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Dec 2025 DOI 10.14302/issn.2691-5014.jphn-25-5577
Gormley MarkCorresponding author
Infants with single ventricle (SV) physiology are at increased risk of undernutrition, which can contribute to adverse outcomes. This is a retrospective case series examining factors associated with undernutrition in patients with SV physiology at one year of age. It includes 56 infants from a single institution who underwent SV palliation between 2003 and 2023. Undernutrition was defined as a weight-for-length z-score (WLZ) below -1, based on World Health Organization (WHO) normative data. Independent variables included surgical interventions, cardiorespiratory factors, and nutritional interventions. Associations between these variables and nutritional status were assessed using Fisher’s exact test. At one year, a total of nine infants (16%) were undernourished. Undernutrition rates significantly declined after 2013 (p=0.02), demonstrating improvements in nutritional outcomes over our study period. Those who used supplemental oxygen or pulmonary medications were undernourished at lower rates. While this difference was not statistically significant, the number of undernourished patients in the cohort may have limited the study’s power. Our findings suggest that early respiratory interventions may provide nutritional benefits in infants with SV physiology.
Jan 2024 DOI 10.14302/issn.2691-5014.jphn-23-4865
Abdullahi Dahie HassanCorresponding author
Background Breastfeeding is a vital practice for infant health and well-being, with exclusive breastfeeding (EBF) during the first six months being particularly crucial. Despite its benefits, EBF is sub-optimally practiced in many low-to-middle income countries. This study focuses on Somalia, a country with historical political instability and poor health indicators, aiming to identify the prevalence and determinants of exclusive breastfeeding among women with infants under six months attending SOS Mother and Child Hospital in Mogadishu. Methods A hospital-based cross-sectional design was used, and data were collected through a structured questionnaire. The study sample consisted of 345 mothers, selected using a systematic sampling technique. Descriptive, bivariate, and multivariate analyses were conducted to assess breastfeeding practices and determine factors influencing exclusive breastfeeding prevalence. Result The study found that the prevalence of exclusive breastfeeding among the study population in Somalia was 44%, influenced by factors such as maternal education, employment, and utilization of antenatal and postnatal care services. Male infants and younger infants had higher odds of being exclusively breastfed. Conclusion and recommendations The study emphasizes the importance of promoting exclusive breastfeeding as the optimal feeding practice for infants in Somalia, highlighting the need for comprehensive health education during antenatal care visits and postnatal counseling. It recommends the development of supportive policies, such as maternity leave and workplace accommodations, along with community-based initiatives and support groups to facilitate and encourage exclusive breastfeeding practices.
Dec 2023 DOI 10.14302/issn.2998-4785.ijne-23-4798
Belle Jarvis ShivonCorresponding author
Gastric pneumatosis though rare, when seen is cause for concern. It has been associated with fulminant necrotizing enterocolitis (NEC) and gastric outlet obstruction, although other associations have been identified. It is not to be confused with pneumoperitoneum and can be managed conservatively as it is not always a harbinger of intestinal perforation. This case report highlights gastric pneumatosis which occurred in association with necrotizing enterocolitis in two late preterm infants. NEC accounts for 5.4% of our Neonatal Intensive Care Unit admissions, however these are the first two cases of gastric pneumatosis seen in the history of our unit. It is crucial for clinical staff to be cognizant of this pathognomonic sign so that cases are not missed, and for the feeding policy that governs the management of late preterm infants to be revisited. That which specifically predisposes a baby with NEC to developing gastric pneumatosis remains unknown and warrants further research.
Mar 2022 DOI 10.14302/issn.2690-4837.ijip-22-4080
O AmaewhuleCorresponding author
Department of Paediatrics, University of Port Harcourt Teaching Hospital. Nigeria.
Myiasis is a parasitic infestation of the body of a mammal caused by Cordylobia Anthropophaga (Tumbu fly) larvae. The infestation is prevalent in Sub-Saharan Africa, South-East Mexico and Central America. It is usually seen among rural dwellers and has no age or sex predilection. We report a case of Tumbu fly myiasis seen in a 7month-old male living in Port Harcourt, Nigeria who was erroneously thought to have bullous impetigo.
Nov 2019 DOI 10.14302/issn.2691-5014.jphn-19-3067
M. Czerkies LauraCorresponding author
Nestlé Nutrition, Arlington, VA
This study evaluated the impact of switching exclusively formula-fed infants with caregiver-perceived formula intolerance to a reduced lactose, partially hydrolyzed 100% whey-based formula (PHF-W) with Lactobacillus reuteri and 2-fucosyllactose. Infants identified as ‘very’ or ‘extremely’ fussy by caregivers were eligible for this single-arm, single-blind study. Subjects switched their current formula to study formula for three weeks. Gastrointestinal tolerance was assessed by the Infant Gastrointestinal Symptom Questionnaire (IGSQ) at baseline and end of the study. Caregivers ranked their infants’ fussiness (not at all, slightly, moderately, very, extremely) after the first three feedings of study formula and 24 hours after enrollment. A paired t-test was used to compare the change in IGSQ score, and a paired t-test and Wilcoxon signed rank test were used to compare post-feeding fussiness scores to baseline. Fifty infants (mean±std age 28.9±14.5 days) were enrolled; 41 completed the study per protocol. Mean (±std) baseline IGSQ score was 34.9±10.0, dropping to 22.1±7.5 after three weeks (p < 0.001). 48/50 (96%) caregivers stated their infants’ fussiness improved after 24 hours, and 2 (4%) remained the same. 42/46 (91%) caregivers stated their infants’ fussiness improved after the first feeding, and 4 (9%) remained the same. Caregiver-ranked fussiness significantly improved after the first, second, and third feedings and after 24 hours as compared to baseline (p < 0.001 for all). IGSQ scores significantly improved after three weeks of feeding with PHF-W containing Lactobacillus reuteri and 2-fucosyllactose in infants with caregiver-perceived intolerance, and improvements in fussiness were noted as quickly as after the first feeding.
