Search

BACKGROUND: Diet quality during infancy can influence nutrient intake and ultra-processed foods (UPFs) consumption throughout later childhood. OBJECTIVES: This study investigated the predictive validity of Infant Diet Quality Index (IDQI) scores from 0 to 1 y of age and consumption of select nutrients and UPFs at different time points in low-income children aged 2-5 y. METHODS: Dietary surveys and 24-h dietary recalls collected between ages 0 and 12 months from 2613 Special Supplemental Women, Infants, and Children Infant Toddler Feeding Practices Study-2 participants were used to assess infant diet quality by final IDQI score ranging from 0 (nonadherence to dietary guidelines) to 1 (complete adherence to guidelines). Single 24-h recalls collected across multiple time points per child aged between 2 and 5 y were used to determine nutrient intakes: vitamin B12 (μg), vitamin D (μg), calcium (mg), iron (mg), zinc (mg), potassium (mg), saturated fat (g), dietary fiber (g), and added sugars (g). Likewise, Nova was used to classify foods (to estimate the percentage of energy from foods) by level of industrial processing at each point in time across ages 2-5 y. Survey-weighted regression analyses estimated associations between total IDQI score and nutrient intake and percentage of energy consumption from each Nova food group at each age between 2-5 y. RESULTS: IDQI scores based on diet quality from 0-1 y of age were positively associated with childrens dietary fiber and potassium intake at ages 2-5 y. Additionally, IDQI was negatively associated with added sugar intake. No associations were observed between IDQI and saturated fat consumption. IDQI scores at age 1 were positively associated with the percentage of energy attributed to unprocessed/minimally processed foods (20%-23%) and negatively associated with UPF consumption at ages 2-5 y (-24% to -29%). CONCLUSIONS: IDQI predicts intake of select nutrients and UPF consumption among low-income US children aged 2-5 y.This trial was registered at https://clinicaltrials.gov/study/NCT02031978 as Feeding My Baby - A National WIC Study, NCT02031978.

Introduction: Although there are acceptable medical reasons for the use of food supplements, most prescriptions for newborns do not comply with current recommendations, putting continued breastfeeding at risk. This study aimed to create and validate a flowchart for newborn supplement prescription. Methods: The flowchart was created and submitted to two rounds of assessments by a panel of judges, who calculated the content validity index (CVI) (acceptable > 0.80). Flowchart use in clinical practice (applicability) was validated by professional prescribers through the resolution of 3 clinical cases. Data were analyzed using Pearson's chi-squared test (p < 0.05). Results: The flowchart was assessed by 17 judges and validated regarding its content (CVI = 0.84). Took part in validating the applicability of this study 169 doctors and nutritionists who work in maternal and child health. There was a statistical association between correct case resolution and flowchart utilization in two of the three clinical cases (p < 0.05). In situation 1, the use of a validated flowchart increased the likelihood of correct answers 7.76 times. Discussion: Prescribing baby formula is complex and requires careful assessment of several factors. Thus, knowledge translation is an effective intervention to eliminate the gaps between knowledge and clinical practice. The validated flowchart allows more assertive conduct regarding breastfeeding management and food supplement prescription for newborns. Significance: What is already known on this subject?: Inappropriate baby formula prescriptions are prevalent, posing a significant risk to exclusive breastfeeding by increasing early weaning rates. Although international guidelines provide clear recommendations for safe usage, health professionals often face challenges in translating these guidelines into clinical practice, resulting in inconsistent and suboptimal decision-making. What this study adds?: This study presents a validated flowchart designed to guide baby formula prescriptions, promoting alignment with international best practices. By comparing clinical decision-making processes with and without the tool, the findings highlight the flowchart's effectiveness in supporting evidence-based decisions, reducing breastfeeding-related risks, and serving as a valuable tool for education and training in maternal and child health. [ABSTRACT FROM AUTHOR]

Nowadays, vegetarian diets are present in a solid way in Western countries' lifestyles. Some families opt for this dietetic pattern for their infants too, during the period of introduction of complementary foods. Many releases have been issued about this subject, with different and often contradictory advice and conclusions. The aim of this work is to provide a comprehensive overview through the analysis of recently published opinions of the implementation of a vegetarian or vegan diet over the course of complementary feeding. The literature agrees about some key points to consider, that is the necessity for the diet to be well-planned, in order to meet energy, macro- and micronutrients requirements, as well as the need to follow the child longitudinally. Also, there is a substantial agreement on the need for fortified foods and/or supplements to be included in the diet. Following these suggestions, most (but not all) of the papers agree that normal growth and development may be achieved. Final considerations, however, are not straightforward to make and more research with better definition of the features of the diet adopted and of supplementation used and long-term follow-up studies are highly warranted. [ABSTRACT FROM AUTHOR]

Background/Objectives: The second highest prevalence of childhood malnutrition in the world is found in Nigeria. Infant and young child feeding practices (IYCF) are crucial predictors of the nutritional status of children. This study evaluated the effects of utilization of the BabyThrive app versus control on IYCF knowledge of Nigerian teenage mothers. Methods: A parallel, randomized controlled trial was conducted with 194 low-income teenage mother–child (0–2 years) dyads in Nigeria. Outcome measures included knowledge concerning food type for an infant, exclusive breastfeeding, complementary feeding, and total IYCF knowledge scores. Results: No significant differences in demographic characteristics or IYCF knowledge were found at baseline. Post-intervention, almost all BabyThrive participants vs. only 36.1% of controls were aware that expressed breast milk is the ideal food for an infant <6 months, when a mother resumes work (p < 0.05). As compared to the BabyThrive group, knowledge of how to maintain breast milk supply (5.2% vs. 83.5%), the duration of safety of breast milk at room temperature (15.4% vs. 85.6%), responsive feeding (58.8% vs. 96.9) and dietary diversity (15.5% vs. 99%) was substantially lower in controls (p < 0.05). Mean knowledge on exclusive breastfeeding (25.17 ± 1.37 vs. 19.87 ± 1.80), complementary feeding (15.68 ± 0.60, vs. 13.51 ± 1.21) and total knowledge scores (46.8 ± 1.79 vs. 38.65 ± 2.71) was higher in the BabyThrive group (p < 0.05). Conclusions: In sum, the BabyThrive app significantly increased maternal IYCF knowledge in comparison with controls. It will be a useful tool to improve maternal IYCF knowledge in resource-limited areas. [ABSTRACT FROM AUTHOR]

Background:: Early infant feeding is essential for children’s development and future health, particularly in preventing obesity, which is the most common nutrition-related disorder in children worldwide. Summary:: Obesity, characterized by excess body fat and numerous complications, arises from a combination of genetic susceptibility and an obesogenic environment, including lifestyle behaviors related to energy balance. Eating habits start to be shaped early in life, making the introduction of solid foods a critical period. Given the high prevalence of obesity, its long-term health consequences, and social implications, prevention is crucial. This narrative review aimed to identify factors related to the introduction of solid foods that influence obesity and suggest feeding strategies to prevent it. Tracking studies indicate that overweight and obesity during childhood often persist into adulthood, with associated complications such as hyperglycemia, dyslipidemia, hypertension, and nonalcoholic fatty liver disease. Complementary feeding involves introducing solid foods besides breast milk or formula. The timing and content of complementary feeding are crucial in influencing obesity risk. Introduction of solid foods before 4 months is associated with higher BMI in childhood. The method of introducing complementary feeding, such as baby-led weaning, has been proposed to predict later obesity risk, though findings are currently inconclusive. Parental feeding practices and socioeconomic factors significantly influence complementary feeding and obesity risk. Early prevention programs, especially those involving parental education on responsive feeding and diet, are promising for reducing obesity risk. Future programs should incorporate parents’ perceptions and motivations to improve intervention effectiveness. [ABSTRACT FROM AUTHOR]

