The Association of Plasma Choline With Growth and Development Among Young Malawian Children Enrolled in an Egg Intervention Trial

Abstract Objectives Choline has been positively associated with child growth and development, but few studies have been in areas of high stunting and low choline intake. This secondary analysis examines the association of plasma choline with growth/development in Malawian children enrolled in a randomized trial of 1 egg/day versus nonintervention control. Methods Venous blood, anthropometric, and developmental measures were collected at enrollment (at age 6–9 mos) and at endline 6 mos later. Plasma choline, betaine, dimethylglycine, and trimethylamine N-oxide were measured using untargeted metabolomics among 400 children. Length, weight, and head circumference were converted to z-scores using WHO Growth Standards. Developmental measures included fine and gross motor, personal social, and language skills (measured and normed using the Malawi Developmental Assessment Tool), memory (elicited imitation [endline only] and visual paired comparison tasks), and attention (Infant Orienting with Attention [IOWA] task). Generalized linear models, adjusted for covariates including group assignment, were used to examine the association of plasma choline with growth/developmental outcomes. Results In cross-sectional models including both time points (baseline, endline) and adjusting for repeated measures, a 1 SD-unit increase in plasma choline was negatively associated with length-for-age z-score (–0.11 SD [95% CI: –0.20, –0.02]) and positively associated with IOWA reaction time (8.8 ms [1.7, 16.0]), meaning slower shifts in attention with higher plasma choline. In predictive models, higher baseline plasma choline predicted lower endline fine motor z-scores (–0.13 SD [–0.22, –0.04]). There were no associations of plasma choline with weight-for-age, head-circumference-for-age, weight-for-length, or the other developmental outcomes. Analysis of other biomarkers revealed few significant associations with growth/development. Conclusions Plasma choline was not strongly associated with growth or development in this sample of Malawian children. The few significant associations suggested poorer growth/development with higher plasma choline. Further research in various contexts is needed. Funding Sources Bill and Melinda Gates Foundation; Egg Nutrition Center.

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The contribution of grandmother involvement to child growth and development: an observational study in rural Pakistan

BMJ Global Health ◽

10.1136/bmjgh-2019-002181 ◽

2020 ◽

Vol 5 (8) ◽

pp. e002181

Author(s):

Esther O Chung ◽

Ashley Hagaman ◽

Katherine LeMasters ◽

Nafeesa Andrabi ◽

Victoria Baranov ◽

...

Keyword(s):

Low Income ◽

Growth And Development ◽

Linear Models ◽

Child Outcomes ◽

Child Growth ◽

Socioemotional Development ◽

Fine Motor ◽

Early Child ◽

Rural Pakistan ◽

Z Scores

IntroductionEarly childhood interventions primarily focus on the mother–child relationship, but grandmothers are often critical in childcare in low-resource settings. Prior research is mixed on how grandmother involvement influences child outcomes and there is a paucity of research on grandmother caregiving in low-income and middle-income countries. We examined the role of grandmother involvement on child growth and development in the first 2 years of life cross sectionally and longitudinally in rural Pakistan.MethodsWe used data from the Bachpan Cohort, a longitudinal birth cohort in rural Pakistan. Maternally reported grandmother involvement in daily instrumental and non-instrumental caregiving was collected at 3 and 12 months. A summed score was created and categorised into non-involved, low and high. Outcomes included 12-month and 24-month child growth, 12-month Bayley Scales of Infant and Toddler Development and 24-month Ages and Stages Questionnaire—Socioemotional. We used multivariable generalised linear models to estimate mean differences (MD) at 12 months (n=727) and 24 months (n=712). Inverse probability weighting was used to account for missingness and sampling.ResultsIn our sample, 68% of children lived with a grandmother, and most grandmothers were involved in caregiving. Greater 3-month grandmother involvement was positively associated with 12-month weight z-scores; however, greater involvement was associated with lower 24-month weight z-scores. High 12-month grandmother involvement was associated with improved 12-month cognitive (MD=0.38, 95% CI −0.01 to 0.76), fine motor skills (MD=0.45, 95% CI 0.08 to 0.83) and 24-month socioemotional development (MD=−17.83, 95% CI −31.47 to –4.19). No meaningful associations were found for length z-scores or language development.ConclusionIn rural Pakistan, grandmothers provide caregiving that influences early child development. Our findings highlight the complex relationship between grandmother involvement and child weight, and suggest that grandmothers may positively promote early child cognitive, fine motor and socioemotional development. Understanding how grandmother involvement affects child outcomes in early life is necessary to inform caregiving interventions.