Sep 2019 DOI 10.14302/issn.2474-3585.jpmc-19-3009
Konadu-Yeboah DominicCorresponding author
Orthopaedic and Trauma Surgeon, Komfo Anokye Teaching Hospital, Kumasi, Ghana, Part-Time Lecturer, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Blount’s disease, also known as tibia vara, is a developmental disorder involving the posteromedial proximal tibial physis resulting in progressive varus, procurvatum and internal torsion of the affected tibia 1. The condition was first published by Blount in 1973 2. The aetiology of this disease is unkown. However, associations exist between blount’s disease and the Afro-Caribbean race, early age of walking and obesity 34. Furthermore, genetic predisposition has been postulated as well as mechanical loading of the physis 456. Affected children are usually overweight and start walking early. It is bilateral in 80% of cases 7.
Aug 2019 DOI 10.14302/issn.2379-7835.ijn-19-2876
Oladejo T AdepojuCorresponding author
Department of Human Nutrition, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
Infant and young child feeding (IYCF) practices directly affect the nutritional status of children under two years of age, and ultimately, impact child survival. These practices are influenced by maternal knowledge and attitudes as well as socio-demographic and cultural factors; and an understanding of such factors is important to scaling up IYCF practices. This study was designed to assess the role of religion on knowledge, attitude and infant feeding practices among Christian and Muslim lactating mothers in Ibadan North Local Government Area (LGA), Oyo State. The descriptive cross-sectional study was conducted among 320 lactating mothers in the LGA. Eight focus group discussions were carried out among Christian and Muslim lactating mothers. An adapted pre-tested questionnaire was used to collect information on socio-demographic characteristics and IYCF knowledge, attitude and practices of the respondents. Knowledge on IYCF was assessed on 14-item scale, and the scores categorised as: ˂5.60 poor, 5.60–10.88 fair, and ˃10.88 good knowledge. Attitude was assessed on 13 statements from the IOWA Infant Feeding Attitude scale with lowest and highest obtainable score of 13 and 65 respectively. A score of ˂44 was ranked as poor, and ˃44 points good. Data were analysed using descriptive statistics and one-way ANOVA. Qualitative data was analysed thematically. Mean age of respondents was 30.0±4.9 years, 55.9% were Muslims, and 63.8% had fair knowledge. There was no significant difference in fair knowledge categorisation (63.7%, 63.8%), but there existed slight difference in good (20.7%, 21.3%) and poor (15.6%, 14.9%) knowledge of the Muslim and Christian respondents respectively. Mothers with poor attitude constituted 56.0%. Muslim religion directly supports pre-lacteal feeding and duration of breastfeeding while the other indirectly supports breastfeeding. Religious practices directly and indirectly affect knowledge, attitude and practices of nursing mothers on infant feeding; hence, healthcare Professionals should pay more attention to nutrition education in religious houses using the infant and young child feeding module.
May 2019 DOI 10.14302/issn.2575-1212.jvhc-19-2722
Rodrigues Reina Moreira PamelaCorresponding author
Department of Veterinary Pathology, UNESP – FCAV – Faculdade de Ciências Agrárias e Veterinárias, Jaboticabal city, São Paulo State, Brazil.
Onychogryphosis is one of the main clinical findings in dogs with visceral leishmaniasis (VL); however, research focusing on the subungual area of infected dogs is scarce. This study aims to assess the subungual area of dogs with VL that presented or not onychogryphosis by means of histopathological analyses and immunohistochemical studies (parasite burden). The third digit of the thoracic and pelvic limbs of Leishmania infantum naturally infected dogs was collected regardless of sex, breed or age. The animals were split into two groups, dogs with onychogryphosis (G1; n=7) and without onychogryphosis (G2; n=9). The digits were evaluated in four areas (dorsal epidermis/dermis, ventral epidermis/dermis, dorsal matrix/dermis and ventral matrix/dermis). All lesions observed (mononuclear inflammatory infiltrate, vacuolar degeneration of basal keratinocytes, dermoepidermal clefting and pigmentary incontinence) were present in both groups, being more severe in the digits of G1 group. Immunostaining of the amastigote forms of Leishmania infantum were observed in the different areas of the digit, with statistical difference between the dorsal epidermis/dermis area and the dorsal matrix/dermis of G1 group. In conclusion, the main histopathological alteration of the digit of dogs with VL is mononuclear inflammatory infiltrate and parasite burden, especially in cutaneous tissue adjacent to the nail matrix. This aspect can influence the onychogryphosis development, due to the presence of the parasite and by inflammatory mediators released in the nail microenvironment.
Nov 2017 DOI 10.14302/issn.2575-1212.jvhc-17-1764
Miguel Carreira L.Corresponding author
Anjos of Assis Veterinary Medicine Centre (CMVAA), Rua D.ª Francisca da Azambuja Nº9 -9A- Barreiro, Portugal
Leishmaniasis treatment monitoring is an important problem, since patient’s frequently present clinical signs improvements with positive indirect immunofluorescence (IFI) titers of anti-Leishmania antibodies, thus making difficult the clinician understand the therapy efficacy. The study aimed 1) to identify over a short period of 30 days, which of the main changes on the serum proteinogram fractions in patients treated with meglumine antimoniate and allopurinol, can be pointed as indicator to classify patients as slower or faster responsive to treatment. A sample of 56 dogs (n=56) with leishmaniasis diagnosis was followed-up for clinical condition, proteinograms and titers of anti-Leishmania antibodies during the treatment period considering three different time points: M0 (diagnosis moment), M1 (15 days after therapy start), and M2 (30 days after therapy start). Two groups of patients were considered according to their clinical condition evolution rate: faster recovery group (FRG) and slower recovery group (SRG). Statistical significant results were considered for p-value <0.05. Statistically significant differences in proteinogram variations between FRG and SRG were registered for TPs (p= 0.03), and for the fractions β (p=0.04), γ (p=0.04), amongst M0 and M2.The PT, β and γ-globulin fractions of proteinogram, in association with patient clinical assessment evolution should be considered as an indicator and a simple way to appoint the efficacy response of the patients to the therapy.
