1) The document discusses environmental enteropathy (EE), a condition caused by ingesting fecal matter that damages the gut and stunts growth. EE is a major cause of stunting in children under 2 in developing countries.
2) A randomized trial in Zimbabwe will test if a water, sanitation, and hygiene (WASH) intervention can reduce EE and stunting by preventing infants from ingesting fecal matter. The intervention provides protected play areas, handwashing, and latrines.
3) The trial will also test if combining the WASH intervention with a nutrition intervention provides added benefits for stunting and anemia reduction beyond either alone. Outcomes will be measured on 4,800 infants to test
The document discusses infant feeding and prevention of mother-to-child transmission (PMTCT) of HIV. It outlines national guidelines for HIV and infant feeding, including promoting exclusive breastfeeding for the first six months unless replacement feeding is acceptable, affordable, feasible, sustainable and safe. The risks and benefits of different infant feeding options like breastfeeding and replacement feeding are presented. Guidelines for counseling mothers on feeding choices and providing follow-up support are also described.
This document discusses the importance of breastfeeding for infant health and development. It reviews several studies that show breastfeeding reduces the risk of morbidity and mortality from various infectious diseases like diarrhea, otitis media, neonatal sepsis, and respiratory infections. However, in many societies false beliefs interfere with breastfeeding and infants are commonly given prelacteal feeds or mixed feeding instead of being exclusively breastfed. The purpose of the study described is to examine the patterns of infectious diseases in non-breastfed infants compared to breastfed infants admitted to the hospital.
The document provides an introduction to the Global Strategy for Infant and Young Child Feeding developed by WHO and UNICEF. It aims to revitalize attention on the impact of feeding practices on children under 5, as malnutrition contributes to over 50% of the 10.6 million annual deaths in that age group. The strategy lists operational targets and current recommendations for feeding from 0-24 months. It describes optimal infant feeding practices that can reduce under-five mortality, such as exclusive breastfeeding for six months and continued breastfeeding up to two years or beyond while complementing with nutritious foods.
Infant and young child feeding in emergenciesPrithwiGhosh1
This document provides guidance on infant and young child feeding in emergencies. It outlines key actions to protect, promote and support optimal infant and young child feeding practices during emergencies. Some of the main points covered include:
- The importance of emergency preparedness and having policies in place to guide responses. National governments should lead coordination of infant and young child feeding responses, with UNICEF or UNHCR providing support as needed.
- Multi-sector collaboration is essential, as is training emergency staff across sectors on infant and young child feeding issues. Needs assessments should inform context-specific responses.
- Immediate action is needed to protect recommended feeding practices and support higher risk groups. Donations of breast
New Frontiers in Infant & Young Child Feeding GrangerCORE Group
This document discusses a pilot program in Niger that used community video to promote responsive feeding practices to improve early childhood nutrition. The program developed and tested indicators to measure responsive feeding behaviors. It found that the intervention generated discussion in communities and some behavior change, such as more nurturing interactions during mealtimes. However, challenges remain due to cultural norms around childcare roles. The program recommends further research on responsive feeding indicators and involving all caregivers to strengthen early childhood development.
Promoting breast feeding as a right of the childNaeem Zafar
In this presentation we will see how breast feeding,, a natural phenomenon and protector of human species has to be protected by Universal laws and legislation. Yet we have to fight for this right through awareness raising and advocacy to the government as well as lay public.
Socio Cultural Factors Related to Health and Disease Aditya Sharma
Socio Cultural Factors Related to Health and Disease
PPT
Heredity
Environment
Lifestyle
Socio-economic conditions
Health services
Education
Income
Housing
The document outlines the 10 steps of the WHO/UNICEF Baby-Friendly Hospital Initiative launched in 1991 to ensure hospitals, maternity facilities, and communities support breastfeeding. The 10 steps include having a written breastfeeding policy, training staff, helping mothers initiate breastfeeding within 30 minutes of birth, and not providing breastfed infants with any food or drink other than breastmilk unless medically necessary. Implementing the 10 steps could save an estimated 1.5 million lives worldwide each year if every baby was exclusively breastfed for the first 6 months.
The document discusses infant feeding and prevention of mother-to-child transmission (PMTCT) of HIV. It outlines national guidelines for HIV and infant feeding, including promoting exclusive breastfeeding for the first six months unless replacement feeding is acceptable, affordable, feasible, sustainable and safe. The risks and benefits of different infant feeding options like breastfeeding and replacement feeding are presented. Guidelines for counseling mothers on feeding choices and providing follow-up support are also described.
This document discusses the importance of breastfeeding for infant health and development. It reviews several studies that show breastfeeding reduces the risk of morbidity and mortality from various infectious diseases like diarrhea, otitis media, neonatal sepsis, and respiratory infections. However, in many societies false beliefs interfere with breastfeeding and infants are commonly given prelacteal feeds or mixed feeding instead of being exclusively breastfed. The purpose of the study described is to examine the patterns of infectious diseases in non-breastfed infants compared to breastfed infants admitted to the hospital.
The document provides an introduction to the Global Strategy for Infant and Young Child Feeding developed by WHO and UNICEF. It aims to revitalize attention on the impact of feeding practices on children under 5, as malnutrition contributes to over 50% of the 10.6 million annual deaths in that age group. The strategy lists operational targets and current recommendations for feeding from 0-24 months. It describes optimal infant feeding practices that can reduce under-five mortality, such as exclusive breastfeeding for six months and continued breastfeeding up to two years or beyond while complementing with nutritious foods.
Infant and young child feeding in emergenciesPrithwiGhosh1
This document provides guidance on infant and young child feeding in emergencies. It outlines key actions to protect, promote and support optimal infant and young child feeding practices during emergencies. Some of the main points covered include:
- The importance of emergency preparedness and having policies in place to guide responses. National governments should lead coordination of infant and young child feeding responses, with UNICEF or UNHCR providing support as needed.
- Multi-sector collaboration is essential, as is training emergency staff across sectors on infant and young child feeding issues. Needs assessments should inform context-specific responses.
- Immediate action is needed to protect recommended feeding practices and support higher risk groups. Donations of breast
New Frontiers in Infant & Young Child Feeding GrangerCORE Group
This document discusses a pilot program in Niger that used community video to promote responsive feeding practices to improve early childhood nutrition. The program developed and tested indicators to measure responsive feeding behaviors. It found that the intervention generated discussion in communities and some behavior change, such as more nurturing interactions during mealtimes. However, challenges remain due to cultural norms around childcare roles. The program recommends further research on responsive feeding indicators and involving all caregivers to strengthen early childhood development.
