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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]

To analyze trends in breastfeeding and complementary feeding indicators for infants and young children receiving primary health care (PHC) services in Brazil, considering the contextual aspects of local nurturing care (NC) environments. Ecological time-series study. Ten feeding indicators were extracted from 1,055,907 food intake records of children aged <2 years reported by PHC facilities from 2015 to 2019. Local NC environments were assessed with the Brazilian Early Childhood Friendly Municipal Index, calculating overall and stratified scores for the NC domains of adequate nutrition, good health, opportunities for early learning, and security and safety. Prais–Winsten regression was used to calculate annual percent changes (APC) by sex and the contrast in APC between the lower and upper quintiles of NC scores. Positive or negative APC with P -values <0.05 represented increasing or decreasing trends. No significant trends of exclusive and continued breastfeeding, food introduction, or minimum dietary diversity were observed, with 2019 prevalences of 54.5%, 45.2%, 92.5%, and 78.2%, respectively. Increasing trends were observed for mixed milk feeding (2019: 19.2%; APC, +2.42%) and minimum meal frequency (2019: 61.1%; APC, +2.56%), while decreasing trends were observed for sweet beverage consumption (2019: 31.9%; APC, −5.92%) and unhealthy foods (2019: 16.1%; APC, −4.69%). Indicator improvements were significantly stronger in environments more favorable for NC. Although the indicators did not meet global targets for infant feeding practices, the results suggest that the local NC environment encompasses facilitators that may be strategic in the design of early childhood programs and policies to improve nutrition. [ABSTRACT FROM AUTHOR]

Background/Objectives: Very low birth weight (VLBW) infants may require enhanced nutrition, even during complementary feeding. However, there are limited data on macronutrient intake during this period, particularly concerning the individual timing of the introduction of solid foods in a representative VLBW infant population. Methods: This prospective observational study analyzed macronutrient intake in VLBW infants with a gestational age < 32 weeks based on whether solid foods were introduced early (<17 weeks corrected age (CA)) or late (≥17 weeks corrected age) Nutritional intake was analyzed using a 24 h recall at 6 weeks CA and 3-day dietary records at 12 weeks, 6, 9, and 12 months CA. Results: In total, 115 infants were assigned to the early and 82 to the late group. The timing of solid food introduction did not affect macronutrient intake, except for a lower fat and higher carbohydrate intake (% of energy) in the early group at 12 weeks and 6 months CA: early vs. late, fat—12 weeks: 47.0% vs. 49.0%, 6 months: 39.2% vs. 43.3%; carbohydrates—12 weeks: 44.9% vs. 43.2%, 6 months: 51.3% vs. 48.0%. Apart from docosahexaenoic acid (DHA) and arachidonic acid (AA), dietary intake recommendations were met in both groups. While nutrient intakes varied significantly between breastfed and formula-fed infants, those with comorbidities exhibited similar nutrient intake levels compared to those without. Conclusions: Our findings suggest adequate macronutrient intakes in VLBW infants irrespective of the timing of solid introduction. However, there is a notable need to enhance dietary intakes of DHA and AA. Future research is crucial to assess whether current nutrient intakes are sufficient for VLBW infants with comorbidities. [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]

Background: Childhood obesity is a crucial public health issue. Early childhood is a critical time to foster the establishment of healthy eating behaviours and growth, which are partly shaped by parental feeding practices. To inform French parents of the recently updated national complementary feeding guidelines for 0–3 years (in terms of nutrition and responsive feeding as a mean to encourage infant appetite control skills and promote healthy growth), an official printed brochure was developed and nationally disseminated in 2021 by the French public health agency, Santé publique France. This randomised controlled trial aims to investigate whether the provision of guidelines through digital (smartphone application) and printed (brochure) tools (vs. the printed brochure alone, usual service) results in healthier parental feeding practices, infant eating behaviours and weight status. Methods: This double-blinded monocentric 2-arm trial is currently conducted among first-time parents living in the area of Dijon (France) and recruited in a maternity ward. From child age 3 to 36 months (mo), an app provides a range of 106 age-adapted messages, including dietary recommendations, educational advice, recipes, and tips (intervention group only). Additionally, parents of both groups are provided with 48 messages related to child general development and the printed brochure at child age 2.7 mo. The primary outcome is the body mass index (BMI) z-score at child age 36 mo. Secondary outcome measures include a combination of online parents' reports and behavioural assessments (experimental meals) of parental feeding practices and infant eating behaviours from inclusion to 36 months of age. Analyses of covariance on these outcomes will assess the effect of the intervention, adjusted for relevant confounders. Complementary mediation and moderation analyses will be conducted. Sample size was determined to be n = 118 in each arm of the trial, plus 20% to compensate for potential attrition. Discussion: This is the first public eHealth randomised control trial in France to assess the effect of a web-based and mobile intervention targeted to first-time parents to improve child feeding practices and child growth. Trial registration: This trial was registered at clinicaltrials.gov as NCT05285761 (March 18, 2022). [ABSTRACT FROM AUTHOR]

Introduction: Complementary feeding (CF) is the process of introducing solid or liquid foods (complementary foods, CFs) other than human breast milk (HBM) or infant formula into infants' diet when HBM or infant formula is no longer sufficient to meet infants' nutritional needs. Primary care pediatricians (PCPs) are paramount in guiding and educating infants' families during CF. Materials and Methods: Our exploratory survey aimed to investigate PCPs' current clinical approach to managing CF. From 1 March 2024 to 30 April 2024, a digital questionnaire composed of 32 multiple-choice questions investigating PCPs' attitudes toward CF in healthy, full-term infants was proposed to 1620 PCPs contacted through scientific societies. Results: The questionnaire was completed voluntarily; 707 PCPs (79.5% female, 66.1% aged over 50 years) fully responded to the survey in the proposed timeframe (participation rate 43.6%). Among the responders, 47.5% recommended traditional CF; 42.1% declared to know the baby-led weaning (BLW) approach and on-demand CF (ODCF), but only 32.8% and 12.5% of them recommended these types of CF, respectively. The vast majority (95%) of participants recommended that CF start between 4 to 6 completed months of age. CF routinely based on vegetarian or plant-based diets was supported by 45/707 (6.1%), only if planned by a specialist by 253/707 (35.8%), and only upon request by caregivers by 257/707 (36.3%). Egg and fish introduction was mostly advised in the first year of life, although in case of a positive family history of food allergy, 13.3% of participants recommended the introduction of egg and fish after 12 months. Conclusions: In conclusion, PCPs did not display a homogenous approach to CF; further studies and educational programs are needed to achieve more flexibility and knowledge on this important nutritional issue. [ABSTRACT FROM AUTHOR]

