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Background: Age-appropriate breastfeeding and adequate complementary feeding play a crucial role in reducing under-5 mortality rates, malnutrition, and mortality worldwide. Given the high prevalence of adolescent pregnancy in Uganda, we aimed to assess the competence of adolescent mothers in infant and young child feeding (IYCF) using data from the 2016 Uganda Demographic Health Survey. Method: Our sample comprised the last children aged 6–23 months of mothers aged 15–29 years, totaling 2594 mother-infant pairs; 402 were aged 15–19 years, 1,388 were aged 20–29 years with their first delivery before the age of 20, and 804 were aged 20–29 years with their first delivery at 20 years or older. We utilized complex sample logistic regression analysis to examine the interactions between adolescent motherhood and IYCF indicators during the previous day of the survey. Results: The rates of ongoing breastfeeding, bottle feeding, minimum meal frequency, minimum dietary diversity, minimum acceptable diet, egg and/or flesh food consumption, zero vegetable or fruit consumption, and unhealthy food consumption were found to be 77.7%, 16.3%, 37.5%, 28.7%, 14.2%, 41.7%, 31.6%, and 14.7%, respectively. Multivariate complex sample logistic regression revealed that women with a history of adolescent pregnancy had lower odds of achieving minimum meal frequency, and higher odds of zero vegetable or fruit consumption. Conclusion: Adolescent mothers and women who give birth during their teenage years are particularly vulnerable to inadequate infant and young child nutrition practices. Targeted interventions and education programs should be implemented to promote optimal complementary feeding practices among mothers in Uganda. [ABSTRACT FROM AUTHOR]

Background & Aims: Despite the WHO and UNICEF recommending exclusive breastfeeding for the first six months of a child's life, global coverage remains low, with only about 44% of infants receiving exclusive breastfeeding during this period. In Indonesia, particularly in the Nias Islands, which have high stunting rates, social and cultural dimensions significantly influence this practice. This study aims to explore in depth the social dimensions behind early infant feeding practices. By understanding these social issues, effective interventions can be developed in the future. Methods: This study was conducted in three remote villages in the Nias Islands using a qualitative approach. The research locations were selected based on District Health Office data about areas with low exclusive breastfeeding coverage or high stunting rates. In each location, the village midwife assisted in identifying and selecting suitable informants for the study. Data were collected through in-depth interviews with 15 mothers, Focus Group Discussions (FGD) with three groups of mothers, and interviews with village midwives and community leaders to understand the influence of social norms and cultural factors. The data were analyzed using thematic analysis. Results: The findings indicate that the low knowledge about the benefits of exclusive breastfeeding, along with socio-cultural perceptions supporting early food introduction, significantly influence this practice. This study also reveals that social pressure and entrenched cultural norms, including the roles and expectations of women, play a significant role in the early introduction of food before six months of age. Conclusion: This study identifies that the combination of inadequate knowledge and a strong socio-cultural landscape contributes to the low prevalence of exclusive breastfeeding in the Nias Islands. This situation necessitates more targeted educational strategies and the inclusion of social and cultural elements in promoting exclusive breastfeeding. [ABSTRACT FROM AUTHOR]

ABSTRACT: Introduction: Breast milk is the optimal food for infants, supporting their physical and emotional development. Breastfeeding should begin within an hour of birth. Study Objectives: a) Assess knowledge of breast milk expression and storage among working mothers. b) Evaluate practices related to expression and storage. c) Provide a self-instructional module on expressed breast milk. d) Measure the module's effectiveness. e) Analyze the association between knowledge, practice, and selected demographic variables. Methodology: An experimental study with 40 working mothers selected via convenience sampling. A structured questionnaire assessed knowledge and practices. Results: Descriptive statistics were used, yielding a "t" value of 9.35. Over 15 days, questionnaires were administered to 3 participants daily, with posttests and the instructional module provided after 15 days. Conclusion: The study showed a significant improvement in knowledge and practices after the self-instructional module was provided. [ABSTRACT FROM AUTHOR]

Childhood is a critical period for immune system development, which is greatly influenced by the gut microbiome. Likewise, a number of factors affect the gut microbiome composition and diversity, including breastfeeding, formula feeding, and solid foods introduction. In this regard, several studies have previously demonstrated that breastfeeding promotes a favorable microbiome. In contrast, formula feeding and the early incorporation of certain solid foods may adversely affect microbiome development. Additionally, there is increasing evidence that disruptions in the early microbiome can lead to allergic conditions and food intolerances. Thus, developing strategies to promote optimal infant nutrition requires an understanding of the relationship between infant nutrition and long-term health. The present review aims to examine the relationship between infant feeding practices and the microbiome, as well as its implications on allergies and food intolerances in infants. Moreover, this study synthesizes existing evidence on how different eating habits influence the microbiome. It highlights their implications for the prevention of allergies and food intolerances. In conclusion, introducing allergenic solid foods before six months, alongside breastfeeding, may significantly reduce allergies and food intolerances risks, being also associated with variations in gut microbiome and related complications. [ABSTRACT FROM AUTHOR]

Age‐appropriate breastfeeding and introduction to complementary foods can shape child feeding practices, ensure adequate energy and nutrient intake and prevent linear growth faltering. This study aimed to assess mothers' and health workers' knowledge of timely introduction to complementary foods and evaluate the relationship between delays in complementary feeding and subsequent linear growth. We conducted two rounds of surveys (March/August 2017) among 249 health workers (n = 249) and caregivers (n = 2635) of children 6–23 months of age. We collected information about socio‐demographic characteristics, knowledge and practice related to timely introduction to complementary foods. The study was conducted in households from the Productive Safety Net Programme (PSNP) districts, in four highland regions of Ethiopia. Delays in the introduction to complementary feeding were widespread with 53% of children 6–8 months of age not consuming solid, semisolid or soft foods in the past 24 h. After controlling for child, caregiver and household characteristics, children not introduced to complementary foods by 6–8 months had a 0.48 SD lower length‐for‐age z‐score at 12–15 months. Caregivers' knowledge was strongly and inversely correlated with untimely introduction of complementary foods in logistic regressions (OR = 0.55, p < 0.01). In turn, local health extension worker's knowledge was strongly correlated with caregiver's knowledge. Consequently, frequent and timely visits by health extension workers emphasising not only on what to feed but also when and how to feed a child are needed. Innovative ways of increasing reach, intensity and frequency of nutrition messaging by using the PSNP interactions as an additional point of contact would need to be explored further. [ABSTRACT FROM AUTHOR]

We aimed to describe how breastfeeding relates to adherence to complementary feeding (CF) recommendations, diet diversification and feeding skills development and whether sociodemographic factors explain any differences observed. The Scottish Maternal Infant and Nutrition Survey for infants aged 8–12 months collected breastfeeding history, CF practices, diet and sociodemographic data using a self‐completion questionnaire. Non‐healthful CF practices were starting CF < 6 months, any consumption of sugar‐sweetened beverages (SSBs), sweet or salty snacks (treats) or unmodified cow's milk and regular consumption of commercial baby foods. Diet diversification and feeding skills were assessed by amount of self‐feeding and number of food groups, meals and snacks eaten daily. Of the 2730 mothers, 20% were solely infant formula fed (IFF) and 48% continued breastfeeding ≥6 months. Compared to IFF babies, mothers who gave any breast milk ≥6 months were more likely to start CF ≥ 6 months compared to those IFF (66% vs. 37%) and less likely to give treats (15% vs. 45%), SSBs (11% vs. 20%) and commercial baby foods (31% vs. 53%). These associations remained highly significant (p < 0.001) even after sociodemographic factor adjustment. Despite starting CF later, infants breastfed ≥6 months ate the same number of food groups and meals as those IFF, were just as likely to self‐feed purees and more likely to self‐feed finger foods daily (87% vs. 81% p < 0.001). Mothers who breastfeed beyond 6 months adhere more to CF recommendations and start CF later compared to IFF, but their babies eat a similarly diverse diet and have similar feeding skills. Key messages: Adhering to breastfeeding recommendations is associated with delayed introduction of complementary foods, without influencing diet diversity or development of infant feeding skills.Breastfeeding duration is a predictor for healthful complementary feeding practices.These associations between breastfeeding duration and healthful complementary feeding practices are not explained by differences in maternal age or deprivation level. [ABSTRACT FROM AUTHOR]