Promoting breast feeding as a right of the childNaeem Zafar
In this presentation we will see how breast feeding,, a natural phenomenon and protector of human species has to be protected by Universal laws and legislation. Yet we have to fight for this right through awareness raising and advocacy to the government as well as lay public.
Socio Cultural Factors Related to Health and Disease Aditya Sharma
Socio Cultural Factors Related to Health and Disease
PPT
Heredity
Environment
Lifestyle
Socio-economic conditions
Health services
Education
Income
Housing
The document outlines the 10 steps of the WHO/UNICEF Baby-Friendly Hospital Initiative launched in 1991 to ensure hospitals, maternity facilities, and communities support breastfeeding. The 10 steps include having a written breastfeeding policy, training staff, helping mothers initiate breastfeeding within 30 minutes of birth, and not providing breastfed infants with any food or drink other than breastmilk unless medically necessary. Implementing the 10 steps could save an estimated 1.5 million lives worldwide each year if every baby was exclusively breastfed for the first 6 months.
This document summarizes an update published in 2007 on HIV transmission through breastfeeding. It reviews scientific evidence from 2001 to 2007 on the risk of HIV transmission through breastfeeding, the impact of different infant feeding options on child health outcomes, and strategies to reduce transmission through breastfeeding in developing countries. The update aims to inform public health recommendations around infant feeding by HIV-infected mothers.
1. The guidelines provide recommendations for appropriate infant and young child feeding in India, including exclusive breastfeeding for the first six months, continued breastfeeding for up to two years or beyond, and introducing complementary foods after six months of age.
2. Key recommendations include early initiation of breastfeeding within one hour of birth, exclusive breastfeeding for six months, and introducing nutritious complementary foods gradually after six months along with continued breastfeeding.
3. Special situations related to infant feeding in cases of maternal or infant illness, HIV, or other medical conditions are also addressed.
The role of civil society is vital for protecting children from vested corporate interests. For this knowledge about popular interventions and their pros and cons is vital.
In this ppt, I have discussed some special cases when a mother may be unsure if and how to breast feed her infant. In these special conditions, what should a doctor advise
POSTER Influence of breastfeeding on infant allergy developmentAnya Guy
This document discusses the influence of breastfeeding on infant allergy development. It finds that exclusive breastfeeding for 6 months and any breastfeeding for 1 year is most beneficial for decreasing food allergy risk. Components in breast milk like food antigens, antimicrobial peptides, and cytokines provide immunoprotective effects that help infants digest potentially allergenic foods. The duration of breastfeeding is correlated with decreased infant allergy development.
1) Interventions to reduce under 5 mortality include improving maternal health, vaccination programs, proper nutrition, and increasing access to clean water and sanitation.
2) Pneumonia is a leading cause of death that can be addressed through vaccination, breastfeeding, and ensuring access to antibiotics.
3) Diarrhea can be reduced by 25-85% through handwashing, water/sanitation improvements, oral rehydration, and rotavirus vaccines.
4) Malaria interventions focus on preventing mosquito bites through nets/repellents and larvaecide as well as early diagnosis and treatment of cases.
Higher maternal educational attainment is associated with decreased exclusive breastfeeding and increased use of formula in both urban and rural Peru. Exclusive breastfeeding rates are significantly higher in rural versus urban mothers across all education levels. Urban mothers also report higher use of other fluids in addition to breastfeeding compared to rural mothers. Targeted breastfeeding campaigns should focus on mothers with higher education and those in urban areas to promote exclusive breastfeeding practices.
The document outlines Methodist Dallas Medical Center's plan to achieve Baby-Friendly designation by adopting several evidence-based practices. The plan includes having a neonatal admission nurse care for infants in the same location as mothers to promote skin-to-skin contact and rooming-in. Research shows these practices improve breastfeeding and maternal-infant bonding. The plan also delays unnecessary interventions like early infant bathing to prevent hypothermia and supports breastfeeding within one hour of birth.
The document provides guidelines on infant feeding and nutrition. It recommends exclusive breastfeeding for the first 6 months as breast milk provides optimal nutrition for infants. From 6-24 months, the guidelines recommend continued breastfeeding along with introducing complementary foods. The document discusses the benefits of breastfeeding for both mother and infant. It also provides information on infant formula types and guidelines for complementary feeding introduction and dietary supplements.
The document summarizes the services provided at an under five clinic. The clinic provides preventative, curative, referral, and educational services to children under five years old under one roof. The overall goal is to provide comprehensive healthcare to young children in a specialized facility. The clinic treats acute and chronic illnesses, monitors growth through periodic weighing and measurement, provides immunizations and nutrition care, and educates mothers on childcare.
This document discusses various feeding methods for infants, including breastfeeding, formula feeding, cup feeding, and finger feeding. It provides advantages and disadvantages of each method. Breastfeeding is described as the best method, providing superior nutrition and protection against diseases. The document also covers composition of breast milk, importance of feeding, indications for formula feeding, benefits of extended breastfeeding beyond 6 months, and guidelines for introducing solid foods during weaning.
MRC/info4africa KZN Community Forum | June 2012info4africa
Ms Philippa Barnard, a Nutritionist at Zoe-Life outlined the Tshwane Declaration of 2011, which advocated breastfeeding as the best infant feeding choice for all babies, regardless of HIV status. This great change in policy created massive potential for decreasing infant and child mortality. Ms Barnard also highlighted some of Zoe-Life's practical insights gained whilst training lay counsellors in infant and young child feeding.
The document is a 20-hour course from UNICEF and WHO on promoting and supporting breastfeeding in baby-friendly hospitals. The course aims to train staff so they can confidently assist mothers with early and exclusive breastfeeding and help facilities achieve baby-friendly designation. It covers topics like the global strategy for infant feeding, the baby-friendly hospital initiative, breastfeeding techniques, challenges, and developing an implementation plan. The document provides guidance through text and illustrations.
This document provides guidelines for optimal infant and young child feeding practices, including recommendations for breastfeeding, complementary feeding, feeding in special situations, and guidelines for feeding preterm or low birth weight infants. The key recommendations are:
1) Exclusive breastfeeding for the first 6 months and continued breastfeeding for up to 2 years or beyond, along with timely introduction of complementary foods after 6 months.
2) Appropriate complementary feeding consisting of locally available and nutritious foods from at least 4 food groups, fed in accordance with the child's needs and abilities.
3) Special considerations for feeding infants in situations like illness, maternal illness, low birth weight, or HIV status.