Background: To evaluate breastfeeding and complementary feeding practices and their determinants among infants and young children in the United Arab Emirates using the 2021 WHO/UNICEF IYCF guidelines. Methods: The Mother and Infant Study Cohort (MISC), is a prospective study of mothers recruited in their third gestational trimester and followed with their infants up to 18 months of age (n = 167). Data were collected at 3rd trimester, delivery, 2, 6, 12, and 18 months postpartum via questionnaires, review of medical records, anthropometric measurements, and 24-hour dietary recalls of the child's intake at 6, 12, and 18 months. Descriptive statistics and multiple logistic regressions were used to report on feeding practices and their determinants. Results: Ever breastfeeding, Early initiation of breastfeeding, and exclusive breastfeeding under 6 months were reported by 84.3%, 99.4%, and 32.9% of participants, respectively. Of children, 96.4% consumed solid foods at 6–8 months; 68.7% and 44.7% continued to be breastfed at 12 and 18 months, respectively. Despite improvement with age; several complementary feeding indicators remained suboptimal at 18 months: Minimum Dietary Diversity: 40.4%, Minimum Meal Frequency: 56.7%, Minimum Acceptable Diet: 23.1%, Sugar-Sweetened Beverages, 26.9%, Zero Vegetables and Fruits: 28.8%, Unhealthy Food Consumption: 65.4%. After adjustment, multiparous mothers had higher odds of exclusive breastfeeding, whereas pregnancy complications were associated with lower odds of exclusive breastfeeding. Continued breastfeeding at 18 months was associated with older age among mothers and lower income. Among the factors associated with complementary feeding indicators were higher physical activity and Minimum Dietary Diversity. While Gestational Diabetes Mellitus, Sugar-Sweetened Beverages, and higher education were associated with lower odds of Zero Vegetables and Fruits, and a higher income was associated with lower Unhealthy Food Consumption. Conclusions: This study reported good rates of Early initiation of breastfeeding and ever-breastfeeding, yet suboptimal exclusive breastfeeding and complementary feeding. The identified risk factors for inappropriate practices could be used to guide nutrition interventions and public health programs in the United Arab Emirates. [ABSTRACT FROM AUTHOR]

Background: Undernutrition among children is a public health concern in most low and middle-income countries (LMICs) and is associated with poor child growth and development. Knowledge about child feeding practices is needed for nutritional policies and programs. Hence, this study assessed the status of minimum acceptable diet (MAD) and its associated factors among children aged 6–23 months in Afghanistan. Methods: This cross-sectional study was based on a secondary dataset of the 2022–2023 Afghanistan Multiple Indicator Cluster Survey (MICS 2022–23). Complete data from 7,876 children aged 6–23 months were analysed. The outcome variable was MAD and was defined according to the WHO and UNICEF recommendations and indicators for young child feeding practices. Bivariate and multivariate binary logistic regression analyses were used to identify factors associated with MAD. Results: About 7.3% of children aged 6–23 months were fed with the recommended MAD. The likelihood of receiving MAD was higher in children aged 13–18 months [adjusted odds ratio (AOR) 2.01 (95%CI: 1.63–2.48)] and 19–23 months [2.11 (95%CI: 1.68–2.66)], in children belonging to households with higher wealth status [1.39 (95%CI: 1.04–1.87), 2.06 (95%CI: 1.51–2.82), and 3.07 (95%CI: 2.14–4.40) for the 3rd, 4th, and 5th quintile of wealth status, respectively], and in children living in rural areas [1.56 (95%CI: 1.21–2.01)]. On the other hand, the maternal age group 30–39 years [0.79 (95%CI: 0.64–0.96)] and non-institutional delivery [0.67 (95%CI: 0.54–0.83)] were associated with reduced odds of MAD. Conclusion: Our study revealed that a small percentage (7.3%) of children received MAD in Afghanistan. This emphasizes the need for policies and interventions aimed at the improvement of child feeding practices to ultimately lead to better child nutrition and health in Afghanistan. [ABSTRACT FROM AUTHOR]

Background: Complementary feeding is crucial for infant growth, but poor hygiene during this period increases the risk of malnutrition and illness. In Ethiopia, national data on hygiene practices during complementary feeding, particularly among mothers of children aged 6–24 months, is limited. This study aims to synthesize existing data through a systematic review and meta-analysis to evaluate the status of hygiene practices and identify key influencing factors, informing public health strategies to improve child health outcomes. Methods: The systematic review methods were defined following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search strategy was implemented using electronic databases (Medline, Global Health, Google Scholar, Web of Science, Embase, CINAHL, and Psyc INFO) as well as grey literature. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to assess the quality of the studies. The meta-analysis was conducted using STATA 17 software to compute pooled prevalence and odds ratios (OR) for the determinant factors, with a 95% confidence interval (CI). Results: The systematic review and meta-analysis included six studies with 2,565 mothers. The overall pooled prevalence of hygienic practices during complementary feeding was 42% (95% CI: 35%–48%). Subgroup analysis showed a prevalence of 41% in southern Ethiopia and 39% in northern Ethiopia. Significant factors associated with better hygiene practices included having hand washing facilities near toilets (AOR: 4.6, 95% CI: 1.04–8.31, p = 0.01) and a positive attitude towards hygiene (AOR: 2.7, 95% CI: 1.07–4.69, p < 0.05). Conclusions: This systematic review and meta-analysis found a low proportion of hygienic practices during complementary feeding in Ethiopia, with maternal attitude and access to hand washing facilities identified as key predictors. Training and counseling for mothers on safe food processing are recommended, along with further research on community interventions and the impact of socio-economic factors on hygiene practices. [ABSTRACT FROM AUTHOR]

Infant and young child feeding practices (IYCF) are crucial for children's growth and development but often deteriorate during periods of instability. A cross‐sectional survey conducted in three oblasts of Ukraine—Kyiv City and Kyiv, Lviv, and Odesa—enroled 724 children 0–23 months of age from 699 households. Using global WHO IYCF Guidelines, 12 indicators of optimal IYCF practices were evaluated. The study found IYCF practices to be relatively stable since 2015, despite the continued escalation of conflict, with an improvement in exclusive breastfeeding (EBF). EBF was reported by 51% of mothers, while breastfeeding was initiated early in 65% of children. Complementary feeding practices were optimal for most children, with 79% having a minimum acceptable diet. Infant formula assistance was independently associated with suboptimal breastfeeding practices in multi‐variable models. Children from households that received formula assistance had 67% (adjusted odds ratio [aOR] 0.33, 95% confidence interval [CI] 0.14–0.73) lower odds of being exclusively breastfed, 65% (aOR 0.35, 95% CI 0.20–0.61) lower odds of continued breastfeeding at 12 months, and 3.3 times (95% CI 2.31–4.78) higher odds of being bottlefed. Baby food assistance did not independently predict a minimum acceptable diet. High levels of optimal complementary feeding sustained since 2015 suggest protective factors for child nutrition in Ukraine, such as domestic agriculture and social safety nets. Additionally, maternal education was consistently linked to better IYCF outcomes, highlighting the need for targeted support for less‐educated mothers. The negative association of formula assistance with EBF warrants further research alongside reinforcement of guidelines to prevent inappropriate formula targeting. Key messages: Infant and young child feeding (IYCF) practices often decline during armed conflict. In Ukraine, key indicators have remained stable since 2015, although prevalence of optimal complementary feeding practice indicators continue to exceed that of breastfeeding practices.The sustained high levels of optimal complementary feeding underscore potentially protective factors for child nutrition present in Ukraine, such as domestic agriculture and social safety nets, that should be closely monitored and maintained.The link between formula assistance and reduced breastfeeding underscores the need for stricter enforcement and oversight of infant formula guidelines, alongside further research.Higher maternal education significantly predicted optimal feeding practices. IYCF programs should provide targeted support to caregivers with lower educational attainment. [ABSTRACT FROM AUTHOR]