Background: Elevated blood pressure (EBP) in preschool children due to unhealthy early feeding practices can track into later years leading to hypertension (HTN) and cardiovascular disease (CVD). Objectives: To identify the determinants of high blood pressure in relation to early breastfeeding, commercial milk formula feeding (CMF) and marketed baby foods. Subjects and methods: 150 children aged 2-5 years were recruited by feeding practices and divided into three groups, (breastfeeding, no breastfeeding and mixed fed groups). All children were subjected to anthropometric measurements of weight, height and blood pressure (BP), which was interpreted using BP standards. Results: EBP both systolic and diastolic were inversely correlated with the early and intense breastfeeding. They were positively correlated with CMF feeding for longer duration and at shorter intervals, pacifier use, sugar or starch added to bottle feeds and high salt and sugar intake, fast foods, snacks of chips and Indomie. Lack of mother's awareness of unhealthy food intake and poor tracking abilities of these practices were prevalent in the groups who consumed more frequent unhealthy foods. Conclusion: EBP is associated with not breastfeeding, CMF, pacifiers, weaning foods and unhealthy marketed foods. Promoting breastfeeding and maternal awareness on healthy feeding practices supported by strict regulations are needed to control and prevent HTN and CVD. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Antropología Biológica is the property of Revista Argentina de Antropologia Biologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The achievement towards 100% exclusive breastfeeding still a challenge in many countries despite adverse impacts due to the absence of exclusive breastfeeding. One consequence from the low practice of exclusive breastfeeding is malnutrition, including stunting that can be prevented by providing optimal food to infants, starting with providing exclusive breastfeeding from birth to 6 months of age. However, the practice of exclusive breastfeeding still low and it is suspected that this practice also decreased during the COVID- 19 pandemic. This study aims to analyze the determinants of exclusive breastfeeding in sub-urban areas during the COVID-19 pandemic. Methods: This study using cross sectional design conducted from interviewing 206 mothers in 2022 who meet the inclusion criteria, consisted of breastfeeding their babies in the last 1 year and live in Sub-urban area in Depok City, West Java. Multiple binary logistic regression used to measure the association and strength between independent variables with the outcome variable. Independent variables with a p-value < 0.25 during the Chi-square test were included in the logistic regression model. Results: Prevalence of exclusive breastfeeding and early initiation of breastfeeding (EIB) was 58.3% and 57.8% respectively. Factors associated with exclusive breastfeeding practices are education, employment status, knowledge and attitude about exclusive breastfeeding, self-efficacy in providing exclusive breastfeeding, EIB practice, and eating pattern. From multivariate analysis, it was found that the dominant factors to exclusive breastfeeding are EIB. Conclusions: The study highlights the importance of improving exclusive breastfeeding practice through early initiation of breastfeeding, mother's knowledge, education and self-efficacy. Therefore, health promotion and education should emphasize the importance of those factors, supported by the health policy and massive campaign as a key success in exclusive breastfeeding. [ABSTRACT FROM AUTHOR]

Background: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) issues infant formula to infants who are not fully breastfed, and prior research found elevated obesity risk among children receiving lactose-reduced infant formula with corn syrup solids (CSSF) issued by WIC. This study was conducted to evaluate associations between a broader set of specialty infant formulas issued by WIC and child obesity risk, whether neighborhood context (e.g. neighborhood food environment) modifies associations, and whether racial/ethnic disparities in obesity are partly explained by infant formula exposure and neighborhood context. Methods: WIC administrative data, collected from 2013–2020 on issued amount (categorical: fully formula fed, mostly formula fed, mostly breastfed, fully breastfed) and type of infant formula (standard cow's milk formula, and three specialty formulas: any CSSF, any soy-based formula, and any cow's milk-based formula with added rice starch) and obesity at ages 2–4 years (defined as a Body Mass Index z-score ≥ 95th percentile according to World Health Organization growth standard) were used to construct a cohort (n = 59,132). Associations of infant formula exposures and race/ethnicity with obesity risk were assessed in Poisson regression models, and modification of infant feeding associations with obesity by neighborhood context was assessed with interaction terms. Results: Any infant formula exposure was associated with significantly higher obesity risk relative to fully breastfeeding. Receipt of a CSSF was associated with 5% higher obesity risk relative to the standard and other specialty infant formulas (risk ratio 1.05, 95% confidence interval 1.02, 1.08) independent of breastfeeding duration and receipt of other specialty infant formulas. The association between CSSF and obesity risk was stronger in neighborhoods with healthier food environments (10% higher risk) compared to less healthy food environments (null). Racial/ethnic disparities in obesity risk were robust to adjustment for infant formula exposure and neighborhood environment. Conclusions: Among specialty infant formulas issued by WIC, only CSSFs were associated with elevated obesity risk, and this association was stronger in healthier food environments. Future research is needed to isolate the mechanism underlying this association. [ABSTRACT FROM AUTHOR]

Background and Aims: Although exclusive breastfeeding (EBF) has many benefits, it is not commonly practiced in several countries as a result of context‐specific challenges. EBF practice is thus a global health discourse because over 200 million children suffer from malnutrition despite the abundance of human milk. The risk of starvation remains very high among African children with less than 40% of them exclusively breastfed. In Africa, the adoption or nonadherence to EBF is a sociocultural issue. Hence, this narrative review examined the sociocultural context of EBF in the region. Methods: PubMed, Google Scholar, and Scopus were searched using keywords related to EBF and Africa. Relevant data from selected studies were synthesized narratively and reported using a structured narrative format. Results: EBF is strongly rooted in every culture and is a culturally determined behavior. Some believe that colostrum is dirty and harmful to newborns and, thus, needs to be purified. Despite the belief that human milk is the best food for babies, mothers often complement human milk with other foods right from birth because of perceived lactation inadequacy. Most African mothers believe in prelacteal feeding to help cleanse the infant's gastrointestinal tract for digestion, quench thirst, flush the bladder and help the mother to rest after childbirth before breastfeeding (BF) is initiated. The role of significant others was equally found important in the decision and duration of BF. The availability of family support (especially from grandmothers and husbands) reportedly encouraged EBF in Africa. The duration and exclusivity of BF in Africa are negatively associated with demographic variables like young age, low level of education, being unmarried, low income, out of employment, and parity (first‐time mother). Conclusion: While there have been some efforts and policies to improve EBF, it is important to consider context‐specific challenges and sociocultural factors. There is a need for more deliberate efforts to encourage mothers through the implementation of effective best practices concerning EBF in Africa. [ABSTRACT FROM AUTHOR]

Circulating food metabolites could improve dietary assessments by complementing traditional methods. Here, biomarker candidates of food intake were identified in plasma samples from pregnancy (gestational week 29, N = 579), delivery (mothers, N = 532; infants, N = 348), and four months postpartum (mothers, N = 477; breastfed infants, N = 193) and associated to food intake assessed with semi-quantitative food frequency questionnaires. Families from the Swedish birth cohort Nutritional impact on Immunological maturation during Childhood in relation to the Environment (NICE) were included. Samples were analyzed using untargeted liquid chromatography–mass spectrometry (LC-MS)-based metabolomics. Both exposure and outcome were standardized, and relationships were investigated using a linear regression analysis. The intake of fruits and berries and fruit juice were both positively related to proline betaine levels during pregnancy (fruits and berries, β = 0.23, FDR < 0.001; fruit juice, β = 0.27, FDR < 0.001), at delivery (fruit juice, infants: β = 0.19, FDR = 0.028), and postpartum (fruits and berries, mothers: β = 0.27, FDR < 0.001, infants: β = 0.29, FDR < 0.001; fruit juice, mothers: β = 0.37, FDR < 0.001). Lutein levels were positively related to vegetable intake during pregnancy (β = 0.23, FDR < 0.001) and delivery (mothers: β = 0.24, FDR < 0.001; newborns: β = 0.18, FDR = 0.014) and CMPF with fatty fish intake postpartum (mothers: β = 0.20, FDR < 0.001). No clear relationships were observed with the expected food sources of the remaining metabolites (acetylcarnitine, choline, indole-3-lactic acid, pipecolic acid). Our study suggests that plasma lutein could be useful as a more general food group intake biomarker for vegetables and fruits during pregnancy and delivery. Also, our results suggest the application of proline betaine as an intake biomarker of citrus fruit during gestation and lactation. [ABSTRACT FROM AUTHOR]

