Infant feeding

Background. Estimates of US childhood asthma prevalence were affected by the 1997 National Health Interview Survey (NHIS) redesign. In 1997, only 5.5% of children were estimated to have asthma compared with 7.5% in 1995. The contribution of the survey redesign to this reported decline is unknown. Objective. To examine the impact of the NHIS 1997 redesign on childhood asthma prevalence estimates. Methods. In 1988, 50% of children from the core NHIS participated in a Child Health Supplement (CHS). The CHS questions differ from those in the core NHIS and are similar to the new asthma questions used in the 1997 NHIS. First, childhood asthma prevalence estimates from the 1988 core NHIS and the CHS were directly compared. A second comparison was limited to the sample participating in both the core NHIS and the CHS. For this sample, the percent difference between core NHIS and CHS estimates was calculated for 6 race/age strata (black and white, ages 0-4, 5-10, and 11-17 years). The 1997 estimates for each stratum were adjusted by these differences, and a new adjusted 1997 estimate was produced using the 1997 population distribution for each stratum. Results. The first method resulted in an 18.6% difference between asthma prevalence estimates from the 1988 core NHIS and CHS (5.1% vs. 4.3%). Simply inflating the 1997 asthma prevalence estimate of 5.5% by 18.6% yielded an adjusted estimate of 6.5%. The second stratification method produced an adjusted 1997 asthma prevalence estimate of 7.3%. Conclusion. The redesigned NHIS likely produces lower asthma prevalence estimates than the previous NHIS. Adjusting the 1997 estimate to compensate for the redesign suggests that childhood asthma prevalence has plateaued since 1995, not declined.

Infant feeding problems are extremely common during breastfeeding establishment. To objectively assess infant sucking, consistent methods to analyze ultrasound images of the infant's oral cavity are required. We developed and assessed the reliability of an extensive ultrasound measurement protocol by measuring nipple diameter and placement. Midline submental ultrasound scans of 30 term breastfed infants were analyzed by two raters. Nipple diameter, nipple hard-soft palate junction distance and tongue hard-soft palate junction distance were measured on two frames: tongue-up and tongue-down. No evidence of measurement bias was found between raters and inter-rater agreement and consistency scores were high. The changes in nipple diameter and placement were consistent with previous descriptions; however, the diameter of the nipple was not consistent in either position. This method provides objective measurements representative of tongue movement, and further investigation is required to ensure usefulness when examining sucking difficulties. (

Aim. This study had two main objectives: (1) to describe the experiences of parents who had a child in the Flinders Medical Centre neonatal unit with a feeding difficulty at 36 weeks gestational age and (2) to develop a preliminary model from the data as an account of the parents' experiences to identify considerations for future and current neonatal unit staff. Background. Family centred care is an important part of nursing practice. Research looking individually at the neonatal unit experience and childhood feeding difficulties has found that they can be stressful situations for parents. However, very little research has been conducted into parental experiences of feeding infants in a neonatal unit and there is no known research which has specifically looked at the effect on parents of having a child with a feeding difficulty in a neonatal unit. Design. A qualitative phenomenological research design was employed. Method. Nine parents whose children had feeding difficulties while in the Flinders Medical Centre neonatal unit, South Australia, participated via retrospective in-depth interviews. Results. Responses were coded to describe parents' experiences and a preliminary model was proposed to explain the data. The main theme linking parental experiences was the desire to take the baby home. The feeding difficulty prevented this from occurring, shifting the feeding interaction from one of relationship development to one of weight gain. Conclusion. This research identifies trigger points that may be acted on to encourage positive parent-child feeding interactions. Relevance to clinical practice. Family centred care is encouraged in paediatric nursing practice. This research identifies trigger points which may inform clinical practice involving parents of infants with feeding difficulties.