Stunting is a condition of stunted physical and cognitive growth caused by malnutrition during the development of children under five. UNICEF and WHO recommendations stipulate exclusive breastfeeding for 6 months and breastfeeding for up to two years. Apart from that, it is very important to provide complementary foods for breast milk for 6-23 months. The aim of the research is to determine the obstacles to the Complementary Feeding assistance program for stunted children aged 6-24 months. The method used is a Systematic Literature Review. Health database with search engines Google Scholar, PubMed, Science Direch, ProQuest and Scinapse. The search strategy uses the keywords: Program Constraints, Complementary Feeding, Stunting and Baduta. Identifying research articles for 2017-2023 and using PRISMA flowcharts and literature eligibility criteria based on the PICOS framework. A total of 10,523 articles were identified. Five articles used cross sectional methods, three survey articles, one descriptive analysis article and one cohort article. There were 10 eligible articles that met the inclusion criteria. Based on the results of the identification of Complementary Feeding assistance programs for stunted children aged 6-24 months. There is a correlation between obstacles to the mentoring program related to non-optimal complementary feeding practices (accuracy, diversity and frequency), lack of knowledge and experience, obstacles in communication skills (delivering key messages), self-efficacy/working mothers, sanitation/environmental conditions, socio-economic, weak regulations and government programs including increasing community-based programs such as posyandu. If children aged 0-23 months receive inappropriate complementary foods, they are at high risk of stunting. Various obstacles to the Complementary Feeding assistance program will influence the program's emphasis on promoting children's growth and development to prevent stunting. Conclusion: the Complementary Feeding mentoring program is not optimal, due to various obstacles (specific and sensitive) faced in providing Complementary Feeding to stunted children aged 6-23 months. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify and characterise the determinants influencing the occurrence of diarrheal diseases in children aged 6–24 months undergoing complementary feeding within a low‐income urban community in Kenya. Methods: This study followed a cross‐sectional design and recruited caregivers of children aged 6–24 months from 302 households. The dependent variable was the 2‐week diarrhoea prevalence among children, with independent variables including sociodemographic characteristics, child immunisation and feeding status, and water and sanitation facilities. Data analysis was performed using SPSS. Descriptive statistics and logistic regression analyses were used to assess associations between independent variables and the occurrence of diarrheal diseases. Results: The majority of caregivers were female (n = 282, 93.4%), aged 25–34 years (n = 156, 51.7%), had attained secondary school education (n = 154, 51%), were unemployed (n = 162, 53.6%), and earned Ksh 10,000 (USD 100) or less. 296 (98%) indexed children were fully vaccinated against rotavirus. Most households used improved drinking water sources (n = 272, 90.1%). Most caregivers did not regularly wash their hands with soap and water (n = 225, 74.5%). The 2‐week diarrhoea prevalence among children was 34.1% (103/302), with 69.9% (72/103) of these cases seeking care at a healthcare facility. Logistic regression analysis revealed that children of caregivers earning Ksh 20,000 and below (aOR = 2.9[1.3–6.5], p = 0.01), and those from households using unimproved sanitation facilities (aOR = 1.9 [CI 1–3.4], p = 0.042), had significantly higher odds of having diarrhoea. Conclusion: The study found a high prevalence of diarrhoea in Kenyan children aged 6–24 months, with caregiver income and household sanitation facilities significantly impacting the occurrence of the disease. The study suggests integrated approaches, including education, income generation, hygiene, and improved nutrition, to address the burden of diarrheal disease. [ABSTRACT FROM AUTHOR]

Background: Under nutrition has been a major problem in developing countries including Tanzania; hence, contributing to about half of the deaths among young children. Objective: The current study aimed at identifying child feeding practices and determinants of stunting in children under the age of five years in Mvomero District. Methods: A cross-sectional study involving 150 mother-child pairs was carried out in Turiani ward, Mvomero district in Morogoro region. Bivariate and multivariate logistic regression models were used to identify factors associated with stunting. A p-value ≤ 0.05 was considered sta-tistically significant. Five focus group discussions comprising 5–9 mothers with children below five years participated in the study. Thematic analysis was used to analyse data from the in-depth interviews. Results: The prevalence of underweight, stunting and wasting in Mvomero district was 16.8, 42.2, and 6.2% respectively. Pre-lacteal feeding was common in the study area (40%). Children were introduced to complementary food too early (<6 months) with plain maize porridge being the first food introduced. About 57.2% of children were on the lowest tercile (≤3 food groups per day) dietary diversity score. Significant determinants of stunting were the family source of income (AOR 1.63, 95% CI: 1.99–2.3), age of a child (AOR 2.66, 95% CI: 1.03–3.50) and family size (AOR 3.22, 95% CI: 1.61–4.27). Other factors were consumption of animal foods (AOR 5.30, 95% CI: 0.26–0.60) and dietary diversity score (AOR 1.615, 95% CI: 1.014–2.574). Conclusion: Child feeding practices in the study area are sub-optimal. These findings have important implications for interventions to address stunting among children. [ABSTRACT FROM AUTHOR]

Throughout infancy, changes in growth and development are observed, including changes in nutritional requirements; at approximately 6 months of age, when complementary feeding begins, breastmilk and/or formula are no longer the sole source of energy and nutrients. Little is known about the impact of complementary feeding (CF) approaches used during this time on infant nutrition and growth. Baby-led weaning (BLW) has continued to gain popularity over the last two decades, emphasizing the importance of examining the adequacy of different CF methods. This narrative review of 19 studies from January 2010 to April 2024 aims to discuss the differences between BLW and conventional weaning (CW). The definition of BLW varied across studies, and no standard definition has been established. Though no differences in energy were reported, macronutrient and micronutrient intakes were variable between approaches, including for micronutrients such as iron and zinc. Of the few studies with growth data, results comparing BLW and CW were conflicting. Differences were seen in the demographics of parents who chose to follow BLW and breastfeeding prevalence and duration prior to complementary feeding. Additional research is needed to understand the impacts of BLW and CW on nutrient intakes and growth to inform recommendations for infant complementary feeding approaches. [ABSTRACT FROM AUTHOR]

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.

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 Childhood obesity is a crucial public health issue. Early childhood is a critical time to foster the establishment of healthy eating behaviours and growth, which are partly shaped by parental feeding practices. To inform French parents of the recently updated national complementary feeding guidelines for 0–3 years (in terms of nutrition and responsive feeding as a mean to encourage infant appetite control skills and promote healthy growth), an official printed brochure was developed and nationally disseminated in 2021 by the French public health agency, Santé publique France. This randomised controlled trial aims to investigate whether the provision of guidelines through digital (smartphone application) and printed (brochure) tools (vs. the printed brochure alone, usual service) results in healthier parental feeding practices, infant eating behaviours and weight status. Methods This double-blinded monocentric 2-arm trial is currently conducted among first-time parents living in the area of Dijon (France) and recruited in a maternity ward. From child age 3 to 36 months (mo), an app provides a range of 106 age-adapted messages, including dietary recommendations, educational advice, recipes, and tips (intervention group only). Additionally, parents of both groups are provided with 48 messages related to child general development and the printed brochure at child age 2.7 mo. The primary outcome is the body mass index (BMI) z-score at child age 36 mo. Secondary outcome measures include a combination of online parents’ reports and behavioural assessments (experimental meals) of parental feeding practices and infant eating behaviours from inclusion to 36 months of age. Analyses of covariance on these outcomes will assess the effect of the intervention, adjusted for relevant confounders. Complementary mediation and moderation analyses will be conducted. Sample size was determined to be n = 118 in each arm of the trial, plus 20% to compensate for potential attrition. Discussion This is the first public eHealth randomised control trial in France to assess the effect of a web-based and mobile intervention targeted to first-time parents to improve child feeding practices and child growth. Trial registration This trial was registered at clinicaltrials.gov as NCT05285761 (March 18, 2022).

