No description available.

No description available.

Complementary feeding is the process of adding additional foods and nutrients to an infant’s milk diet. Advice about the when, the what and the how of introducing complementary foods to infants, varies across European countries, and very little is known about its actual practice. Therefore, the main aim of this thesis was to explore the introduction of complementary foods in two European countries - Italy and the UK - with very different attitudes towards foods, as well as different health care systems. Twenty-three families in Portsmouth, UK, and 23 families in Rome, Italy were visited on three occasions: Visit 1, before the onset of complementary feeding, Visit 2, one week after the introduction of complementary foods and, Visit 3, at 7 months of infant age. Mothers were interviewed about their perceptions and experiences at each visit, and feeding was video-taped at Visits 2 and 3. The feeding process was analysed in terms of maternal feeding style, infant responses and willingness to eat, and mother-infant synchrony. Thematic analysis was conducted on the maternal interviews at Visit 3. Although they were given different advice by health professionals, British and Italian mothers introduced complementary foods at a similar range of infant ages. The age of onset of complementary feeding (early or late) did not influence the willingness of the infant to eat. Both British and Italian infants were introduced to healthy foods (i.e., fruit and vegetables) from the onset of complementary feeding. Contrary to general advice about how to feed infants, interacting with the infant and using distractions during feeding had no implications for infant willingness to eat. Positive child eating habits may be based on a foundation of maternal sensitivity to infant interests and on the creation of dialogue within feeding.

Background In April 2004 Hull City Council introduced free healthy school meals for all primary and special school pupils (approximately 20,500 children from 71 primary schools and 6 special schools) in an attempt to reduce health and education inequalities. The meals were prepared to meet the Caroline Walker Trust (CWT) nutritional guidelines for primary schools. This study was carried out to assess the nutritional content of the meals and children’s actual intake from school dinners in comparison to children’s nutritional intake from packed lunches. The study then aimed to assess how food intake at lunch time impacted upon food consumed for the remainder of the day. Methods Children were recruited onto the study from two schools in Hull. The schools were selected by the number of pupils on roll and the number of children eligible for free school meals. The first phase of research assessing lunch consumption was conducted with 147 children, aged 8 – 11 years. School meals and packed lunches were weighed and photographed before and after consumption to assess actual intakes. The second phase assessed total daily food and nutrient intakes in a small sample of 20 children. All assessments were carried out over five consecutive days. Results The food provided by the schools for lunch met the majority of the CWT nutritional guidelines, however children’s intake did not. Children who ate a hot school dinner consumed only the foods they liked from the school meals provided leading to a low energy and nutrient intake. Large differences, for example 367kcal in comparison to 760kcal, in nutritional intakes were found between those children who ate a hot school dinner and those who ate a packed lunch. Children who consumed a packed lunch consumed significantly (p less than 0.05) more energy, fat, saturated fat, non-milk extrinsic (NME) sugar and sodium than children who ate a hot school dinner, but with this consumed more micronutrients. However, neither of the groups of children met the CWT guidelines for lunch time micronutrient intakes. The food diary analysis revealed that those children who ate a hot school dinner went on to consume food high in energy, fat, saturated fat, NME sugar and sodium later in the day. The significant differences in nutrient intakes between the hot dinner and packed lunch groups at lunch time disappeared when total daily intakes were compared. Differences were found between the children’s nutritional intake from the two schools, which may be due to socio economic factors. Conclusion The free healthy school dinners were not having the desired effect of improving children’s nutritional intake, children chose to eat the foods they liked and left the rest. Children who ate a free healthy school dinner went on to consume foods high in energy, fat, NME sugar and sodium later in the day and overall did not have a lower intake of these macronutrients than those children who had a packed lunch.

Background: This research aims to explore the recommendations of the 2013 Lancet Series on maternal and child nutrition in the case study of Yemen (2013-2014), by answering the question “What mix of public interventions works best in a given context to reduce child stunting prevalence?” Yemen was selected due to its Government commitment to use a multi-sectoral approach in its planning and financing cycle for nutrition. Method: The research applied a mixed method, starting with a literature review and a cross-country secondary-data analysis to produce evidence for composing a research framework for Yemen. Subsequently, a descriptive analysis, two types of regressions (Probit and Poisson) and an adapted ‘Delphi method’ for discussion with decision-makers from various sectors were carried out. Results: Based on the descriptive analysis, Yemen progressed in: maternal and child health care, drinking water supply and sanitation, girls’ education, delayed marriage and pregnancy. However, infant and young child feeding practices remained inadequate. Significant determinants of child stunting identified by the regressions included characteristics of: child (age, gender and diet diversity), mother (undernutrition, birth-spacing and head of family) and household (access to water and sanitation). Children of households that engaged in agriculture, livestock and fishing were the most likely to access diet diversity and animal-protein sources. Other significant determinants of child diet included maternal education, per capita expenditure, income-related shocks and ownership of a cooking stove and fridge. Results: from the adapted ‘Delphi-method’ discussion showed that decision-makers were ready to use multi-sectoral approaches to converge their existing interventions in the most vulnerable geographical areas. However, they were less keen to retarget beneficiaries based on age, gender or livelihoods. Conclusions The research demonstrates how the applied mixed method can provide a comprehensive way to examine child stunting as a multi-sectoral issue, rather than just considering it as a health problem.