Mar 2017 DOI 10.14302/issn.2574-4526.jddd-17-1454
Malik LaraibCorresponding author
Paediatric unit II, P.I.C.U, Abassi Shaheed Hospital, Karachi,
Congenital malformations usually occur during organogenesis and result in complete or partial absence of an anatomical part or alteration in its normal configuration. Major structural anomalies occur in 2-3% of live births.The reported global incidence of tracheoesophageal fistula is roughly 1 in 2,500 live births and in Pakistan, incidence is only reported by those tertiary care centers which have paediatric surgery facilities available.We report a case of esophageal atresia (OA) with tracheoesophageal fistula (TEF) associated with meconium aspiration syndrome (MAS) in an infant. Reporting this anomaly highlights the importance of early diagnosis and thorough clinical examination of a newborn, signifying that a meticulous prenatal workup should be conducted. TEF/OA should be suspected in any newborn presenting with respiratory distress, especially cough, emesis and/or cyanosis during feeds, history of polyhydrominos and inability to pass nasogastric tube. The parents should also be counseled regarding future pregnancies as it carries a 1% risk of recurrence.
Dec 2025 DOI 10.14302/issn.2997-1977.jd-25-5754
Valentine Olagunju GraceCorresponding author
With more than 150,000 affected infants annually, Nigeria bears the largest burden worldwide of sickle cell disease (SCD), making it a significant public health concern. The management of SCD in Nigeria is challenging, despite advancements in medical research and increased knowledge. This review examines the numerous issues surrounding SCD in the nation, including the financial burden on affected families, the lack of specialized care facilities, the absence of newborn screening programs, the sociocultural stigmatization of SCD, and restricted access to high-quality healthcare. Additionally, inadequate public health education and a lack of coordinated national policies result in delayed diagnosis and suboptimal treatment outcomes. We also highlighted recent efforts and recommendations aimed at improving early detection, comprehensive care, and community support. Addressing these challenges through expanded health education and enhanced healthcare infrastructure is essential to reducing morbidity and mortality associated with SCD in Nigeria.
Jun 2025 DOI 10.14302/issn.2379-7835.ijn-25-5560
Bai YeonCorresponding author
The benefits of exclusive breastfeeding are well-known. Despite the legislative and systemic efforts to promote breastfeeding in South Korea, the nation’s current rate of exclusive breastfeeding (5.2%) during the infant’s first six months is alarming. Under the framework of the theory of planned behavior (TPB), this study elicited the beliefs around exclusive breastfeeding commonly held by low-income women participating in NutriPlus, the community nutrition program. Using a convenient sampling method, online open-ended surveys were conducted with two program clinics in Seoul during spring of 2024. The survey included questions about their demography and beliefs regarding indirect theoretical constructs of the exclusive breastfeeding behavior by listing top three things that came to their mind. A total of 120 NutriPlus clients participated in this survey. Though 53.1% of postpartum women were breastfeeding, only 28.1% were breastfeeding exclusively. Based on most frequently mentioned beliefs, we classified them to behavioral, normative, and control beliefs under TPB. Modal behavioral beliefs were healthy babies (n=87) and mother-baby bonding (n=71) and feeding issues (n=96) and inconvenience resulting from the act of breastfeeding (n=86). Family members seemed to shape both positive (n=122) and negative (n=37) normative beliefs. The presence of support (n=84) mattered to facilitate breastfeeding, while feeding issues (n=98) played as barriers. Promotion efforts need to emphasize breastfeeding knowledge and skill building and include family members and society at large to improve the awareness and transform barriers of breastfeeding to facilitators.
Mar 2023 DOI 10.14302/issn.2379-7835.ijn-22-4116
Shuja SabaCorresponding author
Background In Low Middle-Income Countries (LIMCs), malnutrition, especially undernutrition is one of the leading causes of childhood mortality and morbidity. Poor complementary feeding practices are among the most notable contributors to poor nutritional indicators in children under five. This article provides an output of secondary data analysis of the Cost of Diet (CoD) and Optifood component of National Complementary Feeding Assessment conducted by UNICEF Pakistan along with Pakistan Demographic Health Survey (PDHS) 2018. Methods For correlation of Optifood data and CoD data with PDHS data of CF, GraphPad software, MS Excel was used along with manual quantifications. The analysis of DHS-2018 data was conducted using STATA software. Univariate analysis included comparison of categorical variables i.e. various individual, household and community level parameters with that of outcome variables of minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum dietary diversity (MAD) using chi-square test. Findings The overall rate of MMF was 56.6% among children of 6-23 months of age with MDD in 18.6% and MAD in 13.8% of children. Percentage of annual cost spent on nutritious diet for MDD, MMF and MAD varies from 27.86% to 43.08% across all the provinces. Children aged 6–8 months and 9–11 months often consumed infant milk and cereals, while children aged 12–23 months often consumed eggs and grain products. Consumption of dairy products was highest in Punjab, Sindh, AJK, and Islamabad, that of grains roots and tubers was highest in KPK, FATA and GB. Conclusion Considering CF practices in Pakistan are inadequate as indicated by poor MDD, MMF, and MAD, therefore it is imperative that a holistic approach using both communication and non-communication based interventions is to be employed through active stakeholder engagement.