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Diarrhea Prevalence and Child Growth Faltering Are Associated with Subsequent Adverse Child Developmental Outcomes in Bangladesh (CHoBI7 Program)

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0767 ◽

2021 ◽

Author(s):

Christine Marie George ◽

Jamie Perin ◽

Tahmina Parvin ◽

Md Sazzadul Islam Bhuyian ◽

Elizabeth D. Thomas ◽

...

Keyword(s):

Developmental Outcomes ◽

Child Growth ◽

Social Problem Solving ◽

Fine Motor ◽

Linear Regression Models ◽

Developmental Potential ◽

Growth Faltering ◽

Z Scores ◽

Diarrhea Prevalence

Millions of young children annually are not meeting their developmental potential in low- and middle-income countries. Previous studies have shown that diarrheal diseases during early life are associated with subsequent malnutrition. This prospective cohort study of 576 children under 5 years was conducted in urban Dhaka, Bangladesh, to investigate the association between diarrhea prevalence, child growth, and child cognitive developmental outcomes. Height and weight were measured at baseline and a 12-month follow-up. Diarrhea prevalence was assessed through monthly surveillance visits. Developmental outcomes were assessed by communication, fine motor, gross motor, personal social, problem-solving, and combined developmental scores measured by the Extended Ages and Stages Questionnaire (EASQ) at the 12-month follow-up visit. To assess the association between diarrhea prevalence, child growth, and child developmental outcomes, linear regression models were fit using generalized estimating equations to account for clustering at the household level and to approximate 95% CIs. Diarrhea prevalence was negatively associated with change in height-for-age (HAZ) Z-scores from baseline to the 12-month follow-up (coefficient −0.85 [95% CI: −1.42, −0.28]). Diarrhea prevalence was a significant predictor of combined EASQ Z-scores with and without baseline stunting included in the model (−0.89 [95% CI: −1.67, −0.09] [baseline stunting included]) and (−0.88 [95% CI: −1.69, −0.07]). Change in HAZ from baseline to the 12-month follow-up was positively associated with follow-up combined EASQ Z-scores (0.28 [95% CI: 0.15, 0.42]). High diarrhea prevalence and linear growth faltering were associated with negative cognitive developmental outcomes among children residing in urban Dhaka, Bangladesh. Furthermore, high diarrhea prevalence was associated with negative child cognitive developmental outcomes with stunting included in the model, suggesting an effect of diarrhea on cognition independent of stunting.

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Cognitive Outcomes at 18 Months: Findings from the Early Life Interventions for Childhood Growth and Development in Tanzania (ELICIT) Trial

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0596 ◽

2021 ◽

Author(s):

Tarina Parpia ◽

Erling Svensen ◽

Sarah Elwood ◽

Anne Wanjuhi ◽

Ladislaus Blacy ◽

...

Keyword(s):

Growth And Development ◽

Assessment Tool ◽

Child Growth ◽

Cognitive Outcomes ◽

Secondary Outcome ◽

Fine Motor ◽

Micronutrient Deficiencies ◽

Birth Season ◽

Childhood Growth ◽

Enteric Infections

Micronutrient deficiencies and enteric infections negatively impact child growth and development. We enrolled children shortly after birth in a randomized, placebo-controlled, 2 × 2 factorial interventional trial in Haydom, Tanzania, to assess nicotinamide and/or antimicrobials (azithromycin and nitazoxanide) effect on length at 18 months of age. Cognitive score at 18 months using the Malawi Developmental Assessment Tool (MDAT), which includes gross motor, fine motor, language, and social assessments, was a secondary outcome. Here, we present the MDAT results of 1,032 children. There was no effect of nicotinamide (change in development-for-age Z score [DAZ] −0.08; 95% CI: −0.16, 0) or antimicrobials (change in DAZ 0.04; 95% CI: −0.06, 0.13) on overall MDAT score. The interventions had no effect on cognitive outcomes in subgroups defined by gender, socioeconomic status, birthweight, and birth season or on MDAT subscores. Further analyses are needed to identify targetable risk factors for impaired cognitive development in these settings.