Human milk provides infants with antimicrobial, anti-inflammatory, and immunomodulatory agents that contribute to optimal immune system function. The act of breastfeeding allows important bacterial and hormonal interactions between the mother and baby and impacts the mouth, tongue, swallow, and eustachian tubes. Previous meta-analyses have shown that lack of breastfeeding and less intensive patterns of breastfeeding are associated with increased risk of acute otitis media, one of the most common infections of childhood. A review of epidemiologic studies indicates that the introduction of infant formula in the first 6 months of life is associated with increased incidence of acute otitis media in early-childhood. More recent research raises the issues of how long this increased risk persists, and whether lack of breastfeeding is associated with diagnosis of otitis media with effusion. However, many studies suffer from lack of study of younger populations and imprecise definitions of i...

Little is known about premature infants' feeding skill development and the contribution to it of biologic and environmental conditions. Aims: Explore the level and variation in feeding skill performance through the first post-term year and examine the contribution to performance of infant neonatal condition and rate of weight gain per day, maternal feeding behavior, and its interaction with neonatal condition.

Formula-fed infants have depressed plasma tryptophan concentration relative to human milk-fed infants. Because tryptophan alters sleepwaking patterns in adults, a study was designed to de termine whether additional dietary tryptophan could elevate plasma tryptophan concentrations of formula-fed infants to concentrations characteristic of human milk feeding and whether differences in plasma tryptophan or the ratio of plasma tryptophan to the sum of the other plasma large neutral amino acids (tryptophan:LNAA) were of behavioral significance. Infants were fed a formula (13 g protein/L; wheyxasein, 34:66) containing either 0, 294, 588 or 882 umol/L of added tryptophan. Infants fed human milk or commercial formula (15 g protein/L; wheyxasein, 18:82) were included for com parison. In formula-fed groups, plasma tryptophan was directly related to tryptophan intake (r = 0.46, P < 0.0005). Infants fed commercial formula or the formula without added tryptophan had lower (P < 0.001) plasma tryptophan compared with infants fed human milk. Only the infants fed the highest tryptophan formula had sig nificantly higher plasma tryptophaniLNAA ratios than the other experimental groups, and these ratios were similar to those of infants fed human milk. The plasma tryptophan:LNAA ratios, not plasma tryptophan concen trations, were predictive of differences in the infants' sleep latency; infants fed formula containing the highest tryptophan had sleep latencies of 18.7 min, significantly shorter (P < 0.05) than those of infants fed formulas containing less added tryptophan (27.7 min). Feeding infants formulas differing in tryptophan concentration produced differences in sleep latency, which could in fluence neurobehavioral development. This result was obtained with variations in the level of tryptophan within the range found in commercially available formulas.

Background Exclusive breastfeeding, though better than other forms of infant feeding and associated with improved child survival, is uncommon. We assessed the HIV-1 transmission risks and survival associated with exclusive breastfeeding and other types of infant feeding.

The WHO (2001) recommends exclusive breast-feeding and delaying the introduction of solid foods to an infant's diet until 6 months postpartum. However, in many countries, this recommendation is followed by few mothers, and earlier weaning onto solids is a commonly reported global practice. Therefore, this prospective, observational study aimed to assess compliance with the WHO recommendation and examine weaning practices, including the timing of weaning of infants, and to investigate the factors that predict weaning at ≤ 12 weeks. From an initial sample of 539 pregnant women recruited from the Coombe Women and Infants University Hospital, Dublin, 401 eligible mothers were followed up at 6 weeks and 6 months postpartum. Quantitative data were obtained on mothers' weaning practices using semi-structured questionnaires and a short dietary history of the infant's usual diet at 6 months. Only one mother (0.2%) complied with the WHO recommendation to exclusively breastfeed up to 6 months. Ninety-one (22.6%) infants were prematurely weaned onto solids at ≤ 12 weeks with predictive factors after adjustment, including mothers' antenatal reporting that infants should be weaned onto solids at ≤ 12 weeks, formula feeding at 12 weeks and mothers' reporting of the maternal grandmother as the principal source of advice on infant feeding. Mothers who weaned their infants at ≤ 12 weeks were more likely to engage in other sub-optimal weaning practices, including the addition of non-recommended condiments to their infants' foods. Provision of professional advice and exploring antenatal maternal misperceptions are potential areas for targeted interventions to improve compliance with the recommended weaning practices.

