Association of breast feeding and birth interval with child mortality in Pakistan: a cross-sectional study using nationally representative Demographic and Health Survey data

ObjectivesThis study analysed the association between breast feeding (BF) and birth interval (BI) (both succeeding and preceding) with neonatal mortality (NM), infant mortality (IM) and under-5 mortality (U5M).DesignThis cross-sectional study used data from the Pakistan Demographic and Health Survey 2017–2018.SettingsAll provinces, Islamabad and Federally Administered Tribal Areas were included in the analysis.ParticipantsA total of 12 769 children born to ever-married multiparous women aged 30–49 years who gave live birth within 5 years preceding the interview. Multiple births are not included.Data analysisMultivariate logistic regression analysis was used.ResultsWe found that BF was associated with nearly 98% lower risk of NM (OR 0.015; 95% CI: 0.01 to 0.03; p<0.001), 96% lower risk of IM (OR 0.038; 95% CI: 0.02 to 0.06; p<0.001) and 94% lower risk of U5M (OR 0.050; 95% CI: 0.03 to 0.08; p<0.001). Compared with optimal preceding birth interval (PBI) (36+ months), short PBI (<18 months) was associated with around six times higher risk of NM (OR 5.661; 95% CI: 2.78 to 11.53; p<0.001), over five times risk of IM (OR 4.704; 95% CI: 2.70 to 8.19; p<0.001) and over five times risk of U5M (OR 4.745; 95% CI: 2.79 to 8.07; p<0.001). Disaggregating the data by child’s gender, place of residence and mother’s occupational status showed that being ever breast fed was associated with a smaller risk of NM, IM and U5M in all three disaggregations. However, the risk of smaller PBI <18 months was generally more pronounced in female children (NM and U5M) or when the children lived in rural areas (NM, IM and U5M). PBI <18 months was associated with greater risk of NM and IM, and smaller risk of U5M when mothers did a paid job.ConclusionThis study’s significance lies in the fact that it has found BF and BI to be consistent protective factors against NM, IM and U5M. Given Pakistan’s economic constraints, optimal BF and BI are the most cost-effective interventions to reduce child mortality.

Assessment of Feeding Practice among Mothers Attending the Immunisation Clinic of UCMS Hospital, Nepal: A Cross-Sectional Study

INTRODUCTION: Practice of exclusive breast feeding has dramatically reduced infant mortality in developing countries due to reduction in diarrhea and infectious diseases. We conducted a study to assess the feeding practices among mothers with children less than 12 months of age attending the immunization clinic of UCMS hospital, Nepal. MATERIAL AND METHODS: A hospital based cross sectional study was carried out in the immunization clinic of Pediatric ward of UCMS, Nepal for a period of four months. Mothers of child of 0-12 months were included in the study. Sample size was 372 which was based on the number of mothers visited Pediatric ward for immunization of their child of age group 0-12 months during the duration of the study. Mothers were interviewed by using a pre-validated structured questionnaire. Data was analyzed by using SPSS version-20 software and presented by descriptive statistics as frequency and percentages. RESULTS: Most of the children were above six months, 56.5% were of 7-12 months of age group. Exclusive breastfeeding was done in 48.4% children for first six months. Maximum population preferred hospital as their mode of delivery. 93.5% mothers opted for hospital as their place of delivery. 23.4% mothers were illiterate. Night feeding was practiced by 96.2% mothers. CONCLUSION: Breast feeding awareness must be spread among mothers by workshops and health education programs.

Formulation and Evaluation of Donkey Milk (Energy Drink)

Milk is one of the most common causes of food allergies among children under one year of age. No specific therapy exists for this allergy, and thus the only feasible response is to avoid assumption of milk and derived products. Studies conducted on the serum of children with hypersensi-tivity to milk have shown that caseins are the proteins with the greater allergenic potential. However, in some cases, children have also shown hypersensitivity to the β-lactoglobulines and to the α-lactal- bumins. When food intolerance is diagnosed in an infant, it is often necessary to impose a period of total parenteral feeding, followed by breast feeding, considered the most correct method of re-feeding. When human milk can not be given, alternative food sources must be sought. Clinical studies have demonstrated that donkey milk could substitute breast feeding in infants affected by severe Ig-E me- diated milk allergies. In these subjects, donkey milk is not only useful, but also safer than other types of milk. In fact donkey milk composition in lipids (high levels of linoleic and linolenic acid) and pro-teins (low caseins content) is very close to human milk. Lysozyme content in donkey milk resulted to be very high (mean value 1.0 mg/ml) if compared to bovine (traces), caprine (traces) and human milk. The high lysozyme content of donkey milk may be responsible of the low bacterial count reported in literature and also makes this milk suitable to prevent intestine infections to infants. Among seropro-teins, β-lactoglobulin and α-lactalbumin content in donkey milk was respectively 3.75 and 1.80 mg/ml and remained substancially the same during the different stages of lactation. Keywords: Donkey milk, Milk quality, Milk chemical compositions, antibacterial activity, bioactivity, health benefits , therapeutic.

