Search Results (82)

Background: Socioeconomic factors may influence maternal nutrition knowledge (MNK), which directly affects the nutritional status of children under five. This study aims to explore the importance of socioeconomic factors associated with MNK and nutritional status. Methods: This cross-sectional study focused on mothers of children aged 36–59 months (n = 657). A structured questionnaire was employed to collect data on socioeconomic factors. Anthropometric measurements were taken to assess nutritional status. The Boruta algorithm, implemented using R Studio version R.4.5.1, was used to identify the most important socioeconomic factors associated with MNK and nutrition status. Results: The analysis revealed that socioeconomic status (SES) emerged as an important factor associated with MNK and nutrition status, particularly stunting and wasting. However, SES was not confirmed as an important factor associated with underweight. This study uncovered a bidirectional relationship between child nutrition outcomes; underweight was found to be an important factor related to stunting and wasting, whereas stunting and wasting were important factors for underweight. Furthermore, infant and young child feeding (IYCF) indicators, such as weaning practices and exclusive breastfeeding (BF), were found to be important factors for stunting and wasting. Conclusions: The interlinkage among forms of undernutrition, where each nutritional outcome is related to other outcomes, underscores the importance of comprehensively addressing child undernutrition, rather than focusing on single outcomes independently. Moreover, the association between SES and MNK, wasting, and stunting supports approaches based on holistic and multi-sectoral strategies to reduce poverty by WASH programs, promote IYCF practices, and improve healthcare access by providing health insurance coverage. Full article

In emergencies, the maternal and child populations face increased risk of morbidity and mortality, often exacerbated by malnutrition. Breastfeeding, adequate complementary feeding, and appropriate prenatal care can mitigate these risks. This descriptive cross-sectional study compared data collected before and after Hurricane John related to maternal, infant and young child feeding (IYCF) practices and the nutritional status of pregnant women and children under two years of age. Data were collected in December 2024 from the two provinces most affected in Guerrero, Mexico. Surveys were completed for 239 children through caregivers and 76 pregnant women, alongside anthropometric assessments. After the disaster, findings showed a significant decline in breastfeeding among 0–6-month-olds (88.7% to 71.1%) and an increase in dietary diversity in complementary feeding (3.6 ± 2.1 vs. 4.5 ± 1.5 food groups). Malnutrition, based on weight-for-length z-scores, was observed in 4.8% of children aged 0–6 months and 2.6% of those aged 6–24 months. According to mid-upper arm circumference, 8.4% of children aged 0–6 months presented malnutrition. Among pregnant women, based on body mass index, 41.5% had excessive pre-pregnancy weight, while 12.3% were underweight. These findings underscore the urgent need to integrate maternal and child nutrition into emergency preparedness and response strategies to protect vulnerable populations in Mexico. Full article

Background/Objectives: Childhood stunting remains a critical public health issue in low- and middle-income countries. Despite Malaysia’s economic growth, there is limited large-scale evidence on the determinants of stunting among children from infancy to primary school age. This cross-sectional study, part of South East Asian Nutrition Surveys II (SEANUTS II), aimed to determine sociodemographic and environmental risk factors for stunting among 2989 children aged 0.5–12 years. Methods: Children were recruited from four regions in Peninsular Malaysia (Central, East Coast, 2022–2030Northern, Southern). Standing height or recumbent length was measured, and stunting was classified based on WHO criteria (height-for-age Z-score below −2 standard deviations). Parents reported information on socioeconomic status, sanitation facilities, and hygiene practices. Multivariate binary logistic regression was used to determine the determinants of stunting. Results: Stunting prevalence was 8.9%, with infants (aOR = 2.92, 95%CI:1.14–7.52) and young children (aOR = 2.92, 95%CI:1.80–4.76) having higher odds than school-aged children. Key biological predictors included low birth weight (aOR = 2.41; 95%CI:1.40–4.13) and maternal height <150 cm (aOR = 2.24; 95%CI:1.36–3.70). Chinese (aOR = 0.56; 95%CI:0.35–0.88) and Indian children (aOR = 0.16; 95%CI:0.05–0.52) had a lower risk of stunting compared to Malays. Conclusions: This study highlights the ongoing challenge of childhood stunting in Malaysia, with age, birth weight, ethnicity, and maternal height identified as key determinants. These findings call for early identification of at-risk households and targeted support, especially through education and financial aid to foster healthy child growth. Full article

