Practice to introduce complementary foods to infants in Taiwan--changes from 1997 to 2008

The purpose of the study was to understand present infant complementary foods eating and compare trends over the past 10 years in Taiwan. We investigated the methods used to introduce infants to complementary foods, difficulties encountered, sources of information and the principle caregiver's knowledge about infant feeding. This study focused on findings from the 2005-2008 Nutrition and Health Survey in Taiwan (NAHSIT) and compared with those from the 1997-1999 Child NAHSIT. Interviews in both surveys were carried out by trained interviewers. In 2005-2008 survey, 50% of infants aged 7-12 months had started eating baby cereals or juice at age 4-6 months as recommended. The proportions of infants aged 10-12 months who were introduced to particular complementary foods at recommended periods varied from biscuits (51.1%) to tofu (1.1%). The proportions were higher in 2005-2008 than in 1997-1999 for only 3 items. In both survey, more than 80% of mothers were the one who made the decision to introduce their children to complementary foods. More than 75% of caregivers fed baby cereals to their babies from milk bottles. In 2005-2008, the most commonly encountered problem was that the child wouldn't eat. Nutrition knowledge of the caregivers have improved since 1999, but still needs fostering. The timing to introduce complementary foods become later than ten years ago. Whether the delay will affect the normal dietary intakes of children after one year of age needs attention. The government should not only promote breastfeeding, but also reevaluate current evidence-based recommendation on complementary food introduction time.     

Carotenoid composition and content of legumes, tubers and roots by HPLC

A survey was carried out in the district of Kemaman, Terengganu, Malaysia to study infant feeding practices in rural and semi-urban communities. A total of 593 mothers were interviewed and their socio-demographic information recorded. Data on infant feeding practices were collected from mothers who had children up to 15 months of age. Among breast-feeding mothers (n =157), 42.0 % fed their babies for less than 3 months and 58.0% bottle fed for more than 6 months. Sixteen children were found to be fed on sweetened condensed milk with 62.5% of them for the first 3 months. Among those who breast fed their babies, 40.1% were found to have bottle fed at one time or another. The majority of breast feeding mothers belonged to the groups having incomplete primary schooling or completed primary education only and household income below RM600 per month. A substantial number of breast fed babies were given weaning foods in the form of porridge mixture (rice + egg, rice + vegetables, rice + meat, rice+ fish and cereals) between the age of 0 - 3 months. The findings of this study concluded that although breast-feeding is widely practiced, however, their duration has dwindled, and early introduction of solid foods is widespread.     

Early termination of breastfeeding among Philippine urban poor

The research objective was to identify factors that caused mothers to terminate breastfeeding prematurely, i.e., before the infant reached his or her 1st birthday. Nursing for at least 1 year was a minimum goal of health authorities in the area of this research. The study was conducted in 2 urban poor areas and in 2 fringe squatter settlements of Cebu City, a metropolitan area of 500,000 people in the central Philippines. The data were collected by 2 women field workers. The 130 participants, who were within 3 months of delivery, pre- or postpartum were recruited in 1979. They were visited in their homes once a month by the worker who weighed the mother and the baby, inquired about their diets, and recorded breastfeeding experiences and plans. Special attention was given to any problems the mothers were having that might interfere with continued nursing. Other than encouraging mothers to use the local health center, workers did not intervene to support breastfeeding. The mothers were followed for at least the crucial 1st 6 months. Many were followed for a year or more. Of those who agreed to participate prior to delivery, and who composed 1/3 of the total group, some 95% initiated breastfeeding. Of the 3 who did not, 2 tried to nurse but gave up when the newborn showed persistent diarrhea. Between 10-20% of babies were on a mixed diet of breast and bottle feeding, some beginning as early as the 1st month when mothers returned to part-time work. Other mothers, feeling that the babies were not getting enough to eat, added bottles regularly. This pattern did not necessarily lead to the early termination of breastfeeding. With the exception of 2 instances when mothers decided that their babies were big enough to get along without breast milk, the mothers were forced by circumstances as they perceived them to wean the child. Almost all the terminations were abrupt, with the mother continuing to have an adequate supply of milk. The insufficient milk situation reported by 9 mothers is an exception. In most cases, stopping was a crisis, because the mothers felt that to continue would endanger the child while to stop would sacrifice the benefits of breastfeeding. The major reasons for early termination are discussed: diarrhea, insufficient milk, returning to work, mother sick or pregnant, infant refuses the breast or is not growing, and milk is salty or not good.     