Background: Appropriate child feeding prevents nutrient deficiencies, diseases, and deaths in children. However, only 13.3% of children aged 6-23 months in Ghana receive the minimum acceptable diet. Thus, undernutrition remains high in rural northern Ghana, especially among under-fives. This is showing no improvement despite economic development and implementation of globally recommended nutrition & feeding interventions. There is limited context specific evidence about child feeding in rural northern Ghana. Aim: To examine how culture might impact upon the feeding of children under five years of age in rural northern Ghana. Methods: A qualitative ethnographic study was completed between October 2014 and May 2015. Data were collected in a rural Ghanaian community via participant observation and sixty-one ethnographic interviews with mothers, fathers, and grandparents in 15 households, and spiritual leaders are known as "diviners". Themes were developed through inductive analysis of field notes and verbatim transcribed interviews using a framework approach. Results: The content of a child's diet and the pattern of feeding were found to be influenced by the community's notion of food, taboos, and beliefs which originated in a traditional African religion. Shared household responsibility for feeding children and the gendered and age related hierarchy of household decision making also influenced child feeding. Discussion: This study has shown multifaceted taken-for-granted social and cultural influences on child feeding. Whilst mothers are the main recipients of the official public health nutrition and child feeding advice, the communal structures, living arrangements and social interactions support, enhance, and reinforce the community inclined practices that limit mothers' independent decision making. Conclusion: To effect community change and promote uptake of public health nutrition recommendations, a community wide nutrition intervention approach may be more beneficial than the current approach which targets mothers. Furthermore, community and cultural influences must be understood and considered by health professionals if such interventions are to succeed.

No description available.

Widespread concerns about obesity and overweight, have led to a focus on children’s diets, with government responses emphasising family responsibility for the provision of healthy food and for nurturing independent food choices. In parallel, the health promoting school approach attempts to reinforce messages within communities and families. Despite the potential for promoting consistent messages across settings, understanding the interface between families and schools remains limited, with a failure to appreciate the way in which food is embedded within social relationships and contexts. This study aimed to explore the family-school interface. It focused on the recursive interplay between agency and structure, employing ‘practices’ as a way of exploring how agency transforms structure, while also attending to taken-for-granted meanings of food as expressions of the structure. Case study methodology was employed with eleven families across three communities in South Wales to explore the perspectives of parents (n=18) and children (n=18). Audio-diaries together with interviews unpacked tacit understandings behind food practices, which are often difficult to articulate. Interviews with primary school heads and teachers (n=5) explored schools' experiences of family-school interactions. This thesis adds new understandings of the family-school interface, illustrating shifting discourses of control as individuals occupy multiple contexts at different times. These revealed dilemmas in the accomplishment of control: providing children with a balanced diet alongside the practicalities of parental-work, while attending to individualised food preferences. Structure-agency perspectives also uncovered multiple layers of meaning attached to food, emphasising the need to take account of the social context within which control is navigated. Targeted recommendations are considered. For schools, suggestions include improved partnership working with children and parents in order to overcome existing inherent tensions. For families, recommendations acknowledge the wider significance of food beyond nutrition, appreciating the contexts and constraints of family life. Policy recommendations relate to food availability, affordability, and changes to employment structures.

The objectives of the study were to determine infant and young child feeding (IYCF) knowledge of Household Health Promoters (HHPs) and examine its relationship with demographic characteristics. Quantitative, non-experimental descriptive design was used. Seventy-one randomly selected HHPs participated in the study. A structured questionnaire was used to collect the data. The results showed that the mean IYCF knowledge score was 77.8% (N=71). The knowledge of the respondents was not uniform across the components of IYCF which ranged between 19.72% for duration of breastfeeding to 100% for colostrums feeding. None of the socio-demographic characteristic was significantly associated to the mean knowledge score. The study identified that refresher training should be provided to the HHPs on IYCF with emphasis on the aspects of IYCF with scores below the mean / Health Studies

The objectives of the study were to determine infant and young child feeding (IYCF) knowledge of Household Health Promoters (HHPs) and examine its relationship with demographic characteristics. Quantitative, non-experimental descriptive design was used. Seventy-one randomly selected HHPs participated in the study. A structured questionnaire was used to collect the data. The results showed that the mean IYCF knowledge score was 77.8% (N=71). The knowledge of the respondents was not uniform across the components of IYCF which ranged between 19.72% for duration of breastfeeding to 100% for colostrums feeding. None of the socio-demographic characteristic was significantly associated to the mean knowledge score. The study identified that refresher training should be provided to the HHPs on IYCF with emphasis on the aspects of IYCF with scores below the mean / Health Studies