The article aims to identify NBCAL violations and analyze the content of messages posted on the Instagram social network. This qualitative-quantitative study consisted of a convenience sample of profiles identified through specific terms preceded by the hashtag symbol (#). Data were collected for two months by trained researchers using a structured questionnaire. We calculated the product promotion frequency that characterized violation of the NBCAL per category and manufacturer. The messages were analyzed using the content analysis technique. We identified 64 personal accounts of mothers with violations in 89 products, mainly food (n = 72), dairy compounds (54.2%), and infant formulas (45.8%) were the most publicized. Two thematic categories emerged from the posted texts, one related to the quality of the products and the other about breastfeeding difficulty, especially low milk production. The study identified NBCAL violations on the Instagram social network, alerting the need to recognize digital marketing to include it in the rules imposed by the Norm in the virtual context, considering the capillarity of social networks in disseminating information to the public in question. [ABSTRACT FROM AUTHOR]

Objective: The acquaintance period with complementary foods is an essential period for infants in terms of the determination of both their development and short- and long-term health conditions. The method of introduction of complementary foods to the infant, the order in which they are introduced, and the repetitive introduction of foods to the infant are vital for determining the eating behavior and food preferences. Methods: We designed as a single-center, cross sectional, descriptive study. Written and verbal consent was obtained from the mothers, and face-to-face interviews were conducted with the family by the doctors involved in the study. The survey comprised 33 open-ended and closed-ended questions that evaluated the experiences of mothers regarding breastfeeding and complementary feeding. Results: The mothers of 100 infants presenting to the pediatric emergency department participated in the questionnaire survey. The mean age of the infants was 10.48 ± 6.37 months, and 52% of them were boys. Mothers with an educational level higher than elementary school started breastfeeding after waiting for a longer time (p = 0.03). Mothers with elementary school and secondary school graduate education levels exclusively breastfed their infants for a period over 10 months significantly higher than mothers with undergraduate and postgraduate education level (p = 0.0072, RR = 0.44). Among the participants, 53.1% responded that they used formula milk in baby nutrition. Conclusions: Mothers’ knowledge levels regarding the duration of exclusive breastfeeding and the timing of transitioning to complementary feeding were insufficient and inversely proportional to their education level. Moreover, the lack of education on the initiation of formula milk, except for medical indications, in our country was striking. Therefore, all physicians, especially pediatricians, should allocate time for explaining the importance of breastfeeding, timing, and diversity of complementary feeding and seek support from the media. [ABSTRACT FROM AUTHOR]

Microplastics are small plastic pieces with sizes less than 5 mm. They are becoming a global concern due to the potential risk to human health. The potential risks of microplastics may be greater for infants because they do not have sufficiently developed metabolizing enzymes, have less ability to remove microplastics, and have highly sensitive target organs. Infants should be breastfed for the first six months of life. Breast milk is considered to be the most complete and suitable source of nutrition. However, if breastfeeding during this period is not possible, it is necessary to use formulas designed for infant initial feeding. Infants may be exposed to higher levels of MPs through infant foods or plastic products. The aim of this study is to describe the possible sources of exposure to microplastics such as the human placenta, plastic feeding bottles, and toys as well as the presence of released microplastics in infant feces, breast milk, and infant formulas. There is still not enough data available for this study area. Therefore, it is necessary to pay increased attention to minimizing the negative effects of microplastics on human health. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency (ID) is prevalent in Malaysian children. The incidence of ID in infants under 6 months of age is unknown. Our aim was to determine the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in healthy, term infants aged below 6 months in our hospital population. Methods: A prospective longitudinal pilot study of mother-infant pairs was conducted on infants receiving routine immunizations in a mother and child clinic at a university hospital, in Kuala Lumpur, Malaysia. Mothers completed standardized questionnaires at 3- and 5-month postnatal visits. Maternal and infant full blood count, ferritin, and C-reactive protein (CRP) levels were measured at 3 months and for the infants repeated at 5 months. Infant anthropometric measurements were obtained at both visits. We conducted a univariate analysis to identify factors associated with ID and IDA. Results: Altogether, 91 mother-infant pairs were enrolled, with 88 completing the study. No infant had ID or IDA at 3 months; the lowest ferritin level was 16.6 µg/L. At 5 months, 5.9% (5/85) of infants had ID, and 2.4% (2/85) had IDA. Median (interquartile range) infant ferritin levels significantly declined from 113.4 (65.0–183.6) µg/L at 3 months to 50.9 (29.2–70.4) µg/L at 5 months, p < 0.001. Exclusive breastfeeding until 3 or 5 months was significantly associated with ID at 5 months (p = 0.020, and p = 0.008, respectively) on univariate analysis. The drop in ferritin between 3–5 months was significantly associated with weight and length gains between 0–3 months (p = 0.018, p = 0.009, respectively). Altogether, 14.3% of infants exclusively breastfed until 5 months developed ID. At 5 months, 3.4% of infants were underweight, 1.1% stunted, and 10.2% wasted. Conclusions: In exclusively breastfed term infants, ID occurred by 5 months. Early introduction of iron-rich foods should be considered in exclusively breastfed babies. A high prevalence of wasting suggests a calorie deficit in this population and will lead to stunting if not addressed. [ABSTRACT FROM AUTHOR]

The sets the stage for exploring the potential of agricultural innovations in improving infant nutrition. Infant nutrition is of great importance to ensure babies reach their growth and developmental potential. Weaning foods, introduced to children between 6 months to 3 years, play a crucial role in meeting their increasing nutritional demands and developmental needs. However, in many parts of the developing world, complementary feeding remains a challenge, leading to poor feeding practices and inadequate dietary quality of homemade complementary foods. Therefore, there is a need to develop nutritionally balanced, energy-dense, easily digestible, and functional weaning foods. In this study, an infant weaning mix was developed and standardized using cereal-based ingredients. The nutritional composition and mineral content of the mix were analyzed. The results indicated that the mixture provided a moderate amount of protein, energy, and essential minerals, making it a valuable addition to a balanced diet. The sensory evaluation scores revealed that the weaning mix received positive feedback in terms of appearance, color, texture and overall acceptability, suggesting its potential popularity among infants. The weaning mix was developed by replacing wheat with easily digestible and fiber-containing millets, which are nutritionally comparable to major cereals. The aim was to offer a safer alternative to wheat-based mixtures, which can lead to allergies and other health issues. The study emphasized timely and adequate complementary feeding, ensuring infants receive the required nutrients for their growth and development. In conclusion, the developed infant weaning mix shows promise as a nutritious and well-accepted food option for infants during the weaning stage. Further testing and improvements, along with proper feeding practices, can help address the challenges of complementary feeding and contribute to improved nutrition among infants. [ABSTRACT FROM AUTHOR]