Oct 2022 DOI 10.14302/issn.2379-7835.ijn-22-4316
E. Moro GuidoCorresponding author
Board of Directors of AIBLUD (Italian Association of Donor Human Milk Banks), Milan, Italy
Background Growing scientific evidence points to the benefits of human milk for the growth and development of a newborn. Compelling evidence has confirmed the benefits not only for full-term babies but also for preterm infants. Objective This survey was planned by the Italian Ministry of Health together with the Italian Association of Donor Human Milk Banks (AIBLUD) and aimed to evaluate the activity of human milk banks (HMBs) in Italy in the period 2018-2020, analyzing several items and the impact of the COVID-19 pandemic. Methods Following the two surveys performed in 2012 and 2016, a third survey was planned in the year 2021 to evaluate possible changes in the activity of the Human Milk Banks (HMBs) operating in Italy. A questionnaire was sent to all the 41 HMBs officially operating in Italy in the year 2021 with the purpose to obtain national data concerning milk banks activity, number of donors, volume of human milk collected, and other information related to the years 2018, 2019 and 2020. Additional questions related to the impact of the COVID-19 on the activity of HMBs in the year 2020 were included. Therefore the questionnaire proposed in this third survey collected fundamental data on the donation of human milk with the implications related to the COVID-19 pandemic. Results 90% of the banks (37/41) responded to this survey. The collected data confirm the results of the second survey (2016), with a high level of adherence to the Ministerial Guidelines and the AIBLUD recommendations. The application of the principles of the HACCP system continues to improve (89%), while in the last three years there has been a sharp decline in the home collection service for donor human milk (68%). This decline is mainly linked to the interruption of this service due to the limitations imposed by the pandemic. In 2020 (the year of the COVID-19 pandemic) there was a clear reduction in the number of donors with a return to the values of 2016. The volumes of milk collected, and the average duration of donation, however, remained high. The reasons linked to the reduction in the number of donors are described. Conclusion This survey underlines the high quality standard of Italian HMBs and the usefulness of this service for the national health policy. Despite the difficulties due to the COVID-19 pandemic, the Italian HMBs have maintained an efficient and safe service and have guaranteed the collection of satisfactory volumes of donor milk. Lack of information represents the most important barrier to the donation of human milk.
Mar 2022 DOI 10.14302/issn.2575-1212.jvhc-22-4105
Zakir Abadura SadikCorresponding author
Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Jimma University, Ethiopia
Aflatoxins are toxigenic metabolites that are definitely occurring by lethal strains of Aspergillus parasiticus and Aspergillus flavus that commonly dwell and colonize in feed components and various nutritive foodstuffs particularly milk and milk based products. This Review has three main objectives; those are causes of aflatoxin, effects and methods of control in milk and milk products. Drinking of cow milk polluted with aflatoxin may overwhelm immunity and subsidize to stunting in young children, as the young children are not immune-competent during early stage. It has been internationally assessed that aflatoxin is possibly accountable for 30% of the annual cases of liver cancer. Generally, control approaches of aflatoxin can be applied during pre-harvest, cautious management in the time of harvest and postharvest decontamination. Moreover, choosing breed for aflatoxin impervious crop diversities, prevention of aflatoxin production through biological decontamination by microorganisms and their metabolites, rejection of aflatoxin by physical means in addition to inactivation by chemicals are the typical approaches that have been described in different studies. For the reason that cow milk is the most important and principal diet of children, but the risk of exposed to the cancer are more in infants. In addition, according to various investigations it also well thought that young animals are also found to be more vulnerable to aflatoxin than adults. Thus; the contamination of cow milk and milk products by AFM1 should understood as undesirable for young human and animals.
Jul 2021 DOI 10.14302/issn.2641-4538.jphi-21-3897
Pamela NanaCorresponding author
Interstate center in public health in Central Africa (CIESPAC)
Background Water-related diseases are water-related disorders of the body. They are a public health problem as they are responsible for 60% of infant mortality in our developing countries. There are few studies in South Cameroon on the subject. Overall Objective of this work was to study the explanatory behavioral factors of waterborne diseases in children aged 0 to 5 years in the health area of the urban dispensary in Ebolowa in Cameroon in 2020. Methodology This was an analytical cross-sectional study comparing two groups of children (group 1: children affected by waterborne diseases group 2: children unaffected by waterborne diseases) within the health area of the Ebolowa urban area. It lasted 21 months and the study period was from 28 December 2020 to 22 January 2021. We included children aged 0 to 5 years present in households where parents/guardians gave their informed consent. Sampling was probabilistic and cluster sampling. Using the Kelsey formula, we obtained a sample of 420 households and 566 children. Data was collected using a questionnaire and stored in the Excel spreadsheet and analyzed with CDC USA's epi info software 7.2.2.6. The calculation p value was done with Stat Calc at the significance threshold of 0.05. Bold The proportion of waterborne diseases was 97% (549/566) among the children aged 0 to 5 years surveyed. The most common reasons for using the health service for children aged 0-5 years were diarrhea 78.62% (IC75.06-81.80), and malaria 78.09% (74.09-81.30). The median age of children suffering from these pathologies was 36 months (24; 60). The gender ratio (Boys/Girls) was 2.06/1. Conclusion We propose to increase the awareness of mothers/guardians on good practices; also, to increase health promotion in the fight against waterborne diseases.
Jul 2021 DOI 10.14302/issn.2835-2165.jfsh-20-3579
Bedada ShumiCorresponding author
Disease Control and Prevention Department, Bale Zone Health Office, Robe, Ethiopia.
