Abstract Digest: Issue 1, January 2010

Early initiation of breastfeeding and exclusive breastfeeding for 6 months

Assessment of the effect of psychosocial support during childbirth in Ibadan, south-west Nigeria: a randomised controlled trial

Nigerian women who were randomized to receive psychosocial support during childbirth from a companion had a lower Cesarean-section rate, shorter duration of labor, lower pain scores, a more satisfying birth experience, and initiated breastfeeding early. In settings where nurses and midwives are overwhelmed with other tasks, a companion can help encourage the mother to initiate breastfeeding soon after giving birth.

Delayed cord clamping: advantages for infants

One of the many benefits of delayed cord clamping (waiting ~3 minutes after delivery, or until pulsations cease) is a reduction of the risk of anemia in later infancy. Sharing new evidence with health care providers and working out logistical challenges are important steps in incorporating this beneficial procedure into birthing practices.

Neonatal care in rural Karnataka: healthy and harmful practices, the potential for change

Certain delivery practices in rural India, such as early bathing of the baby, can be barriers to early skin-to-skin contact and initiation of breastfeeding. Educating relatives who are influential, especially grandmothers, on optimal birthing and feeding practices may be key to improving newborn care.

The effect of interrupted 5-day training on Integrated Management of Neonatal and Childhood Illness on the knowledge and skills of primary health care workers

A 5-day two-part Integrated Management of Neonatal and Childhood Illness training package, when compared to the conventional 8-day training course, was found to be as effective at improving knowledge and skills of primary health care workers in India, and less costly. Making training packages more cost-effective is critical to expanding child health and nutrition programs.

Complementary feeding

Caregiver verbal encouragement increases food acceptance among Vietnamese toddlers

In Vietnam, when caregivers provided positive verbal comments during feeding to toddlers, the children were more than twice as likely to accept food than when no comments were given. Emphasizing positive caregiver verbalization may enhance responsive feeding in Vietnam.

Development of food-based complementary feeding recommendations for 9- to 11-month-old peri-urban Indonesian infants using linear programming

Linear programming analyses revealed that local food sources in Indoneseia could not meet iron requirements for 9- to 11-mo-old infants, and adequate levels of zinc, calcium, thiamin and niacin were difficult to achieve. Linear and goal programming techniques allow for the formulation of complementary feeding recommendations that are likely to be acceptable and sustainable, and can demonstrate the situations in which fortified products are needed.

A review of interventions based on dietary diversification or modification strategies with the potential to enhance intakes of total and absorbable zinc

Strategies that have the potential to increase the intake of bioavailable zinc, such as agricultural interventions, production and promotion of animal-source foods, and processing strategies to enhance zinc absorption from plant-based diets, are critically reviewed in this document. Programs that integrate animal husbandry into initiatives that include home gardening and nutrition education hold promise for increasing intake of critical nutrients.

Bacterial populations in complementary foods and drinking-water in households with children aged 10-15 months in Zanzibar, Tanzania

While instant, commercially-available fortified complementary foods are convenient because they do not require additional cooking, bacterial counts of such products in Tanzania were higher than those found in cooked porridges, in large part because of contaminated water used to prepare the instant foods. Food safety concerns should be addressed when improving complementary foods in order to minimize risk of exposure to food-borne pathogens and ensuing gastrointestinal illness.

The effects of iron and/or zinc supplementation on maternal reports of sleep in infants from Nepal and Zanzibar

Infants in Nepal and Zanzibar randomized to receive supplemental iron and/or zinc had better sleep patterns than unsupplemented infants. This additional benefit of micronutrient supplementation may be of particular interest to parents of wakeful infants, and may also be associated with improved cognitive and behavioral development.

A large-scale distribution of milk-based fortified spreads: evidence for a new approach in regions with high burden of acute malnutrition

A preventive approach involving blanket (untargeted) distribution of a lipid-based nutrient supplement (Plumpy’doz®) by Médecins san Frontières (MSF) to approximately 60,000 children in Niger aged 6 to 36 months during the 6-month “hungry season” in 2007 was associated with a reduction in the prevalence and incidence of severe acute malnutrition, and the expected rise in new cases during the hungry season was not only arrested but reversed. When compared to the previous year’s program of treatment only (targeted to children with severe acute malnutrition), the blanket distribution strategy cost 29% more but benefitted twice as many children.