scholarly journals Consumption of breast milk, formula and other non-human milk by children aged under 2 years: analysis of eighty-six low- and middle-income countries

2020 ◽  
pp. 1-9
Author(s):  
Paulo AR Neves ◽  
Aluísio JD Barros ◽  
Phillip Baker ◽  
Ellen Piwoz ◽  
Thiago M Santos ◽  
...  
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Breast Feeding ◽  
Milk Formula ◽  
Milk Consumption ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Low And Middle Income ◽  
Economic Inequalities

Abstract Objective: To investigate the prevalence and socio-economic inequalities in breast milk, breast milk substitutes (BMS) and other non-human milk consumption, by children under 2 years in low- and middle-income countries (LMIC). Design: We analysed the prevalence of continued breast-feeding at 1 and 2 years and frequency of formula and other non-human milk consumption by age in months. Indicators were estimated through 24-h dietary recall. Absolute and relative wealth indicators were used to describe within- and between-country socio-economic inequalities. Setting: Nationally representative surveys from 2010 onwards from eighty-six LMIC. Participants: 394 977 children aged under 2 years. Results: Breast-feeding declined sharply as children became older in all LMIC, especially in upper-middle-income countries. BMS consumption peaked at 6 months of age in low/lower-middle-income countries and at around 12 months in upper-middle-income countries. Irrespective of country, BMS consumption was higher in children from wealthier families, and breast-feeding in children from poorer families. Multilevel linear regression analysis showed that BMS consumption was positively associated with absolute income, and breast-feeding negatively associated. Findings for other non-human milk consumption were less straightforward. Unmeasured factors at country level explained a substantial proportion of overall variability in BMS consumption and breast-feeding. Conclusions: Breast-feeding falls sharply as children become older, especially in wealthier families in upper-middle-income countries; this same group also consumes more BMS at any age. Country-level factors play an important role in explaining BMS consumption by all family wealth groups, suggesting that BMS marketing at national level might be partly responsible for the observed differences.

scholarly journals Consumption of breast milk, formula and other non-human milk by children aged under two years: analysis of 86 low and middle income countries

2020 ◽  
Author(s):  
Paulo A. R. Neves ◽  
Aluisio J.D. Barros ◽  
Phillip Baker ◽  
Ellen Piwoz ◽  
Thiago M. Santos ◽  
...  
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Linear Regression Analysis ◽  
National Level ◽  
Milk Formula ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Family Wealth ◽  
Low And Middle Income

AbstractBackgroundConsumption of breast milk substitutes (BMS) by children aged under six months in low and middle income countries (LMICs) is directly driven by country income and family wealth. Multi-country investigations on the consumption of BMS by older children (6–23 months) are lacking.MethodsUsing data from 86 nationally representative surveys carried out in LMICs from 2010 onwards, we analyzed the prevalence of continued breastfeeding at one and two years, and frequency of consumption of formula and other non-human milk by age in months. Indicators were estimated through 24-hour dietary recall. Absolute and relative wealth indicators were used to describe within- and between-country socioeconomic inequalities. Results were stratified by country income groups.FindingsBreastfeeding declined sharply as children became older in all LMICs, especially in upper-middle income countries. Formula consumption peaked at six months of age in low and lower-middle income countries, and at around 12 months in upper-middle income countries. Consumption of formula at any age higher in children from wealthier families in all countries, while breastfeeding was more common among poor children. Multilevel linear regression analysis showed that consumption of formula was positively associated while breastfeeding was negatively associated with absolute national income. Factors at country level explained a substantial proportion of overall variability in formula use and breastfeeding.InterpretationInfant and young child feeding practices vary strongly according to wealth, both within and between countries. Breastfeeding falls sharply as children become older, especially in wealthier families living in upper-middle income countries; this is also the group with highest formula consumption at any age. Country-level factors play an important role in explaining BMS consumption by all family wealth groups in LMICs, suggesting that formula marketing at national level may be partly responsible for the observed differences.FundingThe Bill & Melinda Gates Foundation, through the WHO

scholarly journals Predictors of Contemporary under-5 Child Mortality in Low- and Middle-Income Countries: A Machine Learning Approach