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THE FIRST 6TH-MONTH NUTRITIONAL STATUS OF A FULL-TERM CHILD IN EXCLUSIVE BREASTFEEDING: A LITERATURE REVIEW

SEAJOM: The Southeast Asia Journal of Midwifery ◽

10.36749/seajom.v7i1.131 ◽

2021 ◽

Vol 7 (1) ◽

pp. 1-21

Author(s):

Relisa Nuris Shifa ◽

Sulistiawati ◽

Endyka Erye Frety ◽

Astika Gita Ningrum

Keyword(s):

Literature Review ◽

Nutritional Status ◽

Quality Assessment ◽

Exclusive Breastfeeding ◽

Head Circumference ◽

Assessment Tool ◽

Research Question ◽

Relevant Literature ◽

Child Growth ◽

Full Term

Background: The first six months after birth are part of the first 1000 days, a golden period for child development. In this period, the child needed proper nutrition to support optimal development and as nutrition programming. WHO recommends exclusive breastfeeding (EBF) for the first 6th-month. Adequacy of nutrition and optimal growth can be assessed using the nutritional status. Aim: This study analyzes the relationship between EBF for the first 6 months with the nutritional status of a full-term infant aged 0-6 months. The nutritional status assessed using anthropometric measurements and child growth standards. Methods: This type of literature review research uses the PRISMA, PICO, and Boolean Operator methods. The research question with PICO standard "What is a relationship between exclusive breastfeeding practice and nutritional status of children aged 0-6 months?". Relevant literature was obtained from 8 databases: Scopus, Portal Garuda, Proquest, Mendeley, Pubmed, Oxford, Science Direct, and Sage. Literature was limited to the last 10 years. There are 6 relevant pieces of literature included for review. The literature quality assessment uses a quantitative study quality assessment tool released by the EPHPP (Effective Public Health Practice Project) and produces 5 pieces of literature worthy of review. Results: From 5 kinds of literature, there were various indicators of nutritional status such as weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), Body Mass Index (BMI)-for-age, and head circumference (HC)-for-age. The results were dominated by insignificant results, except the HC-for-age indicator stated that there were significant results. The author explores the causes of insignificant results. Explores based on the indicators that include in studies, the information based on studies, and the possible consequences that adjusted to the data based on the studies. The Author found that the mother plays an important role in the production and provision of breast milk. The quality of breastmilk depends on the mother, also how she gives it to their infant. It has to be based on the WHO recommendation. Conclusion: The result of these studies affirms that EBF didn't significantly affect the indicators of WAZ, LAZ, WLZ, and BMI-for-age, but significantly affected the head circumference-for-age indicator.

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A quasi-experimental study on exploring the use of mobile phone technology for optimizing, tracking and responding to children's developmental progress in Korogocho, Nairobi, Kenya: study protocol

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20200206 ◽

2020 ◽

Vol 7 (1) ◽

pp. 43

Author(s):

Patricia Kitsao Wekulo ◽

Margaret Nampijja ◽

Domnick O. Okullo ◽

Kenneth O. Okelo ◽

Milka Njeri ◽

...