Factors affecting the growth of HIV‐exposed‐uninfected (HEU) children are multi‐factorial, with limited information available on the dietary intake from 6 months. This study compared the dietary intake, micronutrient composition of breastmilk, and growth of HEU and HIV‐unexposed‐uninfected (HUU) infants aged 6 and 12 months in an urban setting. A repeated cross‐sectional study used structured questionnaires to collect socio‐demographic, dietary intake, food group data, and anthropometric measurements in the Siyakhula study. The HEU (48%) and HUU (52%) infants were included (total n = 181). At 6 months, HEU infants had lower weight‐for‐age z‐scores (WAZ) (−0.6 ± 1.1 vs. 0.1 ± 1.2; p < 0.001), length‐for‐age z‐scores (−0.8 ± 1.4 vs. −0.1 ± 1.2; p < 0.001), and mid‐upper‐arm circumference‐for‐age z‐scores (MUACAZ) (0.5 ± 1.1 vs. 1.0 ± 0.9; p < 0.001) than HUU infants. At 12 months, HEU infants had lower WAZ, MUACAZ, and weight‐for‐length z‐scores compared to HUU infants (p < 0.05). Stunting was found at 6 (15%) and 12 (12%) months in HEU infants. The micronutrient composition of breastmilk fed to both groups was similar. Breastfeeding rates were lower in HEU than in HUU infants at 6 (49% vs. 64%; p = 0.005) and 12 (24% vs. 46%; p = 0.002) months. Less than 3% of HEU and HUU infants achieved minimal dietary diversity scores at 12 months. Dietary intake of fat was similar in all breastfed infants, but iron and vitamin B12 were higher in non‐breastfed HEU infants at 12 months. HEU infants had lower breastfeeding rates than HUU infants. A lack of dietary diversity was found in all infants. Nutrition education and counselling in the complementary feeding phase are essential for optimal growth. Key messages: HIV‐exposed‐uninfected (HEU) infants had lower growth than HIV‐unexposed‐uninfected (HUU) infants at 6 and 12 months, but HEU infants could catch up on growth at 12 months. Stunting and underweight were high in HEU infants.At 6 and 12 months, breastfeeding rates were lower in HEU than in HUU infants with a lack of continued breastfeedingDietary diversity was low in HEU and HUU infants, but flesh food consumption was higher in HEU than in HUU infantsDietary intakes were higher in breastfed HEU than HUU infants; HEU infants had better dietary macro‐ and micronutrient intakes than HUU infants. [ABSTRACT FROM AUTHOR]

Emerging research suggests that a more infant‐led approach to complementary feeding may confer benefits for child language, but these findings are based on parent report studies. Using an observational approach this study examines whether different complementary feeding experiences relate to infant language exposure and language use. Fifty‐eight parents recorded a typical infant mealtime in the home (mean infant age = 14 months, SD = 4.15). Observations were coded to measure the prevalence of infant‐led and parent‐led feeding using the Family Mealtime Coding Scheme. Caregiver language use (word types and token directed at the child, mean length of utterances in child‐directed speech, responsiveness and initiations) and the number of infant vocalisations were coded in ELAN using CHAT conventions and parents completed the MacArthur Communicative Development Inventory short form as a measure of child language. Greater observed infant self‐feeding was significantly associated with greater observed exposure to language from caregivers (r = 0.312 percentage of infant self‐feeding correlated with caregiver word types directed at the child) and a greater number of infant vocalisations (r = 0.320 percentage of infant self‐feeding correlated with number of child vocalisations produced). Structural Equation Modelling showed the relationship between infant self‐feeding and infant vocalisations to be significantly mediated by enhanced quality and quantity of caregiver child‐directed speech (model fit: χ2 [5] = 5.01, p = 0.415, CFI = 1.00 [NF = 0.98], RMSEA = 0.006). Differences in the approach to complementary feeding may shape infant's experiences in ways that support language exposure and use. Autonomy associated with infant self‐feeding may enhance opportunities for social interaction. Summary: The complementary feeding period has lifelong consequences for health and well‐being. A more infant‐led approach to feeding which offers the child more independence to feed themselves has been associated with positive eating behaviour outcomes for children.During home‐based mealtime observations, infants who fed themselves more often also produce more vocalisations at mealtimes. These infants were also more likely to be exposed to language from their caregivers.The relationship between infant self‐feeding and infant vocalisations was explained by the greater quality and quantity of caregiver speech directed at the infant.Greater infant autonomy associated with infant self‐feeding may enhance opportunities for social interaction.The different ways that infants are offered food during the complementary feeding period can shape infant's experiences in ways that may support their language exposure and language use. [ABSTRACT FROM AUTHOR]

This study aimed to define complementary feeding trends in Guinea from 2005 to 2018 and complementary feeding risk factors at the individual, household, and community levels. Data from 2005 to 2018 demographic health surveys (DHS) and Multiple Indicator Cluster Surveys were used to describe complementary feeding trends in Guinea. The most recent DHS was used to examine complementary feeding risk factors at the individual, household, and community levels. Complementary feeding indicators including introduction to complementary foods (INTRO), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) were calculated based on the 2010 World Health Organisation guidance. Multivariate logistic regressions were used to identify significant risk factors (p < 0.05). Since 2005, there has been a marginal increase in MDD and MAD, but a decrease in INTRO and MMF. The 2018 DHS survey revealed various complementary feeding risk factors. At the individual level, travelling 1–60 min to get water was associated with decreased odds of meeting INTRO, while iron supplementation and maternal education were associated with increased odds of meeting MMF and MDD, respectively. Routine vitamin A supplementation, fever in the past 2 weeks, and low birth weight were associated with increased odds of meeting MAD. At the household level, being in a lower wealth quintile was associated with decreased odds of meeting MDD and MAD. National and subnational programmes and policies designed to improve infant and young child diets may consider tailored approaches that address the specific indicators and risk factors associated with poorer diets in this Guinean context. Key messages: Between 2005 and 2018 there has been an increase in minimum dietary diversity (MDD) and minimum acceptable die (MAD), but a decrease in INTRO and minimum meal frequency (MMF).As of 2018, 49.9% of infants were introduced to complementary foods between 6 and 8 months of age, 25.0% met MMF, 15.2% met MDD, and 4.4% met MAD.Individual (child vitamin A and iron supplementation, child fever, low birth weight, maternal education, delivery with the help of birth attendant) and household (wealth quintile) level factors were identified as key risk factors for complementary feeding practices. [ABSTRACT FROM AUTHOR]

Although complementary feeding (CF) and maternal attitudes towards infant feeding are known to affect the nutritional status of infants during the neonatal period, studies in this field remain limited. The present study aimed to determine CF practices for infants aged 6–12 months who live in Turkey and maternal attitudes towards infant feeding. In addition, the effects of CF practices and maternal attitudes on the nutritional status of infants were examined. This study included 720 infants, of whom 289 were aged 6–8 months and 431 were aged 9–12 months. CF status was assessed using the CF index (CFI), and maternal attitudes towards infant feeding were measured using the Iowa infant feeding attitude scale (IIFAS). The weight and length measurements of infants were categorized using z‐scores. Infants with weight‐for‐age z‐score (WAZ) and weight‐for‐length z‐score (WLZ) of less than −2 standard deviation were categorized as malnourished. Mothers of malnourished infants were found to have lower CFI and IIFAS scores (p < 0.05). Consistency of fruit feeding and complementary foods in the first 3 days of CF was associated with WAZ. The mothers' level of knowledge about CF and appropriate CF practices significantly affects the nutritional status of infants. The tools used in the present study to monitor CF practices should be incorporated into public health programmes. Key messages: The mothers' level of knowledge about complementary feeding and appropriate practices significantly affects the nutritional status of infants.Mothers of malnourished infants were found to have lower complementary feeding practices.The mode of delivery was found to affect both weight‐for‐age and weight‐for‐length z‐scores of infants.Fruit feeding for the first 3 days affected weight‐for‐age z‐scores negatively. [ABSTRACT FROM AUTHOR]

