Maternal and Child Nutrition最新文献

{"title":"Why Animal-Source Foods Are not Consumed by Women and Children in the Amhara Region: A Qualitative Study","authors":"Netsanet Fentahun,&nbsp;Valerie Flax,&nbsp;Yeshalem Mulugeta","doi":"10.1111/mcn.70006","DOIUrl":"10.1111/mcn.70006","url":null,"abstract":"<p>This study aimed to understand the barriers and facilitators of animal source food (ASF) consumption among women and children in Wag Himra, South Gondar, and Central Gondar zones of Amhara Region, Ethiopia. Women and men with children under 2 years, grandmothers, community and religious leaders, and midwives and health workers were included. Thirty separate focus group discussions and 35 key informant interviews were conducted from July to August 2022. To ensure the quality of qualitative research findings, the criteria of trustworthiness were maintained by the following: credibility, transferability, dependability, and conformability. Qualitative thematic analysis was carried out using Qualitative Data Analysis Miner. Barriers to children's ASF consumption were poverty, age of the child, illness, high cost of ASFs, loss of parents, divorcee, and a lack of livestock. For pregnant and lactating women, the main barriers to ASF consumption were lack of animals in the household, financial constraints, illness, fear of having a big baby, religious fasting, and morning sickness. Family affluence, the availability of ASFs in the household, liking the taste of ASFs, and receiving nutrition education on ASFs were facilitators for children and pregnant and lactating women to consume ASFs. Barriers to ASF consumption in Amhara Region include factors related to livelihoods and social norms or beliefs. Programmes could offer a combination of livelihood supports and social and behaviour change communication to increase ASF consumption by women and children.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Content Analysis of Digital Marketing Strategies of Formula Companies and Influencers to Promote Commercial Milk Formula in Hong Kong","authors":"Wan Ching Ng,&nbsp;Karene Hoi Ting Yeung,&nbsp;Lai Ling Hui,&nbsp;Ka Ming Chow,&nbsp;Esther Yuet Ying Lau,&nbsp;E. Anthony S. Nelson","doi":"10.1111/mcn.70007","DOIUrl":"10.1111/mcn.70007","url":null,"abstract":"<p>This study examines the compliance of the digital marketing strategies used by formula companies and social media influencers in promoting commercial milk formula (CMF) for infants and young children with the International Code of Marketing of Breast-milk Substitutes (International Code) and the Hong Kong Code of Marketing of Formula Milk and Related Products, and Food Products for Infants &amp; Young Children (HK Code). Content analyses on influencers' posts, websites and social media sites of five major formula companies were conducted to identify the digital marketing strategies used, evidence of product cross-promotion, and compliance with the International and HK Codes. Statistical analyses were performed to assess the associations between marketing strategies and social media interactions (likes/comments/shares). The findings revealed widespread noncompliance to the two codes by both influencers and formula companies. Of 1036 influencer (<i>n</i> = 493) and formula company (<i>n</i> = 543) materials mentioned products covered by the Codes, all influencer materials and 95% of company materials violated at least two provisions of the Codes. Persistent brand promotion and cross-promotion strategies were observed in CMF marketing in Hong Kong, with tactics such as parents' sharing, showing images of happy children and families, and celebrity endorsements leading to higher social media interactions. The extensive CMF promotion by influencers and the covert cross-promotion and brand promotion are of particular concern given the lack of regulation in this area. The study calls for a comprehensive review and introduction of legalisation in Hong Kong to govern CMF marketing, ensuring enforcement as outlined in the Convention on the Rights of the Child.