Keyword(s):

Mobile Phone ◽

Growth And Development ◽

Linear Models ◽

Developmental Outcomes ◽

Child Growth ◽

Mixed Linear Models ◽

Clinical Trial Registry ◽

Mobile Phone Application ◽

Mobile Phone Technology ◽

Quasi Experimental

Background: The massive use of technology can be leveraged to facilitate access to growth and development programs for children. Existing programs supporting such initiatives for children younger than three years are inadequate and not accessible to most families. In most cases, primary caregivers are unable to identify delayed milestones in their children’s growth and development due to inadequate information. They therefore often report the cases when they have become very severe and difficult to reverse. In order to promote early identification of possible developmental delays, African Population and Health Research Center together with Val Partners will develop, implement and evaluate the use of mobile phone technology to help caregivers track their children's developmental outcomes.Methods: The study will employ a quasi-experimental design and will use a mixed-methods approach combining quantitative and qualitative methodologies. In one arm, 110 caregivers will be trained on the use of a mobile phone application to assess child growth and development. The other arm, with 110 caregivers, will receive standard care provided by community health volunteers. Child developmental outcomes will be assessed in both arms. Feasibility of the intervention will be assessed qualitatively. Performance data will be compared across the two arms using mixed linear models to assess the effect of the intervention on child development.Conclusions: The findings are expected to provide evidence on whether the intervention is feasible and has an effect on child developmental outcomes. The results will inform the scalability and sustainability of the project.Trial Registration: The trial has been registered with the Pan African Clinical Trial Registry (www.pactr.org) database (ID number: PACTR201905787868050).

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Maternal Functional Health Literacy Does Not Predict Child Growth, Development, or Illness from 6 to 18 Mo of Age in Malawi (P11-004-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-004-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Katherine Cox ◽

Ulla Ashorn ◽

John Phuka ◽

Kenneth Maleta ◽

John Sadalaki ◽

...

Keyword(s):

Health Literacy ◽

Child Growth ◽

Functional Health ◽

Growth Charts ◽

Functional Health Literacy ◽

Funding Sources ◽

Nutrient Supplements ◽

Z Scores ◽

Growth Development ◽

Gates Foundation

Abstract Objectives To examine the association of maternal functional health literacy (FHL), a mother's ability to understand health information written in words and pictures, with child health, growth, and development in rural Malawi. Methods Maternal FHL was measured at six months postpartum among 671 participants in the International Lipid-Based Nutrient Supplements (iLiNS) DYAD-M trial in Malawi. Field staff asked comprehension questions about written health materials that were common in Malawi, such as medication instructions, breastfeeding information, and growth charts. Outcomes were child length-for-age (LAZ) and weight-for-length (WLZ) z scores at age 6 and 18 mo, change in LAZ and WLZ from 6 to 18 mo, motor and language development at 18 mo, and illness monitored weekly from birth to 18 mo (highest quartile prevalence of diarrhea, highest quartile prevalence of malaria or undefined fever, and incidence of acute respiratory infection). In Model 1, we examined the unadjusted association between maternal FHL and each outcome. In Model 2, we adjusted for household and parental background characteristics collected at baseline, child age and sex, and trial group. In Model 3, we added maternal cognition, depression, and caregiving characteristics collected after baseline. Results Over 90% of participants understood the growth charts, immunization record, and breastfeeding information in the health passport. Understanding of medication instructions was lower, with 72% understanding malaria, 81% Panadol, and 63% erythromycin instructions (Figure 1). Maternal FHL z score significantly predicted motor (β ± SE = 0.087 ± 0.040, P = 0.029) and language z scores (β ± SE = 0.093 ± 0.040, P = 0.020) at 18 mo in unadjusted models. However, after adjusting for covariates, these associations were not significant. Maternal FHL was not significantly associated with any other outcomes. Conclusions Revision of written medication instructions in Malawi may be needed to increase mothers’ understanding of how to deliver medication to their children. However, in this sample, maternal FHL was not associated with indicators of child growth, development, or illness after adjusting for parental, household, and caregiving characteristics. Funding Sources This publication is based on research funded by a grant to the University of California, Davis from the Bill & Melinda Gates Foundation. Supporting Tables, Images and/or Graphs

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Effect of Family Support on Child Growth and Development in Sukoharjo, Central Java

Childhood Stunting, Wasting, and Obesity, as the Critical Global Health Issues: Forging Cross-Sectoral Solutions ◽

10.26911/the7thicph.03.53 ◽

2020 ◽

Author(s):

Fitria Hayu Palupi ◽

◽

Ana Wigunantiningsih ◽

Luluk Nur Fakhidah ◽

Siskana Dewi Rosita ◽

...

