International Journal of Child Health and Nutrition

132-137E

Authors: R.A. Mustapha, A.A. Oladapo, T.M. Akinola, J.V. Akinlotan, A.P. Oluwagunwa

The growth rate from birth to three months of some breastfed and non-breastfed infants age 0 – 12 weeks delivered in hospitals at Owo metropolis was evaluated with a view to know the effect of breastfeeding on growth rate. A total of one hundred (100) breastfed and non-breastfed neonates were purposely selected in the neonatal sections of three hospitals in Owo, March 2012. Anthropometry measurement was used to assess growth rate for length, weight, head and mid upper arm circumference of the infants on weekly basis using standard length board, digital weighing scale and shakir tape for twelve weeks. Epi-info 2008 nutritional software was used to determine length for – age z-score, weight for – age z-score, Head and mid-upper arm for age z – scores. Data were analyzed using SPSS soft ware (version 17.0). Results show that the rate of growth in length per week ranged between 0.5 – 1.0cm within 4th to 12th weeks of growth while an average rate of growth in weight of 100 – 400g was discovered between 2nd to 6th weeks of growth among both breastfed and non-breastfed infants. Observation shows that between birth to 4th week formula fed babies tend to be leaner in weight compared to their breastfed counterpart which maintained stable weight within this period. The study shows that breastfeeding significantly (P> 0.05) affect rate of growth among the breastfed infants. Growth pattern of infant skewed toward – 2 and 0 when compared with the NCHS/CDC reference population growth curve. In all, 2% of the breastfed and 8% of non-breastfed were severely underweight. There is no alternative to breastfeeding at this critical stage of life for optimum growth of infants. Therefore, mothers should be encouraged to breastfeed exclusively for 6th months in order to achieve optimum growth and development

144-158

Authors: Byron Chapoterera, J. Chideme Maradzika, Anesu Marume, Admire Zikiti

Background: The dietary patterns are becoming a major public health concern. The current data from various studies in Zimbabwe shows that there was an increase in the prevalence of obesity among secondary school adolescents in Harare. There is a link between eating habits and obesity. This study was conducted to explore the factors influencing dietary practices among adolescents in Zimbabwean schools. Methods:A school based analytic cross sectional study was conducted with 283 pupils aged 13-19 years. Systematic random sampling was used. Data was collected using self-administered questionnaire based on the ecological framework. The aim of the study was to identify the relationship between dietary patterns and occurrence of obesity. Bivariate and multivariate logistic regression analysis was used to identify the relationship between dietary patterns and obesity. Findings: The prevalence of obesity was 11.4%. Females were 6.79 (95% CI: 2.17-21.22 p=0.001) more likely to be obese. Consumption of sugar and sweetened beverages were associated with occurrence of obesity; beverages (AOR=3.62, 95%CI=1.99-10.91 p=0.025); eating of snacks in between meals (AOR=2.40, 95%CI=1.03-5.64 p=0.004); so was being located in high density suburb (0R=0.45, 95CI=0.21-0.99 p=0.023); consuming burgers (OR=4.41, CI=1.54-12.64 p=0.006); being a pupil in lower adolescent with age less than 16 (OR=1.99 95%CI=0.99-4.27 p=0.038). Consuming a special diet that is recommended or as a choice was protective from obesity though this was not statistically significant. Not removing visible fat from meat was a risk factor for developing obesity. Eating the traditional maize meal staple food, sadza was protective to being obese (OR=0.3514, 0.16-0.78)Conclusions: The study showed that obesity is a cause for concern among school children as seen by 11.4% prevalence. Choice of meals is done by parents, eating a home cooked meal such as sadza, participating in meal planning was found to be reinforcing factors. There is need to create awareness on students, parents, teachers and the wider community to increase the adoption of healthy dietary practice among school children.