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Complementary Feeding Practices in Afghanistan: Analysis of the Multiple Indicator Cluster Survey 2022–2023","authors":"Hannah Gardner,&nbsp;Atma Prakash,&nbsp;Shweta Rawal,&nbsp;Said M. Yaqoob Azimi,&nbsp;William Joe,&nbsp;Zivai Murira,&nbsp;Vani Sethi","doi":"10.1111/mcn.70003","DOIUrl":"10.1111/mcn.70003","url":null,"abstract":"<p>Children between the ages of 6 and 23 months require the age-appropriate introduction of complementary foods alongside breastfeeding to meet their nutritional needs, but in humanitarian settings children frequently do not receive appropriate diets. Using data from 9193 children aged 6–23 months in the Afghanistan Multiple Indicator Cluster Survey 2022–2023, this paper provides nationally representative estimates of the percentage of children meeting key IYCF indicators and assesses the child, maternal and household determinants of receiving minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD) using multivariable logistic regression. Results showed that 85%, 65% and 93% of children were not fed a diet that met MDD, MMF or MAD criteria, respectively. Older children (18–23 months) had significantly higher odds of meeting all three criteria compared to younger children (6–11 months) (MDD aOR = 2.46, 95% CI: 1.93–3.12; MMF aOR = 1.29, 95% CI: 1.11–1.50; MAD aOR = 2.00, 95% CI: 1.51–2.65), as did children from the richest households (vs. poorest) (MDD aOR = 2.85, 95% CI: 1.72–4.70; MMF aOR = 1.82, 95% CI: 1.35–2.46; MAD aOR = 3.88, 95% CI: 2.14–7.04). There was substantial variation in the odds of all outcomes by region. Rural residence (vs. urban) was also associated with higher odds of receiving MMF (aOR = 1.60, 95% CI: 1.25–2.05) and MAD (aOR = 1.69, 95% CI: 1.18–2.42) but not MDD. Overall, alarmingly few children in Afghanistan are receiving appropriate complementary diets amidst a context of concurrent political, economic and environmental crises. Reversals to funding reductions are vital to ensure proven interventions responding to the determinants identified here continue to be delivered to support nutrition among Afghanistan's infants and young children.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging South Asian Communities in the United Kingdom to Explore Infant Feeding Practices and Inform Intervention Development: Application of the REPLACE Approach","authors":"Kayleigh Kwah,&nbsp;Maxine Sharps,&nbsp;Naomi Bartle,&nbsp;Kubra Choudhry,&nbsp;Jacqueline Blissett,&nbsp;Katherine Brown","doi":"10.1111/mcn.70009","DOIUrl":"10.1111/mcn.70009","url":null,"abstract":"<p>Breastfeeding in UK Pakistani and Bangladeshi communities is positively and negatively influenced by cultural beliefs and practices. The LIFT (Learning about Infant Feeding Together) project aimed to understand the determinants of infant feeding in these target communities and to engage them in the development of a culturally specific and acceptable infant feeding intervention to support breastfeeding. Reported here is phase one of the LIFT project guided by the REPLACE approach (a framework for the development of community-based interventions). The project involved an initial lengthy period of engagement with the target communities, using methods such as a community outreach event and identification of community peer group champions to help build trust. This was followed by iterative community workshops used to explore and build an understanding of infant feeding practices and the social norms and beliefs underlying these, and to assess community readiness to change. Consistent with previous research, the six key practices and beliefs identified from the workshops were: (1) Disparities between personal views versus cultural and normative barriers, (2) Family relationships and the influence on infant feeding decisions, (3) Pardah (modesty) and being unable to breastfeed in front of others, (4) Discarding colostrum (first breast milk), (5) Pre-lacteal feeds (feeds within a few hours of birth and before any breast or formula milk has been given) and complementary feeding before the baby is 6 months old, and (6) The belief that bigger babies are better and that formula helps babies to grow. Participants perceived that Pakistani and Bangladeshi communities would be amenable to intervention that aimed to change some but not all of the infant feeding behaviours identified. Findings informed the co-development of a culturally appropriate intervention toolkit to optimise infant feeding behaviour.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Recovery From Severe Acute Malnutrition to Normal Nutritional Status and Its Predictors Among Children Aged 6–59 Months in North-East Ethiopia","authors":"Temesgen Gebeyehu Wondmeneh,&nbsp;Amarech Giruma","doi":"10.1111/mcn.13808","DOIUrl":"10.1111/mcn.13808","url":null,"abstract":"<p>Malnutrition is a major disease burden in developing countries, particularly in recurrently drought-affected areas. Despite the Ethiopian government's initiatives to set up stabilization centers in different hospitals to tackle severe acute malnutrition, there is limited data on the time to recover from severe acute malnutrition and its determinants among under-five children in northeast Ethiopia. The objective of the study is to determine time to recovery of under-five children from severe acute malnutrition to normal