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Exclusive breastfeeding (EBF) for the first 6 months of life improves survival, growth and development. In Kenya, recent legislation and policies advocate for maternity leave and workplace support for breastfeeding and breast milk expression. We conducted a qualitative study to describe factors influencing EBF for 6 months among mothers employed in commercial agriculture and tourism. We interviewed employed mothers (n = 42), alternate caregivers and employed mothers' husbands (n = 20), healthcare providers (n = 21), daycare directors (n = 22) and commercial flower farm and hotel managers (n = 16) in Naivasha, Kenya. Despite recognizing the recommended duration for EBF, employed mothers describe the early cessation of EBF in preparation for their return to work. Managers reported supporting mothers through flexible work hours and duties. Yet, few workplaces have lactation spaces, and most considered adjusting schedules more feasible than breastfeeding during work. Managers and healthcare providers believed milk expression could prolong EBF but thought mothers lack experience with pumping. The most frequently suggested interventions for improving EBF duration were to expand schedule flexibility (100% of groups), provide on‐site daycare (80% of groups) and workplace lactation rooms (60% of groups), improve milk expression education and increase maternity leave length (60% of groups). Returning to work corresponds with numerous challenges including lack of proximate or on‐site childcare and low support for and experience with milk expression. These factors currently make EBF for 6 months unattainable for most mothers in these industries. Interventions and supports to improve breastfeeding upon return to work are recommended to strengthen employed mothers' opportunity for EBF. [ABSTRACT FROM AUTHOR]

Abstract: Animal source foods (ASF) provide critical micronutrients in highly bioavailable forms, with the potential to efficiently address undernutrition among young children living in developing countries. There is limited evidence for how livestock ownership might increase ASF intake in poor households either through own-consumption or income generation. Along with lack of nutrition knowledge, gender dimensions may affect the pathways leading from livestock ownership to child ASF intake and ultimately to young child growth. Using data from a large-scale impact evaluation conducted in Kenya, this study tested the hypothesis that co-owned/female-owned livestock would be associated with improved child growth, mediated by increases in ASF consumption. Data were collected from September 2010 to January 2011 from households in six provinces in Kenya on a broad range of agricultural, economic, social, health and nutrition factors. Children ages 6–60 months were included in this analysis (n = 183). In this sample, co-owned/female-owned livestock was valued at 18,861 Kenyan shillings in contrast with male-owned livestock valued at 66,343 Kenyan shillings. Multivariate linear regression models showed a positive association between co-owned/female-owned livestock with child weight-for-age z score (WAZ) after adjusting for caregiver education level, income, child age, and child sex. A mediating effect by child ASF intake was evident, explaining 25% of the relationship of livestock ownership with child WAZ, by Sobel–Goodman test (p < .05). A trend towards significance was demonstrated for co-owned/female-owned livestock and height-for-age z score (HAZ), and no effect was apparent for weight-for-height z score (WHZ). The partial mediating effect may be indicative of other factors inherent in co-owned/female-owned livestock such as higher status of females in these households with greater influence over other child care practices promoting growth. Nonetheless, our study suggests targeting females in livestock production programming may better ensure improvements in child nutrition. [Copyright &y& Elsevier]

Background: One in five young children globally suffer the consequences of stunted growth and development and millions experience deficiencies in zinc, iron, iodine, vitamins A and B12, nutrients found bioavailable in fish foods. Small-scale fisheries have the potential to generate income and augment fish consumption while being environmentally sustainable if appropriately managed. However, those engaged in small-scale fisheries are often marginalized, poor, and malnourished. The Samaki Salama project seeks to better understand and address these challenges through a three-arm, longitudinal matched cluster study which evaluates the impact of an integrated nutrition social marketing and modified fishing trap intervention., Methods: There will be 400 small-scale fisher households enrolled from Kilifi County, Kenya and residing in communities matched on location (rural), livelihoods, and child nutritional status. The sample will include mothers and other caregivers, children 6-60 months, and fishers in the family. Applying a cluster design, the matched communities will be divided into three groups: (1) control ( n = 200); (2) multi-component nutrition social marketing intervention to fishers, mothers, and health workers ( n = 100); and (3) multi-component nutrition social marketing intervention plus modified fishing traps and training ( n = 100). Primary outcomes include child growth, fish food intakes, and fisheries yield of mature fish. Secondary outcomes are diet diversity, child diarrheal morbidity, and fisheries revenue. A process evaluation will be used to monitor and ensure fidelity of intervention delivery., Discussion: This study builds on a growing body of literature illustrating the effectiveness of nutrition focused social marketing campaigns to promote active engagement of participants, high compliance to the intervention, and sustained behavior change. The second intervention element of modified fishing traps that allow immature fish to escape enables participants to act on the messaging they receive and promotes sustainable fishing through increased harvest efficiency and reduced catch of immature fish. The integrated approach of the Samaki Salama intervention provides an example of how to leverage multiple disciplines to address key challenges to human and environmental health and illustrates a pathway for scaling study innovations to other small-scale fisheries systems., Trial Registration: https://clinicaltrials.gov (NCT05254444)., Competing Interests: Author LS was employed by JSI Research & Training Institute, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Blackmore, Wamukota, Kamau-Mbuthia, Humphries, Lesorogol, Cohn, Sarange, Mbogholi, Obata, Cheupe, Cheupe, Sherburne, Chapnick, Cartmill and Iannotti.)