Maternal & Child Nutrition最新文献

{"title":"The costs of Suaahara II, a complex scaled-up multisectoral nutrition programme in Nepal","authors":"Esther M. Choo, Christopher G. Kemp, K. C. Sagun, Uttam Paudel, Jolene Wun, Kenda Cunningham, Pushpa Acharya, Pooja Pandey Rana, Carol Levin","doi":"10.1111/mcn.13658","DOIUrl":"https://doi.org/10.1111/mcn.13658","url":null,"abstract":"Limited evidence exists on the costs of scaled-up multisectoral nutrition programmes. Such evidence is crucial to assess intervention value and affordability. Evidence is also lacking on the opportunity costs of implementers and participants engaging in community-level interventions. We help to fill this gap by estimating the full financial and economic costs of the United States Agency for International Development-funded <i>Suaahara</i> II (SII) programme, a scaled-up multisectoral nutrition programme in Nepal (2016–2023). We applied a standardized mixed methods costing approach to estimate total and unit costs over a 3.7-year implementation period. Financial expenditure data from national and subnational levels were combined with economic cost estimates assessed using in-depth interviews and focus group discussions with staff, volunteers, community members, and government partners in four representative districts. The average annual total cost was US$908,948 per district, with economic costs accounting for 47% of the costs. The annual unit cost was US$132 per programme participant (mother in the 1000-day period between conception and a child's second birthday) reached. Annual costs ranged from US$152 (mountains) to US$118 (plains) per programme participant. Personnel (63%) were the largest input cost driver, followed by supplies (11%). Community events (29%) and household counselling visits (17%) were the largest activity cost drivers. Volunteer cadres contributed significant time to the programme, with female community health volunteers spending a substantial amount of time (27 h per month) on SII activities. Multisectoral nutrition programmes can be costly, especially when taking into consideration volunteer and participant opportunity costs. This study provides much-needed evidence of the costs of scaled-up multisectoral nutrition programmes for future comparison against benefits.","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140838933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study of Suaahara II influence on nutrition governance in Nepal","authors":"Sarah Eissler, Shraddha Manandhar, Kabita Shah, Bishow Neupane, Pooja Pandey Rana, Kristine Garn","doi":"10.1111/mcn.13659","DOIUrl":"https://doi.org/10.1111/mcn.13659","url":null,"abstract":"Maternal and child undernutrition remain major public health problems in Nepal. <i>Suaahara</i> is a USAID-funded multi-sectoral nutrition programme aiming to strengthen local nutrition governance to reduce maternal and child undernutrition, among other objectives. The purpose of this study is to present findings from a recent qualitative evaluation of <i>Suaahara II's</i> influence on the decentralised implementation of Nepal's Multi-sectoral Nutrition Plan (MSNP) and identifying gaps and areas for improvement at the federal, provincial, and local levels to strengthen nutrition governance. This study employed multiple qualitative methods, engaging over 100 multi-sectoral nutrition stakeholders across three levels of government and eight districts. Thematic qualitative analysis was employed to identify emergent and salient themes, which were triangulated with other secondary data sources. <i>Suaahara II</i> had a positive influence on strengthening horizontal coordination for implementing the MSNP and effectively leveraged existing networks to strengthen implementation of nutrition-focused activities at the municipal level. Although there was an observable increased demand for nutrition budgets attributable to <i>Suaahara II</i> activities, sufficient allocation and utilisation, particularly in non-health sectors, did not meet these levels. Nepal's shift to federalism hindered vertical coordination of MSNP implementation. Some formal coordination mechanisms were strengthened, but variation in their effectiveness to strengthen horizontal and vertical coordination to implement MSNP activities continues. Finally, limited government ownership over nutrition activities and facilitating multi-sector coordination to implement the MSNP threatened sustainability of <i>Suaahara II</i>'s outcomes on nutrition governance. Future programmes should continue to build on the progress made under <i>Suaahara II</i>, and specifically aim to address challenges in vertical coordination to strengthen nutrition governance in Nepal.","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140838751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaemia in Indians aged 10-19 years: Prevalence, burden and associated factors