nutritional status and its predictors in northeast Ethiopia. A facility-based retrospective record review was carried out from March 1–20, 2023. The tools for the data extraction format were adapted from the national guidelines for the management protocol for severe acute malnutrition. The Kaplan–Meier survival curve was used to compare different categorical variables. The time-varying covariate Cox-proportional hazards regression model was fitted due to the violation of the Cox proportional hazard assumption (<i>p</i> = 0.007). A <i>p</i>-value &lt; 0.05 was a cutoff point to declare statistical significance. In the final analysis, a total of 372 children aged 6–59 months with severe acute malnutrition were included, 58.1% of whom were recovered. The incidence rate of recovery from severe acute malnutrition was 4.43 per 100 child days. Children living in rural areas (AHR = 0.7, 95% CI: 0.5–0.94) and those without F-100 supplement (AHR = 0.85, 95% CI: 0.79–0.91) had a lower recovery rate from severe acute malnutrition. Children lacking IV antibiotics (AHR = 1.4, 95% CI: 1.03–2.0) and those HIV-free (AHR = 1.76, 95% CI: 1.1–3.3) were more likely to recover from severe acute malnutrition. The percentage of recovery in the study area was found to be lower than the sphere standard. F-100 supplements should be mandatory to improve and speed up the recovery rate. Special attention should be given to children from rural areas, those receiving IV antibiotics, and those living with HIV/AIDS.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13808","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends of Large for Gestational Age and Macrosomia and Their Mediating Effect on the Association Between Diabetes Mellitus and Obstetric Hemorrhage","authors":"Peiran Chen,&nbsp;Yi Mu,&nbsp;Yanxia Xie,&nbsp;Yanping Wang,&nbsp;Zheng Liu,&nbsp;Mingrong Li,&nbsp;Juan Liang,&nbsp;Jun Zhu","doi":"10.1111/mcn.70000","DOIUrl":"10.1111/mcn.70000","url":null,"abstract":"<p>This study aimed to determine the prevalence of large for gestational age (LGA) and macrosomia in China from 2012 to 2021 and explore if LGA and macrosomia mediate the relationship between diabetes mellitus in pregnancy (DIP) and obstetric haemorrhage. The overall annual change rate (ACR) was calculated, and stratification analysis was performed. Mediation analysis assessed the influence of LGA and macrosomia in the association between DIP and obstetric haemorrhage. The nationwide prevalence of LGA and macrosomia was 15.8% and 6.8%, respectively. The ACR for LGA was 0.71% (95% CI, 0.66%–0.76%); pre-2016, −0.44% (95% CI, −0.63% to −0.25%); post-2016, −0.29% (95% CI, −0.39% to −0.19%). The ACR for macrosomia was −1.17% (95% CI, −1.24% to −1.09%); pre-2016, −0.73% (95% CI, −1.03% to −0.43%); post-2016, −2.42% (95% CI, −2.59% to −2.26%). In western and rural area, the ACR for LGA was 1.94% (95% CI, 1.84%–2.05%) and 1.81% (95% CI, 1.73%–1.89%), and LGA was increasing among these women in the post-2016 period. About 7.0% of pregnant women had DIP, and the LGA and macrosomia prevalences among women with DIP were 23.7% and 10.0%, respectively. In the mediation analysis, the total excess risk associated with DIP on obstetric haemorrhage was approximately 0.21 and the proportion mediated by LGA and macrosomia was 12.10% and 11.81%, respectively. In rural areas, the proportion mediated by LGA and macrosomia was amplified to 18.34% and 16.40%. Macrosomia rates declined steadily, but LGA rates increased slightly in disadvantaged areas. LGA and macrosomia mediated the association between DIP and obstetric haemorrhage, and the mediating effect intensified in rural regions. Addressing LGA warrants management for at-risk fetuses.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritising Profits Over Public Health? Why UK Commercial Milk Formula Marketing Regulations Need to be Strengthened and Enforced, Not Weakened","authors":"Victoria Sibson,&nbsp;Marko Kerac,&nbsp;Robert Boyle,&nbsp;Amandine Garde,&nbsp;Andrea Gideon,&nbsp;Shereen Fisher,&nbsp;Catherine Pereira-Kotze","doi":"10.1111/mcn.70002","DOIUrl":"10.1111/mcn.70002","url":null,"abstract":"&lt;p&gt;Current UK public health recommendations for feeding in the first years of life align with those of the World Health Organization and recognise breastfeeding as optimal for infant and maternal health. Exclusive breastfeeding for the first 6 months is therefore recommended, and so is continued breastfeeding, alongside a diet of appropriate, nutritious complementary foods, to 2 years and beyond (SACN &lt;span&gt;2018&lt;/span&gt;; World Health Organization [WHO] &lt;span&gt;2023a&lt;/span&gt;). Beyond health benefits, breastfeeding also has environmental and climate