Search Results (156)

Background/Objectives: Breastfeeding is key to maternal and child health, but adherence to WHO recommendations varies worldwide and is influenced by several maternal and paternal factors. In this study, we aim to describe the prevalence of breastfeeding practices and adherence to WHO guidelines among women, and to explore the maternal and paternal characteristics associated with these practices. Methods: Data were obtained from the “MAMI-MED” cohort, which included women enrolled during the first trimester of pregnancy at ARNAS Garibaldi Nesima in Catania (Italy). Breastfeeding practices and parental characteristics were assessed through interviews conducted at 12- and 24-month follow-ups. Results: The analyses involved 1312 women enrolled between December 2020 and October 2023. Mothers who breastfed, particularly those who exclusively breastfed for the first six months, showed a more favorable socioeconomic profile. Women with a medium (OR = 1.781; 95% CI: 1.258–2.521; p = 0.001) and high level of education (OR = 3.892; 95% CI: 2.255–6.718; p < 0.001), as well as those who had a spontaneous delivery (OR = 1.461; 95% CI: 1.090–1.958; p = 0.011), were more likely to breastfeed. Similarly, adherence to WHO recommendations was higher among women with a medium (OR = 2.144; 95% CI: 1.339–3.433; p = 0.002) and high education levels (OR = 2.611; 95% CI: 1.489–4.580; p < 0.001), non-smokers (OR = 2.256; 95% CI: 1.158–4.395; p = 0.017), and those with adequate gestational weight gain (OR = 1.506; 95% CI: 1.035–2.189; p = 0.032). Conclusions: Sociodemographic and behavioral factors, particularly maternal education, smoking status, mode of delivery, and gestational weight gain, significantly influence breastfeeding practices and adherence to WHO recommendations. These findings highlight the importance of targeted interventions to support breastfeeding, especially among women with less favorable socioeconomic profiles. Full article

Breastfeeding women require specific nutrition to support the quality and secretion of breast milk, which can be achieved through the development of analog rice. Several potential alternatives to develop analog rice, including sago and corn flour, can be developed with the addition of moringa leaf powder due to its high nutritional composition and bioactive compounds, particularly high protein, iron, phytosterols, and flavonoids, which are suitable for breastfeeding women. However, as a new product, besides considering its nutritional value, developing the preferred and acceptable formulation of analog rice remains challenging. This research aims to gain the best formulation and investigate the physicochemical and sensory properties. Three formulations of analog rice were applied in this study utilizing extrusion technology, comprising sago, corn flour, and moringa leaf powder in ratio variations as follows: A, 60:37:3; B, 70:25:5; C, 80:10:10. Overall, the analog rice produced had a green color, a sticky texture, a distinct moringa aroma, and a slightly bitter taste, with Formulation C being most preferred (overall organoleptic value of 2.5, categorized as neutral), containing 6.22 ± 0.83% moisture, 1.04 ± 0.07% ash, 4.08 ± 0.17% protein, 0.46 ± 0.09% fat, 88.21 ± 0.59% carbohydrate, 3.42 ± 1.54% crude fiber, 382.62 ± 3.75 Kcal, 40.12 ± 13.38 ppm iron, 1.09 ± 0.05% sitosterol, 1.16 ± 0.03% stigmasterol, and 0.19 ± 0.07% flavonoid levels. The analog rice provides high energy and lactation-supporting bioactive compounds (iron, phytosterols, and flavonoids), demonstrating potential as a sustainable dietary intervention. This study offers a novel approach through the development of extruded analog rice, which transforms local ingredients into a functional food targeting maternal nutritional gaps by synergizing sago, corn flour, and moringa leaf powder. Full article