Abstract Background Improving the minimum acceptable diet (MAD) is essential for ensuring optimal growth and development of children, as well as preventing malnutrition and its consequences. Previous studies in Ethiopia have focused on the magnitude and determinants of a minimum acceptable diet. However, much emphasis was not given to minimum acceptable diet and its associated factors among 6–23 months old children enrolled in Outpatient therapeutic programs (OTP), particularly, in the study area. This study determines the minimum acceptable diet and associated factors among 6–23-month-old children enrolled in OTP. Methods A community-based cross-sectional study was conducted among 346 randomly selected mothers with children aged 6–23 months who were admitted to the OTP. The data were collected using interviewer-administered structured questionnaires. The data were entered, cleaned, coded into Epidata version 4.6, and exported to SPSS version 26 for further analysis. Multivariate logistic regression was used to assess the determinants of MAD. Results The overall prevalence of minimum Acceptable diet among children aged 6–23 months enrolled to OTP was 14.5% (95% CI: 12.02-19%). The odds of MAD were 1.9 times higher among children aged 18–23 months compared to children aged 6–11 months (AOR = 1.9, 95% CI ((1.2 3.9). The odds of MAD were 2.9times higher in children whose mothers had a good knowledge on recommended feeding (AOR = 2.9, 95% CI (1.2, 6.35). Mothers who had no formal education were 81% less likely to provide minimum acceptable diets for their children compared to their counterpart.(AOR = 1.94, 95% CI = 1.24, 4.19). Conclusion The practice of a minimum acceptable diet is inadequate. Nutrition education should be emphasized to improve the mothers’ nutrition knowledge regarding infant and young child feeding recommendations, to support mothers in overcoming barriers to feeding their children with adequate diets, and to foster complementary feeding practices for malnourished children.

Abstract Background The timely introduction of complementary foods during infancy is necessary for nutritional reasons, and to enable the transition from milk feeding to family foods. In the past years, despite efforts that have been put to increase the utilization of timely initiation of complementary feeding practice in Ethiopia, improvements are not satisfactory. Objective To compare the prevalence of timely initiation of complementary feeding and its associated factors among mothers who have Children 6–24 months in Debre Tabor town and rural Farta district, North-west Ethiopia, 2021. Methods A community-based comparative cross-sectional study was employed from December 1/2020 to 30/ 2020 among 1100 mothers. Data were collected using a structured questioner and analyzed using Statistical Product and Service Solutions. Logistic regression analysis with a 95% confidence interval carried out to determine the association between explanatory and the outcome variables. A P-value of

Abstract Background Breastfeeding duration is a critical component of infant and child nutrition, providing immediate and long-term benefits to both children and their mothers. This study uses data from the lot quality assurance sampling (LQAS) survey to examine the prevalence, patterns, and determinants of breastfeeding cessation in Uganda. Methods This study was a secondary analysis of data collected by the cross-sectional LQAS surveys in 2021 and 2022 covering 77 districts in Uganda. The LQAS survey methodology employs a systematic sampling approach to assess whether predefined quality standards are met within specific subgroups of a population. The study employed spatial analysis, bivariate analysis and logistic regression, both with and without clustering, to explore associations between independent variables and breastfeeding cessation. Unadjusted and adjusted odds ratios with 95% confidence intervals were calculated. Statistical significance was set at 5%. Results Overall, the study analysed 26,377 records of mothers with children under 24 months old. The mothers’ mean age was 27.9 years while that of their children was 11.0 months. While the general breastfeeding cessation rate was 17.7%, cessation was highest (49.7%) among mothers of children 18-23 months. Factors associated with increased odds of breastfeeding cessation included older child’s age, older mother’s age, using modern family planning, being pregnant and having an unknown pregnancy status. Lower odds of breastfeeding cessation were observed among mothers who; were married, lived in larger households, lived in rural residences, whose children received vitamin A supplementation and among all other regions compared to Kampala. Conclusion One in five mothers cessed breastfeeding before their child reached 2 years, with a significant increase in cessation odds among mothers of older children. These findings underscore the importance of interventions to promote breastfeeding continuation and adequate nutrition for non-breastfed infants, particularly in regions with high cessation rates.

South Asian infants and children have a higher predisposition to central adiposity, increasing their risk of metabolic diseases in childhood. Infant feeding practices are a key factor in reducing the risk of obesity in children. The current study aimed to compare infant feeding practices of South Asian-born mothers to Australin-born mothers. The 2010 Australian National Infant Feeding Survey data were used to compare infant feeding practices between South Asian-born mothers and Australian-born mothers with children aged up to 2 years. Chi-square and t-tests were conducted, as well as regression models, with adjustment for covariates, to assess individual infant feeding practices between the two groups. A total of 298 South Asian-born mothers and 294 Australian-born mothers were included. The age at which a child stopped receiving breast milk was lower among Australian-born mothers (3 months) compared with South Asian-born mothers (5 months, p < 0.001). A greater proportion of South Asian-born mothers reported that solids were introduced at or after 6 months of age compared to Australian-born mothers (86% vs. 69%, p < 0.001, respectively). South Asian-born mothers were engaging in some health-promoting infant feeding practices compared to Australian-born mothers; however, they were not meeting the infant feeding guidelines for exclusive breastfeeding and the introduction of solids. Further research is needed to better understand factors influencing infant feeding practices in South Asian-born immigrant mothers in Australia to determine whether culturally tailored interventions are needed to help these women achieve optimal feeding practices for their infants. [ABSTRACT FROM AUTHOR]

Background: Women in Himachal Pradesh encounter various restrictions impacting their reproductive health practices, including menstrual hygiene, breastfeeding, and complementary feeding. This qualitative survey aimed to explore these practices, beliefs, and challenges to inform targeted interventions. Methods: A qualitative survey was conducted from March 2021 to August 2022 across 20 selected blocks in 11 districts of Himachal Pradesh. Focus group discussions (FGDs) included a diverse range of participants, such as women of reproductive age, lactating mothers, Anganwadi workers, ASHAs, and other stakeholders. Thematic analysis identified common themes and patterns related to menstrual hygiene, breastfeeding, and complementary feeding. Results: Thematic analysis revealed key findings in each area. Menstrual hygiene practices included the continued use of cloth instead of sanitary pads, improper disposal of menstrual products, and prevalent social and religious taboos and myths. Despite awareness of breastfeeding benefits, misconceptions about alternative feeding methods persisted. Complementary feeding practices were generally well understood, but certain communities held beliefs against nonvegetarian foods and relied on commercially prepared products. Conclusion: The study underscores the need to address cultural beliefs, provide accurate information, and promote evidence-based practices to enhance reproductive health in Himachal Pradesh. Targeted interventions, education programs, and community-based awareness campaigns are essential to dispel myths, promote positive practices, and empower women to make informed decisions. [ABSTRACT FROM AUTHOR]

This cross-sectional study employs structural equation modelling (sEM) to explore both direct and indirect effects of parental level of education and child individual factors on the length-for-age outcomes in children aged 6–24 months assisted by the Bolsa Família Program in the State of Alagoas. A total of 1448 children were analysed by the sEM technique. A negative standardised direct effect (sDE) of the children's younger age (sDE: −0·06; P = 0·017), the use of bottle feeding (sDE: −0·11; P < 0·001) and lack of a minimum acceptable diet (sDE: −0·09; P < 0·001) on the length-for-age indicator was found. Being female (SDE: 0·08; P = 0·001), a higher birth weight (SDE: 0·33; P < 0·001), being ever breastfed (sdE: 0·07; P = 0·004) and a higher level of parental education (SDE: 0·09; P < 0·001) showed a positive SDE effect on the child's length-for-age. The model also demonstrated a negative standardised indirect effect (SIE) of the sweet beverage consumption (SIE: −0·08; P = 0·003) and a positive effect of being ever breastfed (SIE: 0·06; P = 0·017) on the child's length-for-age through parental level of education as a mediator. This research underscores the crucial role of proper feeding practices and provides valuable insights for the development of targeted interventions, policies and programmes to improve nutritional well-being and promote adequate linear growth and development among young children facing similar challenges. [ABSTRACT FROM AUTHOR]

