Master of Public Health / Department of Human Nutrition / Sandra B. Procter / Nutritionally vulnerable women are more apt to give birth to low birth weight, small for gestational babies who have increased medical complications and higher risk of mortality. Participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) prenatally has been found to enhance positive pregnancy outcomes for women; reduced risk of low birth weights and nutrient deficiencies thus reducing the costs associated with medical care for infants covered by Medicaid, the joint federal and state insurance program for low income women, which covers 40% of infants in the United States. Pregnant women covered by Medicaid insurance are normally at the most risk but are adjunct eligible for the WIC program. This descriptive cross-sectional research study determined the demographic and nutritional characteristics of Medicaid births in the WIC program compared to non-Medicaid births for the 2009 WIC program year, using the Kansas birth certificate, WIC program data linked to the birth certificate by unique identifying code. Results from the study show that the Kansas WIC and Medicaid programs are serving the target population for the objectives of the programs. Mothers of Medicaid births who received WIC food during pregnancy and those in the WIC program are of low socioeconomic status and they are more likely to be younger in age, of minority racial group, less educated, never married and less likely to breastfeed infants at discharge and high likelihood of smoking. Compared to Medicaid births that did not participate in the WIC program, women at the lower margins of low socioeconomic status participated in WIC, signaling that the most vulnerable were getting the needed services. Distinct findings from the Kansas WIC program reveal that Medicaid births in the WIC program were more likely to be breastfed at discharge, compared to Medicaid births not in the WIC program, even though WIC recipients had demographic characteristics associated with low breastfeeding patterns. A study investigating the reasons for not enrolling in WIC by Kansas Department of Health would be beneficial to the WIC program’s goal to provide nutrition support to low income eligible women, infants and children in Kansas.

As práticas alimentares das crianças não são determinadas apenas pelas suas necessidades biológicas, mas também pela interação com o alimento, por fatores emocionais, socioeconômicos, culturais e pela interação com a própria mãe. Os objetivos deste estudo foram conhecer as representações sociais de mães de lactentes sobre a introdução de alimentos complementares, oportunos ou não e identificar os elementos que constituem o processo vivenciado por elas, para a escolha desses alimentos. Foram utilizados os pressupostos teóricos da Representação Social, propostos por Moscovici, os quais se ocupam em explicar um saber gerado na comunicação da vida cotidiana, com finalidade prática de orientar comportamentos e fixar sua posição em relação a um dado objeto. O modelo \"Pesando Riscos e Benefícios\" foi utilizado para dar suporte teórico ampliando a compreensão do processo de alimentação da criança. Os dados foram analisados, segundo a estratégia metodológica do Discurso do Sujeito Coletivo e foram coletados em um ambulatório de pediatria privado, em Jundiaí - SP, junto a 17 mães, após o seu consentimento esclarecido, por meio de entrevistas semi-estruturadas gravadas e transcritas na íntegra. Do material verbal coletado emergiram 13 discursos, organizados em três temas. O primeiro deles, \"Vivenciando o desmame\", foi composto por quatro discursos, tomando-se por base a fala de mães que desmamaram precocemente os filhos, os quais versaram sobre a vivência do desmame, as dificuldades enfrentadas para substituir o leite materno e sobre as representações maternas acerca do alimento e da introdução de alimentos complementares. O segundo tema, \"Tomando posição ante a alimentação da criança\" foi constituído por quatro discursos, os quais discutiram as necessidades das mães e os papéis da família e do médico no contexto da introdução de alimentos complementares. O último tema, \"Fazendo as escolhas alimentares propriamente ditas\", formado por cinco discursos, versaram sobre os elementos de escolha e as representações maternas acerca do alimento e da introdução de alimentos complementares. Concluiu-se que, com base em suas representações, experiências e crenças, as mães realizaram um movimento de avaliação, julgamento, interpretação e construção de indicadores por meio da observação de comportamento da criança, buscando valorá-los em termos simbólicos de risco ou benefício para si ou para o filho, a depender do contexto social em que a mãe e a criança estão inseridas. Tais achados permitiram demonstrar a expansão do modelo teórico \"Pesando Riscos e Benefícios\" para auxiliar a compreensão do significado não só da amamentação, como da introdução da alimentação complementar. Além disso, foi possível conhecer as representações deste grupo de mulheres, acerca do