International Journal of Child Health and Nutrition

Number 3/1, 2014

1-10
Effect of Active Smoking During Pregnancy on Women and Newborn Health

Authors: Emre Yanikkerem, Semra Ay, Selda lldan Çalim

Abstract

View in PDF

Number of views: 43

The aim of the study was to identify the effect of prenatal smoking on mother and newborn health. The study was carried out in 700 women, who delivered at Merkez Efendi Maternity and Children’s Hospital between 1st January, 2011 and 31st December, 2011. Of the sample of women, 15.6% were current and 7.3% were quitting smokers. Women who continued smoking during pregnancy lived in households with husband who smoked and had higher rates of depressive symptoms and pregnancy included hypertension. Smoker women more likely reported to expose physical violence during pregnancy by their partner. Meconium in amniotic fluid was associated with women smoking status. Newborns who were exposed to tobacco smoke prenatally had deficits in weight (-186.6 gr), height (-0.9 cm) and head circumference at birth (-0.6 cm). In the study when women quit smoking during the first trimester, their infants have anthropometric measures similar to infants of nonsmokers. Smoking during pregnancy was related to low birth weight, height, and with small head circumference. Smoking cessation during pregnancy may have a greater impact on baby anthropometrics measures which were similar to infants of nonsmokers. To protect the health of their future unborn children, it would be optimal to target all women of reproductive age to quit smoking before they consider becoming pregnant

11-16
Factors Influencing Acute Exacerbation of Bronchial Asthma Among Children in Malaysia

Authors: Rakhee Yadav, Hematram Yadav, Tan Kok Leong

Abstract

View in PDF

Number of views: 39

The aim of this study was to determine the factors influencing acute exacerbation of bronchial asthma among children in Malaysia. A cross-sectional study was done to identify the factors influencing acute exacerbation of asthma in the University Malaya Medical Centre. In this study 103 known asthmatic children between the ages of 2 to 12 years were analysed. Among the children, 60% had a family history of asthma, 39% allergic rhinitis and only 17% eczema. The main complaints were coryza (84%) and shortness of breath (88%). Majority of the patients were treated as out-patient (58%) and only two were admitted in Intensive Care Unit. The factors that were significantly associated with mild exacerbation compared to a moderate to severe exacerbation was well-controlled asthmatic, good compliance to medications and those who had regular follow up

17-26
Clinical Profile and Outcome among Infants of Diabetic Mothers Delivered at the Brooklyn Hospital Center

Authors: Uchendu O. Uchendu, Patrick Leblanc, Jude M. Thomas, Ossama M. Maher, Yesenia Morales, Belen Fineza

Abstract

View in PDF

Number of views: 38

Background: Diabetes mellitus (DM) is the commonest complication of pregnancy, negatively impacting mothers and fetuses. Few studies suggest amelioration of negative outcomes of DM-associated pregnancies in recent years, due in part to improved care. But increasing prevalence of overweight in developed countries is also affecting many women of childbearing age with concomitant poor glycemic control especially in pregnancy. Hyperglycemia, even at sub-diabetic levels, is associated with increased risk of macrosomia and Cesarean section. There is evidence demonstrating that outcomes of DM-associated pregnancies are similar with those characterized by hyperglycemia of sub-diabetic levels. Perhaps, improvement of care for DM-associated pregnancies on one hand, and the impact of obesity epidemic may have changed the relative frequencies of negative outcomes typically reported for infants of diabetic mothers (IDMs) compared with controls. Aims/Objective:We re-evaluated the relative frequencies of negative outcomes of pregnancies complicated by DM compared with non-diabetic pregnancies. Method/Design: A retrospective cohort analysis was conducted. Result: There were 50 diabetic and 83 non-diabetic mother-infant pairs. Mothers with DM-associated pregnancies had increased risk of delivery by C/Sxn, macrosomic babies, admission to NICU and prolonged hospitalization. Only IDMs had documented birth defects. Notable improvements over previous studies for IDMs include similar gestational ages at delivery and excellent APGAR scores in both groups. Conclusion: IDMs still have higher frequencies of negative outcomes compared with controls but some improvements are noteworthy and should provide impetus for efforts at reducing prevalence of obesity while improving care for DM-associated pregnancies