2021 ◽  
Vol 18 (3) ◽  
pp. 1315
Author(s):  
Andrea Bizzego ◽  
Giulio Gabrieli ◽  
Marc H. Bornstein ◽  
Kirby Deater-Deckard ◽  
Jennifer E. Lansford ◽  
...  
Keyword(s):  
Machine Learning ◽  
Child Mortality ◽  
Learning Approach ◽  
Unique Contribution ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Machine Learning Approach ◽  
Operational Information ◽  
Low And Middle Income

Child Mortality (CM) is a worldwide concern, annually affecting as many as 6.81% children in low- and middle-income countries (LMIC). We used data of the Multiple Indicators Cluster Survey (MICS) (N = 275,160) from 27 LMIC and a machine-learning approach to rank 37 distal causes of CM and identify the top 10 causes in terms of predictive potency. Based on the top 10 causes, we identified households with improved conditions. We retrospectively validated the results by investigating the association between variations of CM and variations of the percentage of households with improved conditions at country-level, between the 2005–2007 and the 2013–2017 administrations of the MICS. A unique contribution of our approach is to identify lesser-known distal causes which likely account for better-known proximal causes: notably, the identified distal causes and preventable and treatable through social, educational, and physical interventions. We demonstrate how machine learning can be used to obtain operational information from big dataset to guide interventions and policy makers.

scholarly journals Protocol for a Multi-Level Policy Analysis of Non-Communicable Disease Determinants of Diet and Physical Activity: Implications for Low- and Middle-Income Countries in Africa and the Caribbean

2021 ◽  
Vol 18 (24) ◽  
pp. 13061
Author(s):  
Maylene Shung-King ◽  
Amy Weimann ◽  
Nicole McCreedy ◽  
Lambed Tatah ◽  
Clarisse Mapa-Tassou ◽  
...  
Keyword(s):  
Physical Activity ◽  
South Africa ◽  
Policy Development ◽  
Salt Intake ◽  
Communicable Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Promotion Of Physical Activity ◽  
Low And Middle Income

Non-communicable diseases (NCDs) are the leading cause of death globally. Despite significant global policy development for addressing NCDs, the extent to which global policies find expression in low-and-middle income countries’ (LMIC) policies, designed to mitigate against NCDs, is unclear. This protocol is part of a portfolio of projects within the Global Diet and Activity Research (GDAR) Network, which aims to support the prevention of NCDs in LMICs, with a specific focus on Kenya, Cameroon, South Africa and Jamaica. This paper outlines the protocol for a study that seeks to explore the current policy environment in relation to the reduction of key factors influencing the growing epidemic of NCDs. The study proposes to examine policies at the global, regional and country level, related to the reduction of sugar and salt intake, and the promotion of physical activity (as one dimension of healthy placemaking). The overall study will comprise several sub-studies conducted at a global, regional and country level in Cameroon, Kenya and South Africa. In combination with evidence generated from other GDAR workstreams, results from the policy analyses will contribute to identifying opportunities for action in the reduction of NCDs in LMICs.

Re: Agreement between current status and retrospective data for prevalence and duration of exclusive breast feeding from low‐ and middle‐income countries surveys

2019 ◽  
Vol 34 (1) ◽  
pp. 100-101
Author(s):  
Ana Elisa Madalena Rinaldi ◽  
Catarina Machado Azeredo ◽  
Leandro Alves Pereira ◽  
Bernardo Lessa Horta ◽  
Wolney Lisboa Conde
Keyword(s):  
Breast Feeding ◽  
Current Status ◽  
Retrospective Data ◽  
Middle Income ◽  
Exclusive Breast Feeding ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals How consistent are associations between stunting and child development? Evidence from a meta-analysis of associations between stunting and multidimensional child development in fifteen low- and middle-income countries