The way mothers feed their babies is, internationally, the subject of research, health policy initiatives, and popular discussion, which commonly affirm the mantra 'breast is best'. On one level, this mantra reflects scientific evidence about nutrition and maternal and infant health. From a socio-cultural perspective, the pro-breastfeeding message has, however, been considered an aspect of morality, which influences maternal identity in important ways. This article explores this idea. It does so primarily by reporting and discussing some findings from a study about British mothers' experiences of using formula milk for infant feeding. The paper begins by contextualising this discussion by briefly outlining some aspects of the construction of infant feeding as a social problem in Britain, focusing in particular on the influence of 'the new paradigm of health'.

Aim: To assess knowledge, infant-feeding education and practices, factors that affect choice of infant feeding option, determinants of mixed feeding, psychosocial challenges and attitudes of HIV-positive women with infants between ages 3-6 months who attended prevention of mother-to-child transmission of HIV services in Gert Sibande district.

Health visitors play a crucial role in supporting mothers who choose to breastfeed and their families. This accessible text enables readers to practise confidently in this vital area, focusing on underpinning knowledge and parent-centred counselling skills, and understanding cultural contexts.

Breastfeeding a child improves the lifelong health of a population, and promoting breastfeeding is an important area of public health practice. Breastfeeding for Public Health incorporates the voices of health visitors, mothers and fathers to give insight into common practical challenges faced and suggestions for overcoming or working around them. Presenting up-to-date research, it explores the practical skills needed by health visitors to support mothers with breastfeeding; how to develop the communication skills and self-awareness necessary to build successful and trusting relationships with women and their families; why breastfeeding is so important for babies' and mothers' health and psychological attachment, closeness and long-term mental health; what we know about the content of breastmilk and the positive effect it has on the baby’s gut microbiome, which in turn benefits the infant’s long-term health and helps to protect against non-communicable diseases; the role of the father and grandparents in successfully initiating and sustaining breastfeeding; and how cultural awareness and sensitivity can influence practice for the better.

Accurate measurement of the duration of exclusive breastfeeding is complicated by factors related to definitions, timing, duration of recall, methods of analysis, and sample biases. Clearly prospective methods are likely to be more accurate but are too expensive to use in most large-scale surveys. Internationally, most surveys use a point-in-time or current status measurement (usually 24-hour recall) and report their findings using an indicator established by the World Health Organisation (WHO) in 1991 that involves combining all babies less than six months old in order to obtain a large enough sample size to result in stable proportions that can be compared over time. However, this indicator is complex to understand and explain and is widely misunderstood, even within the breastfeeding community. It is commonly cited in ways that greatly exaggerate how common exclusive breastfeeding actually is.

Discussion
A life-long or since birth indicator, introduced in 2000, counts infants as no longer exclusively breastfed as soon as anything else is fed to them. This is appropriate to do if for example data are being used to link infant feeding patterns with vertical transmission of HIV or later patterns of infant allergy. However, this indicator underestimates the total extent of exclusive breastfeeding, since some women interrupt but then resume it after a period of supplementation (which could for example only be a small amount of water given a single time).

Summary
Exactly which indicator is best to use depends on the purpose for which the data are being used. However, for surveys, the best approach, rarely used, would be to report indicators based on both point-in-time and life-long data.