Breast feeding and weaning practices of urban housewives in Srinagar

Researchers interviewed 125 mothers in Srinagar, India about breast feeding and weaning practices. Overall the mothers were generally illiterate (52%), housewives (67.2%), Muslim (76%), and from a nuclear family (56%). 39% were in the low income group. Most of the children (48%) ranged for 6-12 months old. 96% of the children had been breast fed. Some of the reasons for breast feeding included nutritional quality, economical, pleased the mother, and made the infant feel secure. 65.8% breast fed their infants on demand. 65.7% weaned their infants between 7-9 months yet 52% believed breast feeding should continue to 18 months. 96% breast fed their infants while ill with diarrhea. 57% believed colostrum to be unhygienic and did not feed it to their infants. 72% decided to breast feed before becoming pregnant while 36% decided to bottle feed before pregnancy. 89% of illiterate mothers breast fed while only 45% of literate mothers did. Further, only 11.8% of the mothers whose family income was 1500 rupees/month breast fed whereas 47% in the lower and 41.2% in the middle income groups did. At 7-9 months, 69.8% of illiterate and 69.5% of literate mothers had already introduced semi solid foods. 78.3% of literate mothers gave semi solid foods to their infants 2 times/day, but only 11.6% of the illiterate mothers did so. Moreover 81.4% of illiterate mothers only fed their infants semi solid foods once a day. Literate mothers were more likely than literate mothers to feed their infants solid foods (75% vs. 46.2%), introduce them at an earlier age (22.2% vs 10%, 7-9 months), and feed them more often (55.5% vs 16.6%; twice a day). In conclusion, the higher the educational status the more likely mothers were likely to breast feed.     

人巨细胞病毒感染母婴传播与母乳喂养

目的 探讨人巨细胞病毒(HCMV)母婴传播中的母乳喂养与婴儿HCMV感染的关系,进而指导感染人巨细胞病毒母乳对婴儿的合理喂养. 方法 应用荧光定量聚合酶链反应( FQ - PCR)方法分别检测113对临床疑诊HCMV感染患儿及其母亲HCMV-DNA含量,用免疫荧光法检测患儿血HCMV - PP65抗原. 结果 母乳HCMV-DNA与配对患儿血HCMV - PP65抗原两者之间有关联(x2=6.48,0.01＜P＜0.025),但关系不是非常密切,阳性母乳配对患儿与阴性母乳配对患儿的血HCMV-DNA之间差异无统计学意义(t=1.432,P＞0.05). 结论 母乳HCMV感染是婴儿获得HCMV感染的重要途径,但是二者关联性不强,故对已感染HCMV的患儿建议母乳喂养,对母亲HCMV阳性,而婴儿HCMV阴性的可将乳汁处理后喂养,更加安全.     

90年代湖南某农村母乳喂养现状及产妇缺乳危险因素调查

对湖南某农村母乳喂养现状及产妇缺乳的危险因素进行调查研究。结果表明,该农村纯母乳喂养率为74.2％,优势母乳喂养率为9.3％,及时添加辅食率为68.5％,1岁继续母乳喂养率为57.9％,2岁继续母乳喂养率为24.2％,奶瓶喂养率为41.3％。缺乳的危险因素主要是产妇的营养状况、精神因素、哺乳习惯、开奶时间,同时还发现缺乳者有家族史。     

A study of dietary practices of pre-school children attending anganwadies in urban slum of Patiala (Punjab)

In India, interviews with mothers of 3-5 year old children living in the Badungarh slum of Patiala City in the Punjab were conducted at 4 anganwadies of the Integrated Child Development Services. The aim of the study was to determine the children's nutritional status. Anganwadies provided the same food supplement daily to 3-5 years old children. The amount provided was less than the recommended amount, however. 75% of the children were not vegetarians. Many children did not like pumpkin brinjal, spinach, and other leafy vegetables. Children's intake of cereals, pulses, green leafy vegetables, milk and milk products, meat, fish and eggs, sugar and jaggery, and fats and oils was lower than recommended allowances. The low intake of meat, fish, and eggs was likely due to the families low income. Consumption of cereals and pulses together resulted in adequate protein intake, but the low intake of leafy vegetables, milk, egg, meat, fish, and fruits resulted in insufficient intake of calcium and bete-carotene. Caloric intake was lower among the 4-5 year olds than among the 3-4 year olds (831.7 vs. 858.9 Kcal). Mothers tended to take the food supplements home to share with all the children in the households. These findings led the researchers to recommend that children eat different and more tastier types of food supplements at the anganwadies. Other recommendations include more frequent checks of food supplement stocks and better supervision.     