2015 ◽  
Vol 19 (8) ◽  
pp. 1339-1347 ◽  
Author(s):  
Ann C Miller ◽  
Megan B Murray ◽  
Dana R Thomson ◽  
Mary Catherine Arbour
Keyword(s):  
Child Development ◽  
Breast Feeding ◽  
Maternal Education ◽  
Meta Analysis ◽  
Middle Income ◽  
Negatively Associated ◽  
Middle Income Countries ◽  
Supportive Parenting ◽  
Developmental Domains ◽  
Low And Middle Income

AbstractObjectiveDespite documented associations between stunting and cognitive development, few population-level studies have measured both indicators in individual children or assessed stunting’s associations with other developmental domains.DesignMeta-analysis using publicly available data from fifteen Multiple Indicator Cluster Surveys (MICS-4) to assess the association between stunting and development, controlling for maternal education, family wealth, books in the home, developmentally supportive parenting and sex of the child, stratified by country prevalence of breast-feeding (‘low BF’<90 %, ‘high BF’ ≥90 %). Ten-item Early Childhood Development Index (ECDI) scores assessed physical, learning, literacy/numeracy and socio-emotional developmental domains. Children on track in three or four domains were considered ‘on-track’ overall.SettingFifteen low- and middle-income countries.SubjectsPublically available data from 58 513 children aged 36–59 months.ResultsSevere stunting (height-for-age Z-score <−3) was negatively associated with on-track development (OR=0·75; 95 % CI 0·67, 0·83). Any stunting (Z-score <−2) was negatively associated with on-track development in countries with high BF prevalence (OR=0·82; 95 % CI 0·75, 0·89). Severe and any stunting were negatively associated with physical development (OR=0·77; 95 % CI 0·66, 0·89 and OR=0·82; 95 % CI 0·74, 0·91, respectively) and literacy/numeracy development in high BF countries (OR=0·45; 95 % CI 0·38, 0·53 and OR=0·59, 95 % CI 0·51, 0·68, respectively), but not low BF countries (OR=0·93; 95 % CI 0·70, 1·23 and OR=0·95, 95 % CI 0·79, 1·12, respectively). Any stunting was negatively associated with learning (OR=0·79; 95 % CI 0·72, 0·88). There was no clear association between stunting and socio-emotional development.ConclusionsStunting is associated with many but not all developmental domains across a diversity of countries and cultures. However, associations varied by country breast-feeding prevalence and developmental domain.

scholarly journals Exploring the Associations between Early Childhood Development Outcomes and Ecological Country-Level Factors across Low- and Middle-Income Countries

2021 ◽  
Vol 18 (7) ◽  
pp. 3340
Author(s):  
Kasim Allel ◽  
Gerard Abou Jaoude ◽  
Stavros Poupakis ◽  
Neha Batura ◽  
Jolene Skordis ◽  
...  
Keyword(s):  
Early Childhood ◽  
Early Childhood Development ◽  
National Level ◽  
Childhood Development ◽  
Multivariate Linear Regression Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Low And Middle Income ◽  
At Home

A poor start in life shapes children’s development over the life-course. Children from low- and middle-income countries (LMICs) are exposed to low levels of early stimulation, greater socioeconomic deprivation and persistent environmental and health challenges. Nevertheless, little is known about country-specific factors affecting early childhood development (ECD) in LMICs. Using data from 68 LMICs collected as part of the Multiple Indicator Cluster Surveys between 2010 and 2018, along with other publicly available data sources, we employed a multivariate linear regression analysis at a national level to assess the association between the average Early Childhood Development Index (ECDI) in children aged 3–5 and country-level ecological characteristics: early learning and nurturing care and socioeconomic and health indicators. Our results show that upper-middle-income country status, attendance at early childhood education (ECE) programs and the availability of books at home are positively associated with a higher ECDI. Conversely, the prevalence of low birthweight and high under-5 and maternal mortality are negatively associated with ECDI nationally. On average, LMICs with inadequate stimulation at home, higher mortality rates and without mandatory ECE programs are at greater risks of poorer ECDI. Investment in early-year interventions to improve nurturing care and ECD outcomes is essential for achieving Sustainable Development Goals.

scholarly journals Prevalence and trends in the childhood dual burden of malnutrition in low- and middle-income countries, 1990–2012

