Maternal and Child Nutrition最新文献

Child malnutrition remains a critical public health concern in Bangladesh, with emerging evidence linking climatic variability to nutritional outcomes. This study examines the impact of unusual seasonal temperature deviations, particularly in the pre- and post-monsoon periods, on child malnutrition. District-level time series climatic data from 2007 to 2018 were analyzed alongside the pooled cross-sectional children's data, the Multiple Indicator Cluster Survey (MICS) of 2012 and 2019, to assess these effects. Factor analysis and multilevel logistic regression model were used for analyzing the data where factor analysis identified the pre- and post-monsoon seasons as a dominant weather factor, and multilevel logistic regression evaluated its association with malnutrition after adjustment for other individual-level, household-level, and maternal characteristics. Results indicate that higher-than-usual temperatures in pre- and post-monsoon seasons significantly increase stunting, while lower-than-usual monsoon temperatures do the same to both stunting and wasting. These findings suggest that deviations from historical climatic norms may negatively affect child nutrition. Strengthening climate-sensitive nutrition policies and early warning systems is essential in mitigating the impact of unseasonal temperature anomalies on child health in Bangladesh.

The postpartum period is a critical stage where maternal confidence and self-efficacy significantly influence breastfeeding success and overall adjustment. Cyberchondria refers to the repetitive searching for health-related information online, which can lead mothers to doubt their caregiving abilities, lower their confidence, and negatively impact their perceived competence in breastfeeding and infant care. This study explored the relationship between cyberchondria, maternal self-efficacy, and breastfeeding perceived competency among postpartum mothers. A cross-sectional survey was conducted with 300 mothers within 2 months of childbirth, recruited through a two-stage random sampling method from primary health care facilities in Zagazig district, Egypt. Participants completed validated Arabic versions of the Cyberchondria Scale (CS), the Perceived Maternal Parenting Self-Efficacy Scale, and the breastfeeding competency scale (BCS). Findings revealed that higher cyberchondria levels were linked with lower maternal self-efficacy and diminished breastfeeding competency. Maternal self-efficacy demonstrated a significant positive association with breastfeeding perceived competency and partially mediated the relationship between cyberchondria and breastfeeding competency. These results suggest that online health-seeking behaviors may undermine maternal confidence and skills, highlighting the importance of incorporating digital health literacy interventions into postpartum care. Supporting mothers in navigating online health information effectively may enhance self-efficacy and improve breastfeeding outcomes.

Commercially produced complementary foods (CPCFs) - commercially produced food or beverage products that are specifically marketed as suitable for feeding infant and young children (IYC) from 6-36 months of age - are increasingly available in Southeast Asia and purchased by caregivers. However, we know little about the nutrient composition of these foods or health-related information on the packaging of the CPCFs available in Nepal. This study assessed nutrient composition and health information on the labels of CPCFs available in urban Nepal. In 2024, we visited 4 large stores (2 supermarkets and 2 departmental stores), 22 small stores (corner stores), and 2 baby stores in Kathmandu Valley. We photographed all CPCFs. To analyse, we extracted nutrient and health information from the label and categorized each CPCF into WHO Southeast Asia Region Nutrient Profile and Promotion model (SEAR NPPM) food sub-categories. Within each category we calculated the proportion meeting energy and nutrient thresholds for nutrient of concerns (protein, total sugar, sodium, and total fat threshold per 100g of product) from the SEAR NPPM and the proportion with health-related labels that complied with SEAR NPPM labelling requirement. We found 61 CPCFs available in seven (3 large, 2 small and 2 baby stores) out of the 28 stores visited. None of these CPCFs met all energy and nutrient thresholds, 75.6% met energy thresholds, 79.5% total fat content thresholds, 50.8% sodium content, and 25% total sugar content. Total sugar content was double the SEAR NPPM threshold of ≤ 3g/100 g, ranging from 1g/100 g for CPCFs in the 'cereals without added high protein' sub-category to 27.4g/100 g for CPCFs in rusks and biscuits' sub-category. Less than five (3.3%) of assessed CPCFs were compliant with the SEAR NPPM labelling requirement. CPCFs in Nepal contained high levels of nutrients of concern and had misleading health information on the labels. To safeguard health and nutrition of older infants and young children, Nepal has a mandatory food standard for cereal-based commercial complementary food that determines nutrient composition, promotional requirements, and food safety parameters. In addition to stronger enforcement of this standard, we recommend similar standards be applied for other CPCF sub-categories.