(1) Background: This study investigated the effect of the lactation period and the type of infant formula on the content of amino acids and selected minerals in an infant's food; (2) Methods: The study material consisted of breast milk (colostrum, n = 38; transitional milk, mature milk, n = 38) and three types of infant formulas (for first and follow-on feeding). Amino acid content was determined using an automatic amino acid analyzer, while minerals were determined by the atomic absorption spectrometry (AAS) technique; (3) Results: Breast milk and infant formulas contained a full range of essential amino acids. In most cases, the content of individual amino acids and minerals decreased with increasing lactation. In infant formulas, there were higher contents of phenylalanine, glutamic acid, proline, serine, and tyrosine in follow-on milk (p < 0.05). The EAA/TAA ratio in breast milk and infant formulas was similar, but the milk differed in their qualitative composition. Infant formulas contained levels of individual minerals that were several times higher—especially Mg, Ca, Mn, and Fe.; (4) Conclusions: Colostrum is more concentrated, and the level of amino acids and minerals is higher in it; as the milk matures, it decreases. In most cases, the content of individual amino acids and minerals is higher in infant formulas than in human milk, which is established through strict Codex Alimentarius procedures to ensure the proper development of infants. [ABSTRACT FROM AUTHOR]

India is a low‐middle income country with a population of 1.4 billion and home to one quarter of the world's children. Exclusive breastfeeding until 6 months and continued breastfeeding until at least 2 years as per global recommendations are common practice. The Indian government and associated organisations have strived to protect breastfeeding, which is important in a country with high under‐5 mortality, malnutrition and stunting. Allergic disease is under‐recognised in India, but despite the absence of a dedicated allergy medical specialty, awareness of allergy is increasing among healthcare practitioners and in the general population. In high‐income countries, overdiagnosis of allergy has become recognised as an issue in recent years. Allergy healthcare professionals have also attracted criticism for close relationships with the formula industry, which appear to have contributed to excessive use of specialised formula products and undermining of breastfeeding. Specialised formula has been used unnecessarily for preventing allergy, based on fraudulent and selectively reported science; and for managing normal infant symptoms which are mislabelled as milk allergy. This forms part of a broader formula industry corporate strategy to widen the boundaries of illness in order to expand sales and markets. In India, allergic disease management is hindered by limited understanding of the disease entity among practitioners, low access to diagnostics, limited healthcare resources, high exposure to air pollution and a large, diverse population. Data specific to India on allergic disease prevalence and interpreting allergy diagnostics are incomplete. The knowledge gaps mean allergy management in India is often extrapolated from guidance developed in high‐income countries with low breastfeeding rates. As the allergy specialty develops in India, local guidance and practice will need to recognise the threat that current allergy practice poses to India's normative infant feeding culture, and ensure that breastfeeding continues to be supported at all levels. [ABSTRACT FROM AUTHOR]

Background: Prelacteal foods might not be safe due high possibility of contaminating with biological entities, which can cause infection to the newborn and might affect the colostrum intake. However, in a nation like Ethiopia where diverse cultural practices are prevalent, this might vary depending on the context. Therefore, the aim of this study was to assess prelacteal feeding practice and its associated factors among children under 24 months old in Degahbour town, Somali region, Ethiopia. Methods: A community-based cross-sectional study was conducted from June 5 to July 30, 2021. Data were collected from 300 mothers who had children aged less than 24 months in Degahbour town by following systematic random sampling method. Bivariable and multivariable logistic regression analyses were performed in order to determine the factors associated with prelacteal feeding practices. Result: 47.3%, 95% CI (42.0%, 53.3%) of the mothers had given prelacteal foods to their newborn baby in the first three days of their life. Being mother living in semi-urban area [AOR: 4.49 (95% CI 2.39,8.42)], delivered in home [AOR=2.15, 95% CI: (1.21,3.82)], lately initiated breastfeeding for indexed child after the first hour of delivery [AOR=2.34, 95% CI: (1.28,4.28)], had no counseling about breastfeeding [AOR = 2.23, 95% CI: (1.28,3.88)], not received ANC follow-up [AOR:2.11; 95%CI (1.19,3.74)], had poor maternal knowledge about breastfeeding [AOR:5.51; 95%CI (3.16,9.62)] were identified as factors associated with practicing prelacteal feeding. Conclusion: In comparison to the regional level figure of 38.8 % and nationally (7.9%) reported in the 2016 EDHS, the prevalence of prelacteal feeding practice is high in Degahbour town. Therefore, reducing prelacteal feeding practice focus should be placed on initiatives that can enhance institutional delivery, ANC follow-up, and mothers' understanding of nutrition throughout their pregnancies, particularly the significance of colostrum feeding right away after delivery. [ABSTRACT FROM AUTHOR]

Objective: to analyze the scenario of the city of Macaé in the commercialization of infant formulas and childcare products, according to the context of the Brazilian Standard for Commercialization of Infant Food (NBCAL). Method: A descriptive, cross-sectional and observational research, between February and May 2022, through a census in pharmacies, supermarkets and baby layette stores that sell products covered by NBCAL. The analysis was carried out by direct observation at three different times and in the same commercial establishment, with an interval of one week between visits. Results: Ten commercial establishments were evaluated (2 baby layette stores, 4 pharmacies and 4 supermarkets). No infringement was found in the trousseau stores for any of the analyzed products, while pharmacies and supermarkets had at least one type of infringement. Pharmacies were the establishments with the worst analysis, as all (100%) presented some type of infraction for infant formulas and 50% for teats, pacifiers, bottles and nipple shields. As for supermarkets, only one (25%) presented an infraction for both analyzed products. Conclusion: The study showed that the establishments carried out illegal commercial promotion of infant formulas and related products, which demonstrates the importance of local training and of establishment employees regarding NBCAL, to guarantee the protection of breastfeeding. [ABSTRACT FROM AUTHOR]

The World Health Organization recommends exclusive breastfeeding on demand until at least the sixth month of life. Breast milk or infant formula is the infant's primary food source until the age of one year, followed by the gradual introduction of other foods. During weaning, the intestinal microbiota evolves to a profile close to that of the adult, and its disruption can result in an increased incidence of acute infectious diseases. We aimed to determine whether a novel starting formula (INN) provides gut microbiota compositions more similar to those of breastfed (BF) infants from 6 to 12 months of age compared to a standard formula (STD). This study included 210 infants (70 per group) who completed the intervention until they reached the age of 12 months. In the intervention period, infants were divided into three groups. Group 1 received an INN formula with a lower protein content, a casein to whey protein ratio of approximately 70/30, twice as much docosahexaenoic acid as the STD formula, a thermally inactivated postbiotic (Bifidobacterium animalis subsp. lactis, BPL1TM HT), and twice as much arachidonic acid as the STD formula contained. The second group received the STD formula, while the third group was exclusively BF for exploratory purposes. In the course of the study, visits were conducted at 6 months and 12 months of age. Compared to the BF and STD groups, the Bacillota phylum levels in the INN group were significantly reduced after 6 months. At the end of 6 months, the alpha diversity indices of the BF and INN groups differed significantly from those of the STD group. At 12 months, the Verrucomicrobiota phylum levels in the STD group were significantly lower than those in the BF and INN groups. Based on the comparison between 6 and 12 months, the Bacteroidota phylum levels in the BF group were significantly higher than those in the INN and STD groups. When comparing the INN group with the BF and STD groups, Clostridium sensu stricto 1 was significantly higher in the INN group. The STD group had higher levels of calprotectin than the INN and BF groups at 6 months. The immunoglobulin A levels in the STD group were significantly lower than those in the INN and BF groups after 6 months. Both formulas had significantly higher levels of propionic acid than the BF group at 6 months. At 6 months, the STD group showed a higher quantification of all metabolic pathways than the BF group. The INN formula group exhibited similar behavior to the BF group, except for the superpathway of phospholipid biosynthesis (E. coli). We hypothesize that the novel INN formula may promote an intestinal microbiota that is more similar to the microbiota of an infant who consumes only human milk before the weaning period. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the relationship between patterning of human milk feeding and growth of infants with congenital heart defects in the first year of life. Inclusion criteria for this prospective cohort study included infants 0–21 days, who had undergone or had planned neonatal corrective or palliative surgery prior to hospital discharge, and whose mothers planned to feed human milk. Data on anthropometric measures (weight, length, head circumference) and infant milk type (human milk, formula, other) were collected at nine time points (0.5, 1, 2, 3, 4, 6, 8, 10, 12 months). Anthropometric data were converted to weight-for-age, length-for-age, head circumference-for-age, and weight-for-length Z-scores using World Health Organization growth reference data. Cluster analysis identified three milk type feeding patterns in the first year: Infants fed human milk only with no formula supplementation, infants fed human milk who then transitioned to a mix of human milk and formula, and infants who fed human milk and transitioned to formula only. General linear models assessed the effect of milk type feeding patterns on growth parameters over time. No effect of milk type pattern × time was found on longitudinal changes in weight-for-age (p for interaction = 0.228), length-for-age (p for interaction = 0.173), weight-for-length (p for interaction = 0.507), or head circumference-for-age (p for interaction = 0.311) Z-scores. In this cohort study, human milk alone or combined with infant formula supported age-appropriate growth in infants with congenital heart defects in the first year. [ABSTRACT FROM AUTHOR]

