International Journal of Child Health and Nutrition

Serum Level of Calcium, Phosphorus and 25 OH Vitamin D in Neo-nates with Indirect Hyperbilirubinemia Treated with Phototherapy

Mon, 10 Aug 2026 00:00:00 +0000

Background: Phototherapy is the standard treatment for neonatal indirect hyperbilirubinemia. However, it may affect calcium-phosphorus metabolism and vitamin D status in neonates.

Objective: To evaluate changes in serum calcium, phosphorus, and 25-hydroxyvitamin D levels after phototherapy in neonates with indirect hyperbilirubinemia.

Methods: An observational prospective study was conducted over six months at Ain Shams University hospitals. Sixty neonates with indirect hyperbilirubinemia requiring phototherapy were included. Total and direct bilirubin, serum calcium, phosphorus, and serum 25 OH vitamin D were measured before initiation and after 48 hours of phototherapy.

Results: Phototherapy significantly reduced total serum bilirubin. However, it was also associated with a decline in serum calcium and phosphorus levels. Additionally, vitamin D levels increased.

Conclusion: Phototherapy effectively reduced bilirubin levels but was associated with decreased serum calcium and phosphorus levels and increased serum 25-hydroxyvitamin D levels. Monitoring of mineral status during phototherapy may therefore be beneficial.

Relationship between Mother's Vitamin D Level and her Child's Status in a Secondary Care Hospital: An Observational Study

Yousef Alrohaimi, Badar A. Almuqhem — Mon, 10 Aug 2026 00:00:00 +0000

Objective: This study aimed to determine the relationships among vitamin D, calcium, phosphorus, and alkaline phosphatase levels in children (aged 0–12 years) and their mothers, and to assess the prevalence of vitamin D deficiency in both groups attending a secondary care hospital in Majmaah, Saudi Arabia. Furthermore, we examined how these biochemical parameters correlate with each other to inform potential nutritional interventions for this population.

Methods: 75 mothers and children between the ages of 0 and 12 who were admitted to the King Khalid hospital in Majmaah city between February 2015 and March 2016 participated in this study. This observational, retrospective, cross-sectional, hospital-based study was conducted at the pediatric division of King Khalid Hospital in Majmaah city.

Results: The study group comprised 62.7% male and 37.3% female children. Mothers aged 20 to 40 accounted for 96% of the population, while those aged 40 and older accounted for 4%. Nearly 98.7% of mothers had serum calcium levels>2.6 mmol/L. While 84% of children had serum phosphorus levels over 1.5 mmol/L. With statistically significant p-values <0.05, vitamin D positively correlates with calcium (r = 0.327; p = 0.004) and phosphorus (r = 0.251; p = 0.030). However, it shows a negative correlation with alkaline phosphatase in children (r = -0.083; p = 0.480). 10.7% of children and 42.7% of mothers had serious vitamin D deficiency, respectively.

Conclusion: This study highlights a significant correlation between vitamin D levels and calcium and phosphorus in children and mothers, with vitamin D positively associated with these minerals. These results underscore the critical need for targeted nutritional interventions to address vitamin D deficiency and improve bone health among children and mothers in this regional population. We recommend community-level screening and supplementation programs targeting mother–child dyads, alongside food fortification policies in Saudi Arabia. Future longitudinal studies with larger sample sizes are warranted to validate the causal relationship between maternal and child vitamin D status and to guide evidence-based regional nutrition policies.

Exploring Socio-Cultural Factors Affecting Early Childhood Oral Health: A Mixed-Methods Study

Mon, 10 Aug 2026 00:00:00 +0000

Purpose: Early Childhood Caries (ECC) remains a major child health problem in Indonesia despite ongoing preventive efforts. ECC is closely associated with poor dietary habits, excessive and unmonitored sugar consumption, and even influences social and cultural aspects. This study aimed to explore socio-cultural, behavioral, and nutritional factors affecting early childhood oral health within Holistic Integrative Early Childhood Education (PAUD HI) settings in Padang City, Indonesia. Methods: A sequential mixed-methods study was conducted. The quantitative phase involved 258 parents of children aged 1–6 years selected from six PAUD HI institutions. Data were collected using questionnaires, and analysis was performed using univariate, bivariate, and multivariate logistic regression. Following this was the qualitative phase, in which 12 parents and 3 school representatives were asked to explain and contextualize the initial quantitative findings. In analyzing this data, Miles and Huberman's thematic approach was used.

Results: There was no statistically significant association between parental oral health behavior and knowledge (OR=8.607, p=0.165), attitude (OR=2.207, p=0.132), belief (OR=0.425, p=0.230), health information exposure (OR=2.512, p=0.186), healthcare support (OR=2.031, p=0.201), or access to health facilities (OR=5.330, p=0.126). The results reveal that no final multivariate regression model was obtained. Sociocultural factors strongly influence habits through family toothbrushing routines, parenting power dynamics, children’s emotional attachment, traumatic dental experiences, and inconsistent control of children's sugar consumption, which are all the results of influences within and outside family settings. These findings elucidate why there is a gap between what parents understand and how they actually implement oral health care practices properly on their children.