at national and regional levels.","authors":"Samuel Scott,&nbsp;Anwesha Lahiri,&nbsp;Vani Sethi,&nbsp;Arjan de Wagt,&nbsp;Purnima Menon,&nbsp;Kapil Yadav,&nbsp;Mini Varghese,&nbsp;William Joe,&nbsp;Sheila C Vir,&nbsp;Phuong Hong Nguyen","doi":"10.1111/mcn.13391","DOIUrl":"https://doi.org/10.1111/mcn.13391","url":null,"abstract":"<p><p>Anaemia control programmes in India are hampered by a lack of representative evidence on anaemia prevalence, burden and associated factors for adolescents. The aim of this study was to: (1) describe the national and subnational prevalence, severity and burden of anaemia among Indian adolescents; (2) examine factors associated with anaemia at national and regional levels. Data (n = 14,673 individuals aged 10-19 years) were from India's Comprehensive National Nutrition Survey (CNNS, 2016-2018). CNNS used a multistage, stratified, probability proportion to size cluster sampling design. Prevalence was estimated using globally comparable age- and sex-specific cutoffs, using survey weights for biomarker sample collection. Burden analysis used prevalence estimates and projected population from 2011 Census data. Multivariable logistic regression models were used to analyse factors (diet, micronutrient deficiencies, haemoglobinopathies, sociodemographic factors, environment) associated with anaemia. Anaemia was present in 40% of girls and 18% of boys, equivalent to 72 million adolescents in 2018, and varied by region (girls 29%-46%; boys 11%-28%) and state (girls 7%-62%; boys 4%-32%). Iron deficiency (ferritin < 15 μg/L) was the strongest predictor of anaemia (odds ratio [OR]: 4.68, 95% confidence interval [CI]: [3.21,6.83]), followed by haemoglobinopathies (HbA2 > 3.5% or any HbS) (OR: 2.81, 95% CI: [1.66,4.74]), vitamin A deficiency (serum retinol <20 ng/ml) (OR: 1.86, 95% CI: [1.23,2.80]) and zinc deficiency (serum zinc < 70 μg/L) (OR: 1.32, 95% CI: [1.02,1.72]). Regional models show heterogeneity in the strength of association between factors and anaemia by region. Adolescent anaemia control programmes in India should continue to address iron deficiency, strengthen strategies to identify haemoglobinopathies and other micronutrient deficiencies, and further explore geographic variation in associated factors.</p>","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":" ","pages":"e13391"},"PeriodicalIF":3.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9480897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40000046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden and risk factors for relapse following successful treatment of uncomplicated severe acute malnutrition in young children: Secondary analysis from a randomised trial in Niger.","authors":"Lilia Bliznashka,&nbsp;Kyra H Grantz,&nbsp;Jérémie Botton,&nbsp;Fatou Berthé,&nbsp;Souna Garba,&nbsp;Kerstin E Hanson,&nbsp;Rebecca F Grais,&nbsp;Sheila Isanaka","doi":"10.1111/mcn.13400","DOIUrl":"https://doi.org/10.1111/mcn.13400","url":null,"abstract":"<p><p>This study aimed to quantify the burden of relapse following successful treatment for uncomplicated severe acute malnutrition (SAM) and to identify associated risk factors in rural Niger. We used data from 1490 children aged 6-59 months discharged as recovered from an outpatient nutritional programme for SAM and followed for up to 12 weeks after admission. Postdischarge SAM relapse was defined as weight-for-height Z-score <-3, mid-upper arm circumference (MUAC) <115 mm or bipedal oedema after having been discharged as recovered. Postdischarge hospitalisation was defined as admission to inpatient SAM treatment or hospitalisation for any cause after having been discharged as recovered. We used multivariate log-binomial models to identify independent risk factors. After programmatic discharge, 114 (8%) children relapsed to SAM and 89 (6%) were hospitalised. Factors associated with SAM relapse were discharge during the lean season (relative risk [RR] = 1.80 [95% confidence interval [CI] = 1.22-2.67]) and larger household size (RR = 1.56 [95% CI = 1.01-2.41]), whereas older child age (RR = 0.94 [95% CI = 0.88-1.00]), higher child MUAC at discharge (RR = 0.93 [95% CI = 0.87-1.00]) and maternal literacy (RR = 0.54 [95% CI = 0.29-0.98]) were protective factors. Discharge during the lean season (RR = 2.27 [95% CI = 1.46-3.51]) was independently associated with postdischarge hospitalisation. Future nutritional programmes in the context of Niger may consider modification of anthropometric discharge criteria or the provision of additional home support or follow-up during the lean season as potential interventions to prevent relapse. More research including postdischarge follow-up is needed to better understand the sustainability of treatment outcomes after discharge and the type of intervention that may best sustain recovery over time. Clinical Trial Registration: ClinicalTrials.gov number, NCT01613547.