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Objective: To assess the effectiveness of outpatient management with ready-to-use and supplementary foods for infants under 6 months (u6m) of age who were unable to be treated as inpatients due to social and economic barriers. Design: Review of operational acute malnutrition treatment records. Setting: Twenty-one outpatient therapeutic feeding clinics in rural Malawi. Participants: Infants u6m with acute malnutrition treated as outpatients because of barriers to inpatient treatment. The comparison group consisted of acutely malnourished children 6–9 months of age who were being treated at the same time in the same location in the context of two different randomised clinical trials. Results: A total of 323 infants u6m were treated for acute malnutrition (130 severe and 193 moderate). A total of 357 infants 6–9 months old with acute malnutrition (seventy-four severe and 283 moderate) were included as contemporaneous controls. Among infants u6m with severe acute malnutrition, 98 (75·4 %) achieved nutritional recovery; in comparison, 56 (75·7 %) of those with severe acute malnutrition 6–9 months old recovered. Among infants u6m with moderate acute malnutrition, 157 (81·3 %) recovered; in comparison, 241 (85·2 %) of those aged 6–9 months recovered. Conclusions: In a rural Malawian population of infants u6m who had generally already stopped exclusive breast-feeding and were now acutely malnourished, treatment with therapeutic or supplementary foods under the community management of acute malnutrition model was safe and effective. In settings where social and financial factors make hospital admission challenging, consideration should be given to lowering the recommended age of ready-to-use therapeutic and supplementary foods to infants u6m. [ABSTRACT FROM AUTHOR]

Objective: To analyze if milk and complementary foods are being sold under the Brazilian Code of Marketing of Infant and Toddler’s Food, Teats, Pacifiers and Baby Bottles (NBCAL), Law 11265/2006 of breastfeeding protection. Methods: Epidemiological survey that analyzed the marketing practices of pharmacies, supermarkets, and department stores in the Southern region of the city of Rio de Janeiro, Brazil, by direct observation. Results: Among the 349 stores in Rio de Janeiro’s South Region, 339 traded milk and complementary foods and, among them, 60.8% were not complying with NBCAL. Infractions to NBCAL were more common for the selling of milk (58.6%) than complementary foods (22.8%). The most recurrent promotion strategy infringing NBCAL was discount pricing without the Ministry of Health disclaimer. Conclusions: Most retail stores infringe NBCAL in the commercialization of milk and complementary foods in the city of Rio de Janeiro, Brazil, a violation of the right to information that may impact mothers’ choice regarding their child’s feeding. [ABSTRACT FROM AUTHOR]

Introduction: A better understanding of current infant feeding practices and factors influencing them may improve the implementation of infant feeding guidelines in the future. Aim: To assess the confidence in knowledge and knowledge of selected infant feeding statements, and to assess selected infant feeding practices among parents of infants aged 4 to 12 months. Material and methods: A cross-sectional study was conducted in Poland. Self-selected parents were recruited through the Internet. Data from 6934 responders, almost exclusively (99.2%) mothers, were analysed. Results and discussion: Almost 68.8% of mothers assessed their knowledge of infant complementary feeding practices as sufficient. In line with current recommendations, most mothers agreed that fruits are a good source of vitamins for infants (75.3%); and disagreed that fruit juices should be given to infants younger than age 1 year (61.1%); plant-based beverages are an appropriate alternative to breast-milk substitutes for infants (59.9%); potentially allergenic foods should be included into infant diet only after other complementary food had been introduced (68.4%), and, the introduction of other potentially allergenic foods should be delayed, if symptoms following the introduction of a new food occur (55.7%). However, some participants, albeit minority, reported the introduction of plant-based beverages (12.5%), cow’s milk (16.7%), and fruit juices to infants younger than 12 months (15.8%), thus, it was against the current recommendations. Conclusions: A discrepancy exists between the confidence in knowledge and knowledge of selected infant feeding statements and feeding practices among Polish mothers of infants aged 4 to 12 months. [ABSTRACT FROM AUTHOR]

Objective: While several studies have shown that milk formula feeding is associated with faster infant weight gain compared with exclusively breast feeding (EBF), we explored the possible reverse association that infant weight gain influences the duration of EBF.Design: Prospective birth cohort study (Cambridge Baby Growth Breastfeeding Study) born 2015-2018.Setting: Cambridge, UK.Participants: Full-term, singleton, normal birthweight infants who received EBF for 2-5 completed weeks (n=54), 6-11 weeks (n=14) or 12 or more weeks (n=80).Intervention: Weight gain from birth to 2 and 6 weeks.Main Outcome and Measure: Duration of EBF.Results: Faster infant weight gain during EBF predicted longer duration of EBF. Among all 148 infants, each +1 unit gain in weight SD score (SDS) between birth and 2 weeks (while all infants received EBF) reduced the likelihood of stopping EBF between 2 and 5 weeks by ~70% (OR 0.32; 95% CI 0.12 to 0.77; adjusted for sex, gestational age at birth, birth weight and mother's age, prepregnancy BMI and education). Similarly, among infants EBF for 6 or more weeks (n=94), each +1 unit gain in weight SDS between birth and 6 weeks reduced the likelihood of stopping EBF between 6 and 11 weeks by ~80% (OR 0.18; 95% CI 0.05 to 0.63).Conclusions: Slower early infant weight gain was consistently associated with subsequent earlier discontinuation of EBF. We conjecture that broader recognition of the wide range of normal infant growth might encourage parents to not stop EBF earlier than they intended. [ABSTRACT FROM AUTHOR]

Objectives: to verify the adequacy of recommendations on food and nutrition for infants available on popular websites in relation to the "Twelve Steps for a Healthy Diet" from the Dietary guidelines for Brazilian children under 2 years of age. Methods: popular websites were searched via the Google platform to collect data about food recommendations for children under 2 years of age. The data was categorized according to criteria developed with the Guide: totally agree, partially agree, disagree, contradictory and absent. The websites were described according to the frequency of each step and the distribution in the categories. Results: 82 websites were included. Most frequent steps: 1 (84.1%), 2 (82.9%) and 4 (63.4%); least present: 8 (23.2%), 10 (19.5%), 11 (3.7%) and 12 (1.2%). The highest percentages of adequacy in relation to the Guide were steps 1 and 4 with 46.4% and 53.8%, respectively. Steps 3 (37.9%) and 7 (75.0%) had the highest percentages of disagreement or contradiction. Conclusions: there is proper information on the internet, however, these are mixed with missing, in disagreement, partially in agreement or contradictory information, which reinforces the importance of disseminating the recommendations of the Guide. [ABSTRACT FROM AUTHOR]

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. Key messages: Data showed a reduction in the quality of infant feeding practices over the first 2 years of life.Breastfeeding decreased over the studied period. There was an increase in the consumption of ultra‐processed and unhealthy foods, which occurred concomitantly to the increase of no consumption of fruits/vegetables.Breastfeeding was an important protective factor against a greater consumption of ultra‐processed food.National nutrition policy should consider promoting breastfeeding and increasing fresh and minimally processed food consumption in children under 2 years. [ABSTRACT FROM AUTHOR]