Conclusion: Risk factors for ECC do not only come from parents’ dental knowledge but also from children’s social and cultural environments. Implementing effective socio-cultural approaches reduces ECC risks, for example, by providing education to parents and children on proper nutritional habits and how to incorporate them into daily routines.

Obesity in Children and Adolescents, Prevalence and its Consequences on the Respiratory, Circulatory and Musculoskeletal Systems

Maria Zofia Lisiecka — Mon, 10 Aug 2026 00:00:00 +0000

Background: This study aimed to summarize and analyze data from 2020 to the first half of 2025 on obesity in children and adolescents in Poland, focusing on its prevalence, pathogenesis, and consequences for the respiratory, cardiovascular, and musculoskeletal systems.

Methods: The work synthesizes results from 52 studies conducted in Poland and abroad, applying epidemiological, clinical, functional, and molecular approaches.

Findings: The findings confirm a rising prevalence of childhood obesity in Poland, with gender and regional disparities: overweight prevalence reaches 32-36%, obesity- 12-14%, with higher rates in rural areas and among boys. Pathogenetically, key roles are played by neuroendocrine dysregulation of appetite, insulin resistance, and socio-economic and genetic influences. Respiratory effects include reduced lung capacity, impaired ventilation, high risk of obstructive sleep apnea (13-59%), and aggravated asthma with heightened inflammation and reduced treatment efficacy. Cardiovascular issues affect about 6% of adolescents with hypertension, alongside early endothelial dysfunction, dyslipidemia, and myocardial hypertrophy linked to insulin resistance and systemic inflammation. Musculoskeletal consequences include joint overload, postural defects, flat feet, impairedmotor coordination, and decreased quality of life, with 30-60% of obese children showing such dysfunctions.

Conclusions: These results highlight the urgency of early detection and multidisciplinary management of pediatric obesity, integrating national and sociocultural considerations in Poland.

The Role of Gut Microbiota in Early-Life Allergen Sensitization and Immune Development

Maria Zofia Lisiecka — Mon, 10 Aug 2026 00:00:00 +0000

Background: Early-life microbial colonisation plays a pivotal role in shaping the infant immune system and influencing susceptibility to allergic diseases.

Objective: This study aimed to establish the relationship between the characteristics of the gut microbiota and the development of allergen sensitisation in infants during their first year of life.

Methods: The research was conducted in Poland at the Medical University of Warsaw between January 2022 and May 2023. The methodology involved prospective monitoring of 112 full-term infants, with sequential collection of faecal samples and microbiota analysis using 16S rRNA gene sequencing at 1, 3, 6, and 12 months of age. Immunological assessment included the determination of total and specific IgE, flow cytometric cell typing, and multiplex analysis of serum cytokine levels.

Findings: The results indicated that infants with signs of sensitisation showed a reduction in microbial alpha-diversity from the 1st month of life (Shannon index: 2.15 vs 2.47), with statistically significant differences emerging from the 3rd month (p<0.05). Beta-diversity based on the Bray-Curtis metric revealed a persistent divergence in microbial communities depending on sensitisation status, most pronounced at 6 and 12 months. Sensitised infants exhibited an increased relative abundance of pro-inflammatory taxa, including Escherichia/Shigella and Klebsiella, whereas non-sensitised infants were dominated by immunoprotective microorganisms such as Bifidobacterium and Faecalibacterium. Furthermore, sensitised infants demonstrated early and sustained elevations in total and specific IgE, as well as a shift in the immune response towards a Th2 profile, characterised by increased levels of IL-4 and IL-5, a reduction in CD4⁺ T cells, and an increase in the proportion of CD19⁺ and NK cells.

Conclusion: The findings confirm the critical role of microbial diversity in immunological calibration and the development of the allergic phenotype. The results may be used in clinical practice by paediatricians, immunologists, and allergists for early diagnosis and risk assessment of allergic diseases in children, as well as in the development of microbiota-targeted interventions and sensitisation prevention strategies within primary healthcare and perinatal monitoring programmes.

Diagnostic Performance of the StrongKids Tool for Identifying Hospital-Acquired Malnutrition in Pediatric Inpatients

Ni Made Erika Suciari, Putu Pradnyanita Mustika, I Wayan Bikin Suryawan — Mon, 10 Aug 2026 00:00:00 +0000

Background: Hospital-acquired malnutrition is a critical yet often underrecognized condition in pediatric inpatients and is associated with adverse clinical outcomes, including prolonged hospitalization and increased morbidity. Reliable screening tools such as STRONGkids are essential to facilitate early identification, but their diagnostic performance may vary across settings.

Methods: This diagnostic accuracy study with prospective in-hospital follow-up was conducted among pediatric inpatients aged 1 month to 18 years in Wangaya Regional General Hospital, Denpasar, from September to November 2025. STRONGkids screening was performed within 24 hours of admission. Hospital-acquired malnutrition was determined based on percentage body weight loss measured at admission and discharge. Diagnostic performance was assessed using sensitivity, specificity, predictive values, likelihood ratios, and ROC curve analysis, with optimal cut-off determined by the Youden Index.