alimento e da introdução de alimentos complementares / The food practices of children are not determined only by their biological necessities, but also by their interaction with the food, for emotional, social, economic and cultural factors and by their interaction with their own mother. The objectives of this study were to know social representations of infants\' mothers about the introduction of complementary foods, propitious or not, and to identify in their experiences what are the reasons to chose those kind of foods. They were used the concepts of Social Representation by Moscovici which explain a knowledge that is generated by everyday life\'s communication and with the purpose to guide behaviors and to sustain them in front of an object. The model \"Thinking Risks and Benefits\" was used to give theoretical support and to increase the understanding of food process of a child. The data were analyzed according methodological strategies of Subjective Speech Collective and were collected from 17 mothers at a private pediatric ambulatory in Jundiaí, a São Paulo\'s city, after their consentment of semi-structured recorded interviews and all of them were transcribed word by word. From the verbal material collected emerged 13 speeches, organized in three themes. \"Living the Weaning Period\", the first one, is made by 4 speeches of mothers who weaned their children and talked about their experiences and their difficulties facing the replacement of breast milk and about motherhood representations of food and introduction of complementary foods. \"Taking Position in front of Child\'s Food Choices\", the second, is made by 4 speeches and debates mothers\' necessities and families and doctors roles in the context of introduction of complementary foods. \"Making the Food Choices Properly\", the last one, is made by 5 speeches that examines elements of choices and motherhood representations about food and the introduction of complementary foods. The conclusion is that based on their representations, experiences and believes, mothers analyse, judge, interpret and construct indicators from observation of children behavior and they search increase their worth in symbolic terms of risks and benefits to themselves or their children. It depends on which social context mother and child are insert. Theses findings allow to show an expansion of theoretical model \"Thinking Risks and Benefits\" to help the understating of meaning not only of breastfeed, but complementary food either. Besides that, it was possible to know the representations of theses groups of women about food and introduction of complementary foods

Breastfeeding is the best food source for the nutritional and health needs of young children. However when a mother returns to work, breastfeeding may be discontinued prematurely. The purpose of this study was to study infant feeding practices used by working mothers in Nairobi. Mothers attending clinics at two hospitals, one a private hospital serving higher socioeconomic groups and the other a public hospital represented the low socioeconomic groups, were interviewed. A structured interview was held with 444 mothers (200 from the low socioeconomic group and 244 from the high socioeconomic group) between January 5th and February 11th 2000. All mothers with infants aged 16-48 weeks who were willing to participate were interviewed. The prevalence of breastfeeding at the time of the study was found to be 94.1%. The low socioeconomic group exhibited a higher prevalence of breastfeeding (99%) with a 10% difference between the low and high socioeconomic groups. The prevalence of exclusive breastfeeding was 13.3% at three months. Early introduction of other feeding methods was high, with 46.4% of the mothers introducing other feeding methods before one month. Multivariate logistic regression was used to determine factors that were associated with exclusive breastfeeding using two separate models for exclusive breastfeeding at one month and two months. The mode of work (fixed working hours as opposed to shift work) was associated with exclusive breastfeeding for at least month (OR=0.45) and two months (OR=0.39). Insufficient milk and return to work were the main reasons cited for cessation of exclusive breastfeeding. / Multiple linear regression was used to find out whether growth rates differed between feeding methods and types of foods for complementary feeding. Bottle-feeding had a significant negative association (-0.240, p=0.018) with baby weight and a downward trend was evident in baby Z-score for age exhibiting a risk of growth faltering in all infants. The results of this study indicate that the prevalence of breastfeeding in Nairobi Kenya has remained considerably high. Working mothers are still committed to breastfeeding despite the long working hours of separation (mean 46.23 hours). However exclusive breastfeeding is low, recommendations are made for interventions to promote exclusive breastfeeding and policies with strategies to enable working mothers to exclusively breastfeed for at least four months.