Adequate and diverse diets are essential for children’s physical and cognitive development, yet food insecurity and malnutrition continue to threaten this fundamental right, which remains a pressing concern in many resource-poor settings. This study investigated food and nutrition security in Early Childhood Development (ECD) centres in Makhanda, South Africa, through a community-based participatory research approach. Using a mixed-methods approach combining questionnaire interviews, focus group discussions, direct observations, and community asset mapping across eight ECD centres enrolling 307 children aged 0–5 years, the study engaged ECD facilitators and analysed dietary practices across these centres. Results indicated that financial constraints severely affect the quality and diversity of food provided at the centres, thus undermining the ability to provide nutritionally adequate meals. The average amount spent on food per child per month at the centres was R90 ± R25 (South African Rand). Although three meals were generally offered daily, cost-driven dietary substitutions with cheaper, less diverse alternatives, often at the expense of nutritional value, were common. Despite guidance from Department of Health dieticians, financial limitations contributed to suboptimal feeding practices, with diets dominated by grains and starchy foods, with limited access to and rare consumption of protein-rich foods, dairy, and vitamin A-rich fruits and vegetables. ECD facilitators noted insufficient parental contributions and low engagement in supporting centre operations and child nutrition provision, indicating a gap in awareness and limited nutrition knowledge regarding optimal infant and young child feeding (IYCF) practices. The findings emphasise the need for sustainable, multi-level and community-led interventions, including food gardening, creating ECD centre food banks, parental nutrition education programmes, and enhanced financial literacy among ECD facilitators. Strengthening local food systems and establishing collaborative partnerships with communities and policymakers are essential to improve the nutritional environment in ECD settings. Similarly, enhanced government support mechanisms and policy-level reforms are critical to ensure that children in resource-poor areas receive adequate nutrition. Future research should focus on scalable, locally anchored models for sustainable child nutrition interventions that are contextually grounded, community-driven, and should strengthen the resilience of ECD centres in South Africa. Full article

Objective: The aim of this study was to assess complementary feeding practices and dietary diversity in relation to the nutritional status of children under five attending health facilities in the Thabazimbi sub-district, Limpopo Province. Methods: A cross-sectional study was conducted among 409 mother–child pairs. Data on socio-demographics, feeding practices, and anthropometry were collected using validated tools. Nutritional status was assessed using WHO growth standards, and dietary diversity was evaluated using WHO infant and young child feeding (IYCF) indicators and a 24 h dietary recall. Associations were analyzed using prevalence ratios in STATA 18. Results: Among 409 children (median age: 18 months, IQR: 12–24), 38% were stunted, 13% were underweight, 5% were thin, and 17% were overweight/obese. Exclusive breastfeeding was reported in 27%, and only 24% met the minimum dietary diversity (DDS ≥ 4). Complementary feeding practices varied significantly by maternal age, with mixed feeding more common among older mothers and younger mothers more likely to receive feeding advice (p = 0.001). Stunting was associated with being a boy (PR = 1.27; 95% CI: 1.00–1.61), age > 24 months (PR = 0.33; 95% CI: 0.16–0.65), and DDS ≥ 4 (PR = 0.72; 95% CI: 0.52–0.99). Underweight was more prevalent among boys (PR = 2.40; 95% CI: 1.40–4.11), but less likely in children with DDS ≥ 4 (PR = 0.43; 95% CI: 0.20–0.92) and those from spouse-headed households (PR = 0.33; 95% CI: 0.13–0.87). Thinness was associated with DDS ≥ 4 (PR = 2.70; 95% CI: 1.13–6.45) and age 12–24 months (PR = 2.80; 95% CI: 1.02–7.64). Overweight/obesity was linked to age 12–24 months (PR = 1.94; 95% CI: 1.25–3.03) and household income > ZAR 15,000 (PR = 4.09; 95% CI: 2.33–7.17). Conclusions: Complementary feeding and dietary diversity deficits contribute significantly to the dual burden of malnutrition in rural Limpopo, highlighting the need for targeted, context-specific nutrition interventions. Full article