Complementary feeding (CF) may influence later eating behaviour and growth. Our previous Randomised Control Trial (RCT) reported that new CF guidelines (NCFGs) implemented in 6–12-month-old infants in Bogota, Colombia, had positive short-term effects on red meat, vegetable and fruit consumption. Here, we assessed the effects of the NCFGs on food consumption, eating behaviour and growth at 6 years of age. Weight and height were measured using 50 children (58.8%) from the cohort. Feeding behaviour was measured using the Child Eating Behaviour Questionnaire (CEBQ) and maternal and child food consumption was measured using a semi-quantitative food frequency questionnaire. The control group (CG) had a significantly higher weekly consumption of chocolate milk drinks (p = 0.05). The mean food responsiveness (FR) score was significantly higher in the CG (p < 0.001). Although HAZ (height for age Z-score) at 6 years of age was significantly higher in the CG (p < 0.02), there was no significant difference between groups in the change in HAZ from 6 months and 12 months to 6 years of age. BMIZ (body mass index Z-score) and % overweight (CG 18.5% versus NCFG 13%) or obese (3.7% versus 0%) were not significantly different between groups. BMIZ was positively predicted by FR (β 0.293; p = 0.014) and negatively predicted by weekly red meat consumption episodes per week at 12 months (β −0.169; p = 0.020). Although there was no direct effect of an intervention on BMIZ at 6 years of age, the results were consistent with an indirect effect via intervention effects on meat consumption at an age of 12 months and FR at 6 years of age. However, further longitudinal studies with a larger sample size are needed. [ABSTRACT FROM AUTHOR]

Background: Improving the minimum acceptable diet (MAD) is essential for ensuring optimal growth and development of children, as well as preventing malnutrition and its consequences. Previous studies in Ethiopia have focused on the magnitude and determinants of a minimum acceptable diet. However, much emphasis was not given to minimum acceptable diet and its associated factors among 6–23 months old children enrolled in Outpatient therapeutic programs (OTP), particularly, in the study area. This study determines the minimum acceptable diet and associated factors among 6–23-month-old children enrolled in OTP. Methods: A community-based cross-sectional study was conducted among 346 randomly selected mothers with children aged 6–23 months who were admitted to the OTP. The data were collected using interviewer-administered structured questionnaires. The data were entered, cleaned, coded into Epidata version 4.6, and exported to SPSS version 26 for further analysis. Multivariate logistic regression was used to assess the determinants of MAD. Results: The overall prevalence of minimum Acceptable diet among children aged 6–23 months enrolled to OTP was 14.5% (95% CI: 12.02-19%). The odds of MAD were 1.9 times higher among children aged 18–23 months compared to children aged 6–11 months (AOR = 1.9, 95% CI ((1.2 3.9). The odds of MAD were 2.9times higher in children whose mothers had a good knowledge on recommended feeding (AOR = 2.9, 95% CI (1.2, 6.35). Mothers who had no formal education were 81% less likely to provide minimum acceptable diets for their children compared to their counterpart.(AOR = 1.94, 95% CI = 1.24, 4.19). Conclusion: The practice of a minimum acceptable diet is inadequate. Nutrition education should be emphasized to improve the mothers' nutrition knowledge regarding infant and young child feeding recommendations, to support mothers in overcoming barriers to feeding their children with adequate diets, and to foster complementary feeding practices for malnourished children. [ABSTRACT FROM AUTHOR]

The quality of complementary feeding can have both short‐ and long‐term health impacts by delaying or promoting child growth and establishing taste preferences and feeding behaviours. We aimed to assess the healthy and unhealthy feeding practices of infants and young children in rural Ethiopia. We conducted two rounds of surveys in December 2017/18 in Habru district, North Wello, rural Ethiopia among caregivers of infants and young children (N = 574). We characterised the consumption of infants and young children using non‐quantitative 24 h recall and the World Health Organization infant and young child feeding indicators. Sociodemographic characteristics, anthropometry and haemoglobin concentrations were assessed. Breastfeeding was a norm as 82% and 67% were breastfed in the first and second rounds. Between the two rounds, dietary diversity increased from 5% to 17% (p < 0.05), but more pronounced increases were observed in the consumption of ultra‐processed food (UPFs). Up to one‐in‐five (22%) of the children consumed UFPs. With an average of only three food groups consumed, the consumption of nutrient‐dense foods like animal source foods, fruits and vegetables was very low particularly among younger children. UPFs are an additional risk factor that contributes to poor quality diets. Behavioural Change Communication interventions, including those in rural areas, should explicitly discourage the consumption of UPFs. Future studies should aim to quantify the amount of UPFs consumed and evaluate how this is associated with diet adequacy and nutritional outcomes. Key messages: Complementary diets in rural Ethiopia are extremely low in diversity.Consumption of unhealthy foods is more prevalent than the proportion that meets the minimum dietary diversity.Consumption of ultra‐processed foods was not associated with household wealth score.Indicators of unhealthy feeding practices should be integrated into nutrition programme monitoring. [ABSTRACT FROM AUTHOR]

Women empowerment is an underlying factor of child feeding and nutrition. However, the lack of standardized measurements has made it difficult to design interventions that embed women empowerment and measure their impacts. This study aimed to assess temporal trends in women empowerment in Ethiopia and evaluate their contribution towards improving dietary diversity in infants and young children. We used women and child data from the Ethiopian Demographic and Health Survey 2005, 2011, and 2016, yielding a total sample of 6113 mother–child pairs. The survey‐based women's empowerment index (SWPER) developed and validated for use in Africa was used to assess three dimensions of women empowerment: (i) social autonomy, (ii) decision making; and (iii) attitude to violence. We used multiple‐linear and multivariable logistic regression to assess the associations between SWPER and the number of food groups consumed/and the minimum dietary diversity (MDD). To determine drivers of changes over time, a regression decomposition analysis was run. Women empowerment indices have improved over the 2005–2016 period, but a significant proportion of women had low standardized SWPER scores for autonomy/social independence (47%) and attitude to violence (49%) domains in 2016. SWPER autonomy and SWPER decision‐making scores were strongly associated with the odds of meeting MDD. Changes in women empowerment accounted for 17% of the improvements in MDD between 2005 and 2016. SWPER was a stronger predictor of the change in MDD, than known predictors like wealth, child age, and urban residence. As a critical underlying driver of child nutrition, women empowerment should be boldly addressed and integrated in nutrition interventions. [ABSTRACT FROM AUTHOR]

Analyze the perceptions of primary health care professionals about the implementation of the Amamenta e Alimenta Brasil Strategy (EAAB). Qualitative research using an open evaluation form comprising three fields: positive aspects, negative aspects and suggestions. The data was systematized using categorical content analysis and analyzed in the light of the scientific literature. The following categories emerged among the positive aspects: «Acquisition of knowledge and clarification of doubts», «Teachinglearning methodology» and «Improvement of communication skills». Among the negative aspects: «Workshop logistics in Basic Health Units», «Limited time for qualification» and «Socio-economic determinants of infant feeding». Suggestions: «Expanding the content to the assisted community» and «Continuing health education activities». There was considerable acceptance of the EAAB among professionals, which favors its implementation process. The negative points and suggestions observed provide support for consolidating and expanding it. [ABSTRACT FROM AUTHOR]

