The importance of mother’s care for improving exclusive breastfeeding practices

ABSTRAKLatar Belakang: Secara global, prevalensi ibu yang memberikan ASI (air susu ibu) secara eksklusif untuk bayinya sampai dengan usia 6 bulan masih rendah (38%). Di Indonesia, pemberian ASI sudah dipraktikkan secara luas, namun yang memberikan hingga 6 bulan hanya 15,3% dan belum meningkat, meskipun Panduan Pemberian Makan Bayi dan Anak dari WHO telah tersedia.Tujuan: Studi ini bertujuan untuk menginvestigasi pentingnya pengasuhan oleh ibu (yaitu ibu memiliki peran terbesar dan menghabiskan waktu terbanyak untuk merawat bayinya sehari-hari) untuk meningkatkan praktik ASI Eksklusif pada populasi dengan tingkat ekonomi rendah.Metode: Studi cross-sectional ini dilakukan pada 408 anak usia 6 - 24 bulan dan pengasuhnya di daerah pedesaan Indonesia. Data riwayat ASI, pengasuhan anak, dan status sosio-ekonomi diambil dengan instrumen kuesioner terstruktur oleh pewawancara yang terlatih.Hasil: Lebih dari setengah (61%) Ibu di populasi ini memberikan ASI secara eksklusif pada bayinya sampai dengan usia 6 bulan. Hasil menunjukkan bahwa bayi mempunyai kesempatan yang lebih besar untuk diberikan ASI eksklusif jika diasuh oleh ibu kandungnya (OR = 4.6., 95% CI = 1.75 - 12.2) dan berasal dari keluarga dengan penghasilan rendah (OR = 1.9 95% CI = 1.08 - 3.2), setelah mengendalikan variabel lain.Kesimpulan: Pada populasi berpenghasilan rendah dimana praktik pemberian ASI telah dilakukan, tetapi pengasuhan anak dilakukan oleh seseorang selain ibu kandung, pentingnya pemberian ASI eksklusif harus terus ditekankan. Edukasi untuk meningkatkan motivasi ibu dan anggota keluarga lainnya dalam memberikan ASI, serta membangun lingkungan kerja yang ramah menyusui adalah hal yang penting untuk dilakukan.KATA KUNCI: ASI eksklusif; pengasuh; ibu kandung; tingkat ekonomi; Indonesia Timur ABSTRACTBackground: Globally, the prevalence of women who exclusively breastfeed their infants to 6 months of age remains low (38%). In Indonesia, breastfeeding is widely practiced but the prevalence of exclusive breastfeeding at 6 months is only 15,3% and has not increased over time, despite WHO IYCF guidelines.Objectives: This study aims to examine the importance of mother’s care for improving exclusive breastfeeding practices in low-income populations in Indonesia.Methods: This cross-sectional study was conducted using 408 children aged 6 - 24 months and their caregivers in rural Indonesia. five districts. Data on breastfeeding history, childcare, and socioeconomic status of families were collected using structured questionnaires by trained interviewers.Results: Over half (61%) of mothers in this population exclusively breastfed their infant at 6 months (?) Results showed that infants are more likely to receive exclusive breastfeeding if they were cared by biological mothers (OR = 4.6., 95% CI = 1.75 - 12.2) and reside in low-income households (OR = 1.9 95% CI = 1.08 - 3.2), after adjusting for confounding variables.Conclusion: In low-income populations where breastfeeding is common but the provision of child care is provided by someone besides the biological mother, the importance of exclusive breastfeeding should continue to be emphasizedKEYWORDS: exclusive breastfeeding; caregivers; biological mothers; economic level; Eastern Indonesi

Monitoring and evaluation design of Malawi's Right Foods at the Right Time nutrition program

Abstract Child stunting is a public health problem in Malawi. In 2014, the Government of Malawi launched the Right Foods at the Right Time (RFRT) program in Ntchisi district delivering nutrition social and behavior change communication, a small-quantity lipid-based nutrient supplement to children 6–23 months, and nutrition sensitive activities. Monitoring and evaluation (M&E) systems are key aspects of successful program implementation. We describe these and the methodology for an impact evaluation that was conducted for this program. Two monitoring systems using traditional and electronic platforms were established to register and track program delivery and processes including number of eligible beneficiaries, worker performance, program participation, and to monitor input, output, and outcome indicators. The impact evaluation used comparative cross-sectional and longitudinal designs to assess impact on anthropometric and infant and young child feeding outcomes. Three cross-sectional surveys (base-, mid-, and end-line) and two longitudinal cohorts of children followed in 6-month intervals from 6 to 24 months of age, were conducted in sampled households in the program and a neighboring comparison district. Additional M&E included qualitative studies, a process evaluation, and a cost-effectiveness study. The current paper describes lessons from this program's M&E, and demonstrates how multiple implementation research activities can inform course-correction and program scale-up

When increasing vegetable production may worsen food availability gaps: A simulation model in India

Translating agricultural productivity into food availability depends on food supply chains. Agricultural policy and research efforts promote increased horticultural crop production and yields, but the ability of low-resource food supply chains to handle increased volumes of perishable crops is not well understood. This study developed and used a discrete event simulation model to assess the impact of increased production of potato, onion, tomato, brinjal (eggplant), and cabbage on vegetable supply chains in Odisha, India. Odisha serves as an exemplar of vegetable supply chain challenges in many low-resource settings