</p>","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":" ","pages":"e13400"},"PeriodicalIF":3.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/b3/MCN-18-e13400.PMC9480908.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40545128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child feeding indexes measuring adherence to New Zealand nutrition guidelines: Development and assessment.","authors":"Teresa Gontijo de Castro,&nbsp;Sarah Gerritsen,&nbsp;Leonardo P Santos,&nbsp;Dirce M L Marchioni,&nbsp;Susan M B Morton,&nbsp;Clare Wall","doi":"10.1111/mcn.13402","DOIUrl":"https://doi.org/10.1111/mcn.13402","url":null,"abstract":"<p><p>New Zealand (NZ) lacks nationally representative or generalisable information on the dietary intakes of pre-schoolers. We used Growing Up in New Zealand cohort data to i) develop child feeding indexes (CFIs) based on National Food and Nutrition Guidelines for 2- and 4.5-year-olds; ii) describe the cohort adherence to the guidelines at 2 (n = 6046) and 4.5 years (n = 5889) and; iii) assess the CFIs' convergent construct validity, by exploring associations with maternal sociodemographic and health behaviours and with child body mass index for age (BMI/age) and the waist-to-height ratio at 4.5 years. The CFIs scores ranged from 0 to 11, with 11 representing full adherence to the guidelines. Associations were tested using multiple linear regressions and Poisson regressions with robust variance (risk ratios [RR], 95% confidence intervals, 95% CI). The CFIs mean scores (SD) at 2 and 4.5 years were, respectively, 6.13 (1.21) and 6.22 (1.26) points. Maternal characteristics explained, respectively, 27.2% and 31.9% of the variation in the CFIs scores at 2 and 4.5 years. In the adjusted model at the 4.5-year interview, in relation to girls ranked in the 5th quintile, those in the 2nd (RR, 95% CI: 1.48; 1.03; 1.24) and 4th (1.53; 1.05; 2.23) quintiles of the CFI were more likely to have BMI/age > +2z (World Health Organization growth standards) at 4.5 years. At 2 and 4.5 years, most children fell short of meeting national guidelines. The associations between the CFIs scores at both time points with maternal characteristics and with children's body size at 4.5 years were in the expected directions, confirming the CFIs' convergent construct validity among NZ pre-schoolers.</p>","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":" ","pages":"e13402"},"PeriodicalIF":3.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/50/MCN-18-e13402.PMC9480915.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Irrigation improves weight-for-height z-scores of children under five, and Women's and Household Dietary Diversity Scores in Ethiopia and Tanzania.","authors":"Dawit K Mekonnen,&nbsp;Jowel Choufani,&nbsp;Elizabeth Bryan,&nbsp;Beliyou Haile,&nbsp;Claudia Ringler","doi":"10.1111/mcn.13395","DOIUrl":"https://doi.org/10.1111/mcn.13395","url":null,"abstract":"<p><p>Evidence on the potential for agricultural intensification to improve nutrition has grown considerably. While small-scale irrigation is a key factor driving agricultural intensification in sub-Saharan Africa, its impact on nutrition has not yet been thoroughly explored. In this study, we assess the impact of adoption of small-scale irrigation in Ethiopia and Tanzania on household and women's dietary diversity, as well as children's nutrition. We use two rounds of primary data collected from irrigators and nonirrigators in Ethiopia and Tanzania. We used a panel fixed effects econometric approach to control for observed household, women and children specific characteristics as well as observed and unobserved time-invariant confounding factors. The results show that among Ethiopian households who reported having faced drought, women in irrigating households have higher Women's Dietary Diversity Score (WDDS) compared to women in nonirrigating households. In Tanzania, women in irrigating households have higher WDDS compared to nonirrigators and the impact of irrigation on WDDS more than doubles among households facing drought. In addition, among Tanzanian households who reported having faced a drought shock, irrigating households have higher Household Dietary Diversity Score compared to nonirrigators. Children in irrigating households in Ethiopia have weight-for-height z-scores (WHZ) that are 0.87 SDs higher, on average, than WHZ of children in nonirrigating households. In Tanzania, irrigation leads to higher WHZ-scores in children under-five among households who reported having experienced a drought in the 5 years preceding the survey. The study shows small-scale irrigation has a strong effect on households' economic access to food and on nutritional outcomes of women and children.</p>","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":" ","pages":"e13395"},"PeriodicalIF":3.