The nutrition transition in sub‐Saharan Africa has led to increased consumption of ultra‐processed foods in infancy, especially sweet foods. This has heightened the risk for nutrition‐related non‐communicable diseases, including dental caries and overweight/obesity, and promotes poor food choices later in life. The present study used a cross‐sectional design to investigate the consumption frequency of ultra‐processed foods and beverages among urban 6‐ to 36‐month‐olds attending four selected health facilities in Kampala using a standardised questionnaire and 24‐h diet recall record. The primary outcome was the consumption of at least one ultra‐processed food or beverage (UPFB) the previous day, and frequency of UPFB consumption of the week before was the secondary outcome. Four hundred and ten caregiver–child pairs were randomly recruited, 94% of caregivers being mothers with a mean age of 30.7 (±5.3) years. Fifty‐nine per cent of mothers and 73% of fathers had attained a college education. The median age of children was 18 months and 51% were female. Most children (57%) consumed at least one UPFB the previous day. In the week before, 69% had consumed UPFB frequently (4–7 days) which was significantly positively associated with maternal education (odds ratio [OR] = 2.85, 95% confidence interval [CI]: 1.02–7.96, p = 0.045) and child's age ([OR = 2.87, 95% CI: 1.62–5.08, p < 0.001], [OR = 3.68, 95% CI: 1.88–7.20, p < 0.001]). In conclusion, the dietary habits of the surveyed Ugandan population were unhealthy, characterised by the frequent consumption of UPFB with added sugar. There is an urgent need to re‐enforce existing Ugandan food regulation guidelines and policies and to build strong nutritional education programmes to enhance health‐promoting environments in early childhood. Key messages: The frequent consumption of ultra‐processed food or beverage (UPFB) in a Ugandan urban population during the complementary feeding period is an indication of an established nutrition transition.The frequent consumption of UPFB is characterised by a high sugar content and sweetened diet and therefore the potentially has health detriments in young children.There is an urgent need to promote traditional diets and minimally processed foods for complementary feeding and introduce policies that discourage consumption of UPFB in early childhood. [ABSTRACT FROM AUTHOR]

Optimal nutrition during infancy is critical given its influence on lifelong health and wellbeing. Two novel methods of infant complementary feeding, commercial baby food pouch use and baby‐led weaning (BLW), are becoming increasingly popular worldwide. Household food insecurity may influence complementary feeding practices adopted by families, but no studies have investigated the use of BLW and baby food pouches in families experiencing food insecurity. The First Foods New Zealand study was a multicentre, observational study in infants 7.0–9.9 months of age. Households (n = 604) were classified into one of three categories of food insecurity (severely food insecure, moderately food insecure, and food secure). The use of complementary feeding practices was assessed via a self‐administered questionnaire, both at the current age (mean 8.4 months) and retrospectively at 6 months. Mothers experiencing severe food insecurity had 5.70 times the odds of currently using commercial baby food pouches frequently (≥5 times/week) compared to food secure mothers (95% CI [1.54, 21.01]), reporting that pouches were 'easy to use' (89%) and made it 'easy to get fruits and vegetables in' (64%). In contrast, no evidence of a difference in the prevalence of current BLW was observed among mothers experiencing moderate food insecurity (adjusted OR; 1.28, 95% CI [0.73, 2.24]) or severe food insecurity (adjusted OR; 1.03, 95% CI [0.44, 2.43]) compared to food secure mothers. The high prevalence of frequent commercial baby food pouch use in food insecure households underscores the need for research to determine whether frequent pouch use impacts infant health. Key messages: Commercial baby food pouches are a popular method of complementary feeding among food insecure households, with almost two‐thirds of mothers who were experiencing food insecurity using pouches frequently.Mothers in food insecure households who used pouches frequently reported using pouches primarily for reasons of convenience and because they considered them to be nutritious.Research investigating the impact of frequent pouch use on infant nutrient intake and health is needed to inform advice given to families by health professionals. [ABSTRACT FROM AUTHOR]

Background: The Mycotoxin Mitigation Trial (MMT) was a community-based cluster-randomized trial designed to assess the effect of dietary aflatoxin (AF) on linear growth. Similar dietary intake between arms was an important component of the trial's program theory and essential for the trial's internal validity and interpretation. Objective: This analysis assessed and compared dietary intake by arm within a sub-sample of infants enrolled in the MMT. Methods: Twenty paired clusters (10 per trial arm) out of the 52 MMT clusters were included in this sub-sample. Up to 15 maternal/infant dyads per cluster were randomly selected for a one-time, structured, multi-pass 24 h dietary recall. Data were collected at the midpoint of the trial, when infants were 12 months of age, over 8 calendar months. We evaluated and compared infant nutrient intake and adequacy of energy, protein, lipid, iron, zinc, calcium, and vitamin A between study arms. Nutrient intake by arm was estimated using mixed-level regression models. Results: A total of 282 mothers participated (n = 140 intervention arm and 142 standard of care (SoC) arm). The mean daily intakes of energy and lipid fed to infants were 505 kcal/day (SD = 225.9) and 13 g/day (SD = 6.9), respectively, in the intervention and SoC arms, with no difference between arms. Intervention infants consumed slightly more protein than SoC infants (13.7 v. 12.3 g/day, p = 0.02). Consumption of iron, zinc, calcium, and vitamin A were low and did not differ between arms. Conclusions: At the midpoint of the MMT, energy, lipid, and micronutrient intake did not differ between arms. Protein consumption was slightly greater in the intervention arm. Guided by the trial's program theory, this analysis advances the interpretation of the MMT trial findings. [ABSTRACT FROM AUTHOR]

Poor breastfeeding and complementary feeding practices are widespread. The beneficial effect of breastfeeding depends on correct breastfeeding practices like timely initiation, colostrum feeding, and avoidance of prelacteal feeding. Breastfeeding support from healthcare professionals can be effective in influencing a mother’s decision to initiate and maintain breastfeeding. To assess knowledge, and perception regarding breastfeeding and complementary feeding and to identify various misconceptions about breastfeeding among nursing students. This descriptive, cross-sectional study was conducted among 120 Nursing students by the Department of Community Medicine, NDMC Medical College and Hindu Rao Hospital Delhi, India. The information was collected by interviewing the nursing students with the help of pretested, predesigned proforma. Statistical Package for Social Sciences (SPSS), version 21 was used for analysis. In this study, significance was set at p

Abstract Background Undernutrition among children is a public health concern in most low and middle-income countries (LMICs) and is associated with poor child growth and development. Knowledge about child feeding practices is needed for nutritional policies and programs. Hence, this study assessed the status of minimum acceptable diet (MAD) and its associated factors among children aged 6–23 months in Afghanistan. Methods This cross-sectional study was based on a secondary dataset of the 2022–2023 Afghanistan Multiple Indicator Cluster Survey (MICS 2022–23). Complete data from 7,876 children aged 6–23 months were analysed. The outcome variable was MAD and was defined according to the WHO and UNICEF recommendations and indicators for young child feeding practices. Bivariate and multivariate binary logistic regression analyses were used to identify factors associated with MAD. Results About 7.3% of children aged 6–23 months were fed with the recommended MAD. The likelihood of receiving MAD was higher in children aged 13–18 months [adjusted odds ratio (AOR) 2.01 (95%CI: 1.63–2.48)] and 19–23 months [2.11 (95%CI: 1.68–2.66)], in children belonging to households with higher wealth status [1.39 (95%CI: 1.04–1.87), 2.06 (95%CI: 1.51–2.82), and 3.07 (95%CI: 2.14–4.40) for the 3rd, 4th, and 5th quintile of wealth status, respectively], and in children living in rural areas [1.56 (95%CI: 1.21–2.01)]. On the other hand, the maternal age group 30–39 years [0.79 (95%CI: 0.64–0.96)] and non-institutional delivery [0.67 (95%CI: 0.54–0.83)] were associated with reduced odds of MAD. Conclusion Our study revealed that a small percentage (7.3%) of children received MAD in Afghanistan. This emphasizes the need for policies and interventions aimed at the improvement of child feeding practices to ultimately lead to better child nutrition and health in Afghanistan.