This document provides guidelines for infant and young child feeding in India. It outlines recommendations such as exclusive breastfeeding for the first 6 months, introducing complementary foods at 6 months, continuing breastfeeding for up to 2 years and beyond, and emphasizing timely initiation of breastfeeding within 1 hour of birth. The document also addresses issues like human milk banking, feeding in specific situations like HIV and illness, the importance of micronutrients, and promoting optimal maternal nutrition and baby-friendly practices. The overall aim is to improve infant and young child feeding practices and nutritional status in India.
Impact of Hepatitis B Virus (HBV) Vaccination in Childrens Born to HBV Positi...IOSR Journals
Perinatal HBV transmission is common in South East Asia approximately 25- 30% of the carrier
pool. The problem is not only to the mother but also pertains to the offspring, in pregnancy hepatitis; the
immune alterations in pregnancy may modify the dynamics of the disease. The infants of the mothers, who are
carrying both HBsAg and HBeAg, have the highest risk of acquiring the HBV infection by the perinatal route.
The over all risk may vary from one population to another, depending on the prevalence of HBeAg positivity in
the pregnant women. It is reported and estimated that 22,000 pregnant women in the United States get infected
with hepatitis B virus, which necessitated hepatitis B vaccination of the newborn mandatory in the United
States.
This study was aimed to bring about authenticated documentation on impact of preventive measures by
vaccination that are essential features to plan and implement health measures package in a country.
Results: Inspite of neonatal vaccination against hepatitis B given to all 158 children born to their HBsAg
positive mothers, 6.8% (6/87) of these infants reached the status of chronic HBV infection from their infected
mothers after 12 months follow-up.
Conclusion: 6.8% (6/87) of the infants developed chronic HBV infection in spite of hepatitis B vaccination all
the children by acquiring HBV from their infected mothers as confirmed by twelve months of follow-up
World Health Organization's Guide to Infant and Child NutritionChris Johnson
The document discusses the importance of optimal infant and young child feeding for growth, health and development. Inadequate nutrition is associated with one third of deaths in children under 5 years old globally and can also lead to long term health and developmental problems. The WHO and UNICEF adopted a Global Strategy for Infant and Young Child Feeding in 2002 to promote appropriate feeding practices from birth to 2 years of age, a critical period of growth and development. Health professionals have a key role in supporting mothers to follow the recommended feeding practices outlined in the strategy.
Role of l. reuteri in colic & easy digestion comfortable and healthy babykuntalbiswas56
Lactobacillus reuteri is a probiotic strain that provides several benefits for infant health and digestion. It reduces crying time in colicky infants by modulating the gut microbiota and decreasing levels of gas-forming bacteria like E.coli. It also reduces inflammation in the gut by immunomodulation, promoting the development of regulatory T cells. Furthermore, L. reuteri promotes development of the enteric nervous system, improving gut motility and decreasing visceral pain. Clinical studies show L. reuteri is more effective at reducing infant crying time compared to the antacid simethicone.
Effect of Breastfeeding on Infant InfectionKarissa Braden
The document summarizes evidence from multiple studies on the relationship between breastfeeding and infant infection. Three studies are critically appraised: a prospective cohort study from Hong Kong found exclusive breastfeeding for at least 3 months was associated with lower risk of hospitalization for infection in the first 6 months. A UK retrospective cohort study found exclusive breastfeeding was associated with 30-63% lower risk of lower respiratory tract infections and diarrhea hospitalizations. A systematic review of 15 large cohort studies found a protective relationship between breastfeeding and incidence of diarrhea and pneumonia, with a 40% reduction in gastrointestinal illness risk and 4.91 times higher hospitalization for infants never breastfed. The evidence suggests breastfeeding, particularly exclusive breastfeeding, significantly reduces the risk of
This presentation was delivered online at the 2010 Vertial International Day of the Midwife. You can find the audio at http://blip.tv/file/3677417 to listen and view at the same time. Sorry I haven't added the audio to the slideshare presentation as I haven't had time! Cheers.
This document summarizes an update published in 2007 on HIV transmission through breastfeeding. It reviews scientific evidence from 2001 to 2007 on the risk of HIV transmission through breastfeeding, the impact of different infant feeding options on child health outcomes, and strategies to reduce transmission through breastfeeding in developing countries. The update aims to inform public health recommendations around infant feeding by HIV-infected mothers.
1. The guidelines provide recommendations for appropriate infant and young child feeding in India, including exclusive breastfeeding for the first six months, continued breastfeeding for up to two years or beyond, and introducing complementary foods after six months of age.
2. Key recommendations include early initiation of breastfeeding within one hour of birth, exclusive breastfeeding for six months, and introducing nutritious complementary foods gradually after six months along with continued breastfeeding.
3. Special situations related to infant feeding in cases of maternal or infant illness, HIV, or other medical conditions are also addressed.
The role of civil society is vital for protecting children from vested corporate interests. For this knowledge about popular interventions and their pros and cons is vital.
In this ppt, I have discussed some special cases when a mother may be unsure if and how to breast feed her infant. In these special conditions, what should a doctor advise
POSTER Influence of breastfeeding on infant allergy developmentAnya Guy
This document discusses the influence of breastfeeding on infant allergy development. It finds that exclusive breastfeeding for 6 months and any breastfeeding for 1 year is most beneficial for decreasing food allergy risk. Components in breast milk like food antigens, antimicrobial peptides, and cytokines provide immunoprotective effects that help infants digest potentially allergenic foods. The duration of breastfeeding is correlated with decreased infant allergy development.
1) Interventions to reduce under 5 mortality include improving maternal health, vaccination programs, proper nutrition, and increasing access to clean water and sanitation.
2) Pneumonia is a leading cause of death that can be addressed through vaccination, breastfeeding, and ensuring access to antibiotics.
3) Diarrhea can be reduced by 25-85% through handwashing, water/sanitation improvements, oral rehydration, and rotavirus vaccines.
4) Malaria interventions focus on preventing mosquito bites through nets/repellents and larvaecide as well as early diagnosis and treatment of cases.
Higher maternal educational attainment is associated with decreased exclusive breastfeeding and increased use of formula in both urban and rural Peru. Exclusive breastfeeding rates are significantly higher in rural versus urban mothers across all education levels. Urban mothers also report higher use of other fluids in addition to breastfeeding compared to rural mothers. Targeted breastfeeding campaigns should focus on mothers with higher education and those in urban areas to promote exclusive breastfeeding practices.
The document outlines Methodist Dallas Medical Center's plan to achieve Baby-Friendly designation by adopting several evidence-based practices. The plan includes having a neonatal admission nurse care for infants in the same location as mothers to promote skin-to-skin contact and rooming-in. Research shows these practices improve breastfeeding and maternal-infant bonding. The plan also delays unnecessary interventions like early infant bathing to prevent hypothermia and supports breastfeeding within one hour of birth.