The function of the immune system is not only dependent on factors like genetics, age, the environment, and exposure to infectious agents and allergens but also on our microbiota and our diet. It has been known for centuries that food can influence health and vulnerability to infection. This is especially true for infants, young children, and the elderly. This review focuses on how nutrition can support immune function from gestation to school-aged children. Immune support begins during pregnancy by the mother’s diet and transfer of nutritional components as well as antibodies to her fetus. After birth, breastfeeding is of crucial importance for immune development as well as for the development of the intestinal microbiota of an infant. If breastfeeding is not possible, early-life formulas are an alternative. These can provide several of the functionalities of breastmilk, as well as the key nutrients a child needs. New foods are introduced during and after weaning, and after this period, children switch to consuming a normal diet. However, due to circumstances, children can be malnourished. This can range from severe protein/energy malnutrition to micronutrient deficiencies and obesity, all of which can affect the function of the immune system. This narrative review describes the immune challenges in early life, explores breastfeeding and early life nutrition, and provides mechanistic insight into the relative contribution of macronutrients, micronutrients and other immunomodulatory food components that can support immune function in early life. Full article

In neonates, estimation of the glomerular filtration rate is problematic, and assessment of renal impairment is challenging. Serum creatinine is a widely used marker, and urine output is an important vital parameter monitored in intensive care settings, particularly in unwell neonates. However, the rapid changes after birth with adaptation to the extrauterine environment is a unique situation in which absolute serum creatinine is not a reliable indicator of renal function. A rise in serum creatinine from the previous value during the neonatal period can be a result of worsening renal function in neonates but is dependent on many other factors. In addition, urine output can be difficult to measure in sick neonates during their intensive care stay. Despite a high prevalence of acute kidney injury (AKI) in preterm and/or unwell infants, the current definitions are not straightforward and do not take postnatal adaptation processes into account. The management of AKI is challenging in very young and small patients because the assessment of fluid status as well as balancing nutritional needs with fluid restriction can be problematic. The Australian Neonatal Medicines Formulary provides advice on drug dosing in the face of reduced renal function in neonates. Predictors (or long-term outcome, or recovery) after AKI diagnosis are still poorly described. Therefore, the diagnosis of neonatal AKI needs to be documented and transferred to the paediatrician responsible for the follow-up of the child. This educational review aims to give a perspective on neonatal kidney function and AKI, the relation of fluid balance and creatinine, the management of neonatal AKI and the consequences for drug dosing and long-term outcomes. Full article

Background/Objectives: There is extensive evidence that breastfeeding saves lives, improves health, and provides value to the economy and societies worldwide. The Philippines and Viet Nam have progressive policies to enable breastfeeding, and breastfeeding rates in these countries have substantively improved. In the Philippines, exclusive breastfeeding under six months (EBF) increased from 35.9% (2008) to 60.1% (2021) and, in Viet Nam, in just over a decade, EBF has more than doubled, from 17.0% (2010) to 45.4% (2021). We aimed to use an evidence synthesis to consolidate learnings from policy support to enable breastfeeding in the Philippines and Viet Nam, to identify insights to improve future programming to improve breastfeeding practices in these two countries, and glean learnings that can potentially be adapted for similar contexts. Methods: This manuscript presents a qualitative evidence synthesis of seven purposively selected research articles from the Philippines and Viet Nam. Results: Since the 1960s, the Philippines and Viet Nam have notably improved policies protecting breastfeeding. Both countries have implemented legislation that is substantially aligned with the International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly resolutions. Both countries have improved paid maternity leave provisions, with Viet Nam providing 6 months of paid leave, yet insufficient coverage to informal workers, and the Philippines providing 3.5 months of paid maternity leave while expanding maternity protection coverage to informal workers. From 2006–2021, breastfeeding rates increased in both countries alongside policy improvements yet barriers to implementation remain. Conclusions: Implementation research has documented policy progress and improved breastfeeding rates in the Philippines and Viet Nam. Our analysis offers valuable lessons potentially applicable beyond these contexts, emphasizing the need for addressing policy gaps and targeted cross-sectoral policy actions to enhance breastfeeding practices. Learnings from implementing national marketing restrictions of commercial milk formula and associated products and maternity protection policies in these countries could inform the implementation of newly developed regional standards together with supportive policies, facilitating the harmonization of regional regulatory environments. Full article

