Emerging favourable as well as unfavourable nutrition patterns are observed in societies undergoing rapid social and economic change. The aim of this thesis is to analyse the associations between household and maternal resources and infant and young child feeding habits and nutritional status in rural Nicaragua, a low-income transitional society. All households (n=1,500) in Los Cuatro Santos with at least one child (0-3 y) were visited to collect information on feeding of the youngest child. Children´s anthropometry was also measured using standardised World Health Organisation (WHO) techniques. Validated instruments were used to assess household and maternal resources. All instruments had been adapted to the local context and piloted in a nearby community.  The education of the mother showed more independent variation in the studied outcomes. The odds for exclusive breastfeeding were highest in infants aged 0 to 5 months of mothers with the lowest education. Further, children aged 6 to 35 months with lowest educated mothers were less likely to consume highly processed snacks (HP snacks) and sugar-sweetened beverages (SSBs). They were also less likely to be exposed to a double burden of suboptimal feeding (concurrent unmet WHO recommended feeding practices and consumption of HP snacks or SSBs). However, children aged 6 to 35 months were more prone to infrequently meet dietary diversity and to more shortness. Children in the same age group with lower educated mothers were also shorter in households with the lowest housing quality. Higher level of maternal education contributed both favourably and unfavourably to child feeding and nutrition. This was reflected in more and less frequent practice of the WHO feeding indicators, but also in more frequent children´s consumption of HP snacks and SSBs. Higher maternal education was associated with taller children, even in households with the lowest housing quality.

Magister Public Health - MPH / Background: Appropriate and adequate infant feeding practices are an important factor in achieving optimal health in infants. Inappropriate and inadequate infant feeding practices contribute significantly to ill-health in infants. Both WHO and UNICEF recommend exclusive breastfeeding for the first six months both in the context of HIV and otherwise unless exclusiv formula feeding can meet each of five conditions: acceptable, feasible, affordable, sustainable and safe (AFASS). The modes of infant feeding include exclusive breastfeeding, formula feeding and mixed feeding. Medical recommendations and social pressures related to infant feeding in high HIV-prevalence low-income communities may have shifted infant feeding practices. The aim of this study was to explore factors influencing infant feeding practices and decision making among women in one such community, Kabwata Township, in Lusaka, Zambia. Method: An exploratory qualitative study was conducted at Kabwata Health Centre in Kabwata Township in Lusaka, Zambia. Convenient sampling was used to recruit 32 women for focus group discussions and three key informants (two nurses and one social worker) for individual interviews. Verbal consent was received from all participants. Semi-structured interview guides were used to elicit discussion by all participants. Discussions were tape recorded and transcribed verbatim. Thematic data analysis was used to analyze the qualitative data. Results: Most FGD participants reported that they themselves initiated breastfeeding soon after giving birth, but not all of them breastfed exclusively for the first six months, as is currently recommended. The major factors influencing infant feeding included; influence from family and friends, stigma and discrimination, influence from health care providers, practical realities such as maternal employment and poverty, and cultural/traditional practices. Conclusion: While breastfeeding is valued and accepted, most women do not or cannot exclusively breastfeed for six (6) months for various reasons. Paradoxically, the social value of breastfeeding and the knowledge that breast milk can transmit HIV reinforce mixed feeding as the predominant feeding practice. Key informants reported that women attending health care services at Kabwata health centre were encouraged and taught to breastfeed their infants exclusively for six months. There is a need to re-look at the way the women are being encouraged, taught and supported so that the apparent knowledge and acceptance of breastfeeding can translate into improved infant feeding practices. Awareness campaigns need to include all stakeholders including family members, the community, employers and the women themselves in order to make exclusive breastfeeding easier for the women.

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The diets of Mongolia infants are deficient in vitamins and minerals and complementary foods are introduced too early. Breastfeeding is the best source of nutrition for infants until 6 months of age. A survey of 50 Mongolian mothers with children under the age of 5 in the town of Sainshand, Dornogobi, was conducted in July 2011. Mongolian infants are among the highest percent of infants in the world who are exclusively breastfed for the first 6 months of their lives, thus providing them with excellent nutrition. However, complementary feedings and supplements are not appropriately used or understood. Therefore, the diets of Mongolian infants are still lacking key nutrients and they are exposed to complementary foods too soon. By obtaining more information on the feeding practices of Mongolian mothers, better education materials and seminars on infant nutrition can be developed, which will improve the overall nutrition and health of the children of Mongolia.

No description available.

No description available.