The document provides guidelines on infant feeding and nutrition. It recommends exclusive breastfeeding for the first 6 months as breast milk provides optimal nutrition for infants. From 6-24 months, the guidelines recommend continued breastfeeding along with introducing complementary foods. The document discusses the benefits of breastfeeding for both mother and infant. It also provides information on infant formula types and guidelines for complementary feeding introduction and dietary supplements.
The document summarizes the services provided at an under five clinic. The clinic provides preventative, curative, referral, and educational services to children under five years old under one roof. The overall goal is to provide comprehensive healthcare to young children in a specialized facility. The clinic treats acute and chronic illnesses, monitors growth through periodic weighing and measurement, provides immunizations and nutrition care, and educates mothers on childcare.
This document discusses various feeding methods for infants, including breastfeeding, formula feeding, cup feeding, and finger feeding. It provides advantages and disadvantages of each method. Breastfeeding is described as the best method, providing superior nutrition and protection against diseases. The document also covers composition of breast milk, importance of feeding, indications for formula feeding, benefits of extended breastfeeding beyond 6 months, and guidelines for introducing solid foods during weaning.
MRC/info4africa KZN Community Forum | June 2012info4africa
Ms Philippa Barnard, a Nutritionist at Zoe-Life outlined the Tshwane Declaration of 2011, which advocated breastfeeding as the best infant feeding choice for all babies, regardless of HIV status. This great change in policy created massive potential for decreasing infant and child mortality. Ms Barnard also highlighted some of Zoe-Life's practical insights gained whilst training lay counsellors in infant and young child feeding.
The document is a 20-hour course from UNICEF and WHO on promoting and supporting breastfeeding in baby-friendly hospitals. The course aims to train staff so they can confidently assist mothers with early and exclusive breastfeeding and help facilities achieve baby-friendly designation. It covers topics like the global strategy for infant feeding, the baby-friendly hospital initiative, breastfeeding techniques, challenges, and developing an implementation plan. The document provides guidance through text and illustrations.
This document provides guidelines for optimal infant and young child feeding practices, including recommendations for breastfeeding, complementary feeding, feeding in special situations, and guidelines for feeding preterm or low birth weight infants. The key recommendations are:
1) Exclusive breastfeeding for the first 6 months and continued breastfeeding for up to 2 years or beyond, along with timely introduction of complementary foods after 6 months.
2) Appropriate complementary feeding consisting of locally available and nutritious foods from at least 4 food groups, fed in accordance with the child's needs and abilities.
3) Special considerations for feeding infants in situations like illness, maternal illness, low birth weight, or HIV status.
This document provides guidelines for infant and young child feeding in India. It outlines recommendations such as exclusive breastfeeding for the first 6 months, introducing complementary foods at 6 months, continuing breastfeeding for up to 2 years and beyond, and emphasizing timely initiation of breastfeeding within 1 hour of birth. The document also addresses issues like human milk banking, feeding in specific situations like HIV and illness, the importance of micronutrients, and promoting optimal maternal nutrition and baby-friendly practices. The overall aim is to improve infant and young child feeding practices and nutritional status in India.
Impact of Hepatitis B Virus (HBV) Vaccination in Childrens Born to HBV Positi...IOSR Journals
Perinatal HBV transmission is common in South East Asia approximately 25- 30% of the carrier
pool. The problem is not only to the mother but also pertains to the offspring, in pregnancy hepatitis; the
immune alterations in pregnancy may modify the dynamics of the disease. The infants of the mothers, who are
carrying both HBsAg and HBeAg, have the highest risk of acquiring the HBV infection by the perinatal route.
The over all risk may vary from one population to another, depending on the prevalence of HBeAg positivity in
the pregnant women. It is reported and estimated that 22,000 pregnant women in the United States get infected
with hepatitis B virus, which necessitated hepatitis B vaccination of the newborn mandatory in the United
States.
This study was aimed to bring about authenticated documentation on impact of preventive measures by
vaccination that are essential features to plan and implement health measures package in a country.
Results: Inspite of neonatal vaccination against hepatitis B given to all 158 children born to their HBsAg
positive mothers, 6.8% (6/87) of these infants reached the status of chronic HBV infection from their infected
mothers after 12 months follow-up.
Conclusion: 6.8% (6/87) of the infants developed chronic HBV infection in spite of hepatitis B vaccination all
the children by acquiring HBV from their infected mothers as confirmed by twelve months of follow-up
World Health Organization's Guide to Infant and Child NutritionChris Johnson
The document discusses the importance of optimal infant and young child feeding for growth, health and development. Inadequate nutrition is associated with one third of deaths in children under 5 years old globally and can also lead to long term health and developmental problems. The WHO and UNICEF adopted a Global Strategy for Infant and Young Child Feeding in 2002 to promote appropriate feeding practices from birth to 2 years of age, a critical period of growth and development. Health professionals have a key role in supporting mothers to follow the recommended feeding practices outlined in the strategy.
Role of l. reuteri in colic & easy digestion comfortable and healthy babykuntalbiswas56
Lactobacillus reuteri is a probiotic strain that provides several benefits for infant health and digestion. It reduces crying time in colicky infants by modulating the gut microbiota and decreasing levels of gas-forming bacteria like E.coli. It also reduces inflammation in the gut by immunomodulation, promoting the development of regulatory T cells. Furthermore, L. reuteri promotes development of the enteric nervous system, improving gut motility and decreasing visceral pain. Clinical studies show L. reuteri is more effective at reducing infant crying time compared to the antacid simethicone.
Effect of Breastfeeding on Infant InfectionKarissa Braden
The document summarizes evidence from multiple studies on the relationship between breastfeeding and infant infection. Three studies are critically appraised: a prospective cohort study from Hong Kong found exclusive breastfeeding for at least 3 months was associated with lower risk of hospitalization for infection in the first 6 months. A UK retrospective cohort study found exclusive breastfeeding was associated with 30-63% lower risk of lower respiratory tract infections and diarrhea hospitalizations. A systematic review of 15 large cohort studies found a protective relationship between breastfeeding and incidence of diarrhea and pneumonia, with a 40% reduction in gastrointestinal illness risk and 4.91 times higher hospitalization for infants never breastfed. The evidence suggests breastfeeding, particularly exclusive breastfeeding, significantly reduces the risk of
This presentation was delivered online at the 2010 Vertial International Day of the Midwife. You can find the audio at http://blip.tv/file/3677417 to listen and view at the same time. Sorry I haven't added the audio to the slideshare presentation as I haven't had time! Cheers.