Suboptimal diets contribute to child malnutrition globally. The Engaging Fathers for Effective Child Nutrition and Development in Tanzania (EFFECTS) study developed interventions that engaged fathers and delivered bundled nutrition and parenting content and tested their individual and combined effects on child dietary diversity and upstream parental behaviors. In a cluster-randomized controlled trial in Mara, Tanzania, 80 villages were randomly assigned (1:1:1:1:1) to standard care, a nutrition intervention engaging either mothers or both parents, or a bundled nutrition and parenting intervention engaging either mothers or both parents. Eligible households (n = 960) had a child under 18 months at enrollment (October 2018-May 2019). Community health workers (CHWs) delivered gender-transformative social and behavior change interventions through parental peer group sessions before March 2020 and subsequently through home visits. The primary outcome, child dietary diversity, and secondary outcomes on child feeding practices, morbidity, growth, and parental behaviors were assessed prior to, during, and after intervention. Intention-to-treat analyses used generalized linear mixed models. Engaging fathers while providing bundled content increased children's dietary diversity by 0.60 food groups/day (95% confidence interval (CI): 0.18-1.02) and 0.96 food groups/week (CI: 0.51-1.41) more than standard care. Significant interaction between father engagement and bundled content was detected for children's consumption of dairy (p = 0.04). Positive intervention effects were detected on several maternal and paternal behaviors related to household food access via home production or local food markets, complementary feeding, and hygiene practices. Gender-transformative interventions, delivered by CHWs engaging both parents with bundled nutrition and parenting content, can synergistically improve children's diets. Trial registration: ACTRN1261900070419.

Optimal infant and young child feeding (IYCF) is a critical intervention during the first 1000 days of life, yet in Ethiopia, caregiving roles remain heavily gendered, often excluding fathers. This systematic review and meta-analysis quantified the extent of paternal engagement in IYCF across Ethiopia and identified key associated factors. Following PRISMA guidelines, a comprehensive search of major databases and gray literatures identified 11 cross-sectional studies involving 6030 fathers. Using a random-effects model, the pooled prevalence of paternal engagement was 41% (95% CI: 25%-57%). Significant predictors of increased engagement included having an education above secondary level (AOR 4.27), smaller family size (AOR 4.03), first-born child (AOR 3.36), and positive perceptions toward IYCF (AOR 2.68). Other factors included positive cultural beliefs (AOR 2.35), good IYCF knowledge (AOR 2.21), and the child being male (AOR 2.09). This study calls for shifting Ethiopia's nutrition strategies from mother-centric to family-centric models by implementing father-inclusive, culturally sensitive programs. Training health extension workers to challenge gender norms through counseling and community dialog will address socio-cultural barriers, promote shared caregiving, and improve child feeding outcomes.

Commercially produced complementary foods (CPCFs) are increasingly preferred over home-prepared foods but do not always comply with international recommendations. The aim of this study was to evaluate the compliance of CPCFs sold in West Africa with the World Health Organization (WHO) European Nutritional and Promotional Profile Model (NPPM). The study was conducted from August to October 2023 and covered 315 outlets in Benin, Mali, Mauritania, Niger, Senegal and Togo. CPCFs compliance with the NPPM was assessed regarding nutritional content and labeling practices based on information recorded from the labels. A total of 673 products were found, 76.1% of which were imported. Cereals (37%), savory meals (25.2%), and purées (22.7%) were the most representative categories, while finger foods/snacks and drinks were the least representative (3.9% and 2.1%, respectively). Overall, 11% of products met all nutritional composition requirements, and none met the labeling requirements. Moreover, almost half of the products exceeded the permitted percentage of energy from sugars (42.3%). Despite this, none of the products displayed a “high sugar content” warning on their labels. The high proportion of products with high sodium content (44.3%) and frequent label claims (95.9%) is also major challenges for these foods. This study also showed that 10.5% of the CPCFs are recommended for children under 6 months of age, contrary to recommendations, while only 13.2% of the products contain information to protect breastfeeding. These results confirm concerns about CPCFs and show the importance of restricting the marketing of certain CPCFs in West Africa.

Prenatal diet affects maternal and child health; however, adherence to dietary guidelines in pregnancy is low. This cross-sectional study aimed to describe overall diet quality and to examine relationships between socioeconomic factors and diet quality in a sample of Australian pregnant women. Participants (n = 1580) completed an online survey and self-reported usual dietary intake (via a food frequency questionnaire [FFQ]) and socioeconomic factors, including highest educational attainment, income, perception of overall financial situation, residential postcode for area-level socioeconomic status (SES), stressful life events, and perceived social support. FFQ responses were converted to an overall diet quality score using the Dietary Guidelines Index 2013 (DGI-13) criteria. Latent class analysis was used to identify groups of stressful life events, and multiple linear regression models examined associations between the socioeconomic factors and DGI-13 score. Overall, adherence to dietary guidelines and prenatal diet quality were low. The mean DGI-13 score was 76.1 (SD 13.7) out of a maximum possible score of 130. All socioeconomic factors were significantly associated with DGI-13 score. For all socioeconomic factors except the perceived social support score, the lowest/most disadvantaged categories and middle/medium categories were associated with clinically important reductions of 5–9 points and 3–6 points, respectively, indicating a social gradient in diet quality. There is a need to improve prenatal diet quality among all women. However, there is an urgent need for systems-level interventions and policy change that target those with lower SES backgrounds to reduce dietary and health inequities.