This thesis investigates the experiences of ten Australian mothers and seven fathers breastfeeding very low birth weight preterm infants, from the baby's birth to 12 months of age. A series of longitudinal in-depth interviews with the parents were used to explore the phenomenon of breastfeeding a preterm infant. Forty-five interviews were undertaken using a hermeneutic phenomenological approach based on the work of Patricia Benner. / The study explores the parents' experiences and understandings of breastfeeding in the preterm context and describes how they managed this challenging situation. Most apparent in this study are the numerous contradictions, tensions and disparities between what the participant parents expected their breastfeeding experiences to be like and what became their reality. Analysis of the data demonstrates the ways in which breastfeeding and feeding the preterm infant were objectified to the detriment of their overall satisfaction. Expressed breast milk became the primary focus of attention, the 'liquid gold' that parents strove for, while the mothers, in effect, became 'milking machines' intent solely on the production of breast milk. This objectification of the breastfeeding experience resulted in parents losing control over many aspects of normal parenting and surrendering their ability to make decisions regarding their infant's care, particularly their nutrition and feeding management following discharge from hospital. / The conflicts and tensions within the preterm-breastfeeding experience were distressing for the participant parents. They considered breastfeeding to be integral to the performance of motherhood and good parenting. Mothers, in particular, in this study tried hard to cope with these contradictions and their implications. The parents' focus on doing best for baby was paramount and they were prepared to do whatever they or others deemed necessary. Although espousing the benefits of breastfeeding for their baby, the participants' experiences showed that hospital staff practices often fostered objectified breast milk feeding, which parents found counterproductive to exclusive at-breast feeding. / This research extends existing knowledge of breastfeeding by explicating in detail parental experience of breastfeeding very low birth weight preterm infants. / Thesis (PhD)--University of South Australia, 2004.

Background Malnutrition is a major risk factor of infant mortality in India. Policies targeting poverty and food insecurity may reduce infant malnutrition. The Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), a wage-for employment policy of the Indian Government, targets deprivation and food insecurity in rural households. MGNREGA could prevent infant malnutrition by improving household food security or increase the risk of malnutrition by reducing the time devoted to infant care if mothers are employed. This study analyzed the effect and the pathways of effect of households' and mothers' participation in MGNREGA on infant malnutrition. Methods A community based mixed methods study using cross-sectional survey and focus group discussions (FGDs) was conducted in Dungarpur district of Rajasthan, India. Cross-sectional study included 528 households with 1,056 participants who were infants 1 to <12 months and their mothers/caregivers. Selected households were divided into MGNREGA-households and non-MGNREGA-households based on participation in MGNREGA between August-2010 and September-20ll. Anthropometric indicators of infant malnutrition-underweight, stunting, and wasting (WHO criteria) were the outcomes. Eleven FGDs with 62 mothers were conducted. Results Of 528 households, 281 participated in MGNREGA (53%). Mothers were employed in 51 (18%) households. Prevalence of wasting was 39%, stunting 24%, and underweight 50%. Households participating in MGNREGA were less likely to have wasted infants (OR 0' 57, 95% Cl 0•37-0'89; p=O'014) and underweight infants (OR 0'48,95% Cl 0•30-0'76; p=0'002) than non-participating households. Stunting did not differ significantly between groups. Although MGNREGA reduced starvation, it did not confer food security to the participating households because of lower than standard wages and delayed payments. Results from path analysis did not support an effect through household food security and infant feeding, but suggested a pathway of effect through birth-weight. Mothers' employment had no significant effect on the outcomes in the cross-sectional study, but the qualitative study indicated that it could compromise infant feeding and care. Conclusion Participation in MGNREGA was associated with reduced infant malnutrition possibly mediated indirectly via improved birth-weight rather than improved infant feeding. Providing child care facilities at worksites could mitigate the negative effects of mother's participation in MGNREGA. Further, improving mothers' knowledge of appropriate feeding practices in conjunction with providing employment (to address deprivation and food insecurity) is key in the efforts to reduce infant malnutrition.