Background and Objectives: Exclusive breastfeeding offers optimal nutrition and health benefits for infants, yet many mothers face challenges that impact their ability to breastfeed. This study aimed to explore breastfeeding practices among Romanian mothers and identify factors associated with successful exclusive breastfeeding. Materials and Methods: A cross-sectional online survey was conducted from February to March 2025, targeting Romanian mothers via social media platforms. The questionnaire, developed specifically for this study, collected data on sociodemographics, birth and neonatal variables, hospital practices, feeding intentions, community influences, and breastfeeding outcomes. A total of 874 valid responses were analyzed using Fisher’s exact tests and multivariable logistic regression. Results: While 87.2% of mothers intended to breastfeed, only 56.1% reported exclusive breastfeeding. Factors significantly associated with reduced likelihood of exclusive breastfeeding included maternal age ≥ 30 years (OR = 1.40, p = 0.042), Cesarean delivery (OR = 1.78, p < 0.001), absence of rooming-in (OR = 2.32, p < 0.001), and pacifier use (OR > 4.7, p < 0.001). Protective factors included non-smoking status (OR = 0.52, p < 0.001) and encouragement to breastfeed by medical staff (OR = 1.60, p = 0.004). Despite external advice to use formula, many mothers continued breastfeeding. Conclusions: Although breastfeeding intention was high, exclusive breastfeeding remains suboptimal in Romania. Targeted support—particularly in maternity hospitals and for mothers recovering from Cesarean sections—alongside prenatal education and consistent postnatal guidance are essential to bridge the gap between intention and practice. Full article

Discourses on breastfeeding extend beyond simple scientific evidence, framed within a dialogue between diverse sociocultural perspectives throughout history. Building on this premise, this article aims to explore, from the perspective of the sociology of deviance, the maternal experiences of women who choose not to breastfeed or cease breastfeeding within the hospital setting. To this end, this qualitative and phenomenological study was conducted, using semi-structured interviews with mothers in the municipality of Lorca who had decided not to breastfeed or had discontinued breastfeeding as a data collection tool. The results indicate that breastfeeding is influenced by the repercussions of delivery room routines and a challenging learning process where complications often arise, contradicting the prevailing innatist discourse of maternal instinct. Within this framework, mothers feel pressured by professionals to breastfeed, and their identities are undermined by symbolic stigma when they express their decision not to breastfeed. We conclude that it is essential to propose clinical approaches and support models that genuinely consider the sociocultural, historical, and experiential factors influencing breastfeeding, moving beyond an exclusive focus on its biological or nutritional aspects. Full article

Background/Objectives: Despite the numerous health benefits of exclusive breastfeeding (EBF) for the infant and the mother, EBF rates in Lao People’s Democratic Republic, Lao PDR, remain at 40%. We investigate how barriers to EBF were overcome by a social transfer intervention. Methods: Data from the Social Transfers for Exclusive Breastfeeding ongoing randomised controlled trial (RCT) (n = 298) in Vientiane, Lao PDR, was used. Mothers in the RCT were randomised equally into a control group, an unconditional transfer group and a conditional transfer group and followed up to six months (n = 280). We used logistic and Cox proportional hazards regression models to investigate the association of predictor variables with EBF at six months and the risk of EBF cessation in each of the three groups. Results: Greater breastfeeding self-efficacy increased the odds of EBF at six months in both intervention groups (unconditional transfer OR 1.39 [95% CI 1.09, 1.87, p = 0.02] and conditional transfer OR 1.26 [1.01, 1.61, p = 0.05]) and reduced the risk of EBF cessation (unconditional transfer HR 0.87 [0.77, 0.98, p = 0.02]). Maternal secondary and tertiary education in the intervention groups showed higher odds of EBF at six months and lower EBF cessation risk. Participants in the intervention group that intended to exclusively breastfeed in pregnancy showed a reduced EBF cessation risk in both intervention groups. Conclusions: Social transfers helped overcome the exclusive breastfeeding barrier of a higher education level and working status and improved EBF outcomes for mothers who intended to exclusively breastfeed and wanted the pregnancy. Breastfeeding self-efficacy positively influences EBF outcome, regardless of whether the mother received a social transfer or not. Full article

Background/Objectives: The Mediterranean diet (MD) is well-studied for its health-promoting effects, while the factors influencing adherence in children remain an important research focus. This study examines the sociodemographic, maternal, perinatal, and lifestyle determinants associated with MD adherence among children aged 6–9 years in an effort to identify key predictors and their impact on long-term nutritional habits. Methods: This study recruited 4851 children from diverse Greek rural and urban regions. The mothers of the enrolled children completed relevant questionnaires on their children’s sociodemographics, perinatal outcomes, anthropometric parameters, breastfeeding practices, and physical activity status. The enrolled children completed the Children’s Depression Inventory (CDI) and the State–Trait Anxiety Inventory for Children—State (STAIC-S) form to assess the presence of depression and anxiety symptoms, respectively. The KIDMED score was used to assess the MD compliance of the enrolled children. Results: The outcomes demonstrated that higher maternal education and family economic status gravitated toward increased MD adherence (p = 0.0071, p ˂ 0.0001), while exclusive breastfeeding (p ˂ 0.0001) and higher physical activity levels (p = 0.0101) were strong predictive factors for MD adherence, highlighting the role of early-life interventions in shaping dietary habits. In contrast, cesarean delivery (p = 0.0173) and higher birth weight (p ˂ 0.0001) were linked to lower MD adherence, indicating potential metabolic and behavioral predispositions. Notably, higher MD adherence correlated with lower prevalence of depressive and anxiety symptoms (p ˂ 0.0001, p = 0.0001), underscoring its potential protective role in mental health. Conclusions: Our findings highlight a complex interplay between early-life and dietary behaviors, while further longitudinal studies are needed to establish causality and optimize evidence-based nutritional strategies and education for childhood health and well-being. Full article