Maternal-channelled infant feeding

Proper feeding of the mother during pregnancy and lactation -- preferably with locally available foods -- will optimize the volume and composition of breast milk (both as the sole food for the young baby and as a supplement for the transitional). This approach will avoid the economic, infective and distributive complexities of introducing cow's milk and bottle feeding unnecessarily, and will also help to retard the decline in breast feeding on a community basis.     

Breast feeding and nutritional status in depressed urban areas of greater manila,Philippines

Marasmic infants were weaned from the breast earlier than nutritionally normal infants in depressed areas of Greater Manila, Philippines. However, bottle feeding was not a statistically significant cause of malnutrition in a sample of 513 six to forty‐eight month old children. Marasmic children were affected by other significant variables such as monther's education, birth order, morbidity, parental employment, and family stability.

Among six to twelve‐month‐old infants, mean weight for age of those bottle‐fed or weaned by two months was slightly greater than for those still breast‐fed, although both groups were severely malnourished. Incidence of bottle feeding was highest in depressed neighborhoods in which the nutritional status of infants was highest.

Because poor urban Filipina mothers, with an average sixth grade education, do bottle‐feed as adequately as they breast‐feed, they could theoretically feed their infants well if instead of purchasing milk they breast‐fed and used the savings to buy weaning foods.     

The convenience of breast feeding

Immediately after delivery when the baby is put to breast, the simplicity of breast feeding becomes apparent. There is no concern about the milk not agreeing with the baby, and if he is kept with his mother so she can feed him on demand, the baby will probably gain more weight than if he were on formula. The mother's milk is always right and is always there. Traveling is convenient if clothes are worn that make discreet nursing possible; a 2-piece outfit such as a blouse and a skirt works well. A rest room or a dressing room can also be used for nursing privacy. A diaper or little blanket thrown over the baby can be a casual cover-up if needed. The nursing mother has no bottles to carry around and no fears of running out of supplies. A study by Spock found that mothers of twins who were breast feeding were better organized than those who were bottle feeding. Although the breast feeding mother is tied down to being a mother of her baby, she grows in discovery of her importance to her baby. Weaning is a gradual process. As the baby nurses less, the mother's milk supply decreases. Even after a baby has been weaned, he might need an occasional nursing to assuage a trying experience like a bump or an illness.     

Infant formula samples and breast feeding among Philippine urban poor

An experiment was performed on the maternity wards of three public hospitals in Cebu City, Philippines to determine whether the distribution of free samples of infant formula reduced the likelihood that mothers would breast feed or caused mothers to terminate nursing early. Samples were given or withheld alternately for 2 week intervals to mothers as they left maternity wards. They were followed for 8 months in the first experiment (N = 273) and for 2 months in a replication (N = 284). We found that there were no statistically significant differences between those who received samples and those who did not in initiation or maintenance of breast feeding. Mothers in both groups frequently turned to mixed schedules, but these varied from day to day depending on money to buy other forms of milk, or on the mother's health, or her plan to be away from the baby for one or more feeding periods. After the baby reached an age of 2-3 months, mothers, with few exceptions, used diluted sweetened condensed milk as a supplement and/or substitute for their own milk. It was found that, while mothers recognize the nutritional, economic and health benefits of breast feeding, they may terminate early on the basis of folk beliefs. Receiving formula samples, however, had no measured effect on their breast feeding practices.     

Waking at night: the effect of early feeding experience

Summary The mothers of 180 preschool children were interviewed in their homes in a survey of feeding preferences and sleeping behaviour. We report here on the differences in current sleeping patterns and the age at which night feeds were dropped. There are clear differences in these two behaviours according to whether the baby was breast or bottle fed, and this result is not explicable in terms of social class. Night feeds disappear more slowly in the breast fed infant, and the problem of night waking both in the first year of life and when at nursery school appears to be associated with earlier breast feeding. The importance of such a finding is discussed in relation to the advice offered to mothers by health professionals.     