BabyWASH Integrating WASH, Nutrition, MNCH, and ECD to Reach Mothers and Chil...CORE Group
The document discusses BabyWASH, an integrated approach to improving water, sanitation, hygiene, nutrition, maternal and child health, and early childhood development for mothers and children under two years old. BabyWASH aims to address the evidence that poor WASH conditions impact health outcomes. The document provides examples of how poor WASH in healthcare facilities increases risks for mothers and babies. It also discusses evidence that many young children live in environments with widespread fecal contamination and identifies the most influential exposure pathways. The BabyWASH Coalition works to increase integration across sectors to improve child well-being in the first 1000 days of life.
This document provides an overview of training for hygiene and sanitation activities. It discusses the aims of promoting good personal and environmental hygiene to protect health. Key topics covered include definitions of hygiene, sanitation, and hygiene promotion. Proper handwashing techniques and the F-diagram for disease transmission are presented. Sessions are outlined on personal hygiene including handwashing, safe disposal of human waste, domestic hygiene through proper garbage disposal, food hygiene practices, and safe drinking water collection, transport, and storage.
Child development can be described across physical, cognitive, and social/emotional domains from conception through adolescence. Numerous theories have attempted to explain child development, including psychoanalytic, behaviorist, biological, cognitive, and systems theories. The document provides an overview of the major 20th century theories of child development, including those proposed by Freud, Erikson, Watson, Skinner, Bandura, Piaget, Vygotsky, Bowlby, Bronfenbrenner and others.
Child Healthcare: Growth and developmentPiLNAfrica
Growth monitoring is an essential part of primary health care for children. It involves regularly measuring a child's weight, height, and head circumference and plotting the measurements on a growth chart called a centile chart. The centile chart shows the range of normal sizes for children of different ages and allows growth to be assessed over time. A child's growth curve is determined by plotting their size measurements from multiple visits on a centile chart and connecting the dots with a line.
The document discusses several key concepts related to individual growth and development:
1. Individual development involves physical growth which can be measured, as well as cognitive, psychological and skill-based maturation.
2. Development is influenced by both biological/hereditary factors like genetics, hormones, intelligence as well as environmental factors like nutrition, culture, socioeconomic status, climate and family dynamics.
3. The principles of heredity like reproduction, variation, dominance, and sex-linked traits impact an individual's inherited physical and mental traits. Interaction between biological predispositions and environmental conditions shape each person's unique development.
The document describes physical and motor development from infancy through early childhood. Key points include:
- The brain grows rapidly in the first few years of life, reaching 70% of adult size by age 2 and 90% by age 5. Important developments include growth of neurons and myelination of the cerebral cortex.
- Fine and gross motor skills develop sequentially from head to toe. Important milestones include sitting, crawling, walking, and grasping objects. Most children achieve these milestones between specific age ranges.
- Motor development is influenced by both biological maturation and environmental stimulation. Lack of opportunities can delay development.
This document discusses child development from infancy through adolescence and provides health and parenting recommendations. It covers the stages of development, what constitutes health, the Millennium Development Goals, aspects of child development including physical, psychological, social-emotional, and spiritual, developmental milestones from early childhood through adolescence including puberty changes, principles of godly and healthy parenting including providing healthcare, guidance, and a safe environment, and recommendations for positive parenting including showing care, trust, discipline, safety, and health education.
Profesora de la Universidad de Bristish Columbia de Canadá en el Seminario Internacional “El Impacto de la Educación Inicial”, organizado por JUNJI, Unicef y el Ministerio de Hacienda.
Child development involves physical, cognitive, and social/emotional changes that occur in predictable stages from birth through adolescence. The document outlines several theories that describe and explain child development, including psychoanalytic, behaviorist, social learning, biological, cognitive, and systems theories. Key theorists discussed include Freud, Erikson, Watson, Skinner, Bandura, Piaget, Vygotsky, Bowlby, Hall, Gesell, and Bronfenbrenner.
This chapter discusses physical, motor, and brain development in infants. It covers principles of growth, development of the nervous system and brain, environmental influences on development, sleep patterns, motor skills development, nutrition, and more. Key topics include rapid physical growth in the first two years, cephalocaudal and other growth principles, synaptic pruning, development of reflexes and motor skills, and the importance of nutrition for development.
The document discusses child development from ages 1-12, covering physical, emotional, intellectual, social, cognitive, religious, and ethical development. It outlines the major stages of growth and differences between growth and development. Key developmental milestones are provided for ages 1-18 months and 18 months to 3 years. The importance of understanding child development and teaching methods appropriate for early learners, such as learning by doing, storytelling, role playing, and activities are emphasized.
Child's individuality has to be appreciated and helicopter parenting will inhibit the growth of child.Montessori school environment provides a space for the child to discover himself/herself.Here the Spiritual embryo is child.Help the child how to think not on what to think.
The fourth edition of Facts for Life contains essential information that families and communities need to know to raise healthy children. This handbook provides practical advice on pregnancy, childbirth, childhood illnesses, child development and the care of children. This edition also features a new chapter on child protection. The book is intended for parents, families, health workers, teachers, youth groups, women’s groups, community organizations, government officials, employers, trade unions, media, and non-governmental and faith-based organizations.
This document summarizes the theories of several influential child development theorists:
- Erik Erikson developed the psychosocial theory of 8 stages from infancy to adulthood focusing on personality development.
- Jean Piaget's theory of cognitive development outlined 4 stages from sensorimotor to formal operations describing how children's thinking abilities develop.
- B.F. Skinner's behaviorism theory proposed that behavior is shaped by its consequences and can be modified through reinforcement.
- Lev Vygotsky emphasized the social and cultural context of development and introduced the concept of the Zone of Proximal Development.
Development templates (preschool and school age years)ryannoel
Kelly, a 3-4 year old, is developing typically across physical, social/emotional, and intellectual domains according to her virtual reports and developmental milestones. She can ride a trike, kick balls, and climb. Socially, she has made friends and plays pretend. Intellectually, she is meeting milestones like counting, naming letters, and telling simple stories. At ages 6-11, Kelly continues to meet developmental expectations across all domains as seen in her school performance, peer interactions, and academic strengths in areas like reading, writing, and problem-solving.