Low-income, African American Adolescent Mothers and Their Toddlers Exhibit Similar Dietary Variety Patterns

ABSTRACT Objective: To examine the relationship between maternal and toddler dietary variety. Design: Longitudinal; maternal and toddler dietary data were collected at 13 months; anthropometry was collected at 13 and 24 months. Setting: Data were collected in homes. Participants: 109 primiparous, low-income, African American adolescent mothers and toddlers. Main Outcome Measures: Maternal and toddler dietary variety and toddler obesity at 24 months. Analysis: Correlations were computed to estimate associations between maternal and toddler dietary variety at 13 months; multiple logistic regression analyses were conducted to estimate associations between maternal and toddler diet and toddler growth. Results: Maternal and toddler fruit, vegetable, snack, meat, dairy, and soda variety were significantly correlated. There was no association between maternal and toddler dietary variety and obesity at 24 months. Adolescent mothers who purchased groceries consumed more fruits and vegetables and provided more variety for their toddlers than those who relied on others to purchase groceries. Conclusions and Implications: Adolescent mothers and toddlers exhibited similar dietary patterns; consuming more sweets and less fruits and vegetables than recommended. Toddlerhood is an optimal time to address healthful dietary patterns and to help adolescent mothers influence grocery purchasing decisions. Goals are to establish healthful dietary patterns and reduce pediatric obesity

The extraordinarily bright optical afterglow of GRB 991208 and its host galaxy

Observations of the extraordinarily bright optical afterglow (OA) of GRB 991208 started 2.1 d after the event. The flux decay constant of the OA in the R-band is -2.30 +/- 0.07 up to 5 d, which is very likely due to the jet effect, and after that it is followed by a much steeper decay with constant -3.2 +/- 0.2, the fastest one ever seen in a GRB OA. A negative detection in several all-sky films taken simultaneously to the event implies either a previous additional break prior to 2 d after the occurrence of the GRB (as expected from the jet effect). The existence of a second break might indicate a steepening in the electron spectrum or the superposition of two events. Once the afterglow emission vanished, contribution of a bright underlying SN is found, but the light curve is not sufficiently well sampled to rule out a dust echo explanation. Our determination of z = 0.706 indicates that GRB 991208 is at 3.7 Gpc, implying an isotropic energy release of 1.15 x 10E53 erg which may be relaxed by beaming by a factor > 100. Precise astrometry indicates that the GRB coincides within 0.2" with the host galaxy, thus given support to a massive star origin. The absolute magnitude is M_B = -18.2, well below the knee of the galaxy luminosity function and we derive a star-forming rate of 11.5 +/- 7.1 Mo/yr. The quasi-simultaneous broad-band photometric spectral energy distribution of the afterglow is determined 3.5 day after the burst (Dec 12.0) implying a cooling frequency below the optical band, i.e. supporting a jet model with p = -2.30 as the index of the power-law electron distribution.Comment: Accepted for publication in Astronomy and Astrophysics, 9 pages, 6 figures (Fig. 3 and Fig. 4 have been updated

Lunar Volatiles and Solar System Science

Understanding the origin and evolution of the lunar volatile system is not only compelling lunar science, but also fundamental Solar System science. This white paper (submitted to the US National Academies' Decadal Survey in Planetary Science and Astrobiology 2023-2032) summarizes recent advances in our understanding of lunar volatiles, identifies outstanding questions for the next decade, and discusses key steps required to address these questions

Elevated protein concentrations in newborn blood and the risks of autism spectrum disorder, and of social impairment, at age 10 years among infants born before the 28th week of gestation

Among the 1 of 10 children who are born preterm annually in the United States, 6% are born before the third trimester. Among children who survive birth before the 28th week of gestation, the risks of autism spectrum disorder (ASD) and non-autistic social impairment are severalfold higher than in the general population. We examined the relationship between top quartile inflammation-related protein concentrations among children born extremely preterm and ASD or, separately, a high score on the Social Responsiveness Scale (SRS total score ≥65) among those who did not meet ASD criteria, using information only from the subset of children whose DAS-II verbal or non-verbal IQ was ≥70, who were assessed for ASD, and who had proteins measured in blood collected on ≥2 days (N = 763). ASD (N = 36) assessed at age 10 years is associated with recurrent top quartile concentrations of inflammation-related proteins during the first post-natal month (e.g., SAA odds ratio (OR); 95% confidence interval (CI): 2.5; 1.2–5.3) and IL-6 (OR; 95% CI: 2.6; 1.03–6.4)). Top quartile concentrations of neurotrophic proteins appear to moderate the increased risk of ASD associated with repeated top quartile concentrations of inflammation-related proteins. High (top quartile) concentrations of SAA are associated with elevated risk of ASD (2.8; 1.2–6.7) when Ang-1 concentrations are below the top quartile, but not when Ang-1 concentrations are high (1.3; 0.3–5.8). Similarly, high concentrations of TNF-α are associated with heightened risk of SRS-defined social impairment (N = 130) (2.0; 1.1–3.8) when ANG-1 concentrations are not high, but not when ANG-1 concentrations are elevated (0.5; 0.1–4.2)