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9480923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40397847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infant feeding policies and monitoring systems: A qualitative study of European Countries.","authors":"Helen Gray,&nbsp;Irena Zakarija-Grković,&nbsp;Adriano Cattaneo,&nbsp;Charlene Vassallo,&nbsp;Mariella Borg Buontempo,&nbsp;Susanna Harutyunyan,&nbsp;Maria Enrica Bettinelli,&nbsp;Stefanie Rosin","doi":"10.1111/mcn.13425","DOIUrl":"https://doi.org/10.1111/mcn.13425","url":null,"abstract":"<p><p>Implementation of the Global Strategy for Infant and Young Child Feeding varies widely among countries. Policymakers would benefit from insights into obstacles and enablers. Our aim was to explore the processes behind the development and implementation of national infant and young child feeding policies and monitoring systems in Europe. A qualitative study design was employed to analyze open text responses from six European countries (Croatia, Germany, Lithuania, Spain, Turkey and Ukraine) using inductive thematic analysis. Countries were selected based on their World Breastfeeding Trends Initiative scores on national policy and monitoring systems. The 33-item online questionnaire was distributed to country representatives and completed by country teams. Key enablers and strengths included strong and continuous government commitment to infant and young child feeding, an operational national breastfeeding authority, a national and active monitoring and evaluation system, implementation of the International Code of Marketing of Breastmilk Substitutes in national legislation, the integration of skilled breastfeeding supporters, the implementation of the Baby-friendly Hospital Initiative, and positive cultural norms and traditions supporting optimal infant and young child feeding. In some countries, UNICEF played a key role in funding and designing policies and monitoring systems. Weak government leadership, the strong influence of the industry, lack of adequate national legislation on the International Code and cultural norms which devalued breastfeeding were particularly noted as obstacles. Government commitment, funding and protection of optimal infant and young child feeding are essential to the implementation of strong national policies and monitoring systems.</p>","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":" ","pages":"e13425"},"PeriodicalIF":3.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7d/64/MCN-18-e13425.PMC9480958.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33438472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of infant feeding practices in children from 9 to 24 months, considering complementary feeding indicators and food processing: Results from the Brazilian cohort of the MAL-ED study.","authors":"Eva Débora de Oliveira Andrade,&nbsp;Amanda de Sousa Rebouças,&nbsp;José Q Filho,&nbsp;Ramya Ambikapathi,&nbsp;Laura E Caulfield,&nbsp;Aldo Ângelo Moreira Lima,&nbsp;Bruna Leal Lima Maciel","doi":"10.1111/mcn.13413","DOIUrl":"https://doi.org/10.1111/mcn.13413","url":null,"abstract":"<p><p>Infant feeding practices impact children's nutritional and health status, influencing growth and development. This study aimed to analyse the evolution of infant feeding practices from 9 to 24 months of age, considering infant and young child feeding (IYCF) indicators and food processing. The infant feeding practices in children from the Brazilian site of the MAL-ED study were evaluated at 9 (n = 193), 15 (n = 182) and 24 months (n = 164) using 24-h dietary recalls. IYCF indicators were evaluated, and the extent of food processing was evaluated, using the NOVA classification. Breastfeeding declined significantly over time, from 77.6% at 9 months to 45.1% at 24 months. Although dietary diversity did not significantly change during the study period (80.5% at 24 months), the minimum acceptable diet significantly increased from 67.9% to 76.1% at 24 months (p < 0.0005). All the studied children consumed sweetened beverages from 9 months. Unhealthy food consumption and zero vegetable or fruit consumption significantly increased over time (p < 0.0005). Unprocessed food consumption decreased from 9 to 24 months of age (p < 0.0005), while ultra-processed food consumption increased (p < 0.0005) during the study period. Logistic regressions showed that, at 9 months, breastfed children presented a lower risk for ultra-processed food consumption (odds ratio [OR] = 0.31; 95% confidence interval [CI] = 0.13-0.77); and children reaching the minimum acceptable diet presented more risk for ultra-processed food consumption (OR = 2.31; 95% CI = 1.01-5.27). In conclusion, data showed a reduction in the quality of infant feeding practices over the first 2 years of life, with a decrease in breastfeeding and an increase in the consumption of unhealthy and ultra-processed foods.