International Journal of Child Health and Nutrition

1-8

Authors: Laura Nabors, Kristen Welker, Brandon Pavilack, Myia Lang, Renee Hawkins, Anne Bauer

Dissemination of obesity prevention programs in different settings is needed. Moreover, new outreach tools to teach parents healthy eating and exercise lessons provided in these programs are important to develop. The pilot studies presented in this paper examined the implementation of the Children’s Healthy Eating and Exercise Program in two different after school programs in 2015 and 2016. Participants were elementary school-age children and their parents. Eight lessons were presented at each school. Child perceptions of healthy eating and exercise goals were examined as well as child knowledge retention and perceptions of behavior change. Parent perceptions of the program were analyzed. Results indicated that children reported improved knowledge and behaviors. Parents reported satisfaction with the program, but remained hard to reach. Children recalled key components of the healthy eating lessons at long-term follow-up assessments. In the second pilot study, children served as health coaches for teaching parents about family goals. Children believed they were successful at coaching parents, but they requested help in developing family eating and exercise goals. Improving outreach to parents and involving siblings remains a goal for future studies as does beginning to examine changes in eating and physical activity using food diaries and accelerometry.

15-21

Authors: Rana H. Mosli, Manal N. Al-Lahyani, Amani Najjar, Doaa A. Zoghbi, Rawan H. Al-Haddad, Hala H. Mosli

Objectives: To examine the association of maternal GDM with 1) child BMI z-score at preschool; 2) breastfeeding initiation and duration, while adjusting for child birthweight in addition to potential confounders.Method: Sample included 53 children (3 - 5 years old) recruited from two preschools in Jeddah, Saudi Arabia. Mothers completed a self-administered questionnaire. Child anthropometry was completed using standardized procedures. BMI z-scores were calculated using the WHO standards/reference data. Linear regression models were tested to examine the association between maternal GDM and child BMI z-score, as well as breastfeeding duration. Logistic regression models were tested to examine the association between maternal GDM and breastfeeding initiation. Models were adjusted for child birthweight, maternal BMI, and maternal age at pregnancy.Results: Mean child BMI z-score was 1.10 (SD= 1.22). About one quarter (24.5%) of mothers reported being diagnosed with GDM. Mean birthweight of children whose mothers were diagnosed with GDM was 3.10 kg (SD= 0.74). Adjusting for covariates, we found that maternal GDM was associated with increased child BMI z-score (B= 1.04, 95% CI= 0.14 -1.94, P-value= 0.02), and lower odds of breastfeeding initiation (OR= 0.10, 95% CI= 0.02 – 0.49, P-value= 0.005). Maternal GDM was not associated with breastfeeding duration (B= -4.75, 95% CI: -11.79 – 2.29, P-value= 0.18).Conclusion: Findings suggest that maternal GDM is associated with higher child BMI z-score at preschool and lower likelihood of breastfeeding initiation. Studies are needed in order to identify the underlying mechanisms of associations. Obesity prevention programs may target children whose mothers were diagnosed with GDM; prenatal breastfeedingcounseling may be offered.

30-38

Authors: Rajan Bhandari, Sangita Kumari Khatri, Khadga Bahadur Shrestha

Background:Severe acute malnutrition is an excessive loss of weight due to the acute shortage of food or illness. It is one of the major public health problems in developing countries including Nepal. According to multiple indicator cluster survey (MICS) 2014, 2.6% severely malnourished in Nepal and 4.4% are severely malnourished in Kavre district. However, there are limited studies about predictors of severe acute malnutrition in Nepal. Thus, this study was aimed to identify the predictors of severe acute malnutrition in Kavre district of Nepal. Methods: Health facility based matched case control study was conducted among 210 (70 cases and 140 controls) children aged 6-59 months from November 2015 to April 2016. Data was collected through face to face interview with mother of eligible children using structured questionnaires. Multivariate analysis was applied to estimate adjusted odds ratio along with 95% confidence interval.Results:Children with severe acute malnutrition were 11.32 times more likely than control to have recurrent diarrhea in past six months (95% CI=4.64-28.21). Similarly, severe acute malnutrition was associated with female sex (AOR=2.44, 95% CI=1.88-6.78), fathers occupation daily labor (AOR=4.69, 95% CI=1.17-13.76) and agriculture (AOR=6.850, 95%CI=3.81-12.93), improper exclusive breast feeding (AOR=6.646, 95%CI=2.11-20.90), not feeding colostrum (AOR=3.89, 95% CI=2.88-11.21), severe food insecurity access (AOR=3.55, 95% CI=1.85-9.77) and monthly income less than average level (AOR=8.214, 95% CI=1.43-22.16). Conclusion: Severe acute malnutrition was independently associated with sex of child, occupation of father, monthly household income, not feeding colostrum, improper exclusive breast feeding, severe household food insecurity access and recurrent diarrhea.