Fermented products represent ecological niches for developing microorganisms of interest as bio-resources for improving human well-being. Lactic acid bacteria (LAB) are frequently associated with food fermentations and represent relevant biotechnological resources for enhancing the overall quality of foods and beverages. Among the other potential applications, LAB isolated from traditional fermented foods can play a significant role in addressing malnutrition in developing countries, positively modulating the finished products’ nutritional quality. Nigeria represents an excellent model region to explore this topic as (i) it is a country where the magnitude of phenomena associated with malnutrition is high; (ii) there is a significant effort linked to the achievement of Sustainable Development Goals (SDGs) of the Food and Agriculture Organization (FAO) of the United Nations (UN); and (iii) there is an interesting diversity of traditional fermented foods and beverages. In nations such as Nigeria, fermented foods are integral to infant and young child nutrition, often serving as complementary foods. This review proposes a detailed overview of traditional Nigerian fermented products, including ogi, gari, fufu, lafun, kunu-zaki, masa, wara, kobele, abacha, pito, and burukutu. An overview of the microbial diversity associated with these matrices is also provided, considering a specific focus on LAB responsible for the spontaneous fermentation of various Nigerian foods. We underlined the potential of different LAB species/stains to produce vitamins naturally, particularly B-group vitamins, suggesting strategies that can be followed for in situ biofortification, enhancing the nutritional value of fermented products. In general, the review, summarizing data on microbial diversity presented in principal traditional fermented foods and beverages in Nigeria, supports future studies to exploit the potential of LAB species/strains from fermented foods to combat micronutrient deficiencies in developing countries, such as Nigeria, with the objective to mitigate hidden hunger and alleviate malnutrition in vulnerable populations. Full article

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

Background: Household food insecurity (HFI) is a serious public health concern in Lebanon. Adverse mental health issues have been reported among food insecure households in addition to physical and nutritional complications. Caregivers in food insecure families tend to adopt different coping mechanisms to mitigate the effects of food insecurity (FI) on their children. Objective: This cross-sectional observational study aimed to explore the relationship between FI, maternal depression, child malnutrition, and differential coping mechanisms adopted by mothers. Methods: A total of 219 women were enrolled in this study; FI was assessed using the household food insecurity assessment (HFIAS), maternal depression using the patient health questionnaire (PHQ-9), and their children’s nutritional status through recall of anthropometric measurements. Pearson’s correlations and logistic regressions were performed to evaluate the associations between HFI, maternal depression, and children’s nutritional status. Results: A strong positive correlation between HFI and maternal depression (p = 0.001) and children’s nutritional status (p = 0.008) was shown. Logistic regressions revealed that being food secure decreased the risk of maternal depression (OR = 0.328, 95% CI 0.125–0.863, p = 0.024), while it did not predict children’s nutritional status. Eight main themes related to coping mechanisms were identified. Conclusions: This study highlights the understudied relationship between food insecurity and maternal depression, showing an increased prevalence of HFI among residents in Lebanon with a positive correlation with increased maternal depression. Further investigation is warranted to better explore how to mitigate the negative impact of food insecurity on mental health, maternal nutritional needs, and Infant and Young Child Feeding (IYCF) practices in Lebanon. Full article

The use of plants for therapeutic purposes is an ancestral practice that dates back to the earliest times in the history of mankind. Even today the exploitation of plants for medicinal purposes plays a big role for the communities, especially in Africa, despite advances in modern medicine. According to the World Health Organization, about 80% of the population in developing countries use plants for their primary health care. In Niger, the use of medicinal plants is a foundation of traditional medicine across all ages. It remains a very common practice, especially in rural areas. This practice concerns all ages of life, including mother–child care. In infants and young children, mothers use plants as fortifiers for their prophylactic or curative powers, or to facilitate growth and weight gain, and also to fight major causes of infant morbidity and mortality. Mothers also use medicinal plants for their galactogenic power to stimulate lactation. This is even more important in rural areas where breastfeeding is the main source of infant nutrition. Over the years, these medicinal plants have been the subject of chemical and biological investigations to back up their therapeutic potential and virtues. This study aims to summarize current knowledge on the most commonly used medicinal plants in Niger in mother–child care. This helps emphasize the validation of ancestral medicinal plants through the scientific evaluation of the bioactive components and mechanisms. Elements of sustainability are discussed in future developments. Full article