Results: Among 92 pediatric inpatients, hospital-acquired malnutrition occurred in 34.7%. No significant associations were observed between malnutrition and sex, age, baseline nutritional status, diagnosis, disease category, or length of hospital stay (all p > 0.05), although baseline nutritional status showed a near-significant trend (p = 0.072). Receiver operating characteristic analysis demonstrated moderate discriminative ability of STRONGkids (AUC = 0.676). A cut-off score of ≥1 yielded the highest Youden Index (0.558), with a sensitivity of 87.5%, specificity of 68.3%, positive predictive value of 59.6%, and negative predictive value of 91.1%.

Conclusion: STRONGkids is a valuable screening tool for early detection of hospital-acquired malnutrition in pediatric inpatients, supporting routine universal nutritional screening.

Associated Factors of Recurrent Wasting among Children Aged 6-59 Months in Indonesia: A Cross-sectional Study

Mon, 10 Aug 2026 00:00:00 +0000

Introduction: Acute malnutrition (wasting) is a major public health problem that contributes significantly to morbidity and mortality among children under five years of age. Although nutrition intervention programmes have proven effective, a key challenge in wasting management is the high rate of recurrence after interventions, which continues to sustain the burden of malnutrition. This study aimed to identify factors associated with recurrent wasting among children aged 6-59 months in Maros Regency.

Methods: A cross-sectional study was conducted in 2025 at Mandai and Turikale Primary Health Centres, involving 250 children with a previous history of wasting selected through purposive sampling. Maternal characteristics were assessed using a structured questionnaire. Data were analysed using the chi-square test and multivariable logistic regression. Due to the cross-sectional design, causal relationships cannot be established.

Results: The prevalence of wasting recurrence was 26.8%. Multivariable logistic regression analysis showed that adequate maternal nutritional status was independently associated with a lower likelihood of wasting recurrence (OR = 0.14; 95% CI: 0.06-0.28; p < 0.001). Similarly, favourable maternal psychosocial conditions, particularly lower levels of anxiety, were significantly associated with reduced odds of recurrence (OR = 0.06; 95% CI: 0.00-0.59; p = 0.016). Appropriate maternal caregiving practices were also associated with decreased likelihood of recurrent wasting (OR = 0.30; 95% CI: 0.09-0.92; p = 0.03). Household income showed a marginal association with wasting recurrence but did not reach statistical significance in the adjusted model.

Conclusion: Maternal nutritional status, psychosocial well-being, and caregiving practices were significantly associated with the recurrence of wasting among children aged 6-59 months. These findings suggest that maternal-related factors are important correlates of wasting recurrence. However, given the cross-sectional design, the results should be interpreted as associations rather than causal relationships. Further longitudinal studies are warranted to better understand potential causal pathways.

Microbiological Safety of Donor Human Milk for Term Infants - Review Article

S. Sarkar — Mon, 10 Aug 2026 00:00:00 +0000

Breastfeeding is recognized as the most secure and optimal approach to infant nourishment. In situations where breastfeeding is insufficient or unavailable, donor human milk from reputable human milk banks is a viable alternative to breast milk. The objective of this paper was to conduct a comprehensive review of the microbiological safety associated with the utilization of donated human milk for infant feeding. Donated human milk is prone to contamination during collection, storage or transportation; therefore, all efforts should be taken to render it microbiologically safe as it is fed to infants, who are more prone to infection. Donor human milk collected, processed and stored under hygienic conditions can be safely used for infant feeding in the absence of the mother’s own milk.

Assessment of Environmental Hygiene Conditions among Students and Teachers in Public Secondary Schools in Cross River State, Nigeria

Mon, 10 Aug 2026 00:00:00 +0000

Background: Lack of access to adequate water, sanitation and hygiene in schools in developing countries is a global problem. Such a lack has been proven to enhance serious health and psychological risks associated with poor toilet hygiene in schools, particularly for vulnerable groups such as students with disabilities, bladder conditions, and teachers. In Cross River State, WASH was introduced to mitigate illness, absenteeism, and long-term health issues stemming from inadequate sanitation, yet there appears to be a lack of empirical data assessing whether the initiative has effectively addressed these concerns.

Objective: The purpose of this study was to examine the hygiene conditions among students and teachers in public secondary schools in Cross River State.

Methods: This study adopted a cross-sectional descriptive survey design to assess environmental hygiene conditions, hygiene knowledge, and hygiene practices among students and teachers in public secondary schools. Using a questionnaire, data were collected and analysed accordingly.

Results: Results showed poor environmental hygiene conditions (students: M = 2.19; teachers: M = 2.42), high hygiene knowledge (students: M = 3.28; teachers: M = 3.62), and low-to-moderate hygiene practices (students: M = 2.45; teachers: M = 2.94).

Conclusions: Poor environmental hygiene conditions may increase students’ vulnerability to infection, absenteeism, and reduced learning engagement. The action required is to ensure that the much-needed sanitation and hygiene facilities are provided in secondary schools and that the environment is conducive to teaching and learning. Lastly, this work has the potential to make important contributions to achieving the United Nations’ Sustainable Development Goals.