Introduction Foodborne diseases are a major public health problem which predominantly affects infants and young children. Appropriate complementary food hygiene practice is very important to reduce the prevalence of foodborne illnesses. However, the information regarding this practice is not available and assessed before. Thus, the study was aimed to assess complementary food hygiene practices among mothers of children aged 6-23 months. Methods A community based cross-sectional study was conducted in Robe town on a samples of 517 mother-child pairs, which were selected by using systematic sampling technique. Data was collected using pre-tested and structured questionnaire, and each variable was described in the frequency and percentage. Bivariable and multivariable logistic regression analyses were used to identify factors associated with complementary food hygiene practice. Odds ratios with 95% confidence interval were used to assess levels of significance. Result The result indicated that 55% of participated mothers scored above the mean score of food hygiene practices. Mothers of children aged 12-23 months had higher odds to practice good food hygiene measures than those of aged 6-11 months (AOR, 1.82 95% CI (1.21, 2.73)). Mothers whose children attended growth monitoring session practice good food hygiene than their counterpart (AOR, 2.74 95% CI (1.49, 5.06)). Mothers having media exposure, and having knowledge on critical times of hand washing had relatively good food hygiene measures (AOR, 0.73 95 CI (1.14, 2.62)). Among food hygiene measures; handwashing with water and soap were low before eating food (17%), before feeding children (21%) and before preparing food (32%) when compared with after visiting the toilet (81%) and touching dirt (68%). Conclusion and Recommendation The study identified that food hygiene practices in the current study were mainly associated with child age, growth monitoring follow-up, maternal awareness about critical times of hand washing, and media exposure. So, improving knowledge of mothers on critical times of handwashing, strengthening growth monitoring follow-up and media promotion are important measures to improve food hygiene practices among mothers of infants and young children.
Aug 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3444
Aboma DanielCorresponding author
Shenen Gibe General Hospital, Msc, IESO
Background In Ethiopia, the levels of maternal and infant morbidity and mortality are among the highest in the world. This is attributed to, among other factors, none use of modern health care services by women. According to the 2011 Ethiopian Demographic Health Survey, more than seven in ten mothers did not receive antenatal care at all. Objectives The objective of this study was to determine level and identify factors influencing maternal antenatal care services utilization among mothers who gave birth in the last twelve months in Gelemso town west Hararghe Oromia, Ethiopia. Methods A community-based cross sectional study design was conducted on 347 study participants in Gelemso town west Hararghe Oromia Ethiopia from July 15, 2017 to August 15, 2017 G.C.A probability to proportional to size sampling technique was used to select the study population in two urban Kebeles. Data were collected using a pre tested structured questionairs. Descriptive results were presented using frequencies, and numerical summary measures. Bivariate analysis was carried out to assess the association between outcome variable and each in dependent variables. Odds ratio with 95% confidence level was estimated to identify factors associated with Antenatal Care (ANC) utilization using multivariable logistic regression. The statistical significance was declared at p- value < 0.05. Result The response rate this study was 98%. The prevalence of antenatal care service utilization was 64.6%. About 146 (42.1%) of the pregnant mother started antenatal care visit during the second trimester of pregnancy and a significant proportion 289(83.3%) had less than the recommended four visits. Educational status (AOR;15.19:CI 95%,6.006,38.417), husband attitude (AOR;1.995:CI 95%,1.016,3.916), marital status(AOR:4.587:CI 95%,1.888,11.146), planned pregnancy (AOR:4.938:CI 95%,2.514,9.702) were major factors associated with antenatal care service utilization. Conclusion Though more than half mother used antenatal care service in the study setting, two in ten of the mothers did not have the minimum number of visits recommended by World Health Organization. Promotion of information, education and communication in the community should be strengthened is to sustain antenatal care service utilization in the community.
Apr 2019 DOI 10.14302/issn.2643-6655.jcap-19-2737
Köhler-Dauner FranziskaCorresponding author
Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm
Background Mothers with a history of childhood maltreatment (CM) are likely to transmit their own experiences to the next generation. This is highly influenced by the quality of maternal behavior that enables to buffer infant’s hypothalamic-pituitary-adrenal (HPA) axis response to stress. From a transgenerational perspective the research question is, if infant’s cortisol stress response is influenced by maternal CM experiences or rather by the behavioral pathways during the first year of life. Methods 53 mother-child-dyads were measured at 12 months of infant’s age in a laboratory visit assessing the maternal quality of interactive behavior using the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE) measured during the strange situation procedure (SSP). Maltreatment experiences were assessed using the childhood trauma questionnaire (CTQ). Salivary cortisol of mother and infant were collected prior to and directly, 15 and 30 minutes after the SSP. Results Infants of disruptive mothers showed a significant increase in cortisol (F (3; 147) = 2.897, p= 0.048) after the SSP compared to infants of mothers with sensitive caregiving. Maternal CM did not influence the infant’s cortisol stress response due to the SSP. However maternal cortisol response was altered by trend due to CM (F (1.392; 71.008) = 3.157, p= 0.066). Conclusions Our data indicate that infant’s cortisol stress reactivity is influenced by the quality of maternal behavior and not by the transgenerational transmission of maternal CM experiences per se. These findings implicate that helping mothers to improve their caregiving behavior may help to improve stress-reactivity of their infant.
Apr 2019 DOI 10.14302/issn.2644-0105.jbfb-19-2681
L. Blanco CynthiaCorresponding author
Division of Neonatology, Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas.
This study compared the effect of container material type on macronutrient changes in human breast milk (HBM) during frozen storage. HBM was collected from breastfeeding mothers and baseline macronutrients were analyzed and recorded. The HBM was aliquoted into milk storage containers of five commonly used materials (low-density polyethylene (LDPE), polypropylene (PP), glass, stainless steel, and silicone). The samples were frozen in a standard freezer (-20°F) for 30, 60, and 180 days prior to thawing and retesting macronutrient values. In the 155 samples analyzed, macronutrient changes among different types of storage materials were insignificant at 30 and 60 days of frozen storage. When comparing macronutrients at baseline to 180 days, there was a significant decrease in protein value over time in LDPE containers as compared to silicone containers (p=0.001). Likewise, there was a significant decrease in total calories from baseline to 180 days in both PP and LDPE containers compared to silicone (p=0.046 and 0.013, respectively). While not significant for short-term storage, HBM has losses of macronutrients (protein) with long-term storage in LDPE and PP plastics. These differences could have major nutritional impact on growth, particularly to infants born prematurely.
Mar 2019 DOI 10.14302/issn.2381-862X.jwrh-19-2617
K Wood NatsukoCorresponding author
Assistant Professor at Washington State University College of Nursing, Spokane, WA, USA.