Human milk (HM) is a complex biological fluid that plays a significant role in infant health, influenced by maternal dietary habits and body composition. This study aimed to explore how maternal diet and nutritional status affect the microbial composition of HM. In this pilot study, 15 mothers were recruited from a maternity ward and assessed for dietary habits through a semi-structured food frequency questionnaire and a 3-day dietary record. Maternal body composition was evaluated using bioelectrical impedance analysis. HM samples were collected for microbiota analysis, focusing on the diversity and composition of bacterial communities via 16S rRNA sequencing. The study identified that maternal nutrient intake significantly correlated with the composition of HM microbiota. Specifically, Firmicutes abundance showed positive correlations with animal protein (τ = 0.39; p = 0.043), total carbohydrates (τ = 0.39; p = 0.043), and vitamin A (τ = 0.429; p = 0.026). Bacteroidota was positively correlated with retinol (τ = 0.39; p = 0.043). Higher consumption of dietary fiber (>24 g/day) did not yield significant differences in bacterial composition compared to lower intake (<24 g/day) (p = 0.8977). Additionally, no significant differences were found in overall bacterial abundance across different maternal characteristics such as age, mode of delivery, or breastfeeding type. This study underscores the importance of maternal diet in shaping the HM microbiota, which may have implications for infant health. Dietary modifications during lactation could be a strategic approach to promote beneficial microbial colonization in HM. Further research is warranted to confirm these findings and explore the underlying mechanisms. Full article

Background/Objectives: The global prevalence of childhood obesity and overweight is steadily increasing, representing a pressing public health concern due to its persistence during adolescence and adulthood and its association with elevated morbidity and mortality risks. This cross-sectional study was designed to examine the potential association between overweight/obesity and the presence of depressive and anxiety symptoms in children aged 6 to 9 years. Methods: A total of 4098 children from various urban and rural regions in Greece were enrolled. Data was collected through maternal questionnaires capturing sociodemographic characteristics, perinatal outcomes, anthropometric measurements, breastfeeding practices, and physical activity levels. Children fulfilled the Children’s Depression Inventory (CDI) and the State-Trait Anxiety Inventory for Children—State form (STAIC-S) to evaluate symptoms of depression and anxiety, respectively. Results: Childhood overweight/obesity was independently and significantly associated with a more than two-fold increased likelihood of presenting depressive and anxiety symptoms. Childhood overweight/obesity was also significantly associated with maternal obesity, gestational weight gain, childbirth weight, mode of delivery, exclusive breastfeeding, and children’s physical activity. Conclusions: Overweight and obesity in children aged 6–9 years are significantly associated with an elevated risk of psychological distress, including depression and anxiety. These findings underscore the need for targeted public health policies and nutritional interventions aimed at promoting healthy lifestyle practices from early childhood. Educational efforts should also support new mothers in adopting and sustaining health-promoting behaviors to mitigate the long-term consequences of childhood obesity. 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

