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Introduction: there is growing interest in the link between maternal and infant vitamin D (VD) levels. Breast milk transmission and the fact that the mother and her child may share risk factors for VD, such as exposure to sunlight, diet, and sociocultural influences may impact VD status, the magnitude of which is largely unknown in our topical low-middle income setting. We assessed the connection between maternal and infant VD status including their correlates., Methods: this cross-sectional study investigated 95 maternal-infant pairs in Jos. Mothers were interviewed using a questionnaire. Blood sampling and analysis of serum total 25 hydroxy VD were performed using the chemiluminescent immunoassay method. Maternal and infant VD levels were classified as VD deficient (VDD), VD insufficient (VDI), and VD sufficient (VDS). The mean maternal and infant VD were compared, and the Spearman correlation between them was assessed, a stepwise linear regression was also performed with infant vitamin D as a dependent variable. For all statistical analysis, p<0.05 was considered significant., Results: the median maternal and infant VD was 29.68 ng/ml and 29.41 ng/ml, respectively. The mean infant VD (32.19 ± 10.61 ng/ml) was comparable to maternal VD (31.12 ± 12.94 ng/ml) (p=0.483), with a Spearman correlation coefficient of 0.3 (p=0.037). Maternal vitamin D (beta=0.539, duration of exclusive breastfeeding (beta=-3.490), and infant age (beta=1.655) were found to be significant independent predictors of infant vitamin., Conclusion: beyond neonatal age, a significant positive relationship between maternal and infants´ VD levels exists and suggests that family-focused vitamin D intervention might be an effective public health approach in the tropical city of Jos., Competing Interests: The authors declare no competing interests., (Copyright: Ishaya Ibrahim Abok et al.)

Introduction: Breastfeeding is a public health practice that is critical for the survival of infants and young children. This study aimed at determining the knowledge, attitude, and future intention to breastfeed among female undergraduates in tertiary institutions in Ekiti State, Southwest Nigeria. Methodology: A prospective cross-sectional study was conducted among 1312 female students of the tertiary institutions in Ekiti State. By convenience sampling, female students were invited to participate in the study after giving verbal consent and those studying medical, nursing, and other courses allied to medicine were excluded. Internal consistency of the data obtained from this research instrument was determined using Cronbach's coefficient Alpha with a reliability value of 0.82. Data analysis was conducted using SPSS version 25. Descriptive as well as inferential statistics were computed. Results were summarized as frequencies and percentages. The differences in knowledge, attitude, and intention to practice breastfeeding as well as other responses among the participants were compared among age groups, faculties and the sources of information using Chi-square test., Result: Although 93% of the respondents agreed that breast milk is important for the development of the infant's brain thereby demonstrating good knowledge; 51.6% of the respondents demonstrated poor perception to breastfeeding believing breastfeeding makes the breast to sag while only 34% of the respondents indicated their intention to breastfeed their future babies., Conclusion: The intention to breastfeed among our study participants was poor. This study revealed the need to increase awareness about breastfeeding and its benefits among this huge population of future mothers.

Aim: We aimed to gain insights into current nutritional management practices of late preterm infants (34-36 weeks gestational age) in Nigeria., Methods: Purposive sampling was employed to recruit 19 healthcare professionals (neonatologists, paediatricians, general practitioners and nurses) involved in the care and nutritional management of late preterm infants in Lagos and Ogun states, Nigeria. Data were collected using interviews, either individually or in small focus groups, between 15 August and 6 September 2022. Thematic analysis of interview transcripts was carried out to interpret the data., Results: Ten distinct themes emerged across the research questions and objectives. For growth monitoring, 11, 6, 1 and 1 of our participants preferred to use the 2006 WHO growth standards, Fenton preterm growth chart, Ballard score and Intergrowth-21, respectively. Regarding the growth velocity of late preterm infants, most healthcare professionals aimed for 15 g/kg BW/day or more during hospitalisation. Breastmilk was unanimously the primary feeding option for late preterm infants. Most healthcare professionals preferred to use international guidelines over local guidelines., Conclusion: Our study shows that there is a wide divergence in the nutritional guidelines used in managing late preterm infants in Nigeria. Regarding growth monitoring, healthcare professionals tended to aim for a growth velocity higher than necessary for late preterm infants, which may be disadvantageous for their long-term health., (© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Objective: This case report seeks to create awareness of the aetiology of rickets of prematurity among very low birth weight infants in Nigeria, Methods and Result: This is a case report of an 800 gramme premature male neonate delivered by caesarean section at 28 weeks gestation following severe maternal pre-eclampsia. The infant was hospitalised for sixty days and fed exclusively on his mother's breast milk for seven months. He had two episodes of sepsis and was transfused twice while on admission. He was on Abidec drops, which contained 400 IU/0.6 ml of vitamin D from the age of two weeks. He defaulted from the follow up clinic at postnatal age of 16 weeks only to reappear at 30 weeks postnatal age with overt clinical, biochemical and radiologic signs of rickets. He responded well to calcium and phosphate supplementation., Conclusion: This case highlights the role of mineral deficiency in the aetiology of rickets of prematurity in very low birth weight infants fed with their mothers' breast milk.