Objective The purpose of this study was to evaluate the feasibility of a home-based educational skill building program to support exclusive breastfeeding for mothers in the early postpartum period. Specific aims were to: (1) evaluate the effectiveness of the study’s recruitment strategy, comparing the use of an intermediary with a direct approach, (2) examine intervention fidelity, (3) examine program adherence, and (4) assess the acceptability of the intervention to participants. Design and Sample A mixed methods within-group, three-occasion descriptive design, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants. Intervention The program was implemented during three, 60-90 minute educational training sessions in the home, delivered at 6, 13, and 27 days postpartum. Results Mothers who adhered to the intervention protocol correctly attributed their infant’s crying behavior to factors other than the adequacy of the mother’s milk supply. All participants were recruited through direct approach. The program was delivered as planned with high fidelity, a high retention rate, and with a high rate of acceptability. Conclusions A fully scripted, at-home, nurse-delivered educational skill building program can be delivered with efficiency to breastfeeding mothers with full-term singleton infants; intervention fidelity, retention, and acceptability were high.
Feb 2019 DOI 10.14302/issn.2641-4538.jphi-19-2589
Ahmadou Diallo AlphaCorresponding author
Ministry of Health
Several studies show that policies to improve maternal and infant health must be contextualised within broader questions and commitments concerning women’s empowerment. There are, however, two-way linkages between women’s empowerment and reproductive services. Certain institutional approaches that support women’s reproductive health can themselves be experienced as empowering whereas others, however well-meaning, can be experienced as disempowering, undermining health and broader goals. It is thus important to discern and support those elements of reproductive services that might have empowerment outcomes, and to avoid others that undermine them. This paper is premised on the hypothesis that approaches to reproductive health that are rooted in women’s life worlds, that support women’s social networks and which enhance women’s confidence and control will have very different empowerment effect from those that subordinate women and their networks to external expertise and (often male) authority and undermine women’s preferences or autonomy. We (a) conduct an audit of positive practices concerning maternal and child health and (b) examine how current support to maternal and infant health articulates with this. Analysis seeks to reposition indigenous knowledge, community wisdom and their secular practices in a way that promotes better health provision that is integrated with these existing practices and that is empowering.
Jan 2019 DOI 10.14302/issn.2691-5014.jphn-18-2456
Mohamadreza AmiriCorresponding author
Vitamin D, the sunshine vitamin, is now recognized not only for its importance in promoting bone health in children and adults, but also for its other health benefits, including reducing the risk of chronic diseases such as autoimmune diseases, common cancer, and cardiovascular diseases. Ultraviolet radiation of the sun with wavelengths of 290-310 nm penetrates into the skin and converts 7-dehydrocholesterol to previtamin D3, which quickly transforms to vitamin D3. Vitamin D (D represents either D2 or D3) made in the skin or ingested through diet is biologically inert and requires two successive hydroxylations first in the liver on carbon 25 to form 25-hydroxyvitamin D 25(OH)D and then in the kidney for a hydroxylation on carbon 1 to form the biologically active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)2D) 121419. The concentration of the produced 25-hydroxy vitamin D in blood circulation is 1,000 times more than 1,25-dihydroxy vitamin D 4, and it is regarded as a standard indicator of vitamin D status in humans 3. 25-hydroxy vitamin D half-life is about 2-3 weeks and it is regulated by calcium (Ca), phosphorus (P), and serum parathyroid hormone (PTH) to some extent. 25-hydroxy vitamin D content also reflects the amount of vitamin D produced in the skin after exposure to sunlight or received through food intake 56. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published from many countries and regions all over the world 7891011. Vitamin D deficiency is a pandemic problem. According to global estimations, more than one billion people around the world suffer from vitamin D deficiency. Among Iranian population, the incidence of vitamin D deficiency varies from 2.5 to 98.5% based on geographic area 1213. Various factors may give rise to vitamin D deficiency, including skin pigments, low levels of vitamin D in diet (insufficient fish oil and egg yolk intake), malnutrition, genetic factors, exclusive breast feeding, vitamin D deficiency of mother during pregnancy, prematurity, chronic use of drugs (e.g., anticonvulsants, aluminum-containing anti-acids, rifampcin, isoniazid, antifungal drugs, antiviral drugs, and glucocorticoids), winter and obesity 113. Cultural habits, the need for full body coverage during outdoor activities and the lack of sunlight programs are the risk factors for low vitamin D levels in women 151617. Children enter foster care due to early childhood adverse experiences such as poor prenatal and infant health care, food insecurity, chronic stress, and the effects of abuse and neglect. As a result, they are at higher risk for poor physical, psychological, neuroendocrine and neurocognitive outcomes compared to others. Foster children are at risk for growth and nutritional deficiencies due to their poor nutritional environment prior to placement in foster care. Insufficient caloric intake results in growth deficiencies. Evidence showed that the risk of stunting and underweight is high in this population 18. The risk of developing hypovitaminosis D was significantly higher in children living in foster homes. One reason is that they are at higher risk of child abuse, emotional deprivation and physical neglect than children living with their families. Moreover, these children most likely do not spend much time outdoors and they lack adequate sun exposure. Another reason is that as children grow up in institutional care, they shift from a diet of vitamin D–fortified formula milk to cooked food, which may not be fortified with vitamin D 1. Iranian government has made some efforts to apply efficient interventions to reduce the prevalence of vitamin D deficiency, and the country’s healthcare system should be managed through accurate planning. Yet, in this country, studies on vitamin D deficiency in children living in foster homes are very limited, and given that timely diagnosis and treatment of this deficiency is vital, this research is conducted in Ali Asghar foster home in Mashhad, Iran.
Aug 2018 DOI 10.14302/issn-2470-0436.jos-18-2222
B. Iguban EleonoreCorresponding author
Department of Ophthalmology and Visual Sciences, University of the Philippines Manila, Philippines.