benefits (Joffe et al. &lt;span&gt;2019&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;Most UK women want to breastfeed (McAndrew et al. &lt;span&gt;2012&lt;/span&gt;), and most start breastfeeding (NHS Digital &lt;span&gt;2024&lt;/span&gt;). However, too few receive the support they need to meet their breastfeeding goals (McAndrew et al. &lt;span&gt;2012&lt;/span&gt;). One major factor undermining their efforts is aggressive and misleading marketing of breastmilk substitutes (including commercial milk formulas, bottles and teats) (World Health Organization [WHO] and the United Nations Children's Fund (UNICEF) &lt;span&gt;2022&lt;/span&gt;; Rollins et al. &lt;span&gt;2023&lt;/span&gt;). Such marketing contributes to the widespread use of commercial milk formulas in the first weeks and months of life for most UK infants (NHS Digital &lt;span&gt;2024&lt;/span&gt;). This is unfortunate: whilst infant formula is safe and suitable to support adequate growth and development, it cannot match full health benefits of breastfeeding (NHS &lt;span&gt;2023&lt;/span&gt;). Other commercial milk formulas are unnecessary for healthy children (NHS &lt;span&gt;2023&lt;/span&gt;; Sibson and Westland &lt;span&gt;2024&lt;/span&gt;; Childs et al. &lt;span&gt;2024&lt;/span&gt;). Effective controls on the marketing of all commercial milk formulas are thus necessary to ensure women and families can make properly informed, independent decisions on how they feed their babies and young children, protected from undue commercial influence.&lt;/p&gt;&lt;p&gt;Kamata and others have exposed the shockingly poor compliance of commercial milk formula companies with UK marketing regulations on the labelling of infant and follow-on formula (Kamata et al. &lt;span&gt;2025&lt;/span&gt;). This is happening despite clear guidance from the Department of Health and Social Care (Department of Health and Social Care [DHSC] &lt;span&gt;2024&lt;/span&gt;) and even though these domestic regulations are already less stringent than the international minimum standards outlined in ‘the Code’ (World Health Organization [WHO] &lt;span&gt;2022&lt;/span&gt;). Formula companies exploit weaknesses in the UK's overburdened and under resourced enforcement system (Conway et al. &lt;span&gt;2023&lt;/span&gt;; Baby Feeding Law Group [BFLG-UK] &lt;span&gt;2025&lt;/span&gt;) to maximise their sales, whilst undermining breastfeeding as well as safe and appropriate formula feeding (UNICEF &lt;span&gt;2024&lt;/span&gt;). Whilst companies benefit from the current regulatory environment, the taxpayer is ultimately burdened with the long-term costs of poor health outcomes that arise from suboptimal infant and young ","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Bottleneck Analysis of Iron and Folic Acid Supplementation Program in Pakistan","authors":"Anamta Ghur,&nbsp;Soha Randhawa,&nbsp;Namira Shahid,&nbsp;Waffa Ali,&nbsp;Banafsha Ali,&nbsp;Saroosh Rashid,&nbsp;Ambreen Khan,&nbsp;Aman Akbar Babri,&nbsp;Khawaja Masood,&nbsp;Saba Shuja,&nbsp;Maliha Fatima,&nbsp;Noshad Ali,&nbsp;M. Imran Khan,&nbsp;Ali Turab","doi":"10.1111/mcn.13797","DOIUrl":"10.1111/mcn.13797","url":null,"abstract":"<p>Iron and folic acid deficiency is a significant public health concern, especially in low and middle-income countries, particularly among women of reproductive age, leading to adverse maternal and child health outcomes. In Pakistan, approximately 41.7% of women of reproductive age have iron deficiency. For this research, we conducted 33 key informant interviews and 32 focus group discussions with stakeholders from all four provinces and the two federally administered regions of Pakistan for in-depth and representative bottleneck assessment. The modified Tanahashi model was used to inform the determinant codes and for coding reliability thematic analysis using NVivo 14. On the supply side, barriers relate to effective forecasting, procurement, and distribution of Iron Folic Acid supplements to the recipients. The demand–supply gap widened due to the supply bottlenecks, impacting the community's trust in the frontline health worker. These factors were gravely impacted by the governance challenges of ensuring sustainable funds, minimizing bureaucratic and procedural delays, and eliminating political pressure. Affordability of Iron Folic Acid and conservative social norms influenced the demand and awareness of Iron Folic Acid and nutritional knowledge among the target population. The stakeholder recommendations emphasize the need for intersectoral collaboration, mass media campaigns, frequent capacity building and incentivizing of healthcare workers, engagement of key community stakeholders, digitizing the health system, improvement in supply chain mechanism, and investment in small-scale innovative solutions.