Background/Objectives: This study aims to determine the prevalence of stunting in children under two years old and its association with the maternal profile (including anthropometric measurements), care, feeding practices, and socioeconomic level. It also attempts to assess if stunting may contribute to an underestimation of wasting by performing a preliminary speculative analysis using the expected height for age instead of the real observed height of the children. Methods: The study employed a cross-sectional design, examining mother–child pairs in the rural municipality of Ampefy in the Itasy Region of Madagascar, between 2022 and 2023. A total of 437 mother–child (0–24 months) pairs participated in the study. A questionnaire was administered to collect data on the maternal lifestyle. Maternal medical histories were reviewed, and anthropometric parameters of both the mothers and their child were taken by specialized and trained health professionals with multiple years of experience. Results: The prevalence of stunting in children was 57.4% (95% CI: 52.64–62.10). Stunting was associated with maternal anthropometric measurements (p < 0.001), maternal education (p = 0.004), and breastfeeding (p = 0.047), which appears to have a protective effect. The weight-for-length z-score indicated that only 12.4% of the total children were affected by wasting. In the preliminary speculative analysis using the WHO height-for-age standard, the theoretical prevalence of wasting was estimated to be 42.3%, with a considerable prevalence of severe wasting. The main limitations of this study were the possible selection bias, the limitations inherent to the taking of anthropometric measurements in small children, and therefore, the possible misclassification of the children. The use of a theoretical weight-for-length z-score to estimate a theoretical prevalence of wasting using an untested speculative analysis is also a limitation to the validity of the estimation. Conclusions: Stunting affected over half of the children included in the study (57.4%), but the prevalence of wasting was below what was expected, at 12.4%. In the preliminary speculative analysis using the expected height for age, it was estimated that wasting could possibly affect up to 42.3% of the children. This discrepancy, while it cannot be taken as factual due to the nature of the analysis, could serve as a warning that perhaps the elevated rates of stunting may be masking wasting in some children and other forms of nutritional assessments may be needed in areas where stunting is prevalent. Full article

Cow’s milk allergy is one of the most prevalent food allergies in infancy. Exclusive breastfeeding is the recommended source of nutrition for the first six months of life, but some infants may develop cow’s milk allergy due to the transfer of milk proteins such as β-lactoglobulin through breast milk. There are still many uncertainties about cow’s milk allergy in breastfed babies. The purpose of this review is to summarize the latest findings mainly focused on immunological mechanisms and challenges in diagnosis. We pointed out which clinical signs in breastfed infants are associated with immediate IgE responses and which are linked to delayed non-IgE mechanisms or mixed IgE/non-IgE-mediated reactions. Since standard IgE tests are often useless in non-IgE cases, diagnosis typically involves dietary elimination and cow’s milk challenge. This study addresses the controversial topic of maternal elimination diets, assessing the nutritional risks to both mothers and infants in relation to their possible benefits. It has also been discussed whether the microbiota signature could be a potential factor in both tolerance development and the risk of cow’s milk allergy in early life. Overall, accurate diagnosis and personalized treatment plans are vital to prevent overdiagnosis and ensure proper growth while maintaining the practice of breastfeeding. Full article

Background/Objectives: Breastfeeding is widely recognized as the best way to feed infants and has numerous health benefits for both mothers and infants. However, despite its well-documented benefits, breastfeeding rates remain lower than recommended in many parts of the world. This systematic review examines factors that create barriers for mothers trying to breastfeed, covering studies published between 2003 and 2025. Methods: A total of 18 studies were included in this systematic review, selected from the following databases: PsycINFO, MEDLINE, Academic Search Complete, Communication and Mass Media Complete, ERIC, SocINDEX, and CINAHL. Studies were selected based on predefined inclusion criteria, focusing on peer-reviewed articles that examined factors influencing breastfeeding practices. Data extraction and quality assessment were performed independently by two reviewers using standardized tools. The review analyzed personal, cultural, economic, and health-related barriers. Results: The analysis revealed multiple barriers to breastfeeding, categorized into personal, sociocultural, economic, and healthcare-related factors. Common challenges included a lack of counseling, latching difficulties, insufficient workplace support, and cultural misconceptions. The heterogeneity of study designs posed challenges in synthesizing the findings. Conclusions: More targeted policies and programs are needed to address these barriers and help mothers succeed in breastfeeding. Improving breastfeeding outcomes worldwide will require better healthcare, social support, and an understanding of cultural influences. Full article