Keyword(s):

Family Support ◽

Growth And Development ◽

Child Growth ◽

Health Science ◽

Fine Motor ◽

Growth Chart ◽

Cluster Sampling ◽

Normal Height ◽

Central Java ◽

Good Family

ABSTRACT Background: Impaired growth and development of children remains a serious problem globally. The role of the family, especially the support and participation of parents are the important factors in monitoring the growth and development of infants/ toddlers. This study aimed to determine the effect of family support on the growth and development of infants/ toddlers. Subjects and Method: This was a cross-sectional study conducted at Kragilan Village, Mojolaban, Sukoharjo, Central Java in November 2018. The study subjects were total of 115 mothers with children aged 1-60 month. Multistage cluster sampling technique was conducted. Dependent variable was growth and development of children. Independent variable was family support. The data for family support was collected by questionnaire. The data for growth of infants/ toddlers was collected by assessing growth chart (monitoring whether weight gain or loss from previous month), assessing length/height-for-age (normal height or stunted), head circumference measurement (macrocephalic/ microcephalic/ normocephalic), and assessing teething chart (erupts/ loss of teeth in accordance with age or not). The data for development of infants/ toddlers was collected by evaluating the gross motor, fine motor, language, and social skills based on child development pre-screening questionnaire. Results: Good family support increases growth (b= 0.895; p <0.001) and development (b= 0.337; p <0.001) of infants/ toddlers. Conclusion: Good family support increases growth and development of infants/ toddlers. Keywords: family support, growth, development Correspondence: Fitria Hayu Palupi. Midwifery Study Program, School of Health Science Mitra Husada Karanganyar. Jl. Brigjen Katamso Barat, Papahan, Tasikmadu, Karanganyar, Central Java, Indonesia. Email: [email protected]. Mobile: +6285326848008. DOI: https://doi.org/10.26911/the7thicph.03.53

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Demographic Correlates of Infant Feeding Practices and Growth Performance in the First Year of Life

International Journal of Pediatrics ◽

10.1155/2018/6569204 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Leila M. Shinn ◽

Christy C. Tangney ◽

Caitlyn Busche ◽

Christine M. Sharp ◽

Mary C. Mullen

Keyword(s):

Growth Performance ◽

Infant Feeding ◽

Head Circumference ◽

Repeated Measures ◽

Feeding Practices ◽

Growth Patterns ◽

Infant Feeding Practices ◽

Demographic Correlates ◽

Z Scores ◽

Weight For Age

The aims of this study are (1) to assess changes in infant WHO growth indicators (weight-for-age, weight-for-length, and head circumference z-scores) from birth to 12 months of age as a function of feeding practices (FP) and (2) to describe the proportion of infants experiencing rapid weight gain (RWG; defined as change in weight-for-age z-score of ≥0.67 between birth and six months) among different FP. The modified Infant Feeding Practices Study II questionnaire was administered to 149 diverse caretakers/mothers of infants who were less than six months of age in a pediatric outpatient clinic. Growth as a function of FP was assessed using repeated measures ANOVA, while logistic regression was used to describe the correlates of RWG. The largest proportion of caretakers was African American (37%), 46% completed college, and 48% were enrolled in the Women, Infants, and Children (WIC) program. Regarding FP, 32% of infants were formula fed, and 18% were breastfed, with the remaining being either mixed fed or complementary fed, with nearly 40% of infants demonstrating RWG. While changes in weight-for-age z-scores differed among FP across time (p<0.05), observed patterns for head-circumference-for-age and weight-for-length z-scores did not. Various demographic correlates (caretaker race-ethnicity, education, and WIC enrollment) were associated with FP. Only the patterns of change in weight-for-age z-scores at 9 and 12 months differed among FP (with breastfeeding being the lowest at both time points). Further study is needed to adequately characterize the correlates of infant growth performance and growth patterns among different FP in such diverse samples. Continued research will allow for the development of an easy-to-use, succinct questionnaire that will allow healthcare providers to individualize feeding recommendations for caretakers of infants.