Abstract Background Complementary feeding is crucial for infant growth, but poor hygiene during this period increases the risk of malnutrition and illness. In Ethiopia, national data on hygiene practices during complementary feeding, particularly among mothers of children aged 6–24 months, is limited. This study aims to synthesize existing data through a systematic review and meta-analysis to evaluate the status of hygiene practices and identify key influencing factors, informing public health strategies to improve child health outcomes. Methods The systematic review methods were defined following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search strategy was implemented using electronic databases (Medline, Global Health, Google Scholar, Web of Science, Embase, CINAHL, and Psyc INFO) as well as grey literature. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to assess the quality of the studies. The meta-analysis was conducted using STATA 17 software to compute pooled prevalence and odds ratios (OR) for the determinant factors, with a 95% confidence interval (CI). Results The systematic review and meta-analysis included six studies with 2,565 mothers. The overall pooled prevalence of hygienic practices during complementary feeding was 42% (95% CI: 35%–48%). Subgroup analysis showed a prevalence of 41% in southern Ethiopia and 39% in northern Ethiopia. Significant factors associated with better hygiene practices included having hand washing facilities near toilets (AOR: 4.6, 95% CI: 1.04–8.31, p = 0.01) and a positive attitude towards hygiene (AOR: 2.7, 95% CI: 1.07–4.69, p

Background: Complementary feeding is crucial for children's growth and development, especially between the ages of 6 to 24 months. Adequate nutritional intake during this period can prevent long-term health issues, such as stunting and obesity. However, many mothers struggle with providing appropriate complementary feeding due to a lack of knowledge and inappropriate feeding practices. Objectives: This study aimed to assess the effectiveness of the Emotional Demonstration (Emo Demo) method in improving maternal knowledge, attitudes, and behaviors related to complementary feeding. Methods: Using a pretest-posttest control group design, 100 mothers with children aged 6 to 24 months were assigned to one of three groups: control (lecture), demonstration, and Emo Demo. Data were collected via questionnaires and observational assessments at multiple intervals to measure the sustainability of behavior changes. Statistical analyses, including ANOVA and Least Significant Difference (LSD) tests, revealed that the Emo Demo method significantly enhanced knowledge, attitudes, and feeding practices compared to traditional methods. Results: The study found no significant demographic differences between groups. ANOVA showed significant improvements in knowledge, attitudes, and behavior (p-value

Background: Wasting, an acute nutritional deficiency, is assessed using weight-for-height with a z-score of

Background: Although infant and young child feeding (IYCF) recommendations are widely accepted in South Africa, inappropriate IYCF practices still exist, leading to malnutrition in children.Objective: To investigate the IYCF practices of caregivers in Copesville, Pietermaritzburg (PMB).Design: A cross-sectional study was conducted.Setting: Masons Clinic, Copesville, PMB.Subjects: Two-hundred and fifty caregivers older than 18 years of age caring for a 6–24-month-old child at the time of the study.Outcome measures: A face-to-face questionnaire was developed using recent, relevant literature and was validated for the study.Results: The mean age of the caregivers was 32.25 (10.42) years. About 96% (n = 239) of infants were ever breastfed. The mean age at which breastfeeding was stopped was 5.9 ± 4.3 months. Mothers who were still breastfeeding planned to continue breastfeeding for a mean duration of 12.6 ± 5.6 months. About 60% (n = 149) of infants were started on solids at the appropriate age of 6 months. Lennon Entressdruppels (16.9%; n = 14), sugar water (15.7%; n = 13) and fruit and vegetables (13.3%; n = 11) were fed before the age of six months. Forty-nine caregivers (19.6%) consulted a traditional healer regarding IYCF. Non-edible items fed to cleanse the stomach included toothpaste and polish (5.6%; n = 8) and disinfectant solution (1.7%; n = 1).Conclusions: Caregivers should be educated on the benefits of continued breastfeeding until two years or beyond and the importance of starting solids at the appropriate age of six months. The potential dangers to the health of infants of feeding non-edible items should also be highlighted.

Frequency of instant food consumption and stunting in children aged 6-23 months Background: Stunting is related to feeding patterns: breastfeeding and complementary foods, especially in the first two years of life. Many commercial complementary food products, such as instant powder and biscuits, still do not meet iron and zinc content requirements. Objective: This study aims to determine the relationship between the frequency of instant food consumption and the incidence of stunting in children aged 6-23 months in Sleman Regency. Methods: This study is an analytic observational study with a cross-sectional design. The research sample was children aged 6-23 months in the working areas of the Minggir Public Health Center, Pakem Public Health Center, and Ngemplak 1 Public Health Center. The sample size for this study was 265 people, consisting of 125 boys and 140 girls. The sampling technique used simple random sampling. Data collected included the characteristics of the research subjects and respondents, frequency of instant food consumption, incidence of stunting, and history of infectious disease. Data analysis used the Chi-Square test. Results: Most children were not stunted (70.6%) and consumed instant food often (58.9%). There was no relationship between the frequency of instant food consumption and the incidence of stunting (p>0.05). There was no significant relationship between gender, age, history of diarrhea, history of pneumonia, mother's education level, mother's employment status, family income, number of family members, and frequency of instant food consumption with the incidence of stunting (p>0.05). A significant relationship exists between the history of acute respiratory infection and the father's education level and stunting incidence (p

Abstract Background Understanding the timing of food introduction in infants is essential for promoting optimal complementary feeding practices. However, existing studies often rely on cross-sectional data, limiting the ability to capture age-specific patterns. We aimed to describe food introduction during the first year of life by identifying patterns related to age at food introduction and associated factors in a cohort of Brazilian infants. Methods Data were collected through standardized questionnaires administered to mothers via face-to-face interviews during the infant’s first month of life and at 3, 6, 9, and 12 months of age. Additionally, two telephone interviews were conducted at 2 and 4 months of age. Information regarding food intake was assessed using a list of 48 foods, with two key aspects recorded: whether the food was introduced (yes/no) and the age at introduction. To define food introduction patterns, we employed k-means cluster analysis. Hierarchical Poisson multiple regression was employed to examine the associations between sociodemographic, biological, and healthcare factors and patterns of food introduction. Results Three distinct patterns were identified and named according to their main characteristics: Pattern 1 – “Low Infant Formula and Timely CF Introduction”; Pattern 2 – “High Infant Formula and Early CF Introduction”; and Pattern 3 – “High Infant Formula and Later Ultra-processed Food Introduction”. Breastfeeding at six months showed a positive association with Pattern 1 (PR = 1.40; 95% CI = 1.10–1.80), while bottle use at four months was negatively associated with Pattern 1 (PR = 0.68; 95% CI = 0.53–0.87). No variables studied exhibited an association with Pattern 2. For Pattern 3, higher prevalences were observed among children whose mothers were aged 34 years (PR = 1.42; 95% CI = 1.04–1.93). Not receiving guidance on the recommended duration of breastfeeding and complementary feeding during prenatal care was associated with a higher prevalence of children in this pattern (PR = 1.35; 95% CI = 1.01–1.80). Conclusions We identified three distinct patterns of age at food introduction in the study population, although none perfectly aligned with Brazilian or WHO dietary recommendations. These findings underscore the need for targeted interventions to promote timely and healthy complementary feeding practices in Brazilian infants.