Maternal nutrition, breast milk micronutrients and infant growth in rural Gambia The World Health Organization recommends exclusive breastfeeding for the first six months of an infant’s life. However, the evidence base to support the adequacy of breast milk with respect to infant micronutrient status, across the duration of exclusive breastfeeding, among women who enter pregnancy and lactation with a poor nutritional status is limited. The research presented in this thesis explores the relationship between maternal nutritional status, breast milk micronutrients and infant status in a rural sub-Saharan context. Existing evidence for associations between maternal dietary intake and nutritional status and breast milk micronutrient composition were systematically reviewed. Most effected by maternal nutrition were breast milk water-soluble vitamin concentrations (except for folic acid), fat-soluble vitamin concentrations were less influenced, and mineral concentrations were generally unaffected (except for iodine and selenium). Next, the impact of feeding practice on infant growth in rural Gambia was explored. In this population, where growth faltering across the first two years of life is endemic, exclusive breastfeeding to six months of age had limited benefit on infant growth. Finally, the impact of maternal multiple micronutrient supplementation on breast milk iodine, thiamin, riboflavin, vitamin B6 and B12 was explored. Supplementation during pregnancy positively influenced maternal status for all investigated micronutrients, and modestly increased breast milk iodine and riboflavin concentrations across the first six months of lactation. No effects on breast milk concentrations of thiamin, vitamin B6 or B12, and limited effect on infant postpartum status, were observed. The research presented in this thesis suggests that concentrations of breast milk micronutrients may be insufficient in settings where maternal micronutrient status is poor, with likely consequences for infant health. This research supports the need for interventions to improve the nutritional status of pregnant and lactating women in resource-poor settings alongside the promotion of exclusive breastfeeding for optimal health outcomes for infants as well as their mothers.

As práticas alimentares das crianças não são determinadas apenas pelas suas necessidades biológicas, mas também pela interação com o alimento, por fatores emocionais, socioeconômicos, culturais e pela interação com a própria mãe. Os objetivos deste estudo foram conhecer as representações sociais de mães de lactentes sobre a introdução de alimentos complementares, oportunos ou não e identificar os elementos que constituem o processo vivenciado por elas, para a escolha desses alimentos. Foram utilizados os pressupostos teóricos da Representação Social, propostos por Moscovici, os quais se ocupam em explicar um saber gerado na comunicação da vida cotidiana, com finalidade prática de orientar comportamentos e fixar sua posição em relação a um dado objeto. O modelo \"Pesando Riscos e Benefícios\" foi utilizado para dar suporte teórico ampliando a compreensão do processo de alimentação da criança. Os dados foram analisados, segundo a estratégia metodológica do Discurso do Sujeito Coletivo e foram coletados em um ambulatório de pediatria privado, em Jundiaí - SP, junto a 17 mães, após o seu consentimento esclarecido, por meio de entrevistas semi-estruturadas gravadas e transcritas na íntegra. Do material verbal coletado emergiram 13 discursos, organizados em três temas. O primeiro deles, \"Vivenciando o desmame\", foi composto por quatro discursos, tomando-se por base a fala de mães que desmamaram precocemente os filhos, os quais versaram sobre a vivência do desmame, as dificuldades enfrentadas para substituir o leite materno e sobre as representações maternas acerca do alimento e da introdução de alimentos complementares. O segundo tema, \"Tomando posição ante a alimentação da criança\" foi constituído por quatro discursos, os quais discutiram as necessidades das mães e os papéis da família e do médico no contexto da introdução de alimentos complementares. O último tema, \"Fazendo as escolhas alimentares propriamente ditas\", formado por cinco discursos, versaram sobre os elementos de escolha e as representações maternas acerca do alimento e da introdução de alimentos complementares. Concluiu-se que, com base em suas representações, experiências e crenças, as mães realizaram um movimento de avaliação, julgamento, interpretação e construção de indicadores por meio da observação de comportamento da criança, buscando valorá-los em termos simbólicos de risco ou benefício para si ou para o filho, a depender do contexto social em que a mãe e a criança estão inseridas. Tais achados permitiram demonstrar a expansão do modelo