Objective: The aim of the present study is to determine the efficiency of third year ophthalmology residents from a tertiary hospital in performing preliminary retinal examination to identify eyes at risk retinopathy of prematurity on the basis of retinal fundus findings up to International Classification of Retinopathy of Prematurity (ICROP) Zone II. Methods: This is a single-center, cross-sectional, prospective comparative research conducted from June to October 2015 at a tertiary training hospital in the Philippines. All infants referred for retinopathy of prematurity screening within the study period where included. The presence of retinal vessel dilatation and tortuosity were identified by third year ophthalmology residents using indirect funduscopy. The residents’ fundus findings were then compared to that of a retina consultant who is proficient in the diagnosis and management of retinopathy of prematurity (ROP). The Kappa index was used to rate inter-observer agreement. The correlation between ROP risk factors and the presence of abnormal retinal vessels were assessed using odd ratio computations. Fisher’s exact test was used to determine the correlation between retinopathy of prematurity and the presence of retinal dilatation and tortuosity. The McNemar’s test was also applied to determine significant differences in the retinal findings of the consultant and ophthalmology residents. Results: A total of 82 eyes of 41 premature infants were evaluated to determine if retinal findings observed by ophthalmology residents were comparable to that of a retina consultant. Odds ratios show that age of gestation, birth weight, and history of blood transfusion are significantly associated with the presence of retinopathy of prematurity. Retinal vessel tortuosity and dilatation are also more common among infants diagnosed with retinopathy of prematurity. There was no significant difference between the retinal vascular findings of the retina consultant and the third year ophthalmology resident in terms of identifying retinal vessel dilatation and tortuosity (P < 0.05). Conclusion: After sufficient and in-depth ophthalmology training, third year ophthalmologists, who will be general ophthalmologists in the future, can reliably identify eyes at risk for severe retinopathy of prematurity on the basis of retinal vascular dilatation and/or tortuosity.
Nov 2017 DOI 10.14302/issn.2574-4518.jsdr-17-1754
Sedky KarimCorresponding author
Cooper Medical School of Rowan University, Camden, NJ
Objective: Individuals diagnosed with Down syndrome (DS) are predisposed to obstructive sleep apnea (OSA). The aim of this study is to assess the prevalence of OSA and factors associated with OSA in this population. Study Design: Systematic literature review and meta-analysis. Methods: Studies of DS and OSA in the English language through May 2017 were reviewed. Since parental report of symptoms has limited validity related to the diagnosis of OSA, only studies using in laboratory polysomnography to diagnose OSA were included. Results: Twenty three studies examining OSA among 1,469 people with DS were found. Among ten studies using community referred samples, 71.5% of people with DS had OSA, compared to 69.6% in referred community samples suspected of having respiratory events. There was an inverse relationship between apnea hypopnea index (AHI) cutoffs and OSA prevalence as higher cutoffs were associated with somewhat lower prevalence. Examining age groups, adults had a higher prevalence of OSA (90.0%) compared to infants (66.5%) and children between 2-21 years of age (69.9%). Oxygen desaturation and gender did not affect prevalence. Although surgery had less effect on successfully treating OSA among DS individuals compared to those without DS in prior studies, lingual tonsillectomy had the greatest effect (mean AHI decrease of 9.0). Conclusion: OSA appears to occur frequently in children and adults with DS. Untreated, OSA may contribute to health problems and premature death, highlighting the potential importance of identifying OSA among people with DS. Even after traditional surgeries (i.e., adenotonsillectomy, tonsillectomy, adenoidectomy), repeating PSG is highly recommended as residual OSA can persist
Feb 2017 DOI 10.14302/issn.2997-2086.jfs-16-1098
Burjonrappa SathyaprasadCorresponding author
Department of Pediatric Surgery, Winthrop University Hospital, Mineola, NY 11501
We report a twin gestation with one fetus afflicted by a left sided Extra-Lobar Sequestration (ELS) in a morbidly obese mother. The ELS was complicated by a left pleural effusion in the second trimester unresponsive to maternal steroid administration. We discuss the need for repeat shunt placement, in the setting of maternal morbid obesity and twin gestation. Shunt replacement was necessary secondary to dislodgement. Delivery at 34 weeks gestation was followed by successful surgical removal of the ELS. At one year follow up the infant has complete expansion of the left lung with no morbidity.
Jan 2017 DOI 10.14302/issn.2379-7835.ijn-16-1408
Bukusuba JohnCorresponding author
School of Food Technology, Nutrition and Bio-engineering, Makerere University, Kampala, Uganda
Despite the agreed global and national stunting reduction targets, Uganda has made very little progress. Understanding context-specific risk factors for stunted growth is therefore pertinent to designing programs to address the problem. A cross-sectional study was conducted in 32 randomly selected villages in Buhweju district, Southwest Uganda. Data entry, cleaning and analysis were carried out using Statistical Package for Social Sciences (SPSS) version 21. A regression analysis was conducted to examine the associations between potential risk factors and stunted growth. The survey covered 256 households and anthropometric measurements were taken for 221 children aged 6–59 months. The majority of the households (66%) in the district were food insecure and had a low socioeconomic status (84%). The prevalence of stunting in Buhweju district was 51%, which is significantly higher than the regional and national averages. Only 28% of the children were exclusively breastfed in the first 6 months of life, and only 10% of them received the minimum acceptable diet (MAD). The findings of this study demonstrate that reductions in stunted growth at national or regional levels has not necessarily translated into similar trends in rural areas of Uganda. The notable contributors to stunting in these areas include morbidity, sub-optimal infant and young child feeding (IYCF) practices, low consumption of animal-source foods, food insecurity, lack of access to high-quality drinking water, sanitation and hygiene (WASH) facilities and poverty. Increased investment in both nutrition specific and sensitive interventions is therefore crucial to address these risk factors.