Abstract Background While complementary feeding can be challenging, little emphasis has been placed on the introduction to food texture/pieces, especially in terms of neurodevelopmental outcomes. This study aims to determine the association between the timing of introduction to food pieces during infancy and neurodevelopment in early childhood. We hypothesized that late introduction to food texture/pieces relates to unfavorable neurodevelopmental outcomes. Methods Families (n = 18329) were recruited from the general population during the nationwide ELFE (Étude Longitudinale Française depuis l’Enfance) birth cohort in France, and 8511 were selected for a complete case analysis. Age at introduction to food pieces was determined based on repeated assessments during the first year. A range of neurodevelopmental outcomes among children were assessed using validated instruments, i.e. composite scores at 1 and 3.5 years, and a score for language acquisition at 2 years. Risk for developmental delay at 3.5 years was defined based on a developmental quotient (DQ) below 90 according to the child’s chronological age and the respective composite score at this age. We used linear regression modelling to evaluate associations between age at introduction to food pieces and the standardised neurodevelopmental scores, while logistic regression models were used in the analyses according to the risk for developmental delay. Results Our findings highlight consistent associations between late introduction to food pieces (i.e., after 10 months, compared to early (before 8 months)) and lower estimates of standardised neurodevelopmental scores at ages 1, 2 and 3.5 years (-0.35 [-0.40; -0.30], -0.15 [-0.20; -0.10] and − 0.18 [-0.23; -0.13], respectively). Infants introduced to pieces late were also more likely to be at risk for developmental delay according to DQ 10 months) is related to lower neurodevelopmental scores. Given the challenges that complementary feeding may pose, concerted efforts are required to enhance our understanding of the sensory aspects of early diets and to ultimately provide guidance.

Background Methods Results Conclusions Infant feeding plays a vital role in neurodevelopment, and a lack of breastfeeding and complementary feeding may increase the risk of developing attention‐deficit/hyperactivity disorder (ADHD). However, empirical evidence on this relationship remains uncertain, as most studies are based on cross‐sectional designs. Therefore, this study aimed to examine this temporal relationship using longitudinal data from a birth cohort.A retrospective cohort study was conducted using data from Wave I (starting at 6 months old, 2005–2006) to Wave IV (up to 5 years old, 2010–2011) of the Taiwan Birth Cohort Study. A total of 19,721 pairs completed the four‐wave interviews and provided information on infant feeding, medical history, ADHD occurrence, and sociodemographic characteristics. An extended Cox model with time‐dependent covariates was used to examine this association.In total, 207 infants developed ADHD during the 54‐month observational period, with an estimated cumulative incidence of 5.56 per 1,000 person‐years. The average breastfeeding duration was approximately 2 months. With complementary feeding, rice solid food (HR = 0.73) was found to be a protective factor against developing ADHD. Significantly associated factors for increasing ADHD risk included males, lower family income, low birth weight, maternal weight, advanced maternal age, child gastrointestinal disease, child seizures, maternal heart disease, and paternal diabetes mellitus.Complementary feeding within 6 months is important to protect infants from developing ADHD. The beneficial effect of breastfeeding within 6 months was not observed while controlling for other risk factors. However, owing to the limitation of a smaller number of ADHD cases, further studies should rely on larger observational periods. [ABSTRACT FROM AUTHOR]

Malnutrition is a prevalent issue among children aged 6-23 mo, particularly those with Down syndrome (DS), who face additional oral-motor and feeding challenges. Appropriate complementary feeding (CF) practices are crucial in achieving adequate nutrition for these children. This study aimed to determine whether maternal knowledge on infant and young child feeding (IYCF) recommendations were associated with the CF practices of mothers and the dietary fat -- specifically polyunsaturated fatty acid (PUFA) -- content of complementary foods given to children. Ten (10) mothers of children with DS aged 6-23 mo from low-income families participated. IYCF knowledge was assessed through a self-administered questionnaire, whereas maternal CF practices characterized by indicators minimum dietary diversity (MDD) and minimum meal frequency (MMF) were determined through an interviewer-administered questionnaire. Lastly, dietary fat was measured through a 2-d multiple pass 24-h food recall. Participants were found to have average to high knowledge of IYCF recommendations. The achievement of MDD and MMF among the children was low at 40% for both. Maternal IYCF knowledge is directly associated with MDD (Tb = 0.3563), inversely associated with MMF (Tb = -0.5345), and weakly associated with PUFA content (Tb = 0.0976). On the other hand, the overall dietary fat content of the diet of the children was strongly associated with their intake of total PUFA (p = 0.7697; α = 0.0092), omega-3 (p = 0.6832; α = 0.0294), and omega-6 fatty acids (p = 0.7091; α = 0.0217). This implies that as children consumed dietary fat as a common component of CF, they were also able to consume PUFA, which is essential for the brain function and development of children with DS. Further studies are recommended to increase sample size and explore other nutritional aspects of feeding infants and young children with DS. [ABSTRACT FROM AUTHOR]

Breastfeeding is important to infant health and survival in Sudan. Exclusive breastfeeding is considered an important criterion when practicing child nutrition, as infants consume only breast milk deprived of introducing any additional food or drink, not even water, and the child continues in this state for six months after birth. To effectively implement and promote breastfeeding in communities, it is necessary to understand the social and demographic factors relevant to infant feeding choices. This study examined cognitive trends regarding breastfeeding in a sample of mothers from the West Kordofan community. Methodology: About 576 housewives participated in descriptive cross-sectional study of children aged 59-60 months. The chosen structured questionnaire was used as the data collection method. The likelihood ratio with a confidence rate of 95% was also used to measure the strength of the association, and the statistical significance was determined at P-value <0:05. Result: The study showed that most of the responding mothers are aware of absolute breastfeeding. Nearly (80%) of the mothers are aware that breast milk alone is sufficient in the first six months. The research also explained that more than half of the study population (55%) have poor general knowledge, while (45%) of them have good knowledge. The analysis showed that the information of respondents from the study population has a significant relationship with the occurrence of diarrhea cases, vitamin A intake, and low birth weight. The analysis also shows the possibility of lower rates of diarrhea in children whose mothers have excellent knowledge of food and nutritional practices. [(95% CI: 0.492-0.874) p-v=0.004)]. Conclusion: Housewives' knowledge of breastfeeding has a significant relationship with the health status of children. Mothers' prior knowledge of vitamin A and its benefits contributed clearly and logically to eating foods rich in vitamins. p-v=0.000]. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion To evaluate agreement with the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) complementary feeding guidelines in a multiethnic community in Lisbon and to identify factors influencing complementary feeding practices among immigrant families.A cross‐sectional survey was conducted from January to March 2022 among caretakers of children aged 6 to 36 months at a primary healthcare facility in Lisbon, Portugal. A questionnaire collected data on demographics, socioeconomic status, complementary feeding practices, and sources of complementary feeding information. Agreement with ESPGHAN guidelines was assessed, and statistical analyses identified associations between complementary feeding inadequacies and socio‐demographic variables.Among 136 participants, 69% were immigrants. The prevalence of complementary feeding inadequacies was 53%, with early introduction of salt (28%) and tea (19%), and delayed introduction of gluten (15%) being the most frequent. Immigrant families exhibited higher rates of inadequacies. Healthcare professionals (71%) and family advice (13%) were the primary sources of complementary feeding information.Adherence to ESPGHAN complementary feeding guidelines was suboptimal, particularly among immigrant families. Tailored healthcare interventions that consider cultural and socioeconomic factors are necessary to enhance the complementary feeding practices. Further research is needed to monitor these practices and evaluate the effectiveness of culturally sensitive healthcare policies. [ABSTRACT FROM AUTHOR]

This integrative review aimed to summarise existing best evidence practice for preventing malnutrition within the First 1000 Days of Life in under-resourced communities. BioMed Central, EBSCOHOST (Academic Search Complete, CINAHL and MEDLINE), Cochrane Library, JSTOR, Science Direct and Scopus were searched as well as Google Scholar and relevant websites for grey literature. Most recent versions of strategies, guidelines, interventions and policies; published in English, focussing on preventing malnutrition in pregnant women and in children less than 2 years old in under-resourced communities, from January 2015 to November 2021 were searched for. Initial searches yielded 119 citations of which 19 studies met inclusion criteria. Johns Hopkins Nursing Evidenced-Based Practice Evidence Rating Scales for appraising research evidence and non-research evidence were used. Extracted data were synthesised using thematic data analysis. Five themes were derived from extracted data: 1. Improving social determinants of health using a multisector approach; 2. Enhancing infant and toddler feeding; 3. Managing healthy nutrition and lifestyle choices in pregnancy; 4. Improving personal and environmental health practices; and 5. Reducing low-birthweight incidence. Further exploration regarding preventing malnutrition in the First 1000 Days in under-resourced communities is required using high-quality studies. Systematic review registration number: H18-HEA-NUR-001 (Nelson Mandela University). [ABSTRACT FROM AUTHOR]