98-104

Authors: Onwaree Sukhosa, Kulnipa Kittisakmontri

Background: Hospitalized children are at risk of malnutrition and vulnerable for many adverse outcomes. Objectives: This study aimed to determine the prevalence of hospital malnutrition in pediatric patients admitted at Chiang Mai University (CMU) hospital and evaluate correlation between malnutrition and outcomes including length of hospital stay (LOS), total hospital cost and mortality.Methods and Study Design: A prospective cohort study was conducted at CMU hospital. Patients aged 1 month to 15 year-old who admitted to general pediatric wards were included. Demographic data, anthropometric assessments including weight, length/height and outcomes were collected. Malnutrition was classified by the WHO growth reference. Results: A total of 217 patients with mean age 68.8 ± 53.8 month-old were analyzed. Majority of them were male (65.4%) while leading diagnosis were oncologic, infectious and congenital heart diseases. The prevalence of all malnutrition was 59.9%. According to the WHO classification, percentages of the patients who were stunted, wasted, both of stunted and wasted, and overweight were 29.9%, 9.2%, 17.1%, and 3.7%, respectively. Moreover, compared to previous study of this center in 1985, more than half of hospitalized children have still assessed as under-malnourished patients. For the hospital outcomes, wasting regardless of stunting had significantly longer LOS (8 vs 5 days, p = 0.001) and higher hospital expenditure (37,283.0 vs 23,630.0 Baht, p = 0.004) while mortality was not different. Conclusions: The prevalence of malnutrition in hospitalized children is common and remains unchanged. Acute malnutrition significantly impact on total hospital cost and prolong LOS comparing with other groups

110-115

Authors: Mohammad El Azhari, Ahmad Abu Slaih, Yousef S. Khader, Abdulhalim Al-Musa, Ibrahim Iblan

Objectives:There is scarcity of data on malnutrition among children in Jordan. Therefore, this study was conducted to assess the nutritional status and estimate the prevalence rates of stunting, underweight, and wasting and their associated factors among children under five. Subjects and Methods:A cross-sectional study was conducted between January and April 2017 among children under five years in Amman, Jordan. All Jordanian children under five years who visited the selected health centers for vaccination or accompanied their mothers during the study period were included in this study. Mothers or caregivers of children were interviewed face-to face using the study questionnaire. Weight in kilograms and height in centimeters were measured for all children. Anthropometric indices were calculated using reference medians recommended by the World Health Organization.Results:This study included a total of 923 (463 boys and 460 girls) children. The prevalence rates of stunting, underweight, and wasting were 6.2%, 3.8%, and 2.8%, respectively. Multivariate analysis showed that low birth weight was significantly associated with stunting (OR = 2.9, 95% CI: 1.4,6.0; p-value=0.003) and underweight (OR =5.6, 95% CI: 2.5,12.3, p-value <0.001). Compared to exclusive breastfeeding, mixed feeding was associated with increased odds of stunting (OR =2, 95% CI: 1.1-3.9, p-value =0.029) and underweight (OR = 2.2, 95% CI: 1.002, 5.0; p = 0.049). None of the variables were significantly associated with wasting.Conclusions:The prevalence rates of stunting, wasting and undernutrition among children under five years in Jordan are low. Low birth weight and mixed feeding were associated with higher rates of malnutrition.

62-69

Authors: Camille Jung, Laurence Beck, Thierry Hanh, Marc Bellaiche

Background:Functional gastrointestinal disorders (FGID) are very common during infancy, leading to frequent medical consultations. The aim of this large, prospective study was to assess the quality of life (QoL) and clinical management of infants with FGID.Methods: Completely or partially bottle-fed infants under 5 months old, presenting one or more FGID (regurgitation, constipation, diarrhea, crying/fussing), were enrolled during initial consultation by 111 pediatricians in private practice throughout France and reassessed at one month. Parents were asked to complete the QUALIN QoL questionnaire at inclusion and at Day 15. Results:A total of 815 infants (mean age 2.1±1.2 months) were evaluable. Mean QoL score improved from +27.2±15.1 at inclusion to +38.0±12.9 at day 15 (p<0.0001) irrespective of FGID symptoms. Multivariate analysis indicated that younger age, dietary advice, and partial breastfeeding were associated with better QoL outcome. Gastrointestinal symptoms showed significant regression at Day 30. The number of bottle feeds followed by external reflux episodes decreased from 80.0±27.4% to 36.1±31.4% at Day 30 (p<0.0001), the weekly number of stools increasing from 3.9±4.0 to 8.0±3.7 (p<0.0001). Conclusion: Medical management based on information, reassurance, lifestyle advice and dietary intervention improved QoL in infants with FGID and led to a reduction in FGID symptoms