Children are vulnerable to malnutrition and infectious diseases that can often be prevented or treated. The document discusses global and national statistics on infant mortality rates and the leading causes of child death. It outlines India's national child health programs since the 1950s that aim to reduce infant and child mortality rates by focusing on interventions like immunization, diarrhea treatment, and prenatal care. Key initiatives include the Universal Immunization Program, Child Survival and Safe Motherhood Program, Reproductive and Child Health Program, and strategies to provide vitamin A supplementation and manage neonatal and childhood illnesses. The goal is to achieve significant reductions in infant, neonatal, and child mortality rates.
Growth refers to an increase in size due to cell multiplication, while development is a progressive change in behavior and capabilities due to maturation and experience. Growth mainly involves physical changes and is measurable, while development includes improved functioning and brings qualitative changes. Both growth and development are influenced by heredity and environment. Education must consider individual differences and maturity levels in order to best support student development.
The document discusses physical development in middle childhood from ages 6-12. It covers growth in height and weight, motor skill development, nutrition needs, health issues like asthma and obesity, safety concerns like injuries from cars and online threats, and addressing special needs through treatments and educational approaches. Motor skills like riding bikes and muscle coordination improve, and risks include accidents and chronic illnesses.
New Frontiers in Infant & Young Child Feeding RosenbaumCORE Group
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Managing diarrhea- Current nutrition perspectives.pptxssuserb9f7cc
Managing diarrhea-
Current nutrition perspectives
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American Chemical Society Presentation on Diarrhea and Child Stuntingleevg11
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American University Honors Thesis - Allie Stauss, Class of 2014Allison Stauss
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The impact of social protection programs in Ethiopia on children’s nutritiona...TogetherForNutrition
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The impact of social protection programs in Ethiopia on children’s nutritiona...essp2
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TESTING A READY-TO–USE–SUPPLEMENTARY-FOOD (RUSF) OF HIGHER PROTEIN QUALITY ON...Adetutu Sadiq
My Final Symposium Presentation for the Summer Research Program I was a part of at Washington University in St. Louis, MO.
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Diarrhea is common in children under 2 years old and is usually caused by viral or bacterial infections. It can lead to dehydration if fluid losses are not replaced. Dehydration is classified as none, some, or severe based on signs like thirst, skin pinch, and sunken eyes. Treatment involves oral rehydration solution to replace fluids based on the dehydration classification. For severe dehydration, IV fluids are given quickly followed by oral fluids. Preventing diarrhea involves exclusive breastfeeding, hand washing, safe water and food, and immunizations. Managing diarrhea at home includes extra fluids, continued feeding, zinc supplementation, and seeking care for danger signs.
This document discusses child health care services in primary health care. The objectives of child health care are to decrease child mortality rates, promote child health, provide nutritious diets, and monitor child growth and development. Key services discussed include newborn care, immunizations, growth monitoring, hygiene, and early detection and treatment of health problems. Newborn care includes immediate care after birth, maintaining temperature and breastfeeding. Immunizations follow a national schedule. Growth is monitored through weight, height, and developmental assessments.
Infant and young child feeding ppt describe the nutritional needs of infant and child. Exclusive breastfeeding for six months and complementary feeding for the child. avoid formula feeding for the child and continue breastfeeding for 24 months.
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Going Beyond Nutrition to Understand Child Growth and Development_Laura Smith_4.25.13
1. EE: Going Beyond Nutrition to Understand
Child Growth and Development
Laura Smith
Rebecca Stoltzfus,Francis Ngure, Brie
Reid, Gretel Pelto, Mduduzi Mbuya,
Andrew Prendergast, Jean Humphrey
Division of Nutritional Sciences
2. (Victora et al. 2010)
The “Window of Opportunity” for Improving Nutrition is
very small… Pre-pregnancy until 18-24 months of age
4. Cause #1: Malnourished
Mother
• Malnourished mothers give birth to babies that are smaller
and shorter than normal
• 50% of Guatemalan babies are born stunted (Ruel 2001)
– Prevalence of stunting at birth not well documented
– Good length data on newborns is very hard to get!
Estimates of 30-50% of stunting is due to intra-uterine factors.
Effective macronutrient interventions for pregnant women are not
well established.
5. Cause #2: Poor Diet
• Systematic review of the efficacy and effectiveness of
complementary feeding interventions in developing countries
– Dewey & Adu-Afarwuah, 2008
– 42 studies/programs, most published 1996-2006
• Children who received interventions gained:
– 0.0 – 0.76 Z scores weight-for-age
– 0.0 – 0.64 Z scores length-for-age
The best studies caused a 0.7 Z score improvement. BUT:
the average growth deficit of African and Asian children is -2.0 Z
At best, diet solved 1/3 of the problem.
6. Cause #3: Diarrhea
• Between 6-18 months of age, children in developing countries
have around 9 episodes of diarrhea.
• Many authors reported that diarrhea accounts for 10-80% of
growth faltering
• But others contend that children grow at “catch-up rates”
between episodes, and thus recover these deficits
The Lancet Nutrition Series (2008) concluded that by
implementing sanitation and hygiene interventions with 99%
coverage, child malnutrition would be reduced by only 2.4%
7. However:
Evidence exists that the effect of WASH
interventions on linear growth is
independent of its effect on diarrhea.
In several studies, WASH had a bigger effect
on growth than it did on diarrhea
8. Peru:
(Checkley, et al)
• Children assessed for diarrhea and growth from birth
to 2 years
• Household sanitation and water assessed
• What predicted height deficit at 2 years?
16% explained by how much diarrhea the
child had experienced
40% explained by the level of sanitation and
water in child’s household
9. Rural Ethiopia: HH Hygiene Index was the
variable most strongly associated with stunting
Alive and Thrive baseline data; F Ngure (2013, in prep)
10. Cause #4:
The Environmental
Enteropathy Hypothesis
• A subclinical condition of the small intestine, called
environmental enteropathy (EE)
• Characterized by:
– Flattening of the villi of the gut, reducing its surface area
– Thickening of the surface through which nutrients must be absorbed
– Increased permeability to large molecules and cells (microbes)
• Likely causes:
– Too many microbes in the gut
– Effects of toxins on the gut
Decreased nutrient absorption + Infiltration of microbes
11. Microbial translocation
Microbial products cross
into blood stream
The lining of the gut
is only one cell thick
If the gut is injured and
becomes permeable, gaps
open up between cells
Chronic immune
activation
Diverts nutrients from
growth to infection-
fighting
12. EE is a major cause of post-natal stunting,
anemia and immune competence
EE can be prevented or reduced by
preventing infants and young children from
ingesting human and animal feces through a
package of interventions that improve
sanitation and hygiene.