Background/Objectives: Early life gut microbiota plays a pivotal role in shaping immunity, metabolism, and overall health outcomes. This is relevant in healthy infants but may be even more crucial in infants with chronic devastating diseases, such as cystic fibrosis (CF). While the introduction of solid foods in healthy infants modifies the composition of colonic microbiota, less knowledge is available on those with CF. The aim of this descriptive observational study was to assess the composition of fecal microbiota in six exclusively breast-fed infants with CF, and then explore the changes induced upon the introduction of different foods. Methods: two types of fecal samples were collected from each subject: one during the exclusive-breastfeeding period, and the other after incorporating each new food in the ad libitum diet. The microbiota composition was analyzed by 16S rRNA amplicon sequencing. Results: Wide heterogenicity in the composition at the phylum level (variable proportions of Actinobacteriota, Proteobacteria, and Firmicutes, and the absence of Bacteroidota in all subjects) was found, and different enterotypes were characterized in each subject by the main presence of one genus: Bifidobacterium in Subject 1 (relative abundance of 54.4%), Klebsiella in Subject 3 (49.1%), Veillonella in Subjects 4 and 5 (32.7% and 36.9%, respectively), and Clostridium in Subject 6 (48.9%). The transition to complementary feeding induced variable changes in microbiota composition, suggesting a subject-specific response and highlighting the importance of inter-individual variation. Conclusions: Further studies are required to identify which foods contribute to shaping colonic microbiota in the most favorable way for patients with CF using a personalized approach. [ABSTRACT FROM AUTHOR]

Background: Complementary feeding is crucial for children's growth and development, especially between the ages of 6 to 24 months. Adequate nutritional intake during this period can prevent long-term health issues, such as stunting and obesity. However, many mothers struggle with providing appropriate complementary feeding due to a lack of knowledge and inappropriate feeding practices. Objectives: This study aimed to assess the effectiveness of the Emotional Demonstration (Emo Demo) method in improving maternal knowledge, attitudes, and behaviors related to complementary feeding. Methods: Using a pretest-posttest control group design, 100 mothers with children aged 6 to 24 months were assigned to one of three groups: control (lecture), demonstration, and Emo Demo. Data were collected via questionnaires and observational assessments at multiple intervals to measure the sustainability of behavior changes. Statistical analyses, including ANOVA and Least Significant Difference (LSD) tests, revealed that the Emo Demo method significantly enhanced knowledge, attitudes, and feeding practices compared to traditional methods. Results: The study found no significant demographic differences between groups. ANOVA showed significant improvements in knowledge, attitudes, and behavior (p-value<0.05). LSD analysis revealed significant changes in the Emo Demo group (p-value=0.010 for knowledge and behavior, p-value=0.028 for attitude), indicating its effectiveness in improving complementary feeding practices. Conclusions: Innovative and emotionally engaging methods like Emo Demo can effectively address the challenges of complementary feeding, ultimately contributing to public health efforts to reduce stunting in Indonesia. Further research is recommended to refine educational strategies for improving maternal nutrition practices in diverse communities. [ABSTRACT FROM AUTHOR]

Background: Wasting, an acute nutritional deficiency, is assessed using weight-for-height with a z-score of <-2SD from growth standards. The prevalence of wasting in Puskesmas Kendit is 14.31%, with Kukusan Village at 29%. Objectives: This study examined the correlation between exclusive breastfeeding, Complementary Feeding (CF), infectious diseases, and wasting in young children. Methods: Conducted with a cross-sectional design, the study sampled 51 toddlers through simple random sampling and analyzed the data using Spearman's correlation. Results: Findings revealed no significant correlation between exclusive breastfeeding and wasting (p-value=0.105). However, there was a significant correlation between CF and wasting (p-value=0.026). Nutrient intake, including energy (p-value<0.001), protein (p-value<0.001), fat (p-value=0.002), and carbohydrates (p-value=0.025), was significantly correlated with wasting, as was the presence of infectious diseases (p-value=0.001). Conclusions: While exclusive breastfeeding tends to reduce wasting, appropriate CF and adequate intake of energy, protein, fat, and carbohydrates are associated with a lower prevalence of wasting. Recommended actions include improving exclusive breastfeeding practices, enhancing the quality of CF, and increasing preventive measures for infectious diseases. [ABSTRACT FROM AUTHOR]

Background: Appropriate complimentary feeding (CF) has the potential to improve growth and development in infants from 6 months to 2 years of age. This study's aim was to assess the effect of a CF education program on the nutritional status of infants aged 3–12 months in the Polokwane Municipality. Methods: A longitudinal (non-randomized), quasi-experimental intervention study was conducted among 187 caregivers. The caregiver-infant pairs (CIPs) in the intervention group (n = 95) received CF education and a six-month telephone follow-up support. The CIPs in the control group (n = 94) received no intervention. We collected data at baseline and end line using structured questionnaires. Intervention effectiveness was evaluated by comparing mean changes in anthropometric measurements between intervention and control groups using difference-in-difference analysis. Per protocol, analysis was run. Results: The results show that the children in the intervention group gained more weight after the intervention, were taller, and the mid-upper arm circumference (MUAC) increased more than in the control group. At baseline, the weight of infants was 7.37 ± 0.83 and 6.69 ± 0.13 kg in the intervention and control. At end line, significant weight and length gain were observed in the intervention group (difference-in-difference (DID) = 1.82 kg, p < 0.001) and (DID = 7.78 cm, p < 0.01), respectively. The intervention group showed significant gain in MUAC of 1.68 cm (p = 0.047), with no noticeable effect on the head circumference at end line; DID (0.16 cm; p = 0.950). Conclusions: Community-based nutrition intervention programs can effectively improve the anthropometric nutritional status of children aged 3–12 months. [ABSTRACT FROM AUTHOR]

Copyright of Neutrosophic Computing & Machine Learning is the property of Multimedia Larga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/Objectives: Plant-based diets (PBDs) are dietary patterns characterized by a certain degree of animal-derived food exclusion. PBDs can be divided into different dietary patterns, from vegetarian to vegan, depending on the degree and the extent of animal-derived food avoidance. PBDs are becoming epidemically popular among the general population, including adult subjects as well as children and adolescents, who often follow the dietary pattern chosen by their families. Methods: Our narrative review aims to analyze the most frequently adopted plant-based dietary patterns in children and adolescents and to evaluate their feasibility, advantages, and risks in terms of health promotion and disease prevention in the developmental age. The MEDLINE–PubMed database was searched to collect and select publications from 1980 to 2024. Results: Subjects following these dietary patterns, especially vegan diets, must be under strict nutritional control and receive adequate micronutrients and vitamin supplementation. Conclusions: Nutrition-skilled professionals should be adequately updated and informed about the feasibility and the risks of these different patterns' adoption at different ages, as they should guide and accompany children and adolescents and their families in their nutritional choices without prejudices, granting adequate macronutrient and micronutrient intake, adequate growth and neurodevelopment. [ABSTRACT FROM AUTHOR]