27-40
Socio-Cultural, Organizational, and Community Level Influences on Physical Activity Levels of Latino Preschool-Age Children: A Qualitative Study

Authors: Ana C. Lindsay, Mary L. Greaney, Katarina M. Sussner, M. Erin Pfeiffer, Karen E. Peterson

Abstract

View in PDF

Number of views: 47

Objectives: As more children grow up in families with immigrant parents of Latino origin, there is a need to understand key influences on physical activity behaviors of young Latino children to prevent obesity in this high-risk group.Design:We conducted six focus groups with low-income Latina mothers (N = 33) whose preschool-aged children (2-5 years) were enrolled in the Supplemental Nutrition Program for Women, Infants and Children (WIC) program in Rhode Island. Data was analyzed using content analysis to identify recurrent themes. Results: Despite understanding the importance of physical activity for overall health, physical activity was not a top priority for the Latino mothers participating in the focus groups. Mothers reported facing numerous barriers to establishing and maintaining healthful physical activity habits for their preschool-aged children and themselves, particularly financial and socio-cultural barriers. Analyses revealed that Latina mothers perceive the WIC as a program focused on the development and maintenance of healthy eating habits and nutritional status of children and not physical activity.Conclusions: Recognizing the importance of socioeconomic position and the influence of cultural factors on physical activity is essential if effective prevention and intervention programs for Latino families and their children are to be designed. Study findings emphasize the importance of the family as a central unit of change and suggest that successful interventions to promote physical activity of low-income Latino preschool children must take into account the needs and constraints of the family unit as a whole. The WIC program has the potential to be a venue for promoting awareness of and educating low-income Latino parents about the importance of helping their children develop and maintain early healthful physical activity habits. The WIC program can also play an important role in facilitating access and creating programs and services that provide increased opportunities for physical activity of young children and their families.

41-47
The Effectiveness of “Emolabeling” to Promote Healthy Food Choices in Children Preschool Through 5th Grade

Authors: Gregory J. Privitera, Taylor E. Phillips, Melissa Misenheimer, Robert Paque

Abstract

View in PDF

Number of views: 46

Obesity has become a growing global concern. Evidence indicates that ecological factors are most predictiv e of obesity among children, and that a new strategy, referred to as emolabeling, may effectively address ecological factors, although the extent to which it can influence food choice is not yet known, but tested here. Specifically, we tested the hypothesis that children aged 3 to 11 years will use emolabels, or emotional correlates of health (i.e. healthy-happy, unhealthy-sad), to make healthy food choices. A cross-sectional design was used with two phases. In Phase 1, children were taught how to use emolabels with a “faces of health” lesson. In Phase 2, children made choices between containers that were laid out on a large table in pairs and varied by taste (tastes good, no information), social norms (popular, not popular), branding (image of a minion, no image), or preference (told what food was in each container). A control pair was labeled with only emoticons. The order and presentation of the containers were counterbalanced for each variation. Results showed that a significant proportion of children in the pre-literacy and the early literacy grades used emoticons to specifically make healthy food choices in each variation (p < .05 for all tests), except when children were told what foods were in the containers. In all, emolabeling effectively influenced food choices for healthy foods among children aged 3 to 11 years, more so than labeling for taste, social norms, and branding, but not preference

48-54
Amount of zinc transferred in breast milk to breastfed Moroccan babies with normal or low birth weight at 1, 3 and 6 months after birth

Authors: Ghizlane choua, Nourddine EL HALOUI, Khalid EL KARI, Hassan AGUENAOU, Najat MOKHTAR