teórico \"Pesando Riscos e Benefícios\" para auxiliar a compreensão do significado não só da amamentação, como da introdução da alimentação complementar. Além disso, foi possível conhecer as representações deste grupo de mulheres, acerca do alimento e da introdução de alimentos complementares / The food practices of children are not determined only by their biological necessities, but also by their interaction with the food, for emotional, social, economic and cultural factors and by their interaction with their own mother. The objectives of this study were to know social representations of infants\' mothers about the introduction of complementary foods, propitious or not, and to identify in their experiences what are the reasons to chose those kind of foods. They were used the concepts of Social Representation by Moscovici which explain a knowledge that is generated by everyday life\'s communication and with the purpose to guide behaviors and to sustain them in front of an object. The model \"Thinking Risks and Benefits\" was used to give theoretical support and to increase the understanding of food process of a child. The data were analyzed according methodological strategies of Subjective Speech Collective and were collected from 17 mothers at a private pediatric ambulatory in Jundiaí, a São Paulo\'s city, after their consentment of semi-structured recorded interviews and all of them were transcribed word by word. From the verbal material collected emerged 13 speeches, organized in three themes. \"Living the Weaning Period\", the first one, is made by 4 speeches of mothers who weaned their children and talked about their experiences and their difficulties facing the replacement of breast milk and about motherhood representations of food and introduction of complementary foods. \"Taking Position in front of Child\'s Food Choices\", the second, is made by 4 speeches and debates mothers\' necessities and families and doctors roles in the context of introduction of complementary foods. \"Making the Food Choices Properly\", the last one, is made by 5 speeches that examines elements of choices and motherhood representations about food and the introduction of complementary foods. The conclusion is that based on their representations, experiences and believes, mothers analyse, judge, interpret and construct indicators from observation of children behavior and they search increase their worth in symbolic terms of risks and benefits to themselves or their children. It depends on which social context mother and child are insert. Theses findings allow to show an expansion of theoretical model \"Thinking Risks and Benefits\" to help the understating of meaning not only of breastfeed, but complementary food either. Besides that, it was possible to know the representations of theses groups of women about food and introduction of complementary foods

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / Pessoas cegas tÃm filhos e, em virtude da limitaÃÃo sensorial, sentem dificuldades no cuidado das suas crianÃas. AlimentaÃÃo complementar do lactente se torna crÃtica, pois envolve nÃo somente a escolha de alimentos, mas preparo, higiene e oferta. A enfermagem assiste as pessoas cegas mediante desenvolvimento de tecnologia assistiva (TA), proporcionando autonomia e independÃncia. Objetivou-se validar TA para pais cegos sobre alimentaÃÃo complementar do lactente, disponibilizada em acesso online. Estudo conforme modelo de Pasquali (2010), realizado entre agosto/2011 e marÃo/2013, no LaboratÃrio de ComunicaÃÃo em SaÃde da Universidade Federal do CearÃ. O referencial teÃrico-metodolÃgico era constituÃdo dos polos teÃrico, empÃrico e analÃtico. O teÃrico contemplou a construÃÃo da tecnologia, por revisÃo integrativa e consulta a materiais especializados; avaliaÃÃo da TA por especialistas em saÃde da crianÃa, aspectos pedagÃgicos e acesso online; e teste piloto com cegos, pais e mÃes naturais ou por adoÃÃo, a partir de 18 anos. O polo empÃrico contemplou a avaliaÃÃo da TA por 89 mÃes e pais cegos. Todos os participantes responderam a instrumentos na escala de Lickert de um a cinco, sendo um a pior nota e cinco a maior. Com o polo analÃtico viabilizou-se a anÃlise estatÃstica dos dados. As variÃveis qualitativas foram analisadas pelos testes Qui-Quadrado e razÃo de verossimilhanÃa. Calcularam-se mÃdia e desvio padrÃo das variÃveis quantitativas e fez-se comparaÃÃo das mÃdias dos tÃpicos por meio do teste t de Student para dados independentes ou pelo teste F de Snedecor (ANOVA). Consideraram-se significantes as anÃlises estatÃsticas inferenciais quando p<0,05. Projeto aprovado pelo Comità de Ãtica em Pesquisa da Universidade Federal do CearÃ. A TA intitulada âCuidando da alimentaÃÃo do bebÃâ abordou os tipos de alimentos complementares; oferta de alimento à crianÃa; preparo