Background: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women. Methods: From 1985–2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White participants; 98% using Medicaid in pregnancy). Study visits, including questionnaires, dietary assessments, and biospecimen collection, occurred in early and late pregnancy as well as at delivery. Medical records were abstracted, and a subset of mothers and infants participated in a six-week postpartum visit. Results: Findings from the Camden Study have added to the understanding of adolescent and young adult maternal health and perinatal outcomes. These include associations of adolescent linear growth while pregnant with smaller neonatal birth size, low dietary zinc intake in early pregnancy with increased risk of delivery <33 gestational weeks, and higher circulating fatty acid levels with greater insulin resistance. More recent analyses have begun to unpack the biochemical pathways in pregnancy that may be shaped by race as an indicator of systemic racism. Conclusions: The Camden Study data and biorepositories are well-positioned to support future research aimed at better understanding perinatal health in under-represented women and infants. Linkages to subsequent health and administrative records and the potential for recontacting participants over 18–39 years after initial participation may provide key insights into the trajectories of maternal and child health across the life course. Full article

Background: In recent years, undernutrition has remained a significant public health issue in Tunisia, increasing the risk of illness and mortality in young children. Therefore, this study aims to analyse the prevalence and factors contributing to undernutrition among Tunisian children aged 0–23 months. Methods: The study included 3265 children aged 0–23 months from the 2011–2023 Tunisia Multiple Indicator Cluster Surveys (MICS). Trends and logistic regression analyses were used to determine the prevalence and predictors of undernutrition. Results: The prevalence of stunting, wasting, and underweight in infants and children aged 0–23 months has increased by 3.3%, 0.5%, and 2.1%, respectively. Stunting and underweight were more common among infants aged 0–5 months (11.8% for stunting, 8.9% for underweight, p < 0.01), and first-time mothers (8.3% for stunting, 4.1% for underweight, p < 0.01). In 2023, compared to 2011, the odds of stunting, wasting, and being underweight had increased by 22%, 16%, and 70%, respectively. Infants aged 0–5 months had higher odds of undernutrition in all three indices. Children of obese or overweight mothers, and those who started breastfeeding late, were more likely to be stunted. Boys had significantly higher odds of wasting and underweight. Children with low birth weight, and duration of breastfeeding > 12 months, had significantly higher odds of being underweight. Conclusions: This study shows that infants aged 0–5 months, first-time mothers, boys, and children from poor households in Tunisia are at a higher risk of undernutrition. To address the growing issue of undernutrition in Tunisian children, enhancing maternal and child health and nutrition services, improving parental education, and implementing community-based programs that provide breastfeeding and nutritional education to infants born to new mothers and mothers with high/low BMI is recommended. Full article

Background/Objectives: Infant and young child feeding (IYCF) practices directly affect child health, development, and survival, especially under 2 years of age and ultimately affect adult life well-being. As the primary caregivers of the children, mothers with higher health literacy may better perceive the benefits of optimal complementary feeding practices, leading to improved health outcomes for their children. In this study, we aimed to assess complementary feeding practices among children aged 6–23 months in Turkey according to 2021 World Health Organization IYCF indicators [minimum dietary diversity (MDD); minimum meal frequency (MMF); minimum acceptable diet (MAD); egg and/or flesh food consumption (EFF); sweet beverage consumption (SwB); unhealthy food consumption (UFC); zero vegetable or fruit consumption (ZVF); and bottle feeding (BoF)] and investigate their associations with sociodemographic characteristics and mothers’ health literacy. Methods: With a descriptive study design, we reached 572 mothers of children aged 6–23 months from five regions of Turkey. We used the Turkey Health Literacy Scale-32 (TSOY-32) to assess mothers’ health literacy. Results: While maternal and child age are significantly associated with more complementary feeding practices, specifically MDD, MAD, and EFF, having multiple children has negative impacts on several complementary feeding indicators, including MDD, MMF, MAD, UFC, and ZVF. The only indicator associated with mothers’ TSOY-32 scores was zero fruit and vegetable consumption. Conclusion: Raising awareness among mothers about the importance of complementary feeding practices and identification of vulnerable groups will guide practitioners and policymakers to improve child health and nutrition. Full article