Environmental Enteropathy and
Stunting Hypothesis:
13. Chronic immune activation
↑ pro-inflammatory
cytokines
Immunosenescence
(premature aging) of adaptive
cell-mediated immune system
↑Hepcidin ↓Growth Factor
(IGF-1)
Anemia Stunting
Impaired response to
vaccines and infections
14. HAZ changes over first 18 months in stunted and non-
stunted infants
Birth 6wks 3mo 6mo 12mo 15mo9mo 18mo
15. IGF-1 and IGFBP3 were lower in stunted
infants, beginning at 6 wk
0 3 6 9 12 15 18
0
20
40
60
80
Age (months)
MedianIGF-1(ng/mL)
0 3 6 9 12 15 18
0
500
1000
1500
IGFBP3
Months
P values for all time points 6 w to 12 mo,
p<0.001
Values for healthy European children range
from 54-170 ng/mL
P values for all time points 6 w to 18 mo,
p<0.001
stunted stunted
16. Development of the WASH Intervention
(Efficacy = “Proof of concept”)
WASH Goal:
All infants never ingest any faeces between birth
to 18 months
17. Conventional WASH formative research
(2008-2009)
Sanitation HIGHLY
valued don’t have a
latrine because lack
money; a Blair VIP is a
source of status
• Infant stools less offensive than adults’
• Handwashing is seldom with soap
• Frequently feed cold leftover food
18. • 6 hour observation of 20 babies, recorded what and how
often went in the mouth and if visibly dirty
• Returned and collected samples of most frequent and
dirtiest things mouthed for micro analysis
Baby Observation Study (2011)
20. If allowed, toddlers consume
poultry feces
Peruvian shantytown families:
– Households who owned free-range poultry:
• Average ingestion of poultry feces by toddlers per
12-hour observation period was 3.9 times
– Marquis GM et al., Am J Public Health 1990
Rural Zimbabwe:
– Not selected for poultry ownership:
• 3 of 7 toddlers directly ate chicken feces during a
6-hour observation period.
– Ngure F et al., submitted, 2012
21. % HH with E
coli + sample
E coil/
Per gram
Average E Coli
Per Day
Infant Food 0% 0 0
Drinking Water
54% 2 800
Soil in
laundry area
60-80% 70 1,400
Chicken feces
100% 10,000,000 10,000,000
Clearly, kids must stop eating dirt and chicken poop!
22. 24
Babies are fed on
*Ground in the yard
(60-80% E coli+) or
*Kitchen floor
(81% E coli+)
23. Source: World Bank, accessed 6.23.11
http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTWAT/EXTTOPSANHYG/
25. A new way of thinking about WASH in the first 1000 days
• Protective play space, to protect developing child from
contaminated soil and animal feces (especially chickens)
• Infant handwashing with soap, when outside of protective
play space.
• Caregiver handwashing with soap after fecal contact and
before preparing/serving food
• Safe disposal of feces—especially of children
• Water treatment
• Avoid feeding leftovers, or reheat
27. Objective
To measure the independent and combined effects of
WASH and infant nutrition on stunting and anemia
among children from birth to 18 months of age
And, on a sample of 1600 infants, measure the
hypothesized “causal pathway” of EE
1000 HIV- mothers
600 HIV+ mothers
28. Protective play space
Goal: Culturally-acceptable, economical product that could be
locally fabricated, which protects babies and toddlers from
ingesting soil while allowing physical and cognitive
development
Engaged a marketing expert (Malinda Sanna, Spark) for
consumer research
Design process led by team from Cornell’s Department of
Design and Environmental Analysis and Human Development
30. SHINE Investigators:
MoHCW
Goldberg Mangwadu – Director of Environmental Health, MoHCW (Co-PI)
Cynthia Chasokela – Director of Nursing
Zvitambo
Jean Humphrey (Co-PI) Mduduzi Mbuya,
Naume Tavengwa, Kuda Mutasa, Robert Ntozini
Johns Hopkins Bloomberg School of Public Health
Larry Moulton, Jim Tielsch (J Humphrey)
Cornell
Rebecca Stoltzfus
University of London
Andrew Prendergast
University of British Columbia
Amee Manges
Funding
Gates, DFID, CIDA,
NIH,
Wellcome Trust,
UNICEF
31.
32. Zimbabwe SHINES
Zimbabwe Sanitation Hygiene Infant Nutrition
Efficacy Study
Observation: babies with healthier guts and less inflammation grow better.
Biological hypothesis: babies who are protected from fecal ingestion will
grow better.
Randomized trial hypotheses: babies whose households receive a
comprehensive Water Sanitation & Hygiene (WASH) intervention will grow
better.
WASH
Intervention
Reduced
fecal
ingestion
Better
Growth
San & Hyg
Behaviors
Healthier Gut
& Less
Inflammation
WASH + Nutrition will have more benefit than either alone.
34. Standard Care
1. Revived VHW network
2. Strengthened PMTCT care
3. EBF Promotion
4. Latrine at end of study
Infant Nutrition
1. Standard care
2. Promote optimal use of local foods
for complementary feeding
3. 20 g Nutributter daily provided for
infants (6-18 mo)
Sanitation/Hygiene
1. Standard care
2. VIP latrine
3. 2 Tippy Taps and soap
4. Water Guard
5. Protected play area
6. Promote safe feces disposal hand
washing, water Rx, hygienic infant
feeding
Infant Nutrition &
Sanitation/Hygiene
1. Standard care
2. All Nutrition interventions
3. All Sanitation/Hygiene interventions
35. Implementation
• Enroll 4,800 pregnant women at 10-12
weeks gestation and follow them until their
babies are 18 months old.
• Interventions delivered by 360 Village
Health Workers on bicycle and Oxfam
• Outcomes measured by 34 Research
Nurses on motorbike
36. Outcomes
• Among all 4800 infants assess growth,
anemia, intervention uptake, relevant
behaviors
• Among 1600 infants, assess causal
pathway (indicators of EE) at 3, 6, 12,
18 months
39. Results: IO phase summary
• Barely no HW for infants:
21 times (in 13/23 HH) in 130 hours
HWWS 6/21: all as part of a bath.
• Adult caregivers’ HWWS after contact with stool-
7.5 % (4 HWWS/53 opportunities)
• 9/23 (39 %) infants took:
3 infants- active soil ingestion
2 took chicken feces
4 took stones from the dirt
40. Results: Micro phase summary
A one year old ingesting chicken feces, soil and
400 ml of contaminated water:
On average 10 million E. coli counts/g of
Chicken feces
Frequency of E. coli: 22/22 HH (100 %)
69 E. coli counts/g of wet shaded area soil:
Frequency: 18/22 HH (82 %)
800 E. coli counts from water.
Frequency: 12/ 22 HH (55 %)
Other bacteria population
41. Key messages
• Chicken feces and soil ingestion are
predominant pathways
• Exploratory soil ingestion and geophagia could
be more prevalent in rural Zimbabwe than
observed for 23 HH - 2 FGDs indicated this.