To evaluate the relationship between infant age of egg introduction and malnutrition‐related growth outcomes in the United States, we analysed secondary data of 1716 mother–child dyads in the Infant Feeding Practices Study II and its Year 6 Follow‐Up Study. Malnutrition‐related growth outcomes included body mass index z‐score (BMIZ), obesity (weight‐for‐height z‐score [WHZ] ≥3 or BMIZ ≥ 2), WHZ, wasting (WHZ < −2), height‐for‐age z‐score (HAZ), and stunting (HAZ < –2). Infant age at egg introduction was analysed as a continuous variable. We used generalised estimating equations to estimate the mean difference in continuous outcomes and relative risk [RR]) for binary outcomes, adjusting for related maternal and child confounders. We also explored interactions with child sex, maternal race/ethnicity, maternal educational level, ever breastfeeding, and formula feeding. In the total sample, a later infant age at egg introduction was associated with a lower mean difference in HAZ (confounder‐adjusted mean difference = −0.08, 95% confidence interval [CI]: −0.12 to −0.03 per month) and a higher risk of stunting (confounder‐adjusted RR = 1.17, 95% CI: 1.03–1.33 per month) at 6 years. The associations between infant age at egg introduction and 12‐month growth outcomes differed by child sex. Among females but not among males, later introduction of eggs was associated with a lower mean WHZ (−0.06 [−0.12 to 0.00] per month) at 12 months. Later egg introduction during infancy was associated with a lower mean HAZ and a higher risk of stunting in 6‐year‐old children. Besides this, it was associated with a lower WHZ among females at 12 months. Key messages: This secondary data analysis evaluated the relationship between infant age at egg introduction and malnutrition‐related growth outcomes among young US children within the Infant Feeding Practices Study II and its Year 6 Follow‐up Study.In the total sample, a later infant age at egg introduction was associated with a lower mean 6‐year height‐for‐age z‐score and a higher risk of stunting at 6 years.The associations between infant age at egg introduction and 12‐month growth outcomes differed by child sex. Later introduction of eggs was associated with a lower mean weight‐for‐height z‐score among females. However, this association was not observed among males. [ABSTRACT FROM AUTHOR]

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a very virulent and contagious coronavirus and has caused a pandemic of acute respiratory disease, named “Coronavirus disease 2019” (COVID-19) that emerged in the late 2019. In breast milk (BM), presence of SARS-CoV-2 virus and its antibodies have been examined. Aims and Objectives: The current observational study was conducted over a period of 1 year in the state of Mizoram to investigate the presence of SARS-CoV-2 virus and antibodies in pregnant mothers and their newborn along with breast milk. Materials and Methods: A total of 115 breast milk samples and 70 breast swabs (before or after breast washing) from 115 women who were recently diagnosed with COVID-19 were collected. Samples were analyzed for SARS-CoV-2 RNA using RT-PCR. Breast milk was also analyzed for SARS-CoV2, IgA, and IgG receptor binding domain (RBD), S2 subunit of the spike protein of SARS-CoV-2. Results: BM RTPCR was found to be positive 78 and 37 BM samples were found to be negative for RTPCR. Among the infants, 32 were exclusively on breastfeed and 83 were mixed feeding infants. Post-breastfeeding four infants were shown the signs and symptoms of COVID-19. IgA and IgG RBD and S2 subunit of the spike protein of SARS-CoV-2 antibodies were positive in 17, 16, and 12 BM samples which show that maternal antibodies to be developed in BM take time for production and the mothers infected almost 10 days ago, only showed presence of those antibodies. Conclusion: Our findings have shown increase admissions of COVID-19 infected antenatal mothers with positive outcome despite the requirement of intensive care. SARS-CoV-2 was detected in BM which was significantly high, but there was no transmission to the babies during the postnatal period. [ABSTRACT FROM AUTHOR]

Objective: The mother–child breastfeeding dyad is a powerful force for achieving healthy, secure and sustainable food systems. However, food system reports exclude breastfeeding and mother's milk. To help correct this omission and give breastfeeding women greater visibility in food systems dialogue and action, we illustrate how to estimate mother's milk production and incorporate this into food surveillance systems, drawing on the pioneering experience of Norway to show the potential value of such analysis. Design: The estimates use data on the proportion of children who are breastfed at each month of age (0–24 months), annual number of live births and assumptions on daily human milk intake at each month. New indicators for temporal and cross-country comparisons are considered. Setting: It is assumed that a breastfeeding mother on average produces 306 l of milk during 24 months of lactation. Participants: The annual number of live births is from Statistics Norway. Data for any breastfeeding at each month of age, between 0 and 24 months, are from official surveys in 1993, 1998–1999, 2006–2007, 2013 and 2018–2019. Results: Estimated total milk production by Norwegian mothers increased from 8·2 to 10·1 million l per year between 1993 and 2018–2019. Annual per capita production increased from 69 to 91 l per child aged 0–24 months. Conclusions: This study shows it is feasible and useful to include human milk production in food surveillance systems as an indicator of infant and young child food security and dietary quality. It also demonstrates significant potential for greater milk production. [ABSTRACT FROM AUTHOR]

Studies on childhood feeding and current food consumption, according to the NOVA classification, in adults are scarce. The objective of this study was to evaluate the relationship between childhood dietary practices and the current consumption of different categories of processed foods in young adults using data from the Nutritionists' Health Study (NutriHS) cohort. A cross-sectional analysis was performed using data of 392 on nutrition undergraduate students or nutritionists aged ≥18 years. Current food consumption was assessed using a food frequency questionnaire and the NOVA classification. The investigated childhood eating practices included fruit and vegetable intake, exclusive breastfeeding, and other breastfeeding practices. Participants breastfed with introduction of solid, semi-solid or soft foods before 6 months had higher current consumption of processed foods than those who were not breastfed (β = 4.30; 95% confidence interval [CI] = 0.56–8.04) and those who did not have the habits of eating fruits and vegetables during childhood consumed less unprocessed and minimally processed foods in adulthood than those who ate fruits and vegetables during infancy (β = −3.76; 95% CI = −0.82 to −6.70). Further, later introduction of infant formula or other types of milk between 3 and 5 months of age had a lower current consumption of ultra-processed foods than those fed infant formula or other types of milk before 1 month age of life (β = −3.09; 95% CI = −6.12 to −0.06). In conclusion, childhood feeding practices were linked to food consumption in adult life in NutriHS cohort, highlighting that the first 1000 days of life seems to impact on food choices during adulthood, with potential to protect against nutrition-related diseases later in life. [ABSTRACT FROM AUTHOR]

The recent re-emergence of vitamin D deficiency (VDD) and rickets among breastfed infants without adequate sunlight exposure and vitamin D supplementation has been reported worldwide. Breastfed infants are particularly vulnerable to VDD because of the low vitamin D content of breast milk, restricted sunlight exposure, increased pollution, and limited natural dietary sources of vitamin D. The prevalence of VDD in breastfed infants differs vastly between studies and nations at 0.6%-91.1%. The recommended intake of vitamin D for lactating mothers to optimize their overall vitamin D status and, consequently, of their breast milk is 200-2,000 IU/day, indicating a lack of consensus. Some studies have suggested that maternal high-dose vitamin D supplementation (up to 6,400 IU/day) can be used as an alternate strategy to direct infant supplementation. However, concern persists about the safety of maternal high-dose vitamin D supplementation. Direct infant supplementation is the currently available option to support vitamin D status in breastfed infants. The recommended dose for vitamin D supplementation in breastfed infants according to various societies and organizations worldwide is 200-1,200 IU/day. Most international guidelines recommend that exclusively or partially breastfed infants be supplemented with 400 IU/day of vitamin D during their first year of life. However, domestic studies on the status and guidelines for vitamin D in breastfed infants are insufficient. This review summarizes the prevalence of VDD in breastfed infants, vitamin D content of breast milk, and current guidelines for vitamin D supplementation of lactating mothers and infants to prevent VDD in breastfed infants. [ABSTRACT FROM AUTHOR]

