Breastfeeding and Beyond
Pages 50-62
Carolyn W. Gunther, Paul Branscum, Julie Kennel, Elizabeth G. Klein, Laura E. Monnat and Gail Kaye

DOI: http://dx.doi.org/10.6000/1929-4247.2013.02.01.8

Published: 28 February 2013

Abstract: This paper draws on the last chapter of my forthcoming book Window to The Womb. How Prenatal Life Shapes a Baby’s Development, which is an unprecedented dialogue between scientific research and maternal subjective experience. It highly acknowledges the supreme importance of the woman’s healthy nutrition and emotional nurturing to create an optimal womb environment and transmit a positive attitude to nutrition – and to life in general – to the child. In particular, breastfeeding may reinforce this attitude and allow for the baby’s smooth transition from the flavours of the amniotic fluid, introduced by the mother’s healthy food, to those present in the breast milk, which the baby recognises as familiar. Therefore, the benefits of breastfeeding are not limited to its nutrients but extend to the reassuring experience of continuity from the womb life, building the foundations of the baby’s emotional security.

Vitamin A Supplementation and Stunting Levels Among Two Year Olds in Kenya: Evidence from the 2008-09 Kenya Demographic and Health Survey
Pages 135-147
Elizabeth W. Kimani-Murage, Crispin Ndedda, Katherine Raleigh and Peninah Masibo

DOI: http://dx.doi.org/10.6000/1929-4247.2012.01.02.5

Published: 31 December 2012

Abstract: Background: High levels of undernutrition, particularly stunting, have persisted in Kenya, like in other developing countries. The relationship betweeen vitamin A supplementation and growth of children in Kenya has not been established, while there are context-specific variations on the relationship. This study explores this relationship in the Kenyan context.

Methods: The study uses data from the 2008-09 Kenya Demographic and Health Survey, involving children aged 24-35 months, a weighted sample of 1029 children. Descriptive and logistic regression analyses were conducted. The outcome variable of interest is stunting, while the exposure variable of interest is ever receiving a dose of vitamin A supplement. Secondary outcomes include underweight and wasting status.

Results: The prevalence of stunting in the study group was 46%; underweight 20%; and wasting 6%. The prevalence of ever receiving vitamin A supplement was 78%. Receiving vitamin A supplement was significantly negatively associated with stunting and underweight status, adjusting for other co-risk factors. The odds of stunting were 50% higher (p=0.038), while for underweight were 75% higher (p=0.013) among children who did not receive Vitamin A supplement compared with those who did.

Conclusion: This study demonstrates that receiving vitamin A supplement may be beneficial to growth of young children in Kenya. However, though freely offered through immunization services to children 6-59 months, some children do not receive it, particularly after completing the immunization schedule. There is need to establish innovative and effective ways of maximizing utilization of this intervention, particularly for children who have completed their immunization schedule.

An Investigation of Patterns and Factors Associated with Exclusive Breast Feeding in Northern Ghana
Pages 92-103
Mahama Saaka, Solomon Addae Takyi and Tetteh Maxwell

DOI: http://dx.doi.org/10.6000/1929-4247.2012.01.02.2

Published: 31 December 2012

Abstract: Introduction: The main aim of this study was to assess the practice of exclusive breastfeeding (EBF) and explore its determinants in Tamale Metropolis, Northern Ghana.
Methods: In this analytical cross-sectional study, systematic random sampling was used to select 355 mother- infant pairs between 0-6 months from among consenting mothers attending post natal care at the Tamale Teaching and West Hospitals in the Tamale Metropolis.
Results: The prevalence of EBF among infants < 6 months in the Tamale Metropolis for the past 24 hours was 92.1 % but it was 75.5 % in the one month prior to the study.
In logistic regression analyses, factors that had significant positive association with EBR were institutional delivery, current mother’s employment, maternal motivation and household wealth index. Compared to home delivery, women who delivered at a health institution were five times more likely to practice EBF (Adjusted odds ratio [AOR] = 5.17, CI: 2.45 – 10.90). Petty traders were four times more likely to exclusively breastfeed, compared to women who were unemployed (A OR = 4.05, CI: 1.93 – 8.51).
EBF provided 80 % (Adjusted OR = 0.2, CI: 0.08-0.37) protection against chronic malnutrition whilst high household index reflecting socio-economic status provided only 10 % protection against chronic malnutrition in the study sample (Adjusted OR = 0.9, CI: 0.81- 0.98).
Conclusion and Recommendation: Strategies that target improving knowledge and skills on lactation management among women, as well as strategies to improve health facility delivery especially among non-working mothers, may help to improve EBF in Northern Ghana.

A Theoretical Proposal for a Perceptually Driven, Food-Based Disgust that Can Influence Food Acceptance During Early Childhood
Pages 1-10
Steven D. Brown and Gillian Harris

DOI: http://dx.doi.org/10.6000/1929-4247.2012.01.01.01

Published: 25 September 2012

Abstract: Disgust, the “revulsion at the prospect of (oral) incorporation of an offensive substance”, is not thought to influence the acceptability of food during infancy and early childhood. This is because the feelings of disgust require a person to have developed an understanding of contagion and to be aware of the nature and origin of a given disgust stimulus, which does not occur until around seven years of age. Despite this need for higher cognitive functioning, studies have demonstrated the potential for disgust in children as young as two years of age. Furthermore, it seems that young children can demonstrate aspects of disgust without having the cognitive understanding of contagion. This review is the first paper to demonstrate how core disgust may influence the acceptability of foods from late infancy. Firstly, food neophobia may act as a catalyst for disgust. Secondly, that disgust in young children can result from the visual perceptual features of food (as opposed to a cognitive response based on non-food disgust stimuli). Thirdly, that some disliked foods have contaminating properties, much like non-food, adult disgust stimuli (e.g. insects). Fourthly, that the response reduces as the child ages and learns more about food and its variability between presentations. Finally, individual differences exist to explain why an individual child may be more or less likely to respond to a given food with a disgust response. This proposal adds to the current debate relating to the motivations of ‘picky’ eating during early childhood and introduces an alternative to the proposal that these behaviours are the result of a child’s desire for autonomy