2016 ◽  
Vol 19 (8) ◽  
pp. 1375-1388 ◽  
Author(s):  
Emma Tzioumis ◽  
Melissa C Kay ◽  
Margaret E Bentley ◽  
Linda S Adair
Keyword(s):  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Middle Income ◽  
Individual Level ◽  
Middle Income Countries ◽  
Country Level ◽  
Before And After ◽  
Dual Burden ◽  
Nationally Representative ◽  
Low And Middle Income

AbstractObjectiveTo describe trends in country- and individual-level dual burden of malnutrition in children <5 years, and age-stratified (<2 years, ≥2 years) country-level trends, in thirty-six low- and middle-income countries (LMIC).DesignUsing repeated cross-sectional nationally representative data, we calculated the prevalence of malnutrition (stunting, wasting, overweight) at each survey wave, annualized rates of prevalence change for each country over time, and trends before and after 2000, for all children <5 years and separately for those </≥2 years. We examined country- (ratio of stunting to overweight) and individual-level (coexistence of stunting and overweight) dual burden in children <5 years.SettingDemographic and Health Surveys from thirty-six LMIC between 1990 and 2012.SubjectsChildren <5 years.ResultsOverall malnutrition prevalence decreased in children <5 years, driven by stunting decreases. Stunting rates decreased in 78 % of countries, wasting rates decreased in 58 % of countries and overweight rates increased in 36 % of countries. Rates of change differed for children </≥2 years, with children <2 years experiencing decreases in stunting in fewer countries yet increases in overweight in more countries. Countries with nearly equal prevalences of stunting and overweight in children <5 years increased from 2000 to the final year. Within a country, 0·3–10·9 % of children <5 years were stunted and overweight, and 0·6–37·8 % of stunted children <5 years were overweight.ConclusionsThe dual burden exists in children <5 years on both country and individual levels, indicating a shift is needed in policies and programmes to address both sides of malnutrition. Children <2 years should be identified as a high-risk demographic.

scholarly journals Addressing barriers to exclusive breast-feeding in low- and middle-income countries: a systematic review and programmatic implications

2017 ◽  
Vol 20 (17) ◽  
pp. 3120-3134 ◽  
Author(s):  
Justine A Kavle ◽  
Elizabeth LaCroix ◽  
Hallie Dau ◽  
Cyril Engmann
Keyword(s):  
Systematic Review ◽  
Breast Feeding ◽  
Community Support ◽  
World Health ◽  
Feeding Problems ◽  
Middle Income ◽  
Exclusive Breast Feeding ◽  
Moderate Evidence ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractObjectiveDespite numerous global initiatives on breast-feeding, trend data show exclusive breast-feeding (EBF) rates have stagnated over the last two decades. The purpose of the present systematic review was to determine barriers to exclusive breast-feeding in twenty-five low- and middle-income countries and discuss implications for programmes.DesignA search of Scopus, MEDLINE, CINAHL and PsychINFO was conducted to retrieve studies from January 2000 to October 2015. Using inclusion criteria, we selected both qualitative and quantitative studies that described barriers to EBF.SettingLow- and middle-income countries.SubjectsFollowing application of systematic review criteria, forty-eight articles from fourteen countries were included in the review.ResultsSixteen barriers to EBF were identified in the review. There is moderate evidence of a negative association between maternal employment and EBF practices. Studies that examined EBF barriers at childbirth and the initial 24 h post-delivery found strong evidence that caesarean section can impede EBF. There is moderate evidence for early initiation of breast-feeding and likelihood of practising EBF. Breast-feeding problems were commonly reported from cross-sectional or observational studies. Counselling on EBF and the presence of family and/or community support have demonstrated improvements in EBF.ConclusionsImproving the counselling skills of health workers to address breast-feeding problems and increasing community support for breast-feeding are critical components of infant and young child feeding programming, which will aid in attaining the 2025 World Health Assembly EBF targets. Legislation and regulations on marketing of breast-milk substitutes, paid maternity leave and breast-feeding breaks for working mothers require attention in low- and middle-income countries.

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