Background: There is significant overdiagnosis of milk allergy in young children in some countries, leading to unnecessary use of specialized formula. This guidance, developed by experts without commercial ties to the formula industry, aims to reduce milk allergy overdiagnosis and support carers of children with suspected milk allergy. Methods: Delphi study involving two rounds of anonymous consensus building and an open meeting between January and July 2021. Seventeen experts in general practice, nutrition, midwifery, health visiting, lactation support and relevant areas of paediatrics participated, located in Europe, North America, Middle East, Africa, Australia and Asia. Five authors of previous milk allergy guidelines and seven parents provided feedback. Findings: Participants agreed on 38 essential recommendations through consensus. Recommendations highlighted the importance of reproducibility and specificity for diagnosing milk allergy in children with acute or delayed symptoms temporally related to milk protein ingestion; and distinguished between children directly consuming milk protein and exclusively breastfed infants. Consensus was reached that maternal dietary restriction is not usually necessary to manage milk allergy, and that for exclusively breastfed infants with chronic symptoms, milk allergy diagnosis should only be considered in specific, rare circumstances. Consensus was reached that milk allergy diagnosis does not need to be considered for stool changes, aversive feeding or occasional spots of blood in stool, if there is no temporal relationship with milk protein ingestion. When compared with previous guidelines, these consensus recommendations resulted in more restrictive criteria for detecting milk allergy and a more limited role for maternal dietary exclusions and specialized formula. Interpretation: These new milk allergy recommendations from non‐conflicted, multidisciplinary experts advise narrower criteria, more prominent support for breastfeeding and less use of specialized formula, compared with current guidelines. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper was to review the role that donor human milk plays in caring for very low birth weight (VLBW) infants. Methods: This review focussed on academic papers and background information published in English and French up to 8 August 2021. Results: Donor human milk provides a useful bridge to successful breastfeeding in hospitalised neonates and does not have a negative impact on the use of mother's own milk and breastfeeding rates at discharge. It helps to prevent key complications of prematurity, particularly necrotising enterocolitis up to 36 weeks of postmenstrual age, which is more common in infants fed formulas based on cows' milk. When it is carefully fortified, it supports the postnatal growth of the majority of very preterm infants. Well‐organised, accessible human milk banks are required to cover the needs of hospitalised infants, and donor human milk must be prioritised for patients who derive the greatest health benefit from it. These include very preterm infants and those born at term, or near term, with surgical digestive malformations or congenital heart disease. Conclusion: Safe, high‐quality donor human milk, which is distributed by well‐organised human milk banks, is essential for the most vulnerable hospitalised neonates. [ABSTRACT FROM AUTHOR]

The influence of marketing on infant and young child feeding and health is well recognized, and an International Code was adopted by the World Health Assembly (WHA) in 1981 to reduce inappropriate marketing and protect breastfeeding. Yet the marketing and influencing continue. This scoping review systematically examined the published research evidence on the nature and extent of exposure to International Code violations from 1981 to August 2021. We used several search strategies involving multi‐language databases, organization websites, citation tracking, and expert consultation, to find research items meeting our inclusion criteria. We evaluated 657 items and retained 153 studies from at least 95 countries in the review. The majority of the studies (n = 113) documenting exposure to inappropriate marketing were published since 2010. Studies reported a broad range of marketing violations targeting mothers and families, health workers, and the general public. Marketing via digital platforms and brand extension has become more frequent. The evidence shows the use of misleading and inaccurate labeling and health and nutrition claims in breach of the Code. Our review confirms that violations of the Code have not ceased and calls for renewed attention from the WHA and national governments to protect the health of children and their mothers. Highlights: Exposure to inappropriate marketing continues across the world in health systems, public spaces, points of sale, media, emergency programs, and direct to mothers.Studies have documented the emergence of products and marketing practices designed to circumvent the Code.Labeling and health and nutrition claims were found that were misleading, inaccurate, and in breach of the Code.Evidence of marketing through social media and other digital platforms has increased over time.Future research, guidance, and policies would benefit from an accessible central repository of comprehensive and comparable measurement tools and evidence. [ABSTRACT FROM AUTHOR]

Background: Early introduction of liquid/solid food before 6 months of age is one of the major barriers to exclusive breastfeeding. Our objective was to analyze the evolution of infant feeding practices for infants under 6 months of age in Latin American and Caribbean countries in the decades of 1990, 2000 and 2010. Method: Cross-sectional time series study with data from Demographic and Health Surveys carried out between 1990 and 2017 in six Latin America and Caribbean countries: Bolivia (1994 to 2008), Colombia (1995 to 2010), Dominican Republic (1996 to 2013), Guatemala (1995 to 2015), Haiti (1994/1995 to 2016/2017), Peru (1996 to 2018). Pooled sample comprised of 22,545 infants under the age of 6 months. Surveys were grouped in three decades: 1990s for surveys from 1990 to 1999, 2000s for surveys from 2000 to 2009, and 2010s for surveys from 2010 to 2017. Exclusive breastfeeding (EBF), predominant breastfeeding (PBF), mixed breastfeeding (mixed BF), supplemented breastfeeding (supplemented BF) and non-breastfeeding (non-BF), and individual foods (water, liquids, milk, infant formula, semi-solid/solid) were analyzed. Prevalence of breastfeeding and food indicators were calculated in pooled sample, according to the infant monthly age groups, decade of survey and residence area(rural/urban). Results: Between 1990s and 2010s, there was an increase in the exclusive breastfeeding prevalence (1990s = 38.1%, 2010s = 46.6%) and a reduction in the PBF prevalence (1990s = 51.7%, 2010 s = 43.1%). There was a decrease in the liquids (1990s = 40.7%, 2010s = 15.8%) and milk prevalence (1990s = 20.4%, 2010s = 8.3%) and an increase in water (1990s = 32.3%, 2010s = 37.6%), and infant formula (1990s = 16.6%, 2010s = 25.5%) prevalence. All breastfeeding indicators, except exclusive breastfeeding, progressively increased according to the monthly age group in three decades, and EBF prevalence sharply decreased from 2 to 3 months of age in all decades. Exclusive breastfeeding prevalence was higher in rural area in the three decades (1990s rural = 43.8%, 1990s urban = 32.4%, 2010s rural = 51.1%, 2010s urban = 42.4%) and infant formula prevalence was higher in urban area (1990s rural = 8.6%, 1990s urban = 24.6%, 2010s rural = 15.9%, 2010s urban = 34.1%). Conclusions: In the last three decades, in all age groups, there was an increase in exclusive breastfeeding prevalence, as well as a significant reduction in liquids and milk. In the rural area, EBF prevalence remains higher than in urban. Increased water and infant formula feeding are the main barriers to achieving the Global Nutrition Target 2025 for exclusive breastfeeding. [ABSTRACT FROM AUTHOR]

Background: Infant and young child feeding practices (IYCF) impact the early and later health status of the population. Limited data is available regarding IYCF in the United Arab Emirates (UAE). This study aimed to evaluate the nutritional status and adequacy of feeding practices, energy, food, and nutrient intakes of UAE infants and toddlers ages 0-23.9 months. Methods: This study is a population-based cross-sectional survey of 276 infants and toddlers aged 0-23.9 months of which 180 were nationals and 96 were Arab non-nationals living in the UAE. Data were collected from the three major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometry was collected and assessed using WHO Anthro-Survey Analyzer, and a multicomponent age-specific questionnaire was used to evaluate IYCF and sociodemographic characteristics. Usual intake of energy, micronutrients, and macronutrients, including supplements, were collected using multiple-pass 24-h dietary recall and analyzed using the PC-side software. IYCF practices were assessed using the WHO indicators. Results: Overall, 4% of children were malnourished, 8% wasted, 15% stunted, 18% at risk of overweight, and 7% overweight and obese. 95% of infants were ever breastfed and 37% exclusively breastfed at 6 months. Around 98% of infants had a timely introduction of complementary food. Macronutrient intake exceeded AMDR for fat, carbohydrates, and protein for 27%, 8% and 2% of toddlers respectively. As for the percentage of those exceeding the ESPGHAN cut-off for free sugars set at 5% of energy intake, 28.6% had excessive intakes overall, 10% in 0-5.9, 21.9% in 6-11.9 and 56.7% in 12-23.9 month. Usual iron intake was below the Estimated Average Requirement (EAR) in 47% of infants 6-11.9 months. Above 12 months, the usual intake of iron and vitamin D were below EAR in 11% and 49% of toddlers respectively. Usual intake exceeded the tolerable upper intake levels (UL) for vitamin A (14 to 18%) and zinc (11 to 22%) across all ages. Approximately 93% of toddlers ages 12–23.9 months did not meet food groups' recommendations for vegetables, 87% for fruits, 48% for milk/dairy, 54% for lean meat and beans, and 33% for grains. Conclusions: This study revealed that a high percentage of infants and toddlers aged 0-23.9 m suffer from a double burden of malnutrition, which is the coexistence of both undernutrition, and overweight and obesity in the same population. In addition to suboptimal feeding practices and inadequate/overconsumption of various nutrients. The findings highlight the need for the development of culturally specific programs aiming to improve the nutritional status of infants and toddlers in the UAE. [ABSTRACT FROM AUTHOR]