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Status gizi dan perkembangan anak usia 3-5 tahun di Kabupaten Bogor

JURNAL GIZI INDONESIA ◽

10.14710/jgi.8.2.143-148 ◽

2020 ◽

Vol 8 (2) ◽

pp. 143-148

Author(s):

Sarah Melati Davidson ◽

Ali Khomsan ◽

Hadi Riyadi

Keyword(s):

Cognitive Development ◽

Child Development ◽

Nutritional Status ◽

Rural Areas ◽

Growth And Development ◽

Developmental Disorders ◽

Child Growth ◽

Fine Motor ◽

Gross Motor ◽

Active Communication

Background: Malnutrition in children under five causes a variety of developmental disorders. The nutritional need for children aged 3-5 age is very critical to reach optimum growth and development. Objectives: The purpose of this study is to analyse the association between nutritional status using WAZ, HAZ, WHZ index with gross motor, fine motor, passive communication, active communication, cognitive, self-help ability and social behavior development childred aged 3-5 years old. Methods: Data was obtained from a study entitled Improving Child Growth and Development through Nutrition and Psychosocial Intervention in Early Childhood Education (PAUD) Setting in Rural Areas and was fully funded by the Nestle Foundation (NF), Switzerland. The study design was cross-sectional, with 120 children aged 3-5 years old as subjects. Locations and subjects were selected purposively in Bogor District. Nutritional status was assesed by WAZ, HAZ, and WHZ index. Child development was assessed by using Bina Keluarga Balita questionnaire.Results: Most of the subjects had good nutritional status dan development level. WAZ indicator significantly associated with gross motor dan cognitive development (p<0.05). HAZ indicator significantly associated with gross motor, active communication skills and cognitive development (p<0.05). WHZ indicator significantly associated with fine motor and cognitive children (p<0.05). Conclusion: Nutritional status is associated with child development.

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Prenatal lead exposure: associations with growth and anthropometry in early childhood in a UK observational birth cohort study

Wellcome Open Research ◽

10.12688/wellcomeopenres.16338.2 ◽

2021 ◽

Vol 5 ◽

pp. 235

Author(s):

Caroline M. Taylor ◽

Jean Golding ◽

Katarzyna Kordas

Keyword(s):

Prenatal Exposure ◽

Lead Exposure ◽

Head Circumference ◽

Child Growth ◽

Birth Cohort Study ◽

Linear Regression Models ◽

Anthropometric Measures ◽

Z Scores ◽

The Uk ◽

Prenatal Lead Exposure

Background: Lead is a neurotoxic metal that crosses the placenta freely. It has adverse effects on a range of birth outcomes. The few studies reporting on the associations of prenatal exposure to lead and child growth have had conflicting results. This study aimed to examine the effect of prenatal exposure to lead on children’s growth from 4 to 61 months of age. Methods: Pregnant women were enrolled in the UK Avon Longitudinal Study of Parents and Children (ALSPAC). Whole blood samples for pregnancies with a live birth were analysed for lead (n=4140). A 10% subsample of the offspring cohort (Children in Focus) were invited to clinics at 10 time points (4–61 months) at which anthropometric measurements were carried out; z-scores for height, weight and BMI were calculated using the 1990 British Growth Reference Standards. Associations between prenatal log10-lead concentrations and z-scores and other anthropometric measures were modelled using adjusted linear regression models in an imputed dataset for children who attended at least one clinic (n=574). Results: The median prenatal blood lead concentration was 3.60 (IQR 2.61–4.16) µg/dl. There was no evidence for any associations of prenatal lead exposure with z-scores for BMI, height or weight in adjusted models from age 4 to 61 months. There were no associations for other anthropometric measures including mid-upper arm circumference, head circumference and waist circumference. There was some evidence for a weakly positive effect of prenatal lead exposure on head circumference in girls at age 43 and 61 months (at 61 months unstandardised B coefficient 1.59 (95% CI 0.12, 3.16) cm, p=0.048) but not at other ages. Conclusions: There was no consistent evidence of associations between prenatal exposure to lead and measures of growth and anthropometry from age 4 to 61 months in this cohort of children in the UK.

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