A shelf-life model based on the storage temperature was developed for a homogenized fruit-based baby food. Bottles of apple compote for infant feeding were collected from a food company and stored at three different temperatures (23, 30 and 37 C) during 420 days. CIELAB color space parameters, vitamin C, 5-hydroxymethylfurfural were measured and sensory analysis (sensory attributes and overall acceptability) was carried out during the length of the study. Weibull Hazard Method was utilized to set the shelf-life end-point of the product at 37 C according to overall acceptability score given by the sensory panel. Considering a 50% probability of panellists to find the product as being unacceptable, the end of shelf-life for the apple-based beikost stored at 37 C was achieved after 346 days. The statistical analysis of the data enabled us to select the most adequate zero-and first-order kinetic equations for both physicochemical and sensory attributes in samples stored at 37 C. Color CIELAB parameters, vitamin C and sensory attributes (color and taste) were selected as the critical parameters. Their rejection times at 23 and 30 C storage temperatures were obtained by extrapolation of the results given by Weibull method at 37 C. Finally, rejection times for critical parameters were used to propose a shelf-life equation that showed 4.5 and 3.4 years of shelf-life when stored at 20 and 23 C, respectively.

Research tools that are comparable across ethnic groups are needed in order to understand sociodemographic disparities in breastfeeding rates. The Infant Feeding Intentions (IFI) scale provides a quantitative measure of maternal breastfeeding intentions. IFI score ranges from 0 (no intention to breastfeed) to 16 (very strong intentions to fully breastfeed for 6 months). The objective of this study was to examine intra-and inter-ethnic validity of the IFI scale. The IFI scale was administered to 218 white non-Hispanic, 75 African-American, 80 English-speaking Hispanic, 62 Spanish-speaking Hispanic and 64 Asian expectant primiparae. Participants were asked their planned duration of providing breast milk as the sole source of milk (full breastfeeding). The IFI scale was examined for intra-ethnic internal consistency and construct validity and for inter-ethnic comparability. For all five ethnic categories, principal component analysis separated the scale into the same two factors: intention to initiate breastfeeding and intention to continue full breastfeeding. Across ethnic categories, the range in Cronbach's alpha was 0.70-0.85 for the initiation factor and 0.90-0.93 for the continuation factor.Within each ethnic category, IFI score increased as planned duration of full breastfeeding increased (P < 0.0001 for all). Within the planned duration categories of <1, 1-3, 3-6 and Ն6 months, the median IFI score by ethnic category ranged from (low-high) 5-8, 9-10, 12-14 and 16-16, respectively. The IFI scale provides a valid measure of breastfeeding intentions in diverse populations of English-and Spanish-speaking primiparae, and may be a useful tool when researching disparities in breastfeeding practices.

This paper describes a methodology to design feasible interventions to improve weaning food hygiene practices of families living in extreme poverty. Educational messages to promote specific behavioural changes were defined and tested by utilizing a combination of ethnographic, survey and observational methods, and integrating viewpoints and suggestions of mothers and caretakers into the decision-making process. This new approach culminated in a household trial in which five groups, each of 15 non-practising mothers, were invited to adopt defined behaviours (handwashing before and after defined events, boiling water for reconstituting powdered milk, feeding gruel by spoon rather than bottlefeeding, not storing gruels and milks, and all four together). All initiated the advocated behaviours and most (53-80%) sustained the new behaviours and practised them every time during a one-month period. Of the four advocated behaviours, spoon-feeding was the most difficult to adopt wholly. The methodology was developed in response to the high priority given to reducing weaning food contamination for diarrhoeal disease control, and the lack of any existing methodology for defining appropriate educational interventions in resource-poor regions. This approach, with its combination of qualitative and quantitative methods and community focus, is recommended for future studies to design hygiene and other health education interventions in developing countries. © 1997 Elsevier Science Ltd

When a new baby arrives among the Beng people of West Africa, they see it not as being born, but as being reincarnated after a rich life in a previous world. Far from being a tabula rasa, a Beng infant is thought to begin its life filled with spiritual knowledge. But how do these beliefs affect the ways the Beng raise their children?
In this unique and engaging ethnography of babies, Alma Gottlieb explores how Beng religious ideology affects every aspect of their childrearing practices, from bathing infants to protecting them from disease to teaching them how to crawl and walk. She shows too how widespread poverty among the Beng sets practical limits on these practices. A mother of two, Gottlieb includes moving discussions of how her experiences among the Beng changed the way she saw her own parenting. Throughout the book she also draws telling comparisons between Beng and Euro-American parenting, bringing home just how deeply culture matters to the ways we all raise our children.
Anyone interested in the culture of infancy, and vice versa, will enjoy The Afterlife Is Where We Come From.