This observational study done during April–December 2020 at a tertiary-care hospital in Haryana (India) enrolled 152 SARS-CoV-2-exposed neonates. Among them, 150 neonates had perinatal SARS-CoV-2 exposure and 2 neonates had late postnatal exposure. Stable infant-mother dyads were roomed-in with precautions to support breastfeeding. Nasopharyngeal swabs collected from neonates were tested for SARS-CoV-2 by reverse transcriptase–polymerase chain reaction (RT-PCR) test. There was a high incidence of prematurity (23%), low birth weight (31%), intrauterine fetal distress (16%), perinatal asphyxia (6%), admission to neonatal intensive care unit (24%), and mortality (1.3%) among neonates with perinatal SARS-CoV-2 exposure. In this sub-group, 20 neonates tested positive for SARS-CoV-2 in nasopharyngeal swab sample(s). A recent official publication by the World Health Organization emphasizes that the perinatal SARS-CoV-2-exposed neonates found RT-PCR positive once in upper respiratory (non-sterile) sample must document viral persistence in another non-sterile sample for confirmation of mother-to-child virus transmission. With this approach, only one neonate was confirmed intrapartum transmission. A telephonic follow-up in discharged neonates at 1 month of age or 1 month postexposure recorded them all to be asymptomatic and doing well. Conclusion: Neonates with perinatal SARS-CoV-2 exposure constitute a high-risk group and it is not uncommon to get a positive RT-PCR report in upper respiratory sample(s) from these babies. Majority of them do not demonstrate viral persistence. Clinical outcomes are favorable in breastfed infants roomed-in with their asymptomatic-mild symptomatic SARS-CoV-2-infected mothers following appropriate safety protocols. What is Known: •Neonates with perinatal exposure suffer a high burden of morbidities and mortality. •Still, an uncertainty exists about rooming-in and breastfeeding among neonates born to SARS-CoV-2 positive mothers. What is New: •With the policy of mother-infant rooming-in and supporting breastfeeding, none of the neonate suffered clinical illness compatible with postnatal SARS-CoV-2 transmission and infection. •Around 13% perinatal exposed neonates demonstrated SARS-CoV-2 RNA in nasopharyngeal swab samples but the majority of them did not demonstrate viral persistence. [ABSTRACT FROM AUTHOR]

Regulating the composition of human breastmilk has the potential to prevent allergic diseases early in life. The composition of breastmilk is complex, comprising varying levels of oligosaccharides, immunoactive molecules, vitamins, metabolites, and microbes. Although several studies have examined the relationship between different components of breastmilk and infant food allergies, few have investigated the relationship between microorganisms in breastmilk and infant food allergy. In the present study, we selected 135 healthy pregnant women and their full-term newborns from a cohort of 202 mother–infant pairs. Among them, 69 infants were exclusively breastfed until 6 mo after birth. At follow-up, 11 of the 69 infants developed a food allergy in infancy while 22 showed no signs of allergy. Thirty-three breastmilk samples were collected within 1 mo after delivery, and 123 infant fecal samples were collected at five time points following their birth. These samples were analyzed using microbial 16S rRNA gene sequencing. The abundance and evenness of the milk microbiota and the number of differential bacteria were higher in the breastmilk samples from the non-allergy group than in those from the food allergy group. The non-allergy group showed relatively high abundance of Bifidobacterium , Akkermansia , Clostridium IV, Clostridium XIVa, Veillonella , and butyrate-producing bacteria such as Fusobacterium , Lachnospiraceae incertae sedis , Roseburia , and Ruminococcus. In contrast, the abundance of Proteobacteria , Acinetobacter , and Pseudomonas in breastmilk was higher in the food allergy group. A comparison of the changes in dominant differential breastmilk microbiota in the intestinal flora of the two groups of infants over time revealed that the changes in Bifidobacterium abundance were consistent with those in the breastmilk flora. Functional pathway prediction of breastmilk microflora showed that the enhancement of the metabolic pathways of tyrosine, tryptophan, and fatty acids was significantly different between the groups. We suggest that changes in the breastmilk microbiota can influence the development of food allergies. Breastmilk contains several microbes that have protective effects against food allergies, both by influencing the colonization of intestinal microbiota and by producing butyrate. This study may provide new ideas for improving infant health through early intervention with probiotics. [ABSTRACT FROM AUTHOR]

Background: There has been no study evaluating the psychopathology in breastfeeding mothers of infants with food allergy (FA). Objective: The aim of the study was to investigate the relationship between dietary elimination and maternal psychopathology, specifically anxiety, depression, and mother‐to‐infant bonding, in breastfeeding mothers of infants with food allergy. Methods: Breastfeeding mothers following an elimination diet due to FA in their children aged 1‐to‐12 months were compared with the healthy controls. The physician‐diagnosed FA group was divided into IgE‐, non‐IgE‐mediated, and infants with some minor symptoms which were not enough to make the diagnosis of FA were classified as Indecisive symptoms for FA group. Mothers completed standardized questionnaires including Symptom Checklist 90R, Beck Depression/Anxiety Inventories (BDI/BAI), Postpartum Bonding Questionnaire (Bonding). Results: Of 179 mother and infants, 64 were healthy, 89 were FA, 16 were indecisive symptoms for FA. The mean age of the mothers and infants were 31.1 ± 4.7 years and 6.3 ± 3.6 months, respectively. The physician‐diagnosed FA groups had higher scores for anxiety (p =.008), anger (p =.042), depression (p <.001), obsession (p =.002), phobia (p =.008), somatization (p =.002), general symptom index (GSI) (p =.001), BDI (p <.001), BAI (p =.008), and Bonding (attachment [p =.001], anger [p =.019], and total [p =.036]) than the healthy ones. The indecisive symptoms for FA group had a similar score pattern to physician‐diagnosed FA, except interpersonal sensitivity, BDI, and attachment. Conclusion: Breastfeeding mothers of infants with FA were more anxious, with higher depression scores than controls, and had many psychopathologies which affected bonding. Interventions targeting negativity in caregivers' social relationships are urgently needed. [ABSTRACT FROM AUTHOR]

The review was carried out to create awareness among individuals, government and non-governmental organizations on the roles of complementary foods for growth and development of infants in developing countries. Literature on complementary foods was critically assessed. Breast milk and complementary foods have been responsible for optimal growth and development of a young child. The period during which other foods or liquids containing nutrients are given to a young baby, along with breast milk, is considered to be complementary feeding. Information has been reported that breast milk becomes insufficient to meet the required nutrients for growth and development after six months. Therefore, the introduction of complementary foods is strongly required for sustainable growth. Unlike in developing countries, the use of complementary foods in the developed countries is well controlled, because of improved technologies, moderate to high incomes and government supports where needed. Conclusively, there is a need to sensitize nursing mothers on the importance of complementary foods for the growth and development of their children. Besides, there is also a need for government interventions to reduce the costs of such foods and to increase their accessibility, especially in the rural areas. [ABSTRACT FROM AUTHOR]