do alimento da crianÃa e higiene da crianÃa e dos alimentos, e foi disponibilizada na pÃgina www.labcomsaude.ufc.br. Quando avaliada pelas nove especialistas, trÃs de cada Ãrea, estas sugeriram: correÃÃes de informaÃÃes de conteÃdo, inclusÃo de linguagem leiga, reforÃar referÃncias à cegueira dos pais no texto e ajuste de mecanismos de acessibilidade. ApÃs os ajustes, as especialistas atribuÃram nota cinco predominante em todos os itens, confirmando sua adequabilidade de conteÃdo e acesso ao pÃblico-alvo. Participaram do pÃlo empÃrico 89 mÃes e pais cegos, prioritariamente mulheres (53,9%), com cegueira de nascenÃa (55,1%), idade mÃdia de 37,91 anos, nÃo casados (52,8%), ensino mÃdio (60,7%) e exercendo atividade remunerada (56,2%), provenientes dos estados de Pernambuco (51,6%) e Piauà (41,6%). A maioria atribuiu nota cinco a todos os itens. As melhores pontuaÃÃes vieram da faixa etÃria entre 30 e 39 anos, casados e com renda familiar entre 2,2 e seis salÃrios mÃnimos. Dentre os tÃpicos da tecnologia, todos apresentaram mÃdias favorÃveis, sendo melhor avaliado o conteÃdo (91,1Â11,7), seguido de acesso online (84,4Â18,9) e aspectos pedagÃgicos (82,9Â15,9). Os resultados viabilizam a hipÃtese que a TA âCuidando da alimentaÃÃo do bebÃâ à meio vÃlido e viÃvel de disseminaÃÃo de informaÃÃes a pais cegos. Ao fim deste estudo, vislumbra-se que o enfermeiro deve utilizar a construÃÃo da TA como estratÃgia de promoÃÃo da saÃde com clientes cegos. / Blind people have children and, due to their sensory limitation, they experience difficulties to take care of their children. Complementary feeding of infants is critical, as it involves not only foods, but also preparation, hygiene and offering. Nursing assists blind people through the development of assistive technology (AT), granting them autonomy and independence. The objective was to validate AT for blind parents about complementary feeding of infants, available online. Study as Pasquali (2010) model undertaken between August/2011 and March/2013 at the Health Communication Laboratory of Universidade Federal do CearÃ. The theoretical and methodological framework consisted of theoretical, empirical and analytic hubs. The theoretical hub covered the construction of the technology through an integrative review and the consultation of specialized materials; assessment of the AT by experts in child health and pedagogical aspects and online access by blind people; and a pilot test with blind people, natural or adoption fathers and mothers, as from the age of 18 years. The empirical hub included the assessment of the AT by a large number of blind mothers and fathers. All participants answered instruments using a Likert scale ranging from one to five, with one indicating the worst and five the best score. The analytic hub permitted the statistical analysis of the data. The qualitative variables were analyzed using the Chi-Square test and likelihood ratio. The means and standard deviation of the quantitative variables were calculated and the means for the topics were compared using Studentâs t-test for independent data or Snedecorâs F-test (ANOVA). Inferential statistical analyses were considered significant when p<0.05. Approval for the project was obtained from the Research Ethics Committee at Universidade Federal do CearÃ. The AT entitled âTaking care of the infantâs feedingâ discussed the types of complementary foods; offering food to the child; preparation of the childâs food and hygiene of the child and was made available on the website www.labcomsaude.ufc.br. When assessed by nine experts, three from each area, they suggested: corrections in content information, non-professional language, references to the parentsâ blindness in the text, access mechanisms. After the adjustments, the experts predominantly scored all items as five, confirming the appropriateness of their content and access to the target public. Eighty-nine blind mothers and fathers participated in the empirical hub, mainly women (53.9%), blind from birth (55.1%), mean age 37.91 years, not married (52.8%), secondary education (60.7%), having a paid job (56.2%), from the states of Pernambuco (51.6%) and Piauà (41.6%). The best scores came from the age range between 30 and 39 years, married and with a family income between 2.2 and six minimum wages. Among the topics addressed in the technology, all obtained favorable mean scores. The highest score was for the content (91.1Â11.7), followed by online access (84.4Â18.9) and pedagogical aspects (82.9Â15.9). The results permit the hypothesis that the AT âTaking care of the infantâs feedingâ is a valid and feasible means to transmit information to blind parents. At the end of this study, it is considered that nurses should use the construction of AT as a health promotion strategy with blind clients.