Pasteurised donor human milk is a vital resource for vulnerable preterm infants. As demand continues to grow, the sustainability of milk banking services relies not only on recruiting donors but also on fostering positive donor experiences. Satisfied donors are more likely to contribute consistently and advocate for the service, enhancing its visibility and community support. A total of 588 formal milk bank donors who donated to Australian Red Cross Lifeblood milk programme between January 2024 and April 2025 were invited to participate in a survey. The survey aimed to explore factors that make milk donors feel valued, evaluate their satisfaction with different aspects of the donation process, and identify barriers that may hinder continued donation. The survey included Likert-scale questions and optional open-text responses. The survey was completed by 257 donors (43.7% response rate). Most (72.4%) felt highly valued by Lifeblood, especially due to receiving milk bags, and having supportive, personal interactions with donor coordinators. However, some donors felt undervalued due to a lack of post-donation communication. Whilst satisfaction with the donation process was high, some respondents found the screening process repetitive and time-consuming. The most reported barrier was limited freezer space (67.7%), followed by time constraints, illness in the household, and the burden of cleaning and sterilising equipment for milk expression at home. Milk banks should adopt donor-centred practices, including streamlining processes to minimise time and effort required for donors, reduce costs incurred by donors where feasible, and enhance post-donation transparency and engagement.

This intervention development study aimed to work with a wide range of stakeholders across the UK to integrate existing global evidence on the effectiveness and implementation of breastfeeding support for mothers with/without long-term conditions and co-develop a complex intervention optimised for delivery in healthcare settings. The intervention development process was informed by four systematic reviews, conducted alongside an embedded programme of co-production work between 2020 and 2025, involving: two stakeholder working groups (SWG) and two parent panels (PP) that met at regular intervals during the study; six focus group discussions (FGD) to ensure engagement with parents from socially disadvantaged groups; and 10 co-production workshops (Co-PW) involving parents, third sector organisations, healthcare practitioners, managers, commissioners, policymakers, and academics. Systematic reviews synthesised data from 116 randomised controlled trials and 16 process evaluations of breastfeeding support interventions for healthy mothers; and 22 trials and 24 studies on views/experiences of breastfeeding support in mothers with long-term conditions. The co-production work involved 23 stakeholders and 16 parents in SWG and PP meetings, 15 parents in FGD, and 128 stakeholders in Co-PW. The resulting Action for Breastfeeding (A4B) Programme comprised four core components (antenatal, postnatal, follow-up, and signposting) with associated implementation strategies, mechanisms of action, and outcomes for evaluation. Materials and guidance to support adoption and delivery were co-designed. The A4B Programme provides an evidence-based and co-produced intervention to deliver organised support for breastfeeding mothers in healthcare settings, with proposed adaptations for mothers with long-term conditions. Some uncertainties remain and these will be investigated in our future work.

This prospective cohort study aims to explore the mechanisms by examining the independent and sequential mediation effects of internalized weight stigma, breastfeeding difficulties, and breastfeeding self-efficacy in the relationship between pre-pregnancy overweight/obesity and exclusive breastfeeding at 6 months postpartum. In Nanjing, China, 296 primiparous women were stratified by pre-pregnancy body mass index (BMI) into two groups: pre-pregnancy overweight/obese (n = 146) and normal BMI (n = 150). Data were collected via questionnaires during the antenatal period and at 6 months postpartum. Women with pre-pregnancy overweight/obesity reported significantly higher levels of internalized weight stigma (M = 30.73, SD = 5.71) compared to their normal-weight counterparts (M = 22.42, SD = 3.75). Path analysis with bias‑corrected bootstrapping was used to test mediation, adjusting for baseline covariates. The study confirmed a negative correlation between pre-pregnancy overweight/obesity and exclusive breastfeeding at 6 months postpartum. Significant indirect paths were identified from pre-pregnancy overweight/obesity to exclusive breastfeeding at 6 months postpartum via internalized weight stigma, breastfeeding difficulties, and breastfeeding self-efficacy. A significant serial indirect path through breastfeeding difficulties and self-efficacy was also identified. This study highlights the critical mediating roles of internalized weight stigma, breastfeeding difficulties, and breastfeeding self-efficacy in the relationship between pre-pregnancy overweight/obesity and exclusive breastfeeding. The findings provide healthcare professionals with evidence-based targets for intervention, emphasizing the need to address weight stigma in prenatal care and enhance breastfeeding support strategies. Future studies in more diverse populations are warranted to confirm generalizability.

Trial Registration: Registered at the Chinese Clinical Trial Registry (registry number: ChiCTR2200057038), trial registration date February 26, 2022