Background: Exclusive Breastfeeding has been recommended the world over as the optimal feeding mode for young infants. A cross sectional study to determine the current level of knowledge and practice of nursing mothers on exclusive breastfeeding in Jos was carried out., Methods: The target population of interest was nursing mothers who have infants aged 6-12 months in Jos, a cosmopolitan city in the north central zone of Nigeria. A pre-tested, structured close ended interviewer questionnaire was used. Four hundred and seventy nursing mothers who consented were recruited for the study through a house-to-house visit. Three assistants (two females and a male) were recruited and trained on the questionnaire administration. Data analysis was by SPSS software and chi-square test of proportion for statistical significance of association was done., Results: Out of the 470 nursing mothers studied 387 (82.3%) were able to define correctly exclusive breastfeeding while 315 (67.0%) practiced or were practicing exclusive breastfeeding at the time of this study. The knowledge and practice of exclusive breastfeeding was found to increase with increasing age and better educational status of the women. Ninety six (20.4%) nursing mothers said they never breastfed their babies while in public place., Conclusion: Although knowledge and practice of exclusive breastfeeding among the women were considerably high, the younger age brackets were less knowledgeable arid adherent to the practice. Targeting adolescents for exclusive breastfeeding education and sensitization is necessary in preparing them for motherhood.

Objective: Because prelacteal feeds can adversely affect breastfeeding, UNICEF/WHO discourage their use unless medically indicated. The study was carried out to determine the proportion of healthcare workers who routinely give prelacteal feeds, and their reasons for doing so; further, to determine whether any differences exist between medically and non-medically trained healthcare workers in their administration of prelacteal feeds., Design: Survey., Setting: Primary, secondary and tertiary health facilities in Kaduna township Nigeria., Subjects: Of 1100 healthcare workers sampled, 747 (68%) responded. Of these 80% had received medical training, 20% had not., Methods: Use of a pretested validated questionnaire., Results: Large proportions of both medical and non-medically trained healthcare workers stated they routinely give prelacteal feeds (doctors, 68.2%; nurses, 70.2%; and non-medical, 73.6%). However their reasons for doing so differed significantly (P=0.00001). Nurses gave mainly for perceived breast milk insufficiency, doctors for prevention of dehydration, hypoglycaemia and neonatal jaundice and non-medical staff to prepare the gastrointestinal tract for digestion and to quench thirst., Conclusions: Most healthcare workers (medical and non-medical) routinely and unnecessarily give prelacteal feeds. Therefore training and retraining programmes in lactation management are necessary and must include non-medical staff. These programmes, while emphasizing the danger of giving prelacteal feeds, must deal with the misconceptions of each group. Deliberate efforts have to be made to incorporate clinical training in breastfeeding in curricula of Schools of Medicine and Nursing.

The present study was carried out to assess the impact of the Baby Friendly Hospital Initiative (BFHI) on breast feeding practices. The variables used to evaluate the BFHI centre included time of initiation of breastfeeding (BF) after delivery, intended duration of BF, adoption of exclusive breastfeeding (EBF) in relation to educational status, location of health centre, and knowledge and practice of positioning the child at the breast. Observation, questionnaire and interview techniques were employed to collect the data among 217 and 214 nursing mothers (NMs) from Urban and Rural Health Centres. Of the 228 NMs who initiated BF within 30 minutes after delivery, 140 (61%) were from a designated BFHI Centre and 88 (39%) were from an undesignated BFHI rural health centre. There was a significant relationship between the practice of EBF and designation of BFHI centre (P = 0.0001). The higher the level of education of the NMs, the higher the present of NMs subscribing to EBF (P = 0.0001). The present study has also confirmed that EBF which was once considered to be less than 3%, has increased significantly to 61%. The success was not unconnected with the inauguration of BFHI. The BFHI is recording huge success in the urban area but the impact is still to be felt in the rural areas.