A prospective, longitudinal and observational study, using a non-clinical population of mother-child dyads was conducted to evaluate the contribution of family-environmental factors in predicting child food avoidance and feeding problems across early childhood. The contribution of maternal feeding practices, mealtime structure and interactional behaviour during mealtimes, were explored in predicting child food avoidance between 2 and 5 years, whilst also evaluating the role of maternal psychopathology and child temperament. This thesis also assessed the validity of maternal reports of child eating behaviour and feeding practices by obtaining independent observations of these constructs, and explored the longitudinal stability and continuity of both independent observations and maternal reports of child eating behaviour and maternal feeding practices. Concurrently and prospectively, observations of mothers eating with their child, displaying high sensitivity, low control, and more positive emotion and verbalisation during mealtimes predicted less avoidant child eating behaviour. Reports of mothers providing a healthy food-related home environment, encouraging balanced food intake, and involving their child in food planning, in addition to a less emotional child temperament, were also significant longitudinal predictors of less avoidant child eating behaviour. Maternal descriptions of their child s eating behaviour were validated by independent observations; however maternal descriptions of their own feeding practices were not. Child eating behaviour and maternal feeding practices were predominantly stable and continuous across early childhood, with the exception of child difficulty to feed and maternal pressure to eat which decreased between the ages of 3 and 4. This thesis demonstrates many interesting and novel findings but primarily through the utilisation of observational and longitudinal data it demonstrates the important causal contribution of family-environmental factors in the development of food avoidant eating behaviours during early childhood.

At present, the process of parental modelling of eating behaviours and attitudes has received limited research interest. While often mentioned as a possible factor in relation to child feeding and the development of eating behaviours, only a few studies have explicitly researched parental modelling. The main aims of this thesis were to develop a new measure to assess modelling multidimensionally and to explore the relationships between parental modelling of eating behaviours with a variety of parent and child factors. Initially, a parental self-report measure (the Parental Modelling of Eating Behaviours Scale; PARM) was developed, validated and piloted as part of a series of studies exploring the associations between modelling and a range of self-reported parental and child factors. To provide further validation for the PARM, an observational coding scheme was developed, based on the newly developed modelling measure, and this was utilised in two further studies which looked at self-reported and observed parent and child factors. The key findings from this thesis suggest a number of beneficial relationships. For example, maternal modelling was positively correlated with healthy food intake in both mothers and their children. In addition, both maternal and paternal modelling were associated with children s increased enjoyment of food and lower levels of food fussiness. Observations of maternal modelling were also found to be positively related to other observed adaptive, non-directive feeding practices, such as encouragement to eat. However, less positive relationships were also identified, with modelling being related to parents mental health symptoms and to unhealthy food intake in both mothers and their children. In conclusion, this thesis has identified three distinct facets of modelling and highlighted factors which might be linked to parental role modelling around eating behaviours. While much of the research within this thesis is exploratory, and the findings require replication, they would suggest that parental modelling has the potential to positively influence children s eating behaviours. However, parents should also be made aware of the potential detrimental effect that modelling less adaptive eating behaviours may have on their children s food intake, particularly those eating behaviours that parents may be unaware of modelling.

Background: An estimated 9.7% of U.S. infants and toddlers are considered overweight. Hispanic infants persistently show higher prevalence rates for being overweight compared to black and white infants. Little is known about factors promoting excessive infant weight gain in Latinos. Purpose: Primary aim of this study was to describe multidimensional factors and maternal feeding practices that may correlate with infant overfeeding in Latina mothers. A secondary aim was to determine whether there was an association between these factors and infant weight gain. Subjects: Sixty-two low-income immigrant Latina mothers and their infants ages 4-12 months receiving assistance through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Design: A descriptive correlational cross-sectional study. Methods: A native Spanish-speaking investigator who guided the participants through the options administered all the measures. Measures included: acculturation indicators; maternal feeding beliefs; maternal feeding practices; maternal knowledge and self-efficacy; food availability/insecurity indicators; infant’s temperament; infant’s 24-hour dietary recall; and infant’s height and weight measures. Univariate and multiple linear regressions were used to examine relationships. Results: Over 25% of infants were at >85th percentile for weight-for-length, and 21% were at > 98th percentile. Among infants at the >85th percentile for weight-for-length, 27% of the mothers wished their infants were heavier. Three-quarters of the participants were not currently breastfeeding their infants (74.2%). Healthier maternal feeding practices were inversely correlated with maternal age and the number of people living at home. Multiple regression results showed infant’s age and maternal education as significant positive predictors of less controlling maternal feeding practices. None of the analyzed factors were significant predictors of infant’s weight gain. Conclusion: Future research is needed to further delineate the primary driving forces behind immigrant Latina mothers’ feeding decisions and practices. Given the protective benefit of breastfeeding in reducing the risk of early childhood and adult obesity, present intervention efforts should focus primarily on the promotion of healthy feeding practices that encourage and support exclusive breastfeeding among this ethnic group.