Introduction: Health issues faced by the Ngleses Village community predominantly affect toddlers, with stunting being a prevalent concern. Stunting is characterized by compromised physical growth, brain development, and cognitive abilities in children, where their height is incongruent with their age due to chronic nutritional problems, indicated by a z-score below -2 SD according to TB/U. One of the risk factors for stunting is inadequate nutritional intake. Delayed introduction of complementary feeding (MPASI) leads to insufficient provision of supplemental food required to bridge energy and nutritional gaps. Methods: The method employed involves educating pregnant mothers and mothers with toddlers about MPASI and demonstrating the preparation of several MPASI recipes. The target audience comprises 20 mothers of toddlers from Ngleses Village. The MPASI workshop aims to enhance the knowledge and understanding of mothers regarding complementary feeding. The utilized media include PowerPoint presentations and cooking demonstrations employing cooking utensils such as stoves, gas burners, pans, and ladles. The procedural implementation encompasses preparation, execution, evaluation, and analysis. Results and Discussion: During the implementation process, the 20 attending mothers from Ngleses Village exhibited a commendable level of attention and enthusiasm in engaging with the material presentation and cooking demonstration. Participants' comprehension levels improved, as observed by comparing post-test scores with pre-test scores. Furthermore, the program yielded six complementary feeding recipes accompanied by compiled basic selling prices, forming a recipe book. This book will be distributed to community health workers (kader) mothers as one of the program's tangible outcomes. Conclusion: It can be concluded that this educational initiative successfully achieved its formulated objectives. [ABSTRACT FROM AUTHOR]

Objective. Evaluate adherence of complementary feeding practices (CFP) to recommendations of the healthy and sustainable feeding guidelines of Mexico for infants and young children (GASS) and document main barriers to compliance with optimal CFP and formulate public policy recommendations to address them. Materials and methods. Using data from Ensanut Continua 2020-23 to evaluate compliance of CPF to GASS through an index that assessed five dimensions (age of introduction, optimal age of introduction, continued breastfeeding, consume of recommended foods and frequency of meals) (assigning 0 or 1 points for compliance). Main barriers were identified for optimal CFP and recommendations for public policy were made. Results. In Mexico, half of children from 6-23 months has a compliance to GASS recommendations 50.9/100 (CI95% 45.5,50.0) or less. Compliance index to recommendations decreases as age increases. There are, different structural, social, cultural and individual barriers that affects CFP. Conclusions. It is imperative to improve CFP to fulfill the "Right to Health" in children <24 months. This requires updating the standards (ac cording to current international guidelines and the healthy and sustainable Mexican dietary guidelines); strengthen primary health care services through the nationwide implementation of the newly designed thousand-days strategy, which includes an important component of CFP and begins with the training of healthcare personnel. [ABSTRACT FROM AUTHOR]

Summary: Background/Objectives: The infant diet represents one of the main modifiable determinants of early growth. This study aimed to investigate the associations of infant feeding practices with body mass index (BMI) until 7.5 years. Subjects/Methods: Analyses were based on data from the French nationwide ELFE birth cohort. Data on breastfeeding (BF) and complementary feeding (CF) were collected monthly from 2 to 10 months. Infant feeding practices were characterized using principal component analyses (PCA) and hierarchical ascendant classification. BMI z‐score was computed at 1, 2, 3, 5 and 7.5 years, from data collected in the child's health booklet; 7.5‐year overweight was defined according to IOTF references. Associations between infant feeding practices and BMI were investigated by linear regression models adjusted for main confounders. Results: Ever breastfeeding was not associated with BMI up to 7.5 years. Compared to intermediate breastfeeding duration (1 to <3 months), longer breastfeeding duration (≥6 months) was related to lower 1‐year BMI, but not at older ages. Compared to the recommended age at CF introduction (4–6 months), early CF (<4 months) was related to higher BMI up to 5 years with a similar trend at 7.5 years, but not to the risk of overweight. The PCA patterns characterized by early baby cereal introduction and late food pieces introduction or by frequent intake of main food groups were related to a lower BMI up to 7.5 years. Conclusion: Breastfeeding was related with a lower BMI in infancy but not thereafter, whereas an early CF initiation (<4 months) was associated with a higher BMI in childhood. [ABSTRACT FROM AUTHOR]

To address high rates of malnutrition among children from vulnerable households in Rwanda, the government initiated a national food supplementation programme. A before and after evaluation, using repeat cross‐sectional surveys in randomly selected villages was conducted; aimed at assessing the effectiveness of providing fortified blended food (FBF) to children 18–23 months of age, pregnant and lactating women in the lowest tier of Rwanda's social support system. Data were collected in 2017, 2018 and 2021 through interviews with caregivers; anthropometric measurements and a capillary blood sample were obtained from children. The primary statistical analysis compared the nutritional status of children before and after the introduction of FBF. We enroled 724 children during each survey. The prevalence of stunting declined from 47% to 35% between 2017 and 2021; in 2018, the prevalence of stunting was 43%. Children had a 42% reduction in the odds of being stunted (adjusted odds ratio [AOR]: 0.58, 95% confidence interval [CI]: 0.47–0.74, p < 0.001) from 2017 to 2021 even after adjusting for inherent, distal, proximal, and intermediate covariates. The reduction in stunting observed within the first year of the programme was not statistically significant (AOR: 0.83, 95% CI: 0.67–1.03, p < 0.091). We observed meaningful reductions in the prevalence of stunting among children which coincided with the introduction of Government‐led initiative to reduce malnutrition. The Rwandan Government has committed to improving the living conditions of vulnerable households and has made strong investments in reducing malnutrition. The impact of these investments can be seen in the overall trend towards improved nutritional status highlighted in this evaluation. Key messages: The national distribution of fortified blended food (FBF) to pregnant and lactating women and 6‐ to 23‐month‐old children living in the most vulnerable households was associated with a meaningful reduction in stunted linear growth, iron deficiency and anaemia among young children after 5 years.This study indicates that stunted linear growth, in early childhood, can be reduced over 5 years when the government is committed to and invests in improving the living conditions of vulnerable households, including the national food supplementation programme.It was attainable to distribute FBF to vulnerable pregnant and lactating women and 6‐ to 23‐month‐old children, in a national programme, over the 5‐year evaluation period, including during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

We aimed to describe how breastfeeding relates to adherence to complementary feeding (CF) recommendations, diet diversification and feeding skills development and whether sociodemographic factors explain any differences observed. The Scottish Maternal Infant and Nutrition Survey for infants aged 8–12 months collected breastfeeding history, CF practices, diet and sociodemographic data using a self‐completion questionnaire. Non‐healthful CF practices were starting CF < 6 months, any consumption of sugar‐sweetened beverages (SSBs), sweet or salty snacks (treats) or unmodified cow's milk and regular consumption of commercial baby foods. Diet diversification and feeding skills were assessed by amount of self‐feeding and number of food groups, meals and snacks eaten daily. Of the 2730 mothers, 20% were solely infant formula fed (IFF) and 48% continued breastfeeding ≥6 months. Compared to IFF babies, mothers who gave any breast milk ≥6 months were more likely to start CF ≥ 6 months compared to those IFF (66% vs. 37%) and less likely to give treats (15% vs. 45%), SSBs (11% vs. 20%) and commercial baby foods (31% vs. 53%). These associations remained highly significant (p < 0.001) even after sociodemographic factor adjustment. Despite starting CF later, infants breastfed ≥6 months ate the same number of food groups and meals as those IFF, were just as likely to self‐feed purees and more likely to self‐feed finger foods daily (87% vs. 81% p < 0.001). Mothers who breastfeed beyond 6 months adhere more to CF recommendations and start CF later compared to IFF, but their babies eat a similarly diverse diet and have similar feeding skills. Key messages: Adhering to breastfeeding recommendations is associated with delayed introduction of complementary foods, without influencing diet diversity or development of infant feeding skills.Breastfeeding duration is a predictor for healthful complementary feeding practices.These associations between breastfeeding duration and healthful complementary feeding practices are not explained by differences in maternal age or deprivation level. [ABSTRACT FROM AUTHOR]