Periods of rapid growth are periods of special vulnerability to nutritional injury. Growth during pregnancy and in the first two years of life is more rapid than at any other stage in the life cycle and hence, optimum nutrition is vital at this time. Physicians are frequently the primary professionals concerned with the dissemination of nutrition advice to pregnant women and mothers of new infants. However, there are no studies in the literature that assess the quality of nutrition information provided by physicians in this important area of maternal and infant nutrition. A study was designed to investigate the nutrition attitudes and practices of general practitioners, pediatricians and obstetricians in the province of British Columbia. The influence of selected variates upon the criterion variables, nutrition attitudes and practices, was assessed. Variates studied included demographic and professional data on country of medical training, sex of respondent, location and type of practice, years of practice, number of patients seen weekly, sources of nutrition information consulted, attendance at continuing education programs, additional training for specialization, and inclusion of nutrition in medical school education. The nature of the relationship between nutrition attitudes and practices was also assessed. In March 1975, questionnaires were mailed to all 1981 practising general practitioners, pediatricians and obstetricians in the province of British Columbia. Questionnaires were returned by 724 ( 41.3% ) general practitioners, 69 ( 62.7% ) pediatricians and 51 ( 43.2% ) obstetricians. Responses from completed questionnaires were analyzed by computer; all tests were conducted at the 5% level of significance. Results were reported at the highest level of significance. Mean scores for nutrition attitudes for general practitioners, pediatricians and obstetricians were 72%, 81% and 64% respectively. Nutrition practices' scores were 60%, 66% and 65% for general practitioners, pediatricians and obstetricians respectively. Regression analysis indicated that nutrition attitude and practice scores of general practitioners were significantly higher for physicians who: (a) were female (b) consulted with a nutritionist-dietitian (c) had additional training (d) attended continuing education programs and (e) had nutrition in their medical school education. General practitioners who were in practice more than 10 years scored significantly lower on the attitude and practice tests. Nutrition practice scores were significantly higher for pediatricians trained in Canada while nutrition attitude scores were higher for pediatricians who were in practice more than five but fewer than 10 years. Obstetricians' attitude scores were significantly lower for physicians who were in practice more than 10 years. Obstetricians who consulted with non-human sources of nutrition information other than professional journals and human sources of information other than nutritionist-dietitians scored significantly higher on the nutrition practice test. Correlation analysis showed that nutrition attitudes were significantly correlated to nutrition practices for general practitioners ( r = 0.370 ), pediatricians ( r = 0.259 ) and obstetricians ( r = 0.424 ). Student t-test analysis indicated that pediatricians' and obstetricians' practice test scores were significantly higher than those of general practitioners. There were no significant differences among the nutrition attitude scores for the three groups. Implications for nutrition educators included the need for nutrition in the medical school curriculum, the incorporation of nutrition into continuing education programs and the need for nutritionists to act as consultants to physicians. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

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.