Factors influencing child mental health: A state‐wide survey of Victorian children

Aims: This study aims to estimate the prevalence of mental health problems among Victorian children and to investigate factors associated with poorer mental health. Method: Computer‐assisted telephone interviews were undertaken with the parents of 3370 randomly selected Victorian children aged 4 to 12 years. They reported on their child's mental health and special health‐care needs as well as their own mental health, family functioning and a range of community and socio‐demographic variables. Population estimates and odds ratios (OR) were calculated with 95% confidence intervals (95% CI). Results: Overall, 11.6% (95% CI = 10.3–12.9%) of Victorian children were estimated to be at risk of having mental health problems. Factors independently placing children at increased risk of mental health problems that were ‘of concern’ include a child having special health‐care needs (OR = 7.89, 95% CI 5.16 to 12.08), unhealthy family functioning (OR = 3.84, 95% CI 2.19 to 6.74), parental mental health problems (OR = 7.89, 95% CI 5.16 to 12.08), neighbourhood safety (OR = 2.47, 95% CI 1.20 to 5.07) and area of residence (OR = 2.01, 95% CI 1.33 to 3.02). Conclusions: A significant proportion of Victorian children are at some risk of mental health problems. These limited but important predictors of children's mental health reinforce the need for policy solutions that will extend beyond those offered by traditional mental health service systems.     

Parental age and child growth and development: Child health check‐up data

Background: The aim of the present study was to determine whether parental age has any influence on child health. Methods: Well‐baby check‐up data at 1 month and at 12 months of age were used. The trends of parental age in association with growth measurements, incidence of physical and developmental abnormalities, occurrence of low birthweight, and maternal history of spontaneous abortion were analyzed. Results: Associations between increasing paternal age and incidence of psychomotor developmental delay at 12 months, increasing paternal and maternal age and increasing birthweight, and increasing parental age and higher incidence of history of spontaneous abortion were found. The incidence of low‐birthweight infants was significantly decreased with increasing paternal age. Conclusions: Not only increasing maternal age but also increasing paternal age have influences on child development and growth in the general population.     

The effect of balanced protein energy supplementation in undernourished pregnant women and child physical growth in low‐ and middle‐income countries: a systematic review and meta‐analysis

The beneficial effect of balanced protein energy supplementation during pregnancy on subsequent child growth is unclear and may depend upon the mother entering pregnancy adequately nourished or undernourished. Systematic reviews to‐date have included studies from high‐, middle‐ and low‐income countries. However, the effect of balanced protein energy supplementation should not be generalised. This review assesses the effect of balanced protein energy supplementation in undernourished pregnant women from low‐ and middle‐income countries on child growth. A systematic review of articles published in English (1970–2015) was conducted via MEDLINE, Scopus, the Cochrane Register and hand searching. Only peer‐reviewed experimental studies analysing the effects of balanced protein energy supplementation in undernourished pregnant women from low‐ and middle‐income countries with measures of physical growth as the primary outcome were included. Two reviewers independently assessed full‐text articles against inclusion criteria. Validity of eligible studies was ascertained using the Quality Assessment Tool for Quantitative Studies (EPHPP QAT). In total, seven studies met the inclusion criteria. All studies reported on birthweight, five on birth length, three on birth head circumference, and one on longer‐term growth. Standardised mean differences were calculated using a random‐effects meta‐analysis. Balanced protein energy supplementation significantly improved birthweight (seven randomised controlled trials, n = 2367; d = 0.20, 95% confidence interval, 0.03–0.38, P = 0.02). No significant benefit was observed on birth length or birth head circumference. Impact of intervention could not be determined for longer‐term physical growth due to limited evidence. Additional research is required in low‐ and middle‐income countries to identify impacts on longer‐term infant growth.     

Social and health behavioural determinants of maternal child‐feeding patterns in preschool‐aged children

Parental child‐feeding attitudes and practices may compromise the development of healthy eating habits and adequate weight status in children. This study aimed to identify maternal child‐feeding patterns in preschool‐aged children and to evaluate their association with maternal social and health behavioural characteristics. Trained interviewers evaluated 4724 dyads of mothers and their 4–5‐year‐old child from the Generation XXI cohort. Maternal child‐feeding attitudes and practices were assessed through the Child Feeding Questionnaire and the Overt/Covert Control scale. Associations were estimated using linear regression [adjusted for maternal education, body mass index (BMI), fruit and vegetables (F&V) intake and child's BMI z‐score]. Principal component analysis defined a three‐factor structure explaining 58% of the total variance of maternal child‐feeding patterns: perceived monitoring – representing mothers with higher levels of monitoring, perceived responsibility and overt control; restriction – characterizing mothers with higher covert control, restriction and concerns about child's weight; pressure to eat – identifying mothers with higher levels of pressure to eat and overt control. Lower socioeconomic status, better health perception, higher F&V intake and offspring cohabitation were associated with more ‘perceived monitoring’ mothers. Higher maternal F&V intake and depression were associated with more ‘restrictive’ mothers. Younger mothers, less educated, with poorer health perception and offspring cohabiting, were associated with higher use of ‘pressure to eat’. Maternal socioeconomic indicators and family environment were more associated with perceived monitoring and pressure to eat, whereas maternal health behavioural characteristics were mainly associated with restriction. These findings will be helpful in future research and public health programmes on child‐feeding patterns.     

Food choices made by low‐income households when feeding their pre‐school children: a qualitative study

The growing concern about poor dietary practices among low‐income families has led to a ‘victim blaming’ culture that excludes wider social and environmental factors, which influence household food choices. This small‐scale qualitative study investigated influences on the diets of young children in families on a low income in the West Midlands, UK. Using semi‐structured interview schedule, rich data was gathered through individual interviews with 11 mothers of pre‐school children. Information was collected about the type and range of food given following the introduction of solid foods including factors influencing parent's knowledge and diet, sources of nutrition advice and financial constraints. Food accessibility and storage issues were also explored. Interviews were audio‐recorded, transcribed and analysed using a modified grounded theory approach. Findings highlighted that parents and professionals may have different interpretations about ‘cooking from scratch’. The results indicated that some parents have poor understanding of what constitutes a healthy diet. However, most parents included fruit and vegetables to varying degrees and were motivated to give their children healthy foods, suggesting that, with adequate support and information, the diets of these children could be improved. There was evidence that when striving to improve the diet of their children, many parents' diets also improved. The findings from this small‐scale in‐depth study highlighted a number of issues for local and national policy and practice in the area of nutrition and child health in the early years.