Nov 2016 DOI 10.14302/issn.2644-0105.jbfb-16-1257
Aumeistere LivaCorresponding author
Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
Background: Breast milk is the ideal food source that contains all components an infant needs. Infants are at risk of receiving possible pollutants and high levels of trans fatty acids through breast milk that may affect their cardiovascular health and cognitive development. Statistics indicate that the proportion of children who are breastfed up to one year of age shows an annual increase in Latvia. Objectives: 1. To review studies conducted among the Latvian population regarding breast milk composition. 2. To evaluate the necessary future studies emphasizing the importance of the trans fatty acid content in a mother’s diet and correspondingly in breast milk and taking into consideration the new changes in Latvian legislation setting the maximum trans fat content in foodstuffs. Conclusions: There is very little research done about the human milk composition in Latvia that could be referable to a general population. It is known that the exposure of breast milk to persistent organic pollutants in Latvia corresponds to the lowest levels detected in the European countries and is not a cause of health disorders. Taking into consideration the adverse effect trans fatty acids have on human’s health regardless of the age, consumption should be as low as possible. Latvia has become the latest European Union country to set the maximum amount of trans fats in foodstuffs, yet there is no information about trans fatty acids content in human milk among women in Latvia. This problem needs to be addressed and set in motion. Therefore, it would be a novel idea to study if the TFA content also declines in milk among Latvian women after the introduction of the new legislation.
Jul 2016 DOI 10.14302/issn.2644-0105.jbfb-16-1121
Anderson GeorgeCorresponding author
CRC Scotland & London, Eccleston Square, London, UK.
The biological underpinnings that drive the plethora of breastfeeding benefits over formula-feeding is an area of intense research, given the cognitive and emotional benefits as well as the offsetting of many childhood- and adult-onset medical conditions that breast-feeding provides. In this article, we review the research on the role of melatonin in driving some of these breastfeeding benefits. Melatonin is a powerful antioxidant, anti-inflammatory and antinociceptive as well as optimizing mitochondrial function. Melatonin is produced by the placenta and, upon parturition, maternal melatonin is passed to the infant upon breastfeeding with higher levels in night-time breast milk. As such, some of the benefits of breastfeeding may be mediated by the higher levels of maternal circulating night-time melatonin, allowing for circadian and antioxidant effects, as well as promoting the immune and mitochondrial regulatory aspects of melatonin; these actions may positively modulate infant development. Herein, it is proposed that some of the benefits of breastfeeding may be mediated by melatonin's regulation of the infant's gut microbiota and immune responses. As such, melatonin is likely to contribute to the early developmental processes that affect the susceptibility to a range of adult onset conditions. Early research on animal models has shown promising results for the regulatory role of melatonin.
May 2015 DOI 10.14302/issn.2379-7835.ijn-14-584
W. Hey DavidCorresponding author
STRIDE California Polytechnic State University, San Luis Obispo, CA 93407
During the past three decades the prevalence of childhood obesity has steadily increased in the United States. Causes of childhood obesity are complex and include numerous individual and environmental factors. The purpose of this study was to determine parent perceptions on the social-ecological barriers (community, school, and family) to physical activity and healthy eating, perceived specific to their children. Self-reported data gathered from a 50-item questionnaire and six focus groups were conducted with parents (n=43) enrolled in the Women, Infants, and Children (WIC) Program. Participants (16 to 67 years old) were predominately female (88.4%), Hispanic (67%), low income, and living in or near Lompoc in Santa Barbara County, CA. The social-ecological model (family, school, and community) was utilized to create focus group questions and provide recommendations as part of the Lompoc Community Health Improvement Project (2006-to-the-present). Popular community barriers for physical activity were: disconnected sidewalks, lack of safe bike routes to school, lack of recreational programming at an affordable cost, and language barriers (lack of marketing physical activity programs in Spanish). Two safety barriers involved parks; fear of injury (dilapidated equipment) and fear of gangs (violence). Common school barriers were: teachers do not lead-by-example, lack of healthy food in school cafeteria, and insufficient time for children to purchase food and eat. Family barriers included: grandparents sabotaging healthy eating environments (e.g., spoiling children), insufficient nutrition knowledge (both children and parents), and economics (not being able to afford healthy food and a recreation/gym membership).
May 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-186
A. Weiss JosieCorresponding author
Christine E. Lynn College of Nursing, Florida Atlantic University
Despite recent improvements in teen pregnancy and birth rates, 2000 teens get pregnant each day in the U.S. Innovative strategies that are effective and acceptable within communities are needed to continue these declines in teen pregnancies. Captivating educational interventions enhanced by infant simulators, such as “Baby Think it Over” (BTIO), can discourage teen pregnancy. The purpose of this research was to evaluate a BTIO intervention to determine the effectiveness of the program in changing 236 high school students’ perceptions of the costs of teen parenting. From a comparison of pre-test/two post-test measures, it appears the participants recognized that teen parenting would be costly in terms of increased difficulty in making responsible decisions as well as the challenges of juggling school with parenting. They also recognized other costs including negative impacts on relationships, on feelings of personal worth, and the likelihood of diminished achievements in the future.
May 2014 DOI 10.14302/issn.2324-7339.jcrhap-12-186
A. Weiss JosieCorresponding author
Christine E. Lynn College of Nursing, Florida Atlantic University
Despite recent improvements in teen pregnancy and birth rates, 2000 teens get pregnant each day in the U.S. Innovative strategies that are effective and acceptable within communities are needed to continue these declines in teen pregnancies. Captivating educational interventions enhanced by infant simulators, such as “Baby Think it Over” (BTIO), can discourage teen pregnancy. The purpose of this research was to evaluate a BTIO intervention to determine the effectiveness of the program in changing 236 high school students’ perceptions of the costs of teen parenting. From a comparison of pre-test/two post-test measures, it appears the participants recognized that teen parenting would be costly in terms of increased difficulty in making responsible decisions as well as the challenges of juggling school with parenting. They also recognized other costs including negative impacts on relationships, on feelings of personal worth, and the likelihood of diminished achievements in the future.