• Water contamination is significant.
• Infants HW barely practiced.
42. Key messages
• Caregiver’s HWWS after fecal contact is not
common.
• WASH interventions need to focus more on
protecting infants from eating earth and chicken
feces
• The idea of a washable mat or playing pen as
a WASH intervention input
43.
44. IYCF Intervention
Promote optimal use of locally available foods,
responsive feeding, nutrient density, feeding during
illness
Provide 20 g/d Nutributter 6-
18 mo
46. Village Health Worker Revitalization
Full complement recruited, trained (8 months) Provide
tools (bike, kit, uniforms)
47. Campaign to promote Exclusive
breastfeeding for all to 6 months
1. Health worker
training
2. Social marketing
48. Implement WHO 2010 Prevention of Mother to Child
Transmission of HIV and Infant Feeding Guidance
49. EE is caused by environmental exposure
• Fetuses and newborns do not have it
• People acquire it moving into developing country
and lose it moving out
• Widely believed:
Result of high exposure to fecal contamination in
an environment of poor sanitation and hygiene
50. • EE is a major cause of child stunting
• EE can be prevented or reduced by
preventing infants and young children from
ingesting human and animal feces through a
package of interventions that improve
sanitation and hygiene.
Environmental Enteropathy and
Stunting Hypothesis:
51. Fecal contaminationEnvironment
Altered bacterial load, composition
and/or timing of colonisation
Intestinal inflammation and reduced
surface area
Increased intestinal permeability
Microbial translocation
Microbiome
Intestinal
pathology
Microbial translocation
StuntingAnemia
Activates innate
immune system
proinflammatory
cytokines
Immune
activation
Activates adaptive
immune system
Immunosenescence
Impaired responses
to vaccinations and
infections
IGF-1 Hepcidin Erythropoiesis
Iron absorption and
mobilization
52. IGF-1
• 70 amino acid polypeptide
• Mostly produced by liver
• Mediates the effects of growth hormone
• Important in fetal and postnatal growth
• Endocrine function (paracrine, autocrine)
• Highly protein bound
– 6 binding proteins
– Mostly IGFBP3
– Acid labile subunit
53. Inflammatory markers were higher in stunted infants
P values for all time points 6 w to 12 mo,
p<0.001
0 3 6 9 12 15 18
5.0
5.5
6.0
6.5
7.0
7.5
8.0
LnCRP
Months
0 3 6 9 12 15 18
0
5
10
15
20
Age
IL-6
0 3 6 9 12 15 18
11
12
13
14
15
Months
LnAGP
0 3 6 9 12 15 18
0
1×1006
2×1006
Months
sCD14
P values from
multivariate models
that included
maternal education,
MUAC, sex, birth
weight, and mixed
feeding.
P=0.007 P=0.064
NSP=0.023
stunted
55. Intestinal Fatty Acid Binding Protein (I-FABP)
• Very small (15kD) cytoplasmic protein
• Found in enterocytes
• Involved in intracellular transport of LCFA
• Rapidly released into blood after cellular damage
• Predominantly expressed in cells at tips of villi in
small intestine
• Elevated in celiac disease compared to healthy
contols
Derikx JP, J Clin Gastroenterol 2009
56. High I-FABP levels in stunted and non-
stunted Zimbabwean infants
Non stunted Stunted
0
2000
4000
6000
8000
I-FABP(pg/mL)
Non stunted Stunted
0
2000
4000
6000
8000
I-FABP(pg/mL)
6 months 12 months
Median 859 Median 978 Median 1148Median 1070
Healthy controls 172.7 pg/mL (±20.2) – mean age 22 yrs (range 1-61 yrs)
Coeliac disease Median 784.7 pg/ml (±145.5)
Advanced HIV (adults) 174.4 pg/mL
P=0.36 P=0.13
57. I-FABP was higher in stunted infants
0 3 6 9 12 15 18
0
1×1006
2×1006
Months
I-FABP
stunted
P value from
multivariate model
that included
maternal education,
MUAC, sex, birth
weight, and mixed
feeding.
P=0.030
58. Summary
• Growth hormone axis is perturbed very early in life in
apparently healthy Zimbabwean infants with poor
linear growth.
• Small intestinal damage and low-grade inflammation
are evident post-natally and associated with stunting
by 18 mo of age
• Diarrhea (measured by clinic visits) was not
associated with stunting.
• Circulating levels of pro-inflammatory mediators and
IGF-1 in mother-infant dyad at birth are associated
with in utero growth.
59. Zimbabwe SHINES
Zimbabwe Sanitation Hygiene Infant Nutrition
Efficacy Study
Observation: babies with healthier guts and less inflammation grow better.
Biological hypothesis: babies who are protected from fecal ingestion will
grow better.
Randomized trial hypothesis: babies whose households receive a
comprehensive Water Sanitation & Hygiene (WASH) intervention will grow
better.
WASH
Intervention
Reduced
fecal
ingestion
Better
Growth
San & Hyg
Behaviors
Healthier Gut
& Less
Inflammation
Editor's Notes
8 items in index: mother’s hands, child’s hands, compound cleanliness, yard swept, garbage observed, indoor cleanliness, floor swept, dirty clothes. Kronbach’sα = 0.77.Regression on HAZ adjusted for WHO IYCF indicators, SES, sanitation, water, child age & sex, size at birth, morbidity, food security, maternal height & age, region.
Cases and controls were selected based on anthropometric indices at 18 mo of age. Eligible infants were born to mothers who tested HIV-negative throughout follow-up, for whom anthropometric data and archived plasma of sufficient volume (>0.2 mL) at >3 time-points were available. Of 14110 enrolled women, 9209 tested HIV-negative at baseline and remained uninfected throughout follow-up. From the 9209 infants born to these women, xxx stunted and 101 non-stunted infants fulfilled our selection criteria at 18 mo. To maximize our sample size, we used all 101 controls, and randomly selected 101 cases from the stunted group. Plasma samples were available for all children at 18 mo, and for x%, x%, x%, x% and x% at birth, 6 w and 3, 6, 12 mo, respectively. Bernard/Robert, could you add data in green highlighted sections?
1 year old baby estimates
Wet areas within reach of a crawling baby and most HH with rubbish pits at the edge of the kitchen yard.
A child ingesting 1 g of chicken feces, I g of laundry area soil and 400 ml of contaminated water