An enquiry into the attitudes of Muslim Asian mothers regarding infant feeding practices and dental health

Recent studies have highlighted some unfavourable dietary practices among Asian infants in the UK. A number of reasons for such nutritional patterns have been suggested. In the present study, attitudes, beliefs and expectations of 100 first-generation Muslim Asian mothers regarding infant feeding practices were explored through group discussions in their mother tongue.
It was found that mothers generally favoured breast-feeding but lacked knowledge of weaning practices. There was great emphasis on the consumption of milk. The advice from health professionals to discontinue using a feeding bottle by 12 months of age was not considered acceptable. Some mothers thought the change might cause infants to stop drinking milk and that there was little alternative suitable nourishing food available for that age group. The main requirement for infant foods was that they must be halal. Sugar was used either because it ensured that more milk would be consumed, or because it was considered to be intrinsically beneficial. Some mothers fed children on demand, some stated that children chose what they wanted to eat, and that mothers lacked firm control of dietary intake.
Against a background of conflicting advice from health professionals, pressure from in-laws, and the powerful influence of advertising, there is considerable scope for the training of health professionals and for continuing education for families and communities.     

Personal preferences and ethnic variations among Anglo and Hispanic breast and bottle feeders

The preferences of Spanish-speaking Hispanics and English-speaking Anglos for breast and bottle feeding were evaluated using marketing research techniques. Preliminary interviews with 55 mothers conducted within the first 48 hr post-partum elicited a list of verbatim responses regarding the positive and negative aspects of both feeding methods. An additional 195 women rank-ordered the most frequently mentioned statements in terms of their preference for each. Socio-demographic data on the mothers were analyzed with chi-square analysis and discriminant analysis. Multidimensional scaling was used to assess the preferred characteristics of breast and bottle feeding. Results indicated that most mothers prefer a method of infant feeding that allows the mother to be 'closer to her baby' and allows the baby to 'grow up healthier.' Bottle feeders perceived bottle feeding to be superior because it insured that baby would be 'full and satisfied' and would 'get all the vitamins and nutrients it needed,' especially when 'mother was not eating right" or was 'on medications.' Analysis of cultural preference patterns revealed that there exists a strong culture pattern or preference for breast feeding and its characteristics among Anglos. In contrast, the Hispanics show no clear preference for either breast or bottle feeding.     

Preliminary data from demographic and health surveys on infant feeding in 20 developing countries

This study describes infant feeding practices in developing countries, specifically complementary liquids and foods in the first year of life. Data were compiled from Demographic and Health Surveys conducted from 1999 to 2003. We analyzed data from those countries with available data, including results for child-level 24-h and 7-d food and fluid intakes. We used datasets from 20 countries with information on >35,000 infants categorized by age: 0-6 and 6-12 mo. For analysis, we grouped data for fluids other than breast milk as water, other milk (e.g., tinned, powdered, animal), infant formula, and other liquids (e.g., fruit juice, herbal tea, sugar water). All specific solid foods were grouped as any solid foods. We present data on breast-feeding and maternal-reported fluid and solid intake by infants in a 24-h period, for individual countries, and in a pooled analysis. Pooled data show that 96.6% of 0- to 6- and 87.9% of 6- to 12-mo-old infants were currently breast-fed. Reported feeding of other fluids was lower among 0- to 6-mo-olds than 6- to 12-mo-olds: water (45.9 vs. 87.4%), other milk products (11.9 vs. 29.6%), infant formula (9.0 vs. 15.1%), and other liquids (15.1 vs. 41.0%). Pooled analysis showed that 21.9% of mothers reported feeding 0- to 6-mo-old infants some type of solid food, and 80.1% of mothers reported feeding solids to 6- to 12-mo-olds. These survey data show that other milks, other liquids, and solid foods are each much more commonly fed throughout infancy than commercial infant formulas in the countries studied.     