Baby-led weaning (BLW) is an approach to the introduction of solid foods that, while not new, has gained rapidly in popularity since it was given this name. While there is, thus far, little direct evidence to justify it, there exists a range of research that provides support for the principles that underpin it, namely the developmental readiness of infants to feed themselves using their hands and their innate ability to respond appropriately to both appetite and satiety. In its practical application BLW is in line with current recommendations and there is tentative evidence that suggests it may lead to positive health outcomes. It is therefore something that health visitors should be prepared to discuss with parents.

Aim: To assess the clinical and cost-effectiveness of different methods of cleaning and sterilisation of infant feeding equipment used in the home. Design: Systematic review of studies from developed countries on the effectiveness of methods of cleaning and sterilisation of infant feeding equipment used in the home. A brief telephone survey of UK-based manufacturers of infant feeding equipment and formula to ascertain the evidence base used for their recommendations, and a comparison of current relevant guidelines in developed countries, informed the work. Results: National guidelines from six countries demonstrated variation and lack of evidence to support current guidance. Manufacturers did not report evidence of effectiveness to support their recommendations. Nine studies were identified; eight conducted between 1962 and 1985 and one in 1997. All had methodological weaknesses. Hand-washing was identified as fundamentally important. Health professionals were reported as not providing appropriate education on the importance and methods of cleaning and sterilisation. Mothers of subsequent babies and women from lower socio-economic groups were less likely to follow recommended procedures. Conclusion: There is a lack of good-quality evidence on effective ways of cleaning and sterilising infant feeding equipment in the home. The evidence base does not answer the question about which of the methods in common use is most effective or most likely to be used by parents. Hand-washing before handling feeding equipment remains important. Further research on the range of methods used in the home environment, including assessment of the views of parents and carers, is required.

Pregnancy is considered a feminine experience in mainstream Canadian culture. Babies identified as female at birth are expected to grow up to become feminine heterosexual mothers. This research considers the desires, choices, and experiences of individuals who were identified as female at birth, but who do not identify as feminine heterosexual women; this dissertation focuses on the reproductive desires, choices, and experiences of butch lesbians, transmen, and genderqueer individuals in British Columbia. Three methods and two distinct populations formed this research. Participant observation was conducted in 21 cities across southern BC. Questionnaires were completed by 28 health care professionals (HCPs), and by 46 butch lesbian, transmen, and genderqueer (BTQ) individuals. Face-to-face interviews were conducted with 10 HCPs, 8 BTQ individuals who had experienced at least one successful pregnancy, and 4 BTQ individuals who had either experienced or been diagnosed with a condition linked to infertility. What I found, is that for many BTQ individuals, reproduction associated with the female body (ie: pregnancy and breastfeeding) is not exclusively considered a feminine desire or experience. In fact, what I discovered is that BTQ individuals who experience pregnancy and breastfeeding explicitly challenge the cultural fetish associating femininity with reproduction (including pregnancy, breastfeeding, mothering, and fertility). Thus, I highlight not only the typically ignored desire and achievement of pregnancy of BTQ individuals, but also how BTQ individuals have experienced breastfeeding, how some BTQ parents raise queerlings, and how some BTQ individuals have negotiated diagnoses and experiences of infertility. Overall, I highlight the unique and various expectations and experiences that butch lesbians, transmen, and genderqueer individuals have regarding their ‘female’ (and potential) biological reproduction. In the end, I hope that by presenting the diverse reproductive experiences, desires, and choices of BTQ individuals, that I can foster more of an understanding of these experiences, desires, choices, and individuals, and thus challenge the cultural fetish that links femininity with ‘female’-associated reproduction. Moreover, I offer recommendations for health care professionals in an effort to foster more understanding in BTQ health care, as well as help to facilitate more queer competent health care professionals.

