分析

目的回顾性分析二胎政策后二胎早产儿的喂养方式和营养状况,为相关政策的制定提供依据。方法统计2017年1月1日—6月30日于厦门市某三级甲等综合医院进行系统的产前检查并住院分娩的1 075例二胎儿,对其26例早产儿的喂养方式和生后42 d营养状况进行分析。结果 1 075例二胎儿中有26例早产儿,占分娩总数的2.42%;1 075例二胎儿喂养方式中,纯母乳喂养708例,配方奶喂养62例,混合喂养305例;以纯母乳喂养为主。在26例早产儿中,消瘦19例,轻度贫血3例,中度贫血1例。结论二胎早产儿的喂养方式与营养状况密切相关,护理人员可根据情况加强针对性的健康管理。

陕西农村地区婴幼儿营养性贫血调查

目的了解陕西农村社区婴幼儿营养性贫血的原因及发病率,改善当地儿童营养状况,提高人口素质。方法采用随机整群抽样方法,对0～18个月的婴幼儿进行调查,获有效资料336份。结果6～18个月婴幼儿的贫血患病率为81.7%,其中轻中度贫血占98.4%。结论陕西农村社区的营养性贫血发病率较高,主要原因是辅食添加不合理,建议通过平衡膳食来控制贫血的发病率。

四川省农村6岁以下儿童营养状况分析

目的 了解农村 6岁以下儿童的营养状况及其影响因素 ,为儿童营养改善工作提供科学依据。方法 使用卫生部“国家营养监测调查表” ,对 846名 6岁以下儿童进行调查 ,运用SPSS8 0统计软件对调查数据进行统计分析。结果 儿童低体重出生率、低体重发生率、发育迟缓发生率和贫血患病率分别为 2 9%、 12 8%、 2 0 7%和 5 3 % ;婴儿 4个月内的纯母乳喂养率、混合喂养率、人工喂养率分别为 5 0 6 %、 48 2 %和 1 2 % ;婴儿添加乳类、谷类、蔬果及豆类、蛋鱼及禽类的平均年龄分别为 6 9、 7 9、 8 6和 9 2个月 ;婴儿适时添加辅食的比例为 18 1% ,添加过早和过迟分别占49 4%和 32 5 %。结论 儿童营养不良和疾病发生率高峰在 2岁以内 ,这可能与该期存在的母乳喂养不足、辅食添加不当等因素有关。提示在进行儿童营养改善时 ,应加大普及营养知识、指导婴幼儿正确喂养的力度。