Awareness about infant feeding practices among nursing personnel

The study examined knowledge of and attitudes toward breast and supplementary feeding of infants among 100 newly trained nurses in India. The nurses had recently completed three years of training in A-grade nursing skills. 100% of respondents agreed that breast feeding was the best option, and water was acceptable as the first feed. Feeding of infants was considered to be appropriate within the first 6 hours of birth and for 1-3 years. 60% preferred bottle feeding. 88% considered that the new-born should be kept with the mother rather than in the nursery. 66% knew that breast feeding was good for the mother's health. 68% preferred time-scheduled feeding. 90% desired milk diluted with water as a breast milk substitute. Respondents listed the following advantages of breast milk: nutritious (mentioned by 30% of respondents), good for the baby's health (20%), hygienic (20%), better for mother-child bonding (20%), time saving (18%), offering resistance against disease (18%), economical (11%), given at appropriate temperature (7%), easily digestible (6%), and easy to feed (2%). Respondents listed the following indications for bottle feeding: mother ill (mentioned by 40% of respondents), lactation failure (18%), cracked nipple (15%), other breast problems (11%), baby not sucking (8%), cleft lip/palate (6%), death of mother (6%), mother using oral contraceptives (4%). The study revealed a preference for 1/8 to 3/4 dilution of milk, because of milk's presumed heaviness. The practice of milk dilution is one of the important reasons for childhood malnutrition, and it demands urgent attention. There was a serious lack of knowledge about colostrum and techniques of feeding, burping, and weaning. Findings also confirmed the preference for bottle, cotton wicks, and fingers for providing milk substitutes. Continuing nursing education should provide better instruction on infant feeding practices.     

Child care decisions: parental choice or chance?

AIM: A study of the context of child care decision making by inner city and suburban mothers, using parents to help develop and administer a semi-structured questionnaire. METHODS: A total of 131 mothers were interviewed (73 inner city and 58 suburban) at home. RESULTS: Inner city mothers were more likely to bottle feed, smoke and adopt risky infant sleeping positions, for example the settee. Virtually all babies (98%) were fully vaccinated and placed prone (95%) to sleep at night. Inner city mothers smoked (71%) despite the known health risks and continued postnatally (55%), mainly as a means of relieving stress. In total, 30% of inner city mothers wanted to breast feed; 19% had succeeded to 6-8 weeks postnatally. Bottle feeding helped both mother and baby to have uninterrupted nights of sleep. Suburban mothers (59%) succeeded in breast feeding, with others choosing bottle feeding mostly because of returning to work. The average weekly alcohol consumption, 32 units inner city and 15 units suburban, was taken in weekend binges by inner city parents, but in daily small amounts by suburban mothers. CONCLUSIONS: The well-being of the baby was the prime concern of all mothers, irrespective of social background. However, inner city mothers made rational decisions to smoke and bottle feed to reduce the impact of stress and allow the mother much needed respite for the good of the entire family.     

Food practices among Trinidadian children

The dietary and feeding practices of mothers belonging to 2 major ethnic groups in Trinidad, the Negroes and the East Indians, were studied. 106 mothers were interviewed: 68 Negroes (38 with infants under 1 year of age, and 30 in the 1-5 year age group) and 38 East Indians (19 offspring in each category). Very few infants under 1 year of age were exclusively breastfed for a period varying from 4-12 weeks. The rest were given bottled milk mixed with arrowroot or parched flour during daytime and breast milk at night. It appears that the practice of breastfeeding is gradually declining among Trinidadian mothers. Partial breastfeeding or supplementary milk is the sole source of animal protein for young infants, frequently accompanied by orange juice or parched flour. Sweetened condensed milk is still being used by some mothers because of its relative cheapness, easy availability, and good storing qualities. Supplementary feedings often started in late infancy include gruels made from arrowroot, parched flour, and cereal. Weaning foods consisted primarily of arrowroot, potatoes, lentil soups, pumpkin, carrots, and fruits in season. As the child gets older, milk and milk products, meat, and other high quality protein are consumed very infrequently. A disappointing observation was the low consumption of readily available green and yellow vegatables. The main nutritional disorders seen in infancy are marasmus and anemia, mainly due to protein and iron deficiencies; severe cases of other types of nutritional disorders are rare. Although there is a certain degree of uniformity in the dietary patterns of children and the methods of feeding them during the weaning period, there are also a number of variations depending on locality, race, religion, agricultural methods, and resources of the soil. Arrowroot is the mainstay of the Negro infant's diet, while parched flour or sago is consumed by an East Indian infant more frequently. East Indian mothers also breastfed less frequently than their Negro counterparts.