International Journal of Child Health and Nutrition

Infant Feeding Practices with Oral Health Implications among Suburban Mothers of Tanzania
Pages 159-165
Hawa Shariff Mbawalla and Shadia Majid

DOI: http://dx.doi.org/10.6000/1929-4247.2017.06.04.4

Published: 08 November 2017


Abstract: Background: Behaviours around infants feeding influence both nutritive value and the detrimental effects of the infant feeding.

Aim: The study aimed to determine infant feeding practices with implication to child’s oral health and examine the related socio-demographic factors.

Materials and Methods: A cross-sectional study among mothers of the infants who were attending RCH clinics in suburban areas of northwest Tanzania. Cluster sampling technique was used to obtain the participants and a structured questionnaire was used to interview the mothers. Frequency distributions and cross-tabulations were used for analysis and reported as proportions and identified differences between the comparative socio-demographic categories.

Results: Study involved 213 mother-infant pairs; infants’ mean age was 7.22 ± 3.48 months and 53.1% were female babies. Almost all (94.6 %) the infants were breastfed and 75.3% of infants under six months of age were exclusively breastfeeding. In infants age older than six months, 32.6% of mothers reported to have initiated complementary food before the baby turned six months and that sugar sweetened foods were mostly used (68.1%) complementary foods. Higher proportion of mothers who had secondary school education or beyond (43.4%) reported to have initiated complementary food before the recommended age than their counterparts. Mothers who were employed reported to mostly (74.5%) use sugar sweetened complementary foods as compared to unemployed mothers.

Conclusion: Infants of this community were mostly breastfed and initiated complementary feeding earlier than recommended time. Employed mothers and those with secondary education or above tended to have unfavorably infant feeding practices than their comparative groups.

Keywords: Breastfeeding, complementary foods, early childhood caries.

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International Journal of Child Health and Nutrition

Evaluation of an After-School Obesity Prevention Program for Children - Pages 1-8

Laura Nabors, Kristen Welker, Brandon Pavilack, Myia Lang, Renee Hawkins and Anne Bauer


Published: 28 February 2018


Abstract: Dissemination of obesity prevention programs in different settings is needed. Moreover, new outreach tools to teach parents healthy eating and exercise lessons provided in these programs are important to develop. The pilot studies presented in this paper examined the implementation of the Children’s Healthy Eating and Exercise Program in two different after school programs in 2015 and 2016. Participants were elementary school-age children and their parents. Eight lessons were presented at each school. Child perceptions of healthy eating and exercise goals were examined as well as child knowledge retention and perceptions of behavior change. Parent perceptions of the program were analyzed. Results indicated that children reported improved knowledge and behaviors. Parents reported satisfaction with the program, but remained hard to reach. Children recalled key components of the healthy eating lessons at long-term follow-up assessments. In the second pilot study, children served as health coaches for teaching parents about family goals. Children believed they were successful at coaching parents, but they requested help in developing family eating and exercise goals. Improving outreach to parents and involving siblings remains a goal for future studies as does beginning to examine changes in eating and physical activity using food diaries and accelerometry.

Keywords Prevention, children, obesity, after-school program, motivational interviewing.


International Journal of Child Health and Nutrition

Foundations for Fitness: A Multi-Cohort Pediatric Weight Management Intervention - Pages 9-14

Kyle M. Morrison and Steven Smith


Published: 28 February 2018


Abstract: This study examined the benefits of a 10-week childhood obesity intervention program on various measures of health. The program involved parents and children who met once weekly for two hours. Each session of the intervention program consisted of a structured dynamic warm-up an aerobic exercise component in a game play setting and a motor-skill specific instruction period. Subjects were recruited from pediatrician recommendation and a total of 99 subjects (n=48 boys, n=51 girls) completed both pretest and posttest intervention measures. The mean age was 9.86 (SD=0.02 years). Each of the following were assessed on pediatric assessment prior to and following the intervention program: height, weight, body mass index (BMI), waist circumference, resting heart rate, resting blood pressure, habitual physical activity, percent body fat, and quality of life. Assessment of the participant’s cardiovascular fitness and the state of home environment in regards to nutrition and physical activity were completed as part of the first and tenth (final) intervention program sessions. Results indicated that the changes observed that were statistically significant included the categories of systolic blood pressure, height, weight, quality of life, habitual physical activity, FNPA score, and PACER scores. Improvements in outcomes measured were modest but this result was expected due to the short intervention program of only ten-weeks duration. Recommendations include increasing the length of the intervention and conducting follow-up assessment to determine long-term impact.

Keywords Obesity, Overweight, Pediatric, Physical Activity, Physical and Health Education, Nutrition, Quality of Life, Self-Efficacy, BMI, Cardio-respiratory fitness, PACER.


International Journal of Child Health and Nutrition

Maternal Gestational Diabetes Associated with Higher Child BMI Z-Score at Preschool and Lower Likelihood of Breastfeeding Initiation - Pages 15-21

Rana H. Mosli, Manal N. Al-Lahyani, Amani Najjar, Doaa A. Zoghbi, Rawan H. Al-Haddad and Hala H. Mosli


Published: 28 February 2018


Abstract: Objectives: To examine the association of maternal GDM with 1) child BMI z-score at preschool; 2) breastfeeding initiation and duration, while adjusting for child birthweight in addition to potential confounders.

Method: Sample included 53 children (3 - 5 years old) recruited from two preschools in Jeddah, Saudi Arabia. Mothers completed a self-administered questionnaire. Child anthropometry was completed using standardized procedures. BMI z-scores were calculated using the WHO standards/reference data. Linear regression models were tested to examine the association between maternal GDM and child BMI z-score, as well as breastfeeding duration. Logistic regression models were tested to examine the association between maternal GDM and breastfeeding initiation. Models were adjusted for child birthweight, maternal BMI, and maternal age at pregnancy.

Results: Mean child BMI z-score was 1.10 (SD= 1.22). About one quarter (24.5%) of mothers reported being diagnosed with GDM. Mean birthweight of children whose mothers were diagnosed with GDM was 3.10 kg (SD= 0.74). Adjusting for covariates, we found that maternal GDM was associated with increased child BMI z-score (B= 1.04, 95% CI= 0.14 - 1.94, P-value= 0.02), and lower odds of breastfeeding initiation (OR= 0.10, 95% CI= 0.02 – 0.49, P-value= 0.005). Maternal GDM was not associated with breastfeeding duration (B= -4.75, 95% CI: -11.79 – 2.29, P-value= 0.18).

Conclusion: Findings suggest that maternal GDM is associated with higher child BMI z-score at preschool and lower likelihood of breastfeeding initiation. Studies are needed in order to identify the underlying mechanisms of associations. Obesity prevention programs may target children whose mothers were diagnosed with GDM; prenatal breastfeeding counseling may be offered.

Keywords Gestational diabetes, Breastfeeding, BMI z-score, Preschool.