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13797","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Phenotype, Infant Size and Breast Milk Composition in Women Living With HIV","authors":"Marlene Gilfillan,&nbsp;Friedeburg. A. M. Wenhold,&nbsp;Helen Mulol,&nbsp;Ute. D. Feucht","doi":"10.1111/mcn.13807","DOIUrl":"10.1111/mcn.13807","url":null,"abstract":"<p>The impact of maternal factors on the size of HIV-exposed-uninfected (HEU) infants and breast milk composition is poorly understood. Anthropometry, bio-electrical impedance, haemoglobin and HIV viral load data of women living with HIV (WLWH) and without HIV (WLWOH) were compared and related to their infants' anthropometric Z-scores and breast milk macronutrients 6 weeks and 6 months postnatally. At both time points, WLWH (6-week: <i>n </i>= 83; 6-month: <i>n </i>= 63) had lower reactance (measure of body cell mass) (6-week: <i>p </i>= 0.016; 6-month: <i>p </i>&lt; 0.001), phase angle (PhA) (measure of cell health) (6-week: <i>p </i>= 0.001; 6-month: <i>p </i>= 0.002) and haemoglobin (6-week: <i>p </i>= 0.002; 6-month: <i>p </i>= 0.004) than WLWOH (6-week: <i>n </i>= 90; 6-month: <i>n </i>= 73). HEU infants had lower weight-for-age Z-scores (WAZ) (6-week: <i>p </i>= 0.010; 6-month: <i>p </i>= 0.005). Breast milk composition did not differ between groups. At 6 weeks, HEU infants had lower head circumference-for-age Z-scores (HCAZ) (<i>p </i>= 0.014). Bivariate regression demonstrated maternal HIV predicted lower infant WAZ (ß = −0.442; <i>p </i>= 0.011) and HCAZ (ß = −0.445; <i>p </i>= 0.014). Maternal body mass index (BMI) and mid-upper arm circumference were positively associated with breast milk protein content (ß = 0.018; <i>p </i>= 0.014 and ß = 0.025; <i>p </i>= 0.002, respectively). At 6 months (bivariate regression) maternal HIV predicted lower infant WAZ (ß = −0.609; <i>p </i>= 0.005) and length-for-age Z-scores (ß = −0.741; <i>p </i>= 0.018). Higher maternal BMI and PhA were associated with higher infant WAZ (ß = 0.622; <i>p </i>= 0.015 and ß = 0.055; <i>p </i>= 0.017, respectively). On multivariable analysis, maternal HIV remained a predictor of lower WAZ (ß = −0.568; <i>p </i>= 0.024). In conclusion, maternal HIV infection and phenotype predict the size of infants and breast milk composition up to 6 months postnatally.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13807","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Breastmilk Feeding for Infants in Foster Care: A Scoping Review","authors":"Vicky Mitchell,&nbsp;Marianne White,&nbsp;Shona Shinwell,&nbsp;Camila Biazus-Dalcin","doi":"10.1111/mcn.13810","DOIUrl":"10.1111/mcn.13810","url":null,"abstract":"<p>Worldwide, around 2.7 million children are not in the care of their parents, and access to breastmilk is often absent from foster care policies. We aimed to explore the evidence available on how foster families, health and social workers and mothers with infants in care can be supported in providing breastfeeding and expressed breastmilk (EBM), and to identify barriers and facilitators for breastfeeding and EMB in foster care. The JBI methodology for scoping reviews was used. Three academic databases and grey literature were searched in March 2023, and data extraction charts were used. The findings were synthesised using thematic analysis. In total, 11 papers were included, 5 peer-reviewed papers and 6 from the grey literature. Five themes were identified in the analysis: ‘Is this safe?’, ‘Substance use: Protecting the breastfeeding rights of mothers and infants’, ‘Making milk accessible through breastfeeding and EBM’, ‘Where are the policies’? and ‘Attitudes around breastfeeding’. The findings showed concern from foster parents around the safety of breastmilk and the challenges of supporting breastmilk provision when infants are in foster care. Training, positive attitudes and multi-disciplinary team involvement can support breastfeeding and the breastfeeding rights for infants in foster care. Health and social care professionals who support mothers and foster families with breastfeeding and EBM feeding lack knowledge and guidance in how to do this safely and with a rights-based approach. We found that facilitating breastfeeding is not prioritised when an infant is placed into foster care and that the breastfeeding rights of mothers and infants require urgent attention in policies and guidelines to facilitate safe and person-centred infant feeding.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 3","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.13810","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}