This paper investigates what substitutes for maternal milk existed for Roman infants whose mothers were not able or not willing to breastfeed. It examines the potential reasons why a mother could or would not breastfeed or why an infant could not suckle, and the various attested or hypothetical alternatives to maternal milk about which literary and archaeological sources as well as anthropological, sociological and practical considerations inform us, from wet nurses to animal milk, from a bottle or from the udder, to allomaternal nursing

Research overwhelmingly suggests that breast milk is the most beneficial nutritional source for infants. How can midwives balance the need to uphold women's choices whilst promoting breastfeeding as the gold standard of infant feeding? Here, the institutional and individual factors surrounding infant feeding are analysed and discussed.

Background. Estimates of US childhood asthma prevalence were affected by the 1997 National Health Interview Survey (NHIS) redesign. In 1997, only 5.5% of children were estimated to have asthma compared with 7.5% in 1995. The contribution of the survey redesign to this reported decline is unknown. Objective. To examine the impact of the NHIS 1997 redesign on childhood asthma prevalence estimates. Methods. In 1988, 50% of children from the core NHIS participated in a Child Health Supplement (CHS). The CHS questions differ from those in the core NHIS and are similar to the new asthma questions used in the 1997 NHIS. First, childhood asthma prevalence estimates from the 1988 core NHIS and the CHS were directly compared. A second comparison was limited to the sample participating in both the core NHIS and the CHS. For this sample, the percent difference between core NHIS and CHS estimates was calculated for 6 race/age strata (black and white, ages 0-4, 5-10, and 11-17 years). The 1997 estimates for each stratum were adjusted by these differences, and a new adjusted 1997 estimate was produced using the 1997 population distribution for each stratum. Results. The first method resulted in an 18.6% difference between asthma prevalence estimates from the 1988 core NHIS and CHS (5.1% vs. 4.3%). Simply inflating the 1997 asthma prevalence estimate of 5.5% by 18.6% yielded an adjusted estimate of 6.5%. The second stratification method produced an adjusted 1997 asthma prevalence estimate of 7.3%. Conclusion. The redesigned NHIS likely produces lower asthma prevalence estimates than the previous NHIS. Adjusting the 1997 estimate to compensate for the redesign suggests that childhood asthma prevalence has plateaued since 1995, not declined.

Clinicians, public health advisors, nutritionists and others have been attempting to increase breastfeeding rates for the last few decades, with varying degrees of success. We need social science researchers to help us understand the role of infant feeding in the family. Some researchers in the area of food and nutrition have found Pierre Bourdieu's theoretical framework helpful. In this editorial, I introduce some of Bourdieu's ideas and suggest researchers interested in infant feeding should consider testing these theories.

This paper describes qualitative and quantitative aspects of testing a 34-item Toddler-Feeding Questionnaire (TFQ), designed for use in Latino families, and the associations between feeding practices and toddler dietary outcomes. Qualitative methods included review by an expert panel for content validity and cognitive testing of the tool to assess face validity. Quantitative analyses included use of exploratory factor analysis for construct validity; Pearson's correlations for test-retest reliability; Cronbach's alpha (a) for internal reliability; and multivariate regression for investigating relationships between feeding practices and toddler diet and anthropometry. Interviews were conducted using a convenience sample of 94 Latino mother and toddler dyads obtained largely through the Supplemental Nutrition Program for Women, Infants and Children (WIC). Data collection included household characteristics, self-reported early-infant feeding practices, the toddler's dietary intake, and anthropometric measurements. Factor analysis suggests the TFQ contains three subscales: indulgent; authoritative; and environmental influences. The TFQ demonstrated acceptable reliability for most measures. As hypothesized, indulgent practices in Latino toddlers were associated with increased energy consumption and higher intakes of total fat, saturated fat, and sweetened beverages. This tool may be useful in future research exploring the relationship of toddler feeding practices to nutritional outcomes in Latino families.

