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To help students understand that references are tools used to locate specific information, one librarian has her third-grade students create their own reference toolboxes as she introduces dictionaries, atlases, encyclopedias, and thesauri. Presents a lesson plan to introduce print and nonprint thesauri to third and fourth graders and includes a sample toolbox and tool forms. (PEN)

We examined associations between dietary patterns at 12 months, characterised using multiple methodologies, and risk of obesity and early childhood caries (ECC) at 24–36 months. Participants were Australian toddlers (n = 1170) from the Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE) birth cohort. Principal Components Analysis (PCA) and the Dietary Guideline Index for Children and Adolescents (DGI-CA) were applied to dietary intake data (1, 2 or 3-days) at 12 months, and regression analysis used to examine associations of dietary patterns with body mass index Z-score and presence of ECC at 24–36 months. Two dietary patterns were extracted using PCA: family diet and cow’s milk and discretionary combination. The mean DGI-CA score was 56 ± 13 (out of a possible 100). No statistically significant or clinically meaningful associations were found between dietary pattern or DGI-CA scores, and BMI Z-scores or ECC (n = 680). Higher cow’s milk and discretionary combination pattern scores were associated with higher energy and free sugars intakes, and higher family diet pattern scores and DGI-CA scores with lower free sugars intakes. The association between dietary patterns and intermediate outcomes of free sugars and energy intakes suggests that obesity and/or ECC may not yet have manifested, and thus longitudinal investigation beyond two years of age is warranted.

Breastfeeding to 12 months and beyond offers considerable health benefits to both infants and mothers. Despite these recognized benefits, relatively few women in high income countries breastfeed for 12 months, and rarely breastfeed to 24 months. The aim of this study was to identify the prevalence and determinants of continued breastfeeding to 12 and 24 months amongst a cohort of Australian women participating in the Adelaide-based Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE). Duration of breastfeeding was known for 1450 participants and was derived from feeding related data collected at birth, 3, 6, 12 and 24 months. Multivariable logistic regression analysis was used to investigate the relationship between explanatory variables and continued breastfeeding to 12 and 24 months. In total, 31.8% of women breastfed to 12 months and 7.5% to 24 months. Women who were multiparous, university educated, had not returned to work by 12 months and whose partners preferred breastfeeding over bottle feeding were more likely to be breastfeeding at 12 months. While women who had introduced complementary foods before 17 weeks and formula at any age were less likely to be breastfeeding at 12 months. Mothers who were born in Asian countries other than India and China, had not returned to work by 12 months and had not introduced formula were more likely to be breastfeeding at 24 months. The majority of the determinants of continued breastfeeding are either modifiable or could be used to identify women who would benefit from additional breastfeeding support and encouragement.

There is conflicting evidence of an association between breastfeeding and dental decay in very young children (early childhood caries (ECC)). While a recent systematic review and meta‐analysis reported that breastfeeding up to the age of 12 months reduced the risk of ECC, breastfeeding beyond 12 months was associated with a greater risk (Cui et al., 2017). The evidence however, is limited and inconsistent, with some studies finding an association only if breastfeeding continued beyond 18 or 24 months. Furthermore, a recent national study from Australia demonstrated that sustained breastfeeding (> 24 months) was not associated with ECC amongst children exposed to fluoridated water (Ha et al., 2019), indicating that the use of fluoridated water early in life moderated the relationship. The purpose of this presentation is to 1) critique the evidence related to breastfeeding practices and ECC; and 2) report the findings of an investigation into the effects of breastfeeding duration and night‐time breastfeeding on ECC amongst a cohort of Australian toddlers. The Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE) is a population‐based birth cohort study conducted in Adelaide, Australia (Do et al., 2014). Data on breastfeeding practices were derived from questionnaires completed by mothers at recruitment, 3, 6, 12 and 24 months. The primary exposures were 1) duration of breastfeeding, defined as minimal (0 ‐ <1mo), breastfed for 1 ‐<6 months, breastfed for 6 ‐ < 12 months, and sustained (≥ 12months), and 2) the practice of night‐time breastfeeding at 12 months, defined as Yes or No. Standardised oral epidemiological examinations were conducted by trained and calibrated dental practitioners on children when they were 2‐3 years old (median 29.1, IQR 5.2 months). The primary outcome was ECC prevalence (presence of any decayed, missing or filled primary tooth surfaces), defined as Yes or No. Multivariable regression models generated adjusted prevalence ra

Food packaging is used for marketing purposes, providing consumers with information about product attributes at the point-of-sale and thus influencing food choice. The Australian government focuses on voluntary policies to address inappropriate food marketing, including the Health Star Rating nutrition label. This research explored the way marketing via packaging information influences Australian parents’ ability to select healthy foods for their children, and who parents believe should be responsible for helping them. Five 90-min focus groups were conducted by an experienced facilitator in Perth, Western Australia. Four fathers and 33 mothers of children aged 2–8 years participated. Group discussions were audio-recorded and transcribed verbatim and inductive thematic content analysis conducted using NVivo11. Seven themes were derived: (1) pressure of meeting multiple demands; (2) desire to speed up shopping; (3) feeding them well versus keeping them happy; (4) lack of certainty in packaging information; (5) government is trusted and should take charge; (6) food manufacturers’ health messages are not trusted; (7) supermarkets should assist parents to select healthy foods. Food packaging information appears to be contributing to parents’ uncertainty regarding healthy food choices. Supermarkets could respond to parents’ trust in them by implementing structural policies, providing shopping environments that support and encourage healthy food choices.

Background: Mobile technology offers unique opportunities to reach people with health promotion interventions. Breastfeeding is an important public health issue, and fathers are a key support. Milk Man is a father-focused breastfeeding app that sought to engage fathers with information and conversation about breastfeeding, with the goal to impact positively on breastfeeding duration. Objective: The study aimed to describe the process evaluation of the Milk Man app that was trialed in the Parent Infant Feeding Initiative randomized controlled trial. Methods: The app used an information library, gamification, push notifications, and social connectivity via a Web-based conversation forum, which included polls and conversation starters, to engage fathers with breastfeeding information. Fathers had access to the app from approximately 32 weeks of gestation to 6 months postpartum. Process evaluation data were collected from a self-completed questionnaire administered via a Web-based link sent to participants at 6 weeks postpartum, and app analytics data were collected directly from the app. Quantitative data from both sources and qualitative responses to open-ended questions were used to triangulate findings to investigate patterns of usage and the effectiveness of each app engagement strategy to motivate and engage users. Results: A total of 80.3% (586/730) of participants, who were randomized to receive the app, downloaded Milk Man. Push notifications and interest in what other fathers had posted in the forum were the 2 main motivators to app use. Fathers used the app most while their partners were still pregnant and in the weeks immediately after the birth of their baby. Perspectives on the gamification strategy were varied. However, at 6 weeks postpartum, approximately one-third of fathers still using the app said that the gamification elements were encouraging the app use. The ease of use of the app and the design were important elements that were rated positively. T