Neonates with preterm, gastrointestinal dysfunction and very low birth weights are often intolerant to oral feeding. In such infants, the provision of nutrients via parenteral nutrition (PN) becomes necessary for short-term survival, as well as long-term health. However, the elemental nutrients in PN can be a major source of oxidants due to interactions between nutrients, imbalances of anti- and pro-oxidants, and environmental conditions. Moreover, neonates fed PN are at greater risk of oxidative stress, not only from dietary sources, but also because of immature antioxidant defences. Various interventions can lower the oxidant load in PN, including the supplementation of PN with antioxidant vitamins, glutathione, additional arginine and additional cysteine; reduced levels of pro-oxidant nutrients such as iron; protection from light and oxygen; and proper storage temperature. This narrative review of published data provides insight to oxidant molecules generated in PN, nutrient sources of oxidants, and measures to minimize oxidant levels.

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Breastfeeding is essential to break the vicious cycle of under nutrition of children. This study was aimed to assess the breastfeeding practices and nutritional status of children aged one to five years in Jaffna district. The study design was descriptive cross sectional. Height, weight, haemoglobin, albumin and serum ferritin of children were measured. Structured interviewer administered questionnaire was used to obtain socio-demographic factors, breastfeeding practices and dietary pattern. Among the total of 846 children (414 boys), 64.4% (545) were exclusively breastfed for 6 months. Among 585 children who were breastfed, 55.6% were breastfed beyond two years while 12.6% were breastfed beyond three years. Working mothers (13.7%) had discontinued the exclusive breastfeeding (EBF) before the completion of six months (45.7%) when compared with the non-working mothers (67.4%). The prevalence of underweight, wasting and stunting was 33, 22 and 26% respectively. Prevalence of under nutrition was significantly high (54.2%) in non-EBF children. Prevalence of anaemia was high among non-EBF children (45.8%). Furthermore the early cessation of EBF before six months depended on the type of family (nucleated or extended) and wealth class of the households (p<0.05). The rate of EBF was low in Jaffna District and duration of breastfeeding of most of the children had not reached 2 yrs. Prevalence of under nutrition was significantly high among the non-exclusively breastfed children. EBF for six months was not practised due to several factors and have contributed to high prevalence of malnutrition in Jaffna district.

Background Iodine status, including Iodine Deficiency (ID) of the children aged 12–59 months of Jaffna District, Sri Lanka, have never been studied. This study thus aimed to assess ID among children aged 12–59 months by monitoring the Urinary Iodine Concentrations (UIC), the prevalence of goitre, and the factors causing ID. Method A cross-sectional study was conducted among 846 children aged 12–59 months in Jaffna District, Sri Lanka. Sociodemographic characteristics and other factors were collected using an interviewer-administered questionnaire. Dietary pattern of children was obtained using semi-quantitative food frequency questionnaire. We performed urinary iodine estimation and physical examinations to detect the goitre, according to the World Health Organization criteria. A multivariate logistic linear regression model was used to identify the factors that causing ID. Result The median UIC was 146.4 μg/L (interquartile range = 112.6–185.3 μg/L). Based on the UIC (<100 μg/L), 17.8% had ID, of which 15.7% and 2.1% had mild and moderate ID. The mean consumption of iodine from food was 128.7 (±20.2) μg/day. Gender variation had no influence on ID (p>0.05). Median UIC was significantly associated with living area, wealth status, type of drinking water, and method of iodized salt usage. A higher percentage of ID was significantly associated with younger age [AOR 2.32 (95% CI: 1.31–4.10)], urban area [AOR 1.94 (95% CI 1.27–2.96)], inland regions [AOR 3.20 (95% CI 1.85–5.55)], improper method of iodized salt usage [AOR 3.63 (95% CI: 1.38–9.56)], and low consumption of iodine-containing foods. The neck palpation revealed that only three children had goitre (0.4%). Conclusion This study revealed that high ID among the children in Jaffna children was due to improper usage of iodized salt, even though the iodized salt is freely available in the region, living area, and age, while the prevalence of goitre was not significantly identified as a public health problem.

Background The short duration of exclusive breastfeeding (EBF) has an impact on the growth and development of babies. Since no studies have been reported on EBF practices of the rural mothers in Jaffna District, Sri Lanka, this study was aimed to assess the factors influencing the early cessation of EBF. Methods This was a community-based cross-sectional study, and 338 mother-child pairs were selected. Socio-economic and demographic factors, the influence of the mode of delivery, and knowledge on EBF were obtained using an interviewer-administered questionnaire. The details of EBF and reasons for the cessation of breastfeeding before six months were obtained from the mothers. Multivariate analysis was performed to explore the correlates of breastfeeding. Results About 38.8% of the mothers ceased EBF before six months, 71.2% had practiced EBF for six months. The early discontinuation of the EBF by the employed mothers (AOR 4.3; 95% CI 1.3–13.9), those who delivered low birth weight babies (AOR 3.6; 95% CI 1.6–8.2) and delivered the babies by caesarian sections (AOR 2.9; 95% (1.2–6.9) (p≤0.05). The EBF practiced by mothers of rural Jaffna was not associated with the gender of the babies, type of family, number of children in a family, religion of the household, knowledge on EBF, and family income. Conclusion The prevalence of EBF up to six months was low in rural Jaffna, and it was influenced by employment, birthweight of the babies, and the mode of delivery.