This paper reports on current initiation and prevalence rates, in Western Australia, differentiating 'any' breastfeeding with 'exclusive' breastfeeding whilst exploring patterns and reasons for stopping breastfeeding. The results presented are part of a larger study examining women's perceptions of care and wellbeing in the early postnatal period. A cross sectional survey was used to examine infant feeding practices during the hospital stay and at 9 weeks post birth from Western Australian women with a registered live birth between February and June 2006. Data obtained from 2,669 women revealed a 93% (n = 2,472) initiation rate of any breastfeeding. More multiparous women (73.5%) were exclusively breastfeeding in hospital compared to primiparous women (65.2%), which decreased to 57.1 and 49.2%, respectively at 9 weeks. Of those who had ceased by 9 weeks, more multiparous women (71.1%) ceased before 3 weeks. Reasons cited for ceasing in order of frequency were insufficient milk supply, infant related reasons, pain and discomfort and emotional reasons. Younger maternal age, primiparous women, lower maternal education levels, offering a combination of breast milk and formula in hospital and caesarean birth were significant independent predictors of early cessation. Although initiation rates including ''any'' breast milk are meeting NHMRC dietary guidelines of 90%, the 60% target of exclusive breastfeeding is not being achieved for 3 months or in fact at 9 weeks. Targeted support for at risk groups such as younger, less well-educated, primiparous women must continue. Evidence based policies to protect breastfeeding must address the practice of offering formula to breastfed infants in hospital and the impact of increasing interventions such as caesarean births.

Many new mothers discontinue breastfeeding prematurely due to difficulties encountered rather than maternal choice. Research has shown that a significant predictor of breastfeeding duration is maternal confidence. Using self-efficacy theory as a conceptual framework to measure breastfeeding confidence, the Breastfeeding Self-Efficacy Scale (BSES) was developed and psychometrically tested among English-speaking mothers. The purpose of this methodological study was to translate the BSES into Spanish and determine the psychometric characteristics of the BSES in a sample of 100 Puerto Rican women. The psychometric assessment of the original study was replicated including internal consistency, principal components factor analysis, and comparison between contrasted groups. This study is the first to examine the psychometric characteristics of the Spanish-version BSES administered in-hospital and provide further evidence of the reliability and validity of the instrument. J Hum Lact. 19(1):35-42.

Objectives: To study the nutritional status of under-five children and to assess whether infant feeding practices are associated with the undernutrition in anganwari (AW) areas of urban Allahabad.Methods: Under-five-years children and their mothers in selected four anganwari areas of urban Allahbad (UP) participated in the study. Nutritional assessment by WHO criterion (SD- classification) using summary indices of nutritional status: weight-for-age, height-for-age and weight-for-height was done. Normal test of proportions, Chi-square test for testing association of nutritional status with different characteristics and risk analysis using odds ratios with 95% confidence intervals was also done.Results: Among all under five children surveyed, 36.4% underweight (<2SD weight- for-age), 51.6% stunted (<2SD height- for-age), and 10.6% wasted (<2SD weight- for-height). Proportions of underweight (45.5%) and stunting (81.8%) were found maximum among children aged 13–24 months. Wasting was most prevalent (18.2%) among children aged 37–48 months. Initiation of breast-feeding after six hours of birth, deprivation from colostrum and improper complementary feeding were found significant (P<0.05) risk factors for underweight. Wasting was not significantly associated (P>0.10) with any infant feeding practice studied. ICDS benefits received by children failed to improve the nutritional status of children.Conclusion: Delayed initiation of breast-feeding, deprivation from colostrum, and improper weaning are significant risk factors for undernutrition among under-fives. There is need for promotion and protection of optimal infant feeding practices for improving nutritional status of children.

Background: A proper infant-feeding practice is essential for child's survival, growth and development. Nearly half of all deaths in under-5 children are attributable to improper nutrition, which translates into unnecessary loss of 3 million young lives a year. The prevalence of malnutrition among children in India is among the highest in the world and the most common reason for malnutrition is improper feeding practices.