Abstract

View in PDF

Number of views: 35

The amount of zinc in breast milk is generally regarded as sufficient to cover the increasing zinc demands of most infants. However, this is not well investigated where stores zinc may be compromised in babies with low birth weight (LBW) who are born with low stores of zinc. In Morocco, this is the first time that the amount of zinc transferred in breast milkhas been estimated. This study included 32 mother-baby pairs. In our case study, we aimed to measure The quantity of zinc in mothers’ breast milk with normal birth weight (NBW) and LBW babies who were exclusively or not exclusively breast fed at 1,3 and 6 month after birth. The results showed that the majority of mothers have a BMI 25 kg/m2 this means that all mothers are overweight during 6 months after birth. Zinc concentration (mg/l) in mothers’ breast milk decreased from first month to six month. p- value showed that for mothers with NBW babies, there is a significant difference between the 1 and 6 month (p=0.0003) and between 3 and 6 month after birth (p=0.0007). For mothers with LBW babies, p-value showed a significant difference between the zinc concentration in breast milk in the 1st and 3rdmonth (p=0.0007), 1 and 6 month (p< 0.0001) and between 3rd and 6th month after birth (p=0.0056). The rate of NBW babies who were exclusively breastfed was 36.67%, 30.25% and 10% successively in 1st, 3rd and 6th month after birth. For LBW babies, the rate of exclusively breastfed was 15.38%, 7.69% and 2.69% successively in 1st, 3rd and 6th month after birth. Based on the K. Brown study in 2009, we can develop a mathematical equation to our own population using our data: Ln [Zinc] = 0.960 – 0.161*Ln(âge) – 0.187*Ln(âge)2. In conclusion the zinc concentration in milk is within normal range and decreases with the age of the babies. The predicted model of zinc concentration in breast milk was developed and tested.

55-59
Refeeding Syndrome in a Critically Ill Child

Authors: Fabíola I. Suano de Souza, Heitor Pons Leite, Walter Jacob Chwals, Werther Brunow de Carvalho

Abstract

View in PDF

Number of views: 44

Objective: To report a case of a child interned in an ICU of a University Hospital who developed refeeding syndrome, and to review the specific literature pertinent to this area. Case Report: An eight year-old, previously healthy, male patient was admitted for necrotizing pneumonia. On admission the child had a z-score of weight for height of 0.38 and height for age of -0.74. Following 60 days’ hospital admission he had lost 27.5% of initial weight. Enteral tube feeding, with an energy intake equivalent to the basal metabolic rate plus 20% for stress, was initiated and gradually increased during the stabilization phase. After receiving 2000 kcal/day for 5 days, hypophosphatemia was detected in association with an increase in hepatic enzymes and hyperglycemia. No concomitant worsening of the white blood count or evidence of inflammatory activity was present. These alterations were accompanied by an increase in pulse rate and body temperature, thereby leading to a diagnosis of refeeding syndrome. Energy intake decreased to 1520 kcal/day, resulting in a marked improvement of the laboratorial parameters in less than a week. Conclusions: Refeeding syndrome is a potentially dangerous complication of increased caloric administration in critically ill pediatric patients. Early recognition and appropriate adjustment of nutritional support is important to avoid the serious consequences which may ensue if this condition is left untreated

60-66
Economic Recessions and Infant Mortality in the U.S., 1999-2008

Authors: David Bishai, Qingfeng Li, Sai Ma

Abstract

View in PDF

Number of views: 39

Objectives: Prior studies of US data from the 1990s have shown that economic growth is associated with higher all cause mortality. This paper updates prior findings to more recent data on US infant mortality for blacks and whites. Methods: We analyzed data from 50 US states from 1999 to 2008 using state fixed-effects regression models stratified to identify the racially disparate impact of each state’s economic performance on infant mortality, controlling for state policy-related variables, reflecting population,% black, % on TANF, % on Medicaid, and alcohol consumption. Results: Economic recessions are significantly associated with lower post-neonatal mortality for white infants, but not black infants. Each 1% decrement a state’s gross state product, would be associated with an approximately 2.3 fewer infant deaths (95% CI: -0.294-4.894) in an average state with 64,000 total births. Results were robust to the inclusion of state trends, national trends, state fixed effects, lagged gross state product, and the inclusion of measures of unemployment and state policy variables. Conclusions: This study in combination with studies from the 1990s reflects growing evidence that economic growth in the US can be harmful to child health. Policy makers need to be informed and mindful about the “side effects” of economic growth on health