In late 2023, the World Health Organization (WHO) released the WHO Guideline for complementary feeding of infants and young children 6-23 months of age (WHO Guidelines). This was based on systematic literature reviews, extensive consultation with regional offices and a review of existing WHO guidance relevant to infants. In this paper we describe the similarities and differences between the recent WHO Guidelines and the current Australian Guidelines and highlight some of their limitations. The WHO provides advice relevant to all countries in the world, while the Australian infant feeding guidelines are limited to the Australian context. This results in more emphasis on the use of micronutrient supplements in the WHO Guidelines which are not routinely used in Australia. Both sets of guidelines emphasise the importance of exclusive breastfeeding in the first six months of life followed by continuing breastfeeding as long as the mother and infant desire, although there are small differences in wording. No additional foods or drinks are needed before six months, when complementary foods should then be introduced. A variety of different foods and textures should be offered. Toddler milks are not needed. The WHO Guidelines state that animal milk, such as cows' milk, can be given from 6 months, while Australia recommends that cows' milk only be given after 12 months due to the possibility of iron deficiency. Cows' milk also has higher concentrations of protein and electrolytes. Both guidelines give very similar advice. [ABSTRACT FROM AUTHOR]

Background: The timely introduction of complementary foods during infancy is necessary for nutritional reasons, and to enable the transition from milk feeding to family foods. In the past years, despite efforts that have been put to increase the utilization of timely initiation of complementary feeding practice in Ethiopia, improvements are not satisfactory. Objective: To compare the prevalence of timely initiation of complementary feeding and its associated factors among mothers who have Children 6–24 months in Debre Tabor town and rural Farta district, North-west Ethiopia, 2021. Methods: A community-based comparative cross-sectional study was employed from December 1/2020 to 30/ 2020 among 1100 mothers. Data were collected using a structured questioner and analyzed using Statistical Product and Service Solutions. Logistic regression analysis with a 95% confidence interval carried out to determine the association between explanatory and the outcome variables. A P-value of < 0.05 was considered statistically significant. Results: The prevalence of timely initiation of complementary feeding among urban and rural mothers was 69.8% with (95% CI: 66%, 74%) and 51.9% with (95% CI: 48- 56%) respectively. Urban residence [AOR = 1.39, 95% CI: (1.02–1.94)], had antenatal care visits [AOR = 0.24 (95%CI: (0.13, 0.44)], had post natal care checkups [AOR = 0.44, 95%CI: (0. 27- 0.72)] and being a governmental employee [AOR = 2.82; 95% CI: (1.91–6.1)] were factors associated with timely initiation of complementary feeding among urban mothers. Whereas in rural settings: institutional delivery [(AOR = 2.21, CI: 1.35–3.65)], post natal care checkups [(AOR = 0.53, CI: (0.36–0.77)] being daily laborer [AOR = 3.47; 95% CI: (1.78–6.75)] were associated with timely initiation of complementary feeding. Conclusion: The prevalence of timely introduction of complementary feeding in children aged 6–24 months is still low in the study areas. There was also disparity between urban and rural mothers in which urban mothers practiced better. [ABSTRACT FROM AUTHOR]

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A multicenter cross-sectional study was conducted among 245 experienced Spanish paediatricians, who completed an online survey based on clinically relevant topics in nutrition during the first two years of life and their recommendations to parents in daily clinical practice. Most participants advise about the choking risk associated with baby-led weaning (BLW) and more than 60% consider that infants can receive an insufficient variety and quantity of nutrients with this practice. The general opinion is that there is a lack of evidence for delaying the introduction of gluten and other allergenic foods in the complementary feeding of healthy infants. Most participants agree/strongly agree that two servings of dairy products are the adequate daily amount in a diversified diet and 93.4% disagree/strongly disagree with the use of vegetal beverages under 1 year of life. There is a general agreement to avoid added salt and sugar before 12 months of life, the consideration that organic foods do not have a better nutritional profile than non-organic ones, and the limitations of vegetarian diets especially for adequate provision of micronutrients. Overall, there is an adequate knowledge of the new trends by paediatricians and younger ones seemed more in favor of them and interested in receiving more information on most topics. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding duration is a critical component of infant and child nutrition, providing immediate and long-term benefits to both children and their mothers. This study uses data from the lot quality assurance sampling (LQAS) survey to examine the prevalence, patterns, and determinants of breastfeeding cessation in Uganda. Methods: This study was a secondary analysis of data collected by the cross-sectional LQAS surveys in 2021 and 2022 covering 77 districts in Uganda. The LQAS survey methodology employs a systematic sampling approach to assess whether predefined quality standards are met within specific subgroups of a population. The study employed spatial analysis, bivariate analysis and logistic regression, both with and without clustering, to explore associations between independent variables and breastfeeding cessation. Unadjusted and adjusted odds ratios with 95% confidence intervals were calculated. Statistical significance was set at 5%. Results: Overall, the study analysed 26,377 records of mothers with children under 24 months old. The mothers' mean age was 27.9 years while that of their children was 11.0 months. While the general breastfeeding cessation rate was 17.7%, cessation was highest (49.7%) among mothers of children 18-23 months. Factors associated with increased odds of breastfeeding cessation included older child's age, older mother's age, using modern family planning, being pregnant and having an unknown pregnancy status. Lower odds of breastfeeding cessation were observed among mothers who; were married, lived in larger households, lived in rural residences, whose children received vitamin A supplementation and among all other regions compared to Kampala. Conclusion: One in five mothers cessed breastfeeding before their child reached 2 years, with a significant increase in cessation odds among mothers of older children. These findings underscore the importance of interventions to promote breastfeeding continuation and adequate nutrition for non-breastfed infants, particularly in regions with high cessation rates. [ABSTRACT FROM AUTHOR]

This review article examines the critical role of promoting breastfeeding and complementary feeding practices in addressing maternal malnutrition and improving maternal and child health outcomes. It begins with an introduction highlighting the significance of these practices in achieving optimal nutrition, followed by a discussion of methodology involving a comprehensive review of existing literature and the interventions (Like PLA approach and awareness raising through 1000 days Window of Opportunity etc.) being implemented under the project "Improved Resilience through Food and Nutrition Security" by Farmers Development Organization. The purpose of the review is to underscore the importance of breastfeeding and complementary feeding in maternal and child health, offering insights into successful interventions, challenges, and recommendations for improvement. Results emphasize the profound impact of these practices, emphasizing the need for early initiation of breastfeeding and the introduction of nutritious complementary foods. In conclusion, the urgent need for concerted efforts to promote these practices is emphasized, with the potential for significant progress in enhancing overall public health through evidence-based intervention. [ABSTRACT FROM AUTHOR]