Reconstitution and Transmission of Gut Microbiomes and Their Genes between Generations

Microbiomes are transmitted between generations by a variety of different vertical and/or horizontal modes, including vegetative reproduction (vertical), via female germ cells (vertical), coprophagy and regurgitation (vertical and horizontal), physical contact starting at birth (vertical and horizontal), breast-feeding (vertical), and via the environment (horizontal). Analyses of vertical transmission can result in false negatives (failure to detect rare microbes) and false positives (strain variants). In humans, offspring receive most of their initial gut microbiota vertically from mothers during birth, via breast-feeding and close contact. Horizontal transmission is common in marine organisms and involves selectivity in determining which environmental microbes can colonize the organism’s microbiome. The following arguments are put forth concerning accurate microbial transmission: First, the transmission may be of functions, not necessarily of species; second, horizontal transmission may be as accurate as vertical transmission; third, detection techniques may fail to detect rare microbes; lastly, microbiomes develop and reach maturity with their hosts. In spite of the great variation in means of transmission discussed in this paper, microbiomes and their functions are transferred from one generation of holobionts to the next with fidelity. This provides a strong basis for each holobiont to be considered a unique biological entity and a level of selection in evolution, largely maintaining the uniqueness of the entity and conserving the species from one generation to the next.

A Cross Sectional Study on Knowledge and Attitude Regarding Exclusive Breast Feeding among Women of Reproductive Age Group in Chennai, Tamil Nadu

Aim & Objectives: To assess the knowledge and attitude on exclusive breast feeding among reproductive age group women in Chennai. Materials and Methodology This is a cross sectional quantitative descriptive study. The data was collected by handing out physical questionnaire forms to volunteers or by sending a link of the google form format of the same questionnaire. The data was collected from February 2021 to September 2021. The both physical and online forms data collected were compiled with help of Microsoft Excel. These compiled data were then analyzed using SPSS 16.0 software. All the frequencies and percentages were also obtained from this. Results: In this study a total of 342 volunteers participated, all belonging to the reproductive age group i.e., 15 years to 45 years. Majority of the participants were among the age group 20 to 30 years belonging to both married and unmarried category. Out of the 342 volunteers, 74.2% (254) of the participants planned to breast feed their infants for several months. 60% of participants had scored more than 75% overall. The lowest score seen was 26/40 points. So no one in my study had low knowledge (less than 20). The knowledge percentage and attitude percentage here are 68.6% 65.4% respectively. My interpretation of the knowledge and attitude is that we need to increase the knowledge about the term “Exclusive Breast Feeding” and also encourage the mothers to breast feed their infants. Conclusion: Although most have scored more than 75%, some important questions were chosen incorrectly. This might be mostly due to the fact that there is lack of knowledge with respect to the term “exclusive” breastfeeding. This suggests that there has to be more awareness created amongst the youth population, who are tomorrow’s mothers. The need for them to know the importance of these matters lies in hands being doctors. It should be taught from school level itself.

Exclusive breastfeeding practice and its associated factors among children aged 6-23 months in Woldia Town, Northwest Ethiopia

Background: Inappropriate practice of exclusive breastfeeding (EBF) is still a major problem worldwide.Objective: To identify exclusive breastfeeding practice and its associated factors among children aged 6-23 months in Woldia Town.Methods: A Community based cross-sectional study was carried out.Interviewer-administered questionnaire was utilized to collect the data. The questionnaire was adapted from the 2016 Ethiopia Demographic and Health Survey. Hosmer-Lemeshowmodel was fitted at a P-value of 0.91. Finally, Variables having P-Value <0.05 with 95% CI was considered as significant factors.Result: The prevalence of exclusive breastfeeding practice was 46.2% (95% CI: 42.0, 49.8). Being employed mothers (AOR=0.62,95% CI:0.44,0.87), being head of a household (AOR=0.52,95% CI:0.32,0.83),not g getting husband support (AOR:0.5,95%CI:0.34,0.74),not fed colostrum’s (AOR:0.36,95%CI:0.23,0.57),not affected by traditional belief (AOR:3.59,95% CI:2.09-6.17) shows significant association with Exclusive breast feeding practice.Conclusion: The prevalence of exclusive breast feeding practice was relatively lower than the National prevalence. Some demographic variable and traditional beliefs were significantly associated with exclusive breast feeding. Designing model policies that empower the role of women and eradicating bad traditional beliefs in the community is fundamental step. Keywords: Exclusive Breastfeeding; Breastfeeding practice; Breastfeeding Promotion.

Effect of Peppermint Water V/S Lanolin Ointment Application in Management of Cracked Nipple among Lactating Postnatal Women

Background of the study: Breast feeding is considered as the ideal method of feeding and nurturing infants. It is a dream for most mothers to have comfort in breast feeding, but sore nipples are still a common problem and pain or cracks frequently occur after breast feeding. The present study evaluated the Effect of peppermint water v/s lanolin ointment application in management of cracked nipple among lactating postnatal women. Objectives: The objectives of the study were to assess the intensity of cracked nipple in lactating post-natal mothers, to compare the effect of Peppermint water and Lanolin in the management of cracked nipple, to find out the association between the pre interventional level of cracked nipples and selected demographic variables. Methodology: The study design used was Quasi experimental two group pretest posttest design. Consecutive sampling was used to select 60 postnatal mothers with cracked nipple who met the sample selection criteria. Informed consent was obtained from the samples who fulfils the inclusion criteria. The tools used in this study were modified visual analogue scale, nipple soreness rating scale, nipple trauma scale. Out of 60 samples 30 were selected for Peppermint water application and 30 were selected for Lanolin ointment application. Results: The data when analyzed using descriptive and inferential statistics revealed a significant reduction in the level of pain, soreness and trauma after the application of Peppermint water compared to lanolin ointment. There was no association between pre interventional level of cracked nipple and selected demographic variables. Conclusion: The study concluded that Peppermint water is better than Lanolin ointment in management of cracked nipple among postnatal mothers. Cracked nipple is a prevalent problem among postnatal mothers and health care personnel should be equipped with good assessment tools and cost-effective interventions. Key words:Peppermint water, Lanolin ointment, Cracked nipple, Lactating postnatal women