80-89

Authors: Firas S. Azzeh

Background: The World Health Organization (WHO) recommends optimal feeding practices during infancy and early childhood for better health and growth of children. Objective: To determine the factors affecting exclusive breastfeeding (EBF) duration and the time of introducing complementary feeding (CF) in Mecca City, Saudi Arabia.Methods: This cross-sectional study recruited 814 Saudi mothers. All mothers filled out a closed questionnaire on family sociodemographics, health status of mothers and infants, and postpartum breastfeeding habits and patterns. The patterns of CF and bottle-feeding were examined, and binary logistic regression was performed.Results: The mean ± standard deviation EBF duration was 4.6 ± 2.5 months. The EBF rate showed a sharp decrease from 50.6% at birth to 14.4% at 6 months among children. Employment of mothers, weight at childbirth <2.5 kg, weight of 2.6–3 kg at child birth, postnatal disease in infants, and pacifier use for infants were associated with a low EBF rate. Intermediate education of the mother was found to increase EBF duration as compared to mothers with higher levels of education. Most mothers introduced plant-based CFs to infants at 4 months of age (median), but animal-based CFs were introduced only after 8 months (median). The median age of starting milk formula was 3 months. Conclusion and Recommendation: The reported rate of EBF is far below the current international recommendations. The patterns of CF practices and bottle-feeding differ widely from the WHO recommendations in Mecca City. National campaigns should be implemented to promote EBF in Saudi Arabia

16-33

Authors: Jocelyn E. Finlay, Melanie K. Norton, Iván Mejía- Guevara

Introduction:Contributing to the Sustainable Development Goals, Global Goals, Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030, we clarify the interaction between maternal age, parity and birth intervals to examine the effects on child health. Methods:We use Demographic and Health Survey data from 33 sub-Saharan African countries, and apply multivariate Poisson and logistic models to first examine the effect of maternal age (15-17, 18-19, 20-24, 25-29, 30-39) on infant mortality and stunting, then modify this relationship by parity and account for the confounding effects of short birth intervals. Results:We find that poor infant mortality outcomes of children born to teen mothers are driven by higher parity children, not first-born children. While first-born children of teen mothers are at a high risk of stunting, they are likely to survive. Short birth intervals have a negative effect on infant survival and stunting outcomes. But controlling for short birth intervals does not completely offset the effect of young age at birth on child survival outcomes. Discussion:High parity children of young mothers are at a high risk of infant mortality, driven in part – but not completely – by short birth intervals. Policies aimed at delaying first birth are warranted, but should not overshadow the need to support adolescent mothers at risk of multiple births that are tightly spaced.

43-53

Authors: Aysen Akay, Emre Yanikkerem

Background:The aim of the population-based study was to determine prenatal, obstetric, neonatal outcomes and contraceptive behaviors in women with four or more pregnancies. Methods:This study was conducted with women (n=294) using a questionnaire in two family centers of Manisa, Turkey where the fertility rate was high. Results:In the study, the mean number of pregnancies was 5.6±1.5. Loving children, willing to have a larger family and to have a male child were determined the main reasons of extreme fertility. Although 93.2% of women did not desire to have children in the future, only 43.3% of them used a birth control method. The rates of gestational diabetes, hypertension, depression, physical violence, lower weight of baby, risk of miscarriage, preterm birth and cesarean section were higher in the women with more pregnancies. Conclusions:It is very important to provide women with more pregnancies who had unmet need with client-centered counseling to encourage them to use more effective methods.