Despite the high protein levels, essential fatty acids and minerals that are found in edible insects, they are still not being used in complementary feeding. The aim of this study was to investigate maternal perception on use of edible insects for complementary feeding and nutrition status of children in Kakamega and Siaya Counties, Kenya. The study adopted a cross-sectional analytical design which was used on a sample of 592 mother-child pairs (aged 6-23 months) in Kisa North, West Yimbo and West Ugenya wards. Majority of the mothers were in the childbearing age group of 15-49 years, were married and 57.9% in Kisa North, 65.7% in West Ugenya and 64.6% in West Yimbo had attained primary education. Generally, 50.9%, 54.2% and 48.8% of the household heads in Kisa North, West Ugenya and West Yimbo, respectively had attained primary education. About 49.5% and 38.9% of the mothers in Kisa North and West Ugenya practiced farming while 35.3% of those in West Yimbo engaged in business. About 40.3% of the household heads in West Ugenya were farmers, 48.7% in Kisa North were casual labourers while 66.3% in West Yimbo engaged in fishing. Approximately 42.1%, 33.7% and 39.3% of the mothers in Kisa North, West Ugenya and West Yimbo respectively disagreed about the use of edible insects for complementary feeding. More than half (65.3%, 56.6% and 61.7%) of the children in Kisa North, West Ugenya and West Yimbo respectively attained the Minimum Dietary Diversity. More than half (58.9% and 55.8%) of the children in West Yimbo and West Ugenya respectively and 29.7% in Kisa North attained the Minimum Acceptable Diet. In terms of nutrition status, the prevalence rates of wasting were (6.3% in West Ugenya, 7.0% in West Yimbo and 6.0% in Kisa North), stunting rates (19.5% in West Ugenya and an equal proportion of 19.9% in West Yimbo and Kisa North) and underweight rates (9.2% in West Ugenya, 9.0% in West Yimbo and 8.8% in Kisa North). There were significant relationships between the maternal perceptions of the appropriateness of insects in complementary food and the ward of residence (ꭓ²=16.86, p value=0.030), marital status of the mother (ꭓ²=11.14, p value=0.025), main source of income for the household head (ꭓ²=33.35, p value=0.007) and the education level of the household head (ꭓ²=48.67, p value=0.009). This information will be useful to the Ministry of Health through the division of nutrition for inclusion in the MIYCN policy the use of edible insects as a complementary food. [ABSTRACT FROM AUTHOR]

BackgroundImplementing appropriate complementary food hygiene practices is essential to lower the incidence of food-borne disease and malnutrition in children. However, this aspect is often overlooked in resource-limited settings, and information regarding these practices is not fully available and is not assessed enough. Therefore, this study aimed to assess complementary food hygiene practices and their associated factors in Dessie Zuria, South Wollo Zone, Amhara, Ethiopia, in 2023.MethodsAn institutional-based cross-sectional study design was conducted from 17 April to 18 May 2023, among 366 mothers with children aged 6–23 months. Dessie Zuria was purposively selected, and a systematic random sampling technique was used to recruit study participants. Data were collected using pretested and structured questionnaires. Finally, the data were entered using EPI-info and then exported to SPSS version 26. Bivariable and multivariable logistic regression analyses were used to identify factors associated with complementary feeding hygiene practices. Both crude odds ratios (COR) and adjusted odds ratios (AOR) with a 95% confidence level (CI) were computed, and a p-value of

Background: Breastfeeding for the first six months and complementary feeding until twelve months are crucial for child growth. A mother's knowledge, attitude, and practice (KAP) on infant feeding significantly impact infant development. Objective: To assess mothers' KAP toward breastfeeding and complementary feeding. Methodology: A cross-sectional study of 200 mothers with 18- to 24-month-old children at six suburban health clinics in Malaysia. Data were collected via a self-explanatory questionnaire and analyzed using descriptive statistics, chi-square, and Spearman's Rho. Results: Most mothers had good KAP: 72.5 % had good knowledge, 75.5 % had a positive attitude, and 87 % had good practice. Factors such as maternal age (30–39), multiparity, and vaginal delivery were associated with KAP. Significant positive correlations were found between knowledge and attitude (r = 0.591) and attitude and practice (r = 0.525). Conclusions: Continued education on breastfeeding and complementary feeding is essential for improving infant feeding practice, and enhancing child development, potentially reducing healthcare costs.

Background The study focused on understanding infant and young child feeding practices (IYCF) among Muslim mothers in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), Philippines. Objective Recognizing the cultural and religious sensitivities associated with these practices, the research aimed to identify influencing factors and assess the influence of advertisements on maternal decisions regarding infants' and children's diets. Methods A total of 74 Muslim mothers with infants 6-23 months old were recruited and participated in the focus group discussions (FGD). Ten FGD sessions were conducted in Maguindanao Province, Philippines from July to August 2021. Verbatim transcriptions of audio-recorded discussions were transcribed into Microsoft Word files and QSR NVivo version 12 was used in the coding and analysis of the transcripts. Results Mothers exhibited limited awareness of such important complementary feeding issues as preferring fruits and vegetables while avoiding junk food as chips. IYCF information came primarily from health workers and other mothers - their own mothers, mothers-in-law, and midwives. Television commercials were identified as particularly influential in shaping maternal feeding decisions. Conclusions There was a diversity of breastfeeding practices and limited knowledge, especially of complementary feeding among these Muslim mothers. Both traditional beliefs and marketing were said to influence feeding choices. This underscores the need for culturally-sensitive interventions and targeted educational initiatives to enhance maternal knowledge and advocate for optimal infant feeding practices within Muslim communities, as well as regulation of the marketing of commercial infant foods.

ABSTRACT Weaning is a crucial stage in an infant's development when they gradually move from being breastfed to receiving complementary foods. The typical age for introducing weaning foods is 4–6 months. This period is often characterized by rapid weight gain, so proper nutrition essential for optimal growth and development. Foods with a balanced nutrition are very important for regulating metabolism for healthy growth of children. Cereal grains and legumes have a major role in both commercial and homemade weaning foods. In developing countries, cereals and legumes are the optimal choices for producing nutrient‐dense, high‐protein, and high‐energy weaning foods. It is crucial to research and develop composite legume blends for their expanded utilization as weaning foods. Understanding the importance of complementary foods and introducing them appropriately are critical to the health and development of the infant. Furthermore, fortification and supplementation with minerals and vitamins can play a vital role in such foods. This article provides an overview of recommendations made by health authorities in relation to the onset of weaning, types/combination of foods, and infant dietary requirements and highlights the importance of including legumes in the weaning diet to address nutrient deficiencies, particularly in regions with high rates of malnutrition.

Background: Children in the 6–23-mo age group need to consume adequate energy and nutrients for healthy growth, brain development, cognition, and future productivity. Yet, large deficits remain. Complementary feeding practices can be improved on a large scale, but whether interventions reach and benefit disadvantaged mothers is not known. Objectives: To assess inequalities in complementary feeding practices and coverage following large-scale program implementation in 3 low- and middle-income countries. Methods: We re-analyzed evaluation data from randomized controlled studies conducted in Bangladesh, Ethiopia, and Vietnam and calculated socioeconomic inequality using Erreygers index for intervention and nonintervention areas. Intervention coverage indicators were developed in each country for interpersonal communication, community mobilization, agricultural extension, and media. We compared the direction and magnitude of inequalities in intervention and nonintervention areas. Results: At the endline, coverage, and practices related to complementary feeding were better in intervention areas, but coverage and practices favored the better-off and more educated mothers. In Bangladesh, only 5, and in Vietnam, only 1 out of 16 coverage variables measured favored disadvantaged mothers or were neutral; in Ethiopia, out of 18 coverage variables measured, 11 favored disadvantaged mothers or were neutral, and in all 3 countries, only 5–6 variables out of 16 that were measured favored disadvantaged mothers or were neutral. Conclusions: Inequalities exist both in how children in the 6–23-mo age group are fed and in programs aimed at improving complementary feeding practices. Programs favor the better-off and more educated mothers. We need to better understand context-specific program barriers and tailor targeted interventions to reach disadvantaged mothers.