</p>","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":" ","pages":"e13413"},"PeriodicalIF":3.4,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9480934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40712777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Very low prevalence of iron deficiency among young French children: A national cross-sectional hospital-based survey.","authors":"Anne-Sylvia Sacri,&nbsp;Serge Hercberg,&nbsp;Laurent Gouya,&nbsp;Corinne Levy,&nbsp;Alain Bocquet,&nbsp;Béatrice Blondel,&nbsp;Catherine Vincelet,&nbsp;Pascale Hebel,&nbsp;Isabelle Vinatier,&nbsp;Mariane de Montalembert,&nbsp;Henrique Barros,&nbsp;Yann Le Strat,&nbsp;Martin Chalumeau","doi":"10.1111/mcn.12460","DOIUrl":"https://doi.org/10.1111/mcn.12460","url":null,"abstract":"<p><p>Although iron deficiency (ID) is considered the most frequent micronutrient deficiency in industrialized countries and is associated with impaired neurodevelopment when occurring in early years, accurate recent estimations of its prevalence are lacking. Our objective was to estimate ID prevalence and associated sociodemographic markers in young children in France. The Saturn-Inf national cross-sectional hospital-based survey recruited 3,831 French children <6 years old between 2008 and 2009 to assess lead poisoning prevalence and to establish a biobank. This secondary analysis measured serum ferritinemia (SF) in sera kept frozen at -80 °C for children with sufficient serum aliquots and C-reactive protein <10 mg/L. For the 657 participating children (17% of the Saturn-Inf study), the median age was 3.9 years (interquartile range: 2.2-5.1); 52% were boys. The median SF was 44 μg/L (interquartile range: 28-71). ID prevalence was 2.8% (95% confidence interval [1.7, 4.7]) and 3.2% (95% confidence interval [2.0, 5.1]) with an SF threshold of 10 and 12 μg/L, respectively. Low SF was significantly associated (p < .05) with mother being a migrant (32 vs. 45 μg/L for a mother born in France) or unemployed (37 vs. 50 μg/L for a mother employed). In this first national cross-sectional hospital-based study in France, ID prevalence was much lower than that in other French and European studies performed in underprivileged populations but close to the lowest values observed in other population-based studies in Europe.</p>","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/mcn.12460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34963290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Those who care much, understand much.\" Maternal perceptions of children's appetite: Perspectives from urban and rural caregivers of diverse parenting experience in Bangladesh.","authors":"Nurun Naila,&nbsp;Baitun Nahar,&nbsp;Monica Lazarus,&nbsp;Gaelen Ritter,&nbsp;Muttaquina Hossain,&nbsp;Mustafa Mahfuz,&nbsp;Tahmeed Ahmed,&nbsp;Donna Denno,&nbsp;Judd Walson,&nbsp;Scott Ickes","doi":"10.1111/mcn.12473","DOIUrl":"https://doi.org/10.1111/mcn.12473","url":null,"abstract":"<p><p>Appetite in children is an important determinant of nutritional intake and growth. The information used by caregivers to understand children's appetite can help inform infant and young child feeding promotion and appetite assessment. We conducted a qualitative study to (a) explore maternal perceptions and responses to children's appetite and (b) to identify how these factors differ by type of caregiver, level of maternal experience, and urban versus rural context. We used purposive sampling to recruit mothers and alternate caregivers into 14 total focus group discussions (six to eight participants in each group; N = 95) in both urban and rural settings in Bangladesh. To understand children's appetite, caregivers monitor children's dietary patterns, emotional signs, and physical and verbal cues. Healthy appetite was observed by willingness to eat diverse foods, finish offered portions, and by acceptance of foods without excessive prompting. Child illness was cited for a cause of low appetite, which was manifested through fussiness, and avoiding commonly consumed foods. Mothers described a limited set of feeding practices (offering diverse foods, playing, and cheering children with videos) to encourage consumption when children lacked appetite. Mothers' stress related to work was noted as a barrier to identifying appetite cues. Urban mothers described a lower access to instrumental social support for child feeding but informational support than mothers in the rural setting. Understanding caregivers' perceptions of children's appetite may inform strategies to improve responsive feeding and tool development to assess changes in appetite as early indicators of change in health or nutrition status among high-risk children.</p>","PeriodicalId":501646,"journal":{"name":"Maternal & Child Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/mcn.12473","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35188604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}