Human milk is an invaluable food resource for infants and young children in Sub-Saharan Africa. Statistics on production of human milk at local and national levels are lacking. In this article, estimates of the quantity of human milk production in Mali, Senegal, Nigeria, and Zimbabwe were calculated. Annual production in the urban and rural areas in Mali was 13 and 17 kg per capita, respectively. National annual median production ranged from 93,000 (Zimbabwe) to 1.3 million metric tons (Nigeria), and from 9 (Zimbabwe) to 15 kg per capita (Mali). Given a value of (US)$1 per liter, inclusion of human milk in calculations of the gross national product (GNP) for these countries would increase this value by more than 5% for Mali, and nearly 2% for Senegal. Human milk is a significant food source to children in this region and should be included in national food statistics due to its nutritional and economic importance.

Community-based, quantitative studies of dietary intake by 5- to 28-months-old Nigerian children were conducted during episodes of diarrhoea and subsequent convalescent and healthy periods. Energy intakes during diarrhoea (85.3 kcal/kg per d) were slightly lower than during health (95.9 kcal/kg per d, P less than 0.05), using paired analysis of intra-individual differences. When intake was disaggregated by food source, no differences by illness status were found in energy intake from breast milk or liquid pap. There were no differences in frequency or duration of breastfeeding by illness status, but pap was provided more frequently and in smaller amounts during illness. Energy intake from other foods, including solids, was greater during health than diarrhoea (P less than 0.05) with an increase in number of servings per day. There was no evidence of caretakers either withholding food during illness or providing extra food during the convalescent phase. The magnitude of illness-associated differences in these children's daily intake was small relative to the deficit in their intakes, even on healthy days, when compared to the amounts recommended for this age group.

Riboflavin content of breast milk was determined in 100 lactating Nigerian women attending the clinic 6 weeks post partum. The women, from different ethnic groups, were fully breastfeeding at the time of the study and consisted of primi and multigravidae. Urine and milk samples were obtained at the clinic and analyzed for riboflavin. Parity had no effect of breast milk riboflavin (P0.05), the mean riboflavin content was 0.34 + or - 0.07 mg/1 (range 0.22-0.47 mg/1) with 27% of the mothers secreting above 0.4 mg riboflavin/1. There was no association between urinary riboflavin excretion and milk riboflavin. A greater number of infants, if exclusively breast fed without vitamin supplementation, may not meet their daily need for riboflavin. Storage of breast milk samples in the refrigerator for as long as 2 weeks had no effect on the component riboflavin. This may be an advantage where breast milk banks are operated.

380 milk samples (96 colostrum and 284 mature milk samples) collected from 240 lactating Nigerian women within the first 9 months of lactation were analyzed for zinc, copper, iron, calcium, and magnesium concentrations by atomic absorption spectrophotometry. Mean levels of zinc, copper, iron, calcium, and magnesium in colostrum were 5.83, 0.52, 0.55, 400, and 33 mcg/ml, respectively; the levels for the same minerals in mature milk collected in the 8th and 12th week of lactation were 3.08, 0.29, 0.38, 300, and 31 mcg/ml, respectively. While milk levels of all minerals decreased with increase in lactation age, zinc levels showed the fastest rate of decrease. Milk zinc levels at the 9th month were only 13% of that in colostrum. Similar percentages for copper, iron, calcium, and magnesium were 49, 60, 34, and 74%, respectively. Estimates of intake by solely breastfed infants during the first 6 months showed gross inadequacies when compared with Recommended Daily Allowances. Results suggest the need for early supplementation, especially as zinc deficiencies as well as a high incicdence of iron deficiency anemia has been reported in Nigerian infants.

A cross-sectional study of breast-feeding practice amongst rural Nigerian mothers and their babies is reported. At 1, 14, 30, 60 and 90 d after birth 56, 17, 45, 31 and 26 mothers/baby pairs were studied. Ninety-five per cent of the babies had sips of water immediately after birth--only 3 were offered the breast at this time. Breast-feeding was begun in the others between 2 to 25 h after birth. At 14, 30, 60 and 90 d respectively, mean breast milk intakes were 252.9 +/- 88 g, 393 +/- 199, 341 +/- 156 and 350 +/- 181 g. Intake was related to the number of breastfeeds given by the mother. Reports of breastmilk intake of babies should also record child rearing practices as these could affect breastmilk consumption.