Choline is an essential micronutrient that may influence growth and development; however, few studies have examined postnatal choline status and children's growth and development in low- and middle-income countries. The aim of this observational analysis was to examine associations of plasma choline with growth and development among Malawian children aged 6-15 months enrolled in an egg intervention trial. Plasma choline and related metabolites (betaine, dimethylglycine and trimethylamine N-oxide) were measured at baseline and 6-month follow-up, along with anthropometric (length, weight, head circumference) and developmental assessments (the Malawi Developmental Assessment Tool [MDAT], the Infant Orienting with Attention task [IOWA], a visual paired comparison [VPC] task and an elicited imitation [EI] task). In cross-sectional covariate-adjusted models, each 1 SD higher plasma choline was associated with lower length-for-age z-score (-0.09 SD [95% confidence interval, CI -0.17 to -0.01]), slower IOWA response time (8.84 ms [1.66-16.03]) and faster processing speed on the VPC task (-203.5 ms [-366.2 to -40.7]). In predictive models, baseline plasma choline was negatively associated with MDAT fine motor z-score at 6-month follow-up (-0.13 SD [-0.22 to -0.04]). There were no other significant associations of plasma choline with child measures. Similarly, associations of choline metabolites with growth and development were null except higher trimethylamine N-oxide was associated with slower information processing on the VPC task and higher memory scores on the EI task. In this cohort of children with low dietary choline intake, we conclude that there were no strong or consistent associations between plasma choline and growth and development.

BackgroundHealthy nutrition during the first year of life is critical for optimal growth and development. Limited techniques are available to assess diet quality in infancy, and few have been shown to be predictive of dietary and adiposity outcomes in low-income children.ObjectiveThe objectives of this study were to construct an Infant Diet Quality Index (IDQI) to assess the diet quality from birth to 12 mo and to determine whether the IDQI exhibits predictive validity by estimating the longitudinal associations of IDQI scores with diet quality and weight status at 2 to 4 y.DesignData were analyzed from the longitudinal Women, Infants, and Children Infant and Toddler Feeding Practices Study-2 (unweighted, n = 2858; weighted. N = 392,439) using one 24-h dietary recall and survey responses during infancy. The newly constructed IDQI consists of 16 equally-weighted components: 1) breastfeeding duration; 2) exclusive breastfeeding; age of first introduction of: 3) solids, 4) iron-rich cereals, 5) cow milk, 6) sugar-sweetened beverages, 7) salty/sweet snacks, 8) other drinks/liquids, and 9) textured foods; frequency of consuming 10) fruit or 11) vegetables; frequency of consuming different 12) fruit or 13) vegetables; 14) nonrecommended bottle-feeding practices; 15) use of commercial baby foods; and 16) number of meals and snacks. Regression analysis was used to estimate associations between the total IDQI score (range, 0-1) and Healthy Eating Index-2015 (HEI-2015) scores and body mass index z-scores (BMIz) at 2 to 4 y of age, adjusted for covariates (e.g., child age, sex and race/ethnicity; maternal education level, etc.) RESULTS: The total IDQI score was positively associated with HEI-2015 at the age of 2 y (β = 16.7; 95% CI: 12.6, 20.9; P < 0.001), 3 y (β = 14.5; 95% CI: 8.1, 21.0; P < 0.001), and 4 y (β = 15.4; 95% CI: 8.4, 22.4; P < 0.001); and negatively associated with BMIz at the age of 2 y (β = -1.24; 95% CI: -2.01, -0.47; P = 0.002) and 4 y (β = -0.92; 95% CI: -1.53, -0.30; P = 0.003).ConclusionsThe IDQI has predictive validity for diet quality and weight status in low-income US children.

Summary: Introduction: Over the last two decades, there have been some efforts to improve maternal and child health around the globe. However, the efforts are still lacking longstanding outcomes. Lack of awareness and access to information for decision-making has been an obstacle for women, especially in developing countries. This study aims to find potential strategies to improve maternal and child health using mHealth in Ethiopia to enhance service uptake and future decisions. Methods: This study applies cluster randomized controlled trials to test if mobile phone (mHealth) text messages can improve the uptaking of postpartum family planning and child feeding practices such as prelacteal feeding, initiation of breastfeeding, exclusive breastfeeding, and complementary feeding. Repeated data collections during the first and fifth months enhance understanding of child feeding practice and its improvement compared to baseline information. It can also help to understand postpartum family planning practices among mothers. The sample size includes 672 mothers who are in the third trimester, have access to a mobile phone, can use mobile phones, and can read and understand text messages. Multilevel logistic regression, generalized estimation equation, and survival analysis are the models for final analysis. The models enable us to determine the percentage differences between baseline and intervention groups. Ethics: The team has collected ethical clearance to conduct the study from the Arba Minch University Board of Institutional Ethical Review. Dissemination: As part of open science communication, the team is committed to publishing the protocol, procedures, findings of the trial, and then the data. Trial registration number: PACTR202211547107725 Pan African Clinical Trial Registry.

Abstract Introduction Despite strategies and recommendations for complementary feeding initiation were applied globally, mothers initiated complementary feeding to the infants on time was low. Previous works of literatures were not identified the effect of parity on time to initiate complementary feeding. Particularly, evidences regarding to this in Ethiopia is scanty. Therefore, this study aimed to identify the effect of parity on time to initiate complementary feeding among mother-infants pairs in Northwest Ethiopia. Methods A community-based prospective cohort study was carried out among 732 primipara, and 1464 multipara mothers who had a live birth in Northwest Ethiopia. Data were collected using Kobo collect software at the start of and on a monthly bases until the end of the follow up period. Parity as exposure variable and other confounders were analyzed using cox proportional hazard regression. Kaplan-Meier survival curve and the Schoenfeld residuals global test (P-value = 0.4861) was performed. Hazard ratio (HR) with 95% confidence intervals (CI) was used to declare statistical significance of predictors. Results The overall incidence rate of initiation of complementary feeding among primipara and multipara mothers were 16.27 (95%CI: 15.04, 17.61) and 13.30 (95%CI: 12.53, 14.12) person months’ observations respectively. The median time to initiate complementary feeding among primipara and multipara mothers for their infants was 5 and 6 months respectively. Primipara mothers had a 30% higher rate to initiate complementary feeding early (AHR = 1.30, 95%CI: 1.17, 1.43). Age from 15 to 24 and 25–34 years (AHR = 1.69, 95%CI: 1.36, 2.09; and AHR = 1.45, 95%CI: 1.17, 1.81) and Birth type (twin) (AHR = 1.29, 95%CI: 1.02, 1.64) were statistically significant predictors for time to initiate complementary feeding. Conclusions Parity was identified as a statistically significant predictor for time to initiate complementary feeding. The incidence rate of early and late initiation of complementary feeding was higher among primipara than multipara mothers. Besides, the median time to initiate complementary feeding was earlier among primipara than multipara mothers. So, a parity based complementary feeding practice education should be advocated to tackle the gap and further reduce infants and children malnutrition. Relatively younger age and twin delivered mothers initiated complementary feeding against the recommendation. Therefore, intervention considering such statistically significant predictors could have a public health importance.

Weaning, the transition from a milk-based diet to solid food, coincides with the most significant shift in gut microbiome composition in the lifetime of most mammals. Notably, this period also marks a “window of opportunity” where key components of the immune system develop, and host-microbe interactions shape long-term immune homeostasis thereby influencing the risk of autoimmune and inflammatory diseases. This review provides a comprehensive analysis of the changes in nutrition, microbiota, and host physiology that occur during weaning. We explore how these weaning-associated processes differ across species, lifestyles, and regions of the intestine. Using prinicples of microbial ecology, we propose that the weaning transition is an optimal period for microbiome-targeted therapeutic interventions. Additionally, we suggest that replicating features of the weaning microbiome in adults could promote the successful engraftment of probiotics. Finally, we highlight key research areas that could deepen our understanding of the complex relationships between diet, commensal microbes, and the host, informing the development of more effective microbial therapies.