Introduction: Stunting is still a health issue in Indonesia. The main factors causing stunting in Toddlers are exclusive breastfeeding and complementary feeding. Stunting is the highest nutritional issues in Trenggalek. Stunting prevalence in Puru Village of Trenggalek is 12.41%. The aim of this research is to study the correlation between exclusive breastfeeding, frequency, and quantity of complementary feeding with stunting among toddlers in Puru Village, Suruh District, Trenggalek. Materials and methods: This research uses observational analytics with a cross-sectional design. The total sample taken is 58 of 137 total population of toddlers by purposive sampling in February 2023. The inclusion criteria are toddlers aged 6 to 59 months. Toddlers who are sick or suffer from birth defects were excluded. Results:There was a relation between exclusive breastfeeding and stunting (p-value=0.019). Toddlers who are not exclusively breastfeeding are 77 times higher risk of stunting than toddlers who are exclusively breastfeeding because Odds Ratio value is 77. It means exclusive breastfeeding reduces the risk of stunting. There was a relation between frequency of complementary feeding with stunting (p value=0.000). Frequency of complementary feeding is being protective factor of stunting which Odds Ratio value is 0.38. There was a relation between quantity of complementary feeding with stunting (p value=0.000). Toddlers do not get the right quantity of complementary feeding according to age have a 3 times greater risk of stunting (Odds Ratio value is 3). Conclusion: There was a relation between exclusive breastfeeding, frequency, and quantity of complementary feeding with stunting. [ABSTRACT FROM AUTHOR]

Background/Objectives: Complementary feeding (CF), is defined as the process of providing foods in addition to milk when breast milk or milk formula alone are no longer adequate to meet nutritional requirements. CF affects not only growth but also the subsequent development of the child's dietary preferences. The Mediterranean diet (MedDiet) is one of the most studied dietary patterns worldwide. The main purpose of this article is to provide practical guidance for CF to caregivers introducing the Greek MedDiet, summarizing the current different approaches. The evidence-based information provided could be used by developers to create a reliable digital app for CF based on Mediterranean foods and traditional dishes. Methods: An in-depth literature review of the existing guidelines and recently published research data on CF using PubMed, national recommendations, and grey literature were undertaken. Results: Practical, simple, evidence-based, comprehensive tables are presented. The tables serve as a guide to simplify the process of introducing Mediterranean foods in CF. Τhe tables consist of a total of more than 90 foods and day-to-day guidance for the first 13 weeks of CF. Furthermore, specific dietary guidance and suggestions regarding the order and content of meals during CF are given. Discussion: The tables are based on updated recommendations, summarizing the optimal feeding practices in a MedDiet-based perspective. Conclusions: Conclusively, there are significant contradictions among different organizations that present practical issues and cause confusion among caregivers. An effort was carried out to provide practical evidence-based guidance for caregivers introducing MedDiet during CF. [ABSTRACT FROM AUTHOR]

Background: While complementary feeding can be challenging, little emphasis has been placed on the introduction to food texture/pieces, especially in terms of neurodevelopmental outcomes. This study aims to determine the association between the timing of introduction to food pieces during infancy and neurodevelopment in early childhood. We hypothesized that late introduction to food texture/pieces relates to unfavorable neurodevelopmental outcomes. Methods: Families (n = 18329) were recruited from the general population during the nationwide ELFE (Étude Longitudinale Française depuis l'Enfance) birth cohort in France, and 8511 were selected for a complete case analysis. Age at introduction to food pieces was determined based on repeated assessments during the first year. A range of neurodevelopmental outcomes among children were assessed using validated instruments, i.e. composite scores at 1 and 3.5 years, and a score for language acquisition at 2 years. Risk for developmental delay at 3.5 years was defined based on a developmental quotient (DQ) below 90 according to the child's chronological age and the respective composite score at this age. We used linear regression modelling to evaluate associations between age at introduction to food pieces and the standardised neurodevelopmental scores, while logistic regression models were used in the analyses according to the risk for developmental delay. Results: Our findings highlight consistent associations between late introduction to food pieces (i.e., after 10 months, compared to early (before 8 months)) and lower estimates of standardised neurodevelopmental scores at ages 1, 2 and 3.5 years (-0.35 [-0.40; -0.30], -0.15 [-0.20; -0.10] and − 0.18 [-0.23; -0.13], respectively). Infants introduced to pieces late were also more likely to be at risk for developmental delay according to DQ < 90 (OR [95%CI] = 1.62 [1.36; 1.94]). Conclusions: This study shows that late introduction to food pieces (> 10 months) is related to lower neurodevelopmental scores. Given the challenges that complementary feeding may pose, concerted efforts are required to enhance our understanding of the sensory aspects of early diets and to ultimately provide guidance. [ABSTRACT FROM AUTHOR]

Background: Understanding the timing of food introduction in infants is essential for promoting optimal complementary feeding practices. However, existing studies often rely on cross-sectional data, limiting the ability to capture age-specific patterns. We aimed to describe food introduction during the first year of life by identifying patterns related to age at food introduction and associated factors in a cohort of Brazilian infants. Methods: Data were collected through standardized questionnaires administered to mothers via face-to-face interviews during the infant's first month of life and at 3, 6, 9, and 12 months of age. Additionally, two telephone interviews were conducted at 2 and 4 months of age. Information regarding food intake was assessed using a list of 48 foods, with two key aspects recorded: whether the food was introduced (yes/no) and the age at introduction. To define food introduction patterns, we employed k-means cluster analysis. Hierarchical Poisson multiple regression was employed to examine the associations between sociodemographic, biological, and healthcare factors and patterns of food introduction. Results: Three distinct patterns were identified and named according to their main characteristics: Pattern 1 – "Low Infant Formula and Timely CF Introduction"; Pattern 2 – "High Infant Formula and Early CF Introduction"; and Pattern 3 – "High Infant Formula and Later Ultra-processed Food Introduction". Breastfeeding at six months showed a positive association with Pattern 1 (PR = 1.40; 95% CI = 1.10–1.80), while bottle use at four months was negatively associated with Pattern 1 (PR = 0.68; 95% CI = 0.53–0.87). No variables studied exhibited an association with Pattern 2. For Pattern 3, higher prevalences were observed among children whose mothers were aged < 20 years (PR = 1.54; 95% CI = 1.13–2.01) or > 34 years (PR = 1.42; 95% CI = 1.04–1.93). Not receiving guidance on the recommended duration of breastfeeding and complementary feeding during prenatal care was associated with a higher prevalence of children in this pattern (PR = 1.35; 95% CI = 1.01–1.80). Conclusions: We identified three distinct patterns of age at food introduction in the study population, although none perfectly aligned with Brazilian or WHO dietary recommendations. These findings underscore the need for targeted interventions to promote timely and healthy complementary feeding practices in Brazilian infants. [ABSTRACT FROM AUTHOR]

It is recommended that infants are introduced to complementary foods from 6 months old, moving from a solely milk diet to eating a family diet by 12 months old. Although home cooking of family foods is recommended, a rapidly growing market producing baby food products (BFP) such as jars, pouches and snacks has developed. These are often accompanied by marketing claims around nutritional, health and developmental impacts despite research highlighting high sugar content. Although numerous studies have explored drivers of infant formula choice and use, little research has examined the drivers of BFP use. This study used an online survey for United Kingdom parents of infants aged 4–12 months to explore use of BFP alongside perceptions and drivers to purchase products. Overall, 271 parents participated (173 used BFP and 98 did not), with a descriptive analysis of closed items and a thematic analysis for open ended text conducted. The top motivators for using BFP were convenience, time saving, and baby's perceived enjoyment of products. The most purchased puree was fruit based and the most purchased baby snacks were vegetable puffs/sticks, with snack purchases being more common than purees in this sample. Aspects such as perceived healthiness drove choice, with snack foods being seen to enhance self‐feeding skills, appetite regulation and motor development. Those who did not use BFP did not trust them and preferred to feed their baby home cooked foods. The findings are important for professionals working with parents, to support them through the transition to solid foods, particularly around raising awareness of marketing techniques and how to check content of foods to make a more informed choice. Key messages: Parents had multiple reasons for using BFP. The most common motivators were convenience, time saving and infants' perceived enjoyment of them.Some parents perceive baby food products to have nutritional benefits due to health halo statements on packaging. Statements such as low in salt or high in fibre led to perceptions that the product was healthy.Baby snacks were the most common BFPs used, sometimes by parents who did not use purees as self‐feeding was seen to support development. Almost a quarter offered baby puffs daily compared to one in six using fruit purees daily. [ABSTRACT FROM AUTHOR]