Background/Objectives: This study investigates the prevalence and impact of the double burden of malnutrition (DBM), malnutrition and overnutrition, in infants aged 0–24 months in the rural municipality of Ampefy, Itasy region, Madagascar. The Global Nutrition Report 2022 highlights the widespread issue of malnutrition, affecting 2 billion adults and 38 million children under five. Madagascar, characterized by severe poverty and high malnutrition rates, serves as a critical case study. Methods: A structured questionnaire was administered to 437 mother–child pairs from November 2022 to March 2023, collecting data on maternal education, dietary habits, and socio-economic status. Anthropometric measurements were taken using either a stadiometer or UNICEF length charts to assess height/length and an electronic scale to determine weight. Results: Findings reveal a high prevalence of malnutrition, with 29.7% of children affected by either wasting, stunting, and/or underweight, and 13.3% classified as overweight or obese. This study identifies significant age-related differences, with younger children more likely to be overweight and older children more likely to suffer from stunting or wasting. Maternal nutritional status, breastfeeding practices, and socio-economic conditions are strongly associated with child malnutrition outcomes. Lower dietary diversity among mothers and insufficient antenatal care are significant risk factors. Households with lower incomes and limited access to water and transport face higher malnutrition risks. Conclusions: This study underscores the critical need for targeted nutritional interventions and education to address DBM in Madagascar, highlighting the importance of maternal health and dietary diversity in early childhood development. Further longitudinal research is recommended to establish causality and develop comprehensive public health strategies. Full article

Background: Almost half of all deaths worldwide in children under five are related to malnutrition. Malnutrition encompasses a wide array of nutritional conditions and emerging evidence indicates a growing overlap of these different forms of malnutrition. Nutrimetry, which combines assessments of height-for-age (HAZ) with BMI-for-age (BMIZ) to offer a more integrated assessment of nutritional status, can be particularly useful in low-resource settings to correctly reflect the complex interplay of stunting and overweight. Objective: The objective of this study is to explore the impact of malnutrition on children in Madagascar and demonstrate how integrating HAZ assessments with BMIZ can reveal the double burden of malnutrition—encompassing both undernutrition and overnutrition—within the same population. Methods: This cross-sectional observational study employing Nutrimetry was carried out in rural communities in the Itasy region of Madagascar. A systematic random sampling method was used to choose the 500 women to invite to participate from the approximately 5000 who formed the pool of potential participants. A total of 437 were able to be invited and all invited women agreed to participate, resulting in 437 mother–child (0–24 months) pairs being included in the study. Results: Chronic undernutrition or thinness (31.6%), overweight and obesity (21.3%), and stunting (57.6%) were prevalent among the children included in the study. Among children with chronic undernutrition, 55.06% were identified as stunted. Among children with overweight or obese, 61.03% were identified as stunted. This highlights a significant overlap between inadequate weight and stunting. A socioeconomic analysis revealed significant barriers, including limited financial resources and poor dietary diversity, exacerbating malnutrition. Maternal nutritional status and breastfeeding practices also emerged as critical determinants of child nutritional outcomes. Conclusions: The study underscores the importance of prioritizing height assessments as a preliminary step in nutritional evaluations to prevent undetected acute malnutrition. Full article

Background/Objectives: Breastfeeding is a cornerstone of infant nutrition, promoting optimal development and health benefits for both mother and child. Despite high initiation rates in Poland (97%), exclusive breastfeeding (EBF) drops sharply, reaching only 4% by six months postpartum. The aim of this study is to identify factors associated with breastfeeding practices and barriers to exclusive breastfeeding (EBF) among Polish women during the postpartum period, with particular emphasis on the role of medical personnel support and maternal stress levels. Methods: A cross-sectional observational study, adhering to STROBE guidelines, was conducted from January to May 2023. The study included 1092 Polish women, surveyed using the Computer-Assisted Web Interview (CAWI) methodology. The women exclusively breastfeeding accounted for 79% (n = 863) of the study group. The remaining women supplemented their child with modified milk (n = 229; 21%). Statistical analyses were performed using IBM SPSS Statistics (Version 26.0), and logistic regression to assess associations between variables and breastfeeding outcomes. Results: Logistic regression analysis indicated that in the women experiencing low or medium stress, none of the analysed support factors significantly influenced the likelihood of exclusive breastfeeding discontinuation. However, women experiencing high stress, receiving counselling for effective breastfeeding (OR = 0.467; 95% CI: 0.232–0.941; p = 0.033) and assistance with proper breastfeeding (OR = 0.424; 95% CI: 0.220–0.819; p = 0.011) were associated with a lower likelihood of introducing formula feeding. The main reported reasons for early breastfeeding cessation included breast health issues, mental exhaustion, lack of medical support and infant-related difficulties. Conclusions: The findings allow us to underscore the urgent need for targeted interventions to improve breastfeeding rates in Poland. New evidence indicates that women experiencing higher levels of stress require increased support from medical personnel in order to breastfeed exclusively. Full article