BackgroundA prelacteal feed is any food except mother’s milk provided to a newborn before initiating breastfeeding. Prelacteal feeding is a major barrier to exclusive breastfeeding. It is a prevalent practice in Nepal. Little is known about the factors associated with providing prelacteal feeds to the Nepalese newborn. This study explored the factors associated with providing prelacteal feeds to children under three years in Nepal using the Nepal Demographic and Health Survey (NDHS) 2011.MethodsThis study utilised the NDHS 2011 child dataset which is a nationally representative study. The rates of providing prelacteal feeds were reported as a proportion. Complex Sample Analysis method was used to account for the cluster design and sample weight of the study. Chi-square tests and multiple logistic regression were used to analyse the factors associated with providing prelacteal feeds.ResultsA sample of 3948 mothers were included in the study. A total of 841 [26.5% (95% CI: 23.1%–30.3%)] weighted proportion) of mothers reported of providing prelacteal feeds to their newborn infants. Plain water (n = 75), sugar/glucose (n = 35), gripe water (n = 3), sugar/salt solution (n = 3), fruit juice (n = 3), infant formula (n = 96), tea (n = 3) and other milk other than breast milk (n = 556) were some of the types of prelacteal feeds reported. The multiple regression analysis showed that the mothers who had no education, were not working, were from the middle wealth quintile, who had not attended four antenatal care visits, were first time mothers and who were from the Terai/Plain region were more likely to provide prelacteal feeds.ConclusionsGiven that one in four infants were provided with prelacteal feeds, there is a need to implement breastfeeding promotion programs to increase the practice of exclusive breastfeeding and reduce prelacteal feeding practices. Breastfeeding counseling at antenatal clinics and peer support for exclusive breastfeeding should be included as part of breastfeeding promotion programs. Mobilisation of female community health volunteers for peer counseling is also a feasible option for Nepal.

Introduction Female sexual dysfunction is highly prevalent and reportedly has adverse impacts on quality of life. Although it is prevalent after childbirth, women rarely seek advice or treatment from health care professionals. Aim The aim of this study was to assess the sexual functioning of Australian women during the first year after childbirth. Methods Postpartum women who had given birth during the previous 12 months were invited to participate in this cross-sectional study. A multidimensional online questionnaire was designed for this study. This questionnaire included a background section, the Female Sexual Function Index, the Patient Health Questionnaire (PHQ-8), and the Relationship Assessment Scale. Responses from 325 women were analyzed. Results Almost two-thirds of women (64.3%) reported that they had experienced sexual dysfunction during the first year after childbirth, and almost three-quarters reported they experienced sexual dissatisfaction (70.5 %). The most prevalent types of sexual dysfunction reported by the affected women were sexual desire disorder (81.2%), orgasmic problems (53.5%), and sexual arousal disorder (52.3%). The following were significant risk factors for sexual dysfunction: fortnightly or less frequent sexual activity, not being the initiator of sexual activity with a partner, late resumption of postnatal sexual activity (at 9 or more weeks), the first 5 months after childbirth, primiparity, depression, and relationship dissatisfaction. Conclusion Sexual satisfaction is important for maintaining quality of life for postpartum women. Health care providers and postpartum women need to be encouraged to include sexual problems in their discussions.

BackgroundLow birth weight (LBW) is a major cause of neonatal deaths in developing countries including Nepal. Its social determinants in Nepal have rarely been identified. This study aimed to identify the factors associated with low birth weight among under-five children comparing data from the Nepal Demographic and Health Surveys (NDHS) of 2006 and 2011.MethodsPooled data from the Nepal Demographic and Health Surveys (NDHS) of 2006 and 2011 were analysed initially and the two survey data were then compared separately. The association between LBW and socio-demographic and health related factors were analysed using multiple logistic regression analysis with a stepwise backward elimination procedure. Complex Sample Analysis method was used to account for study design and sampling.ResultsA total of 2845 children, 923 children in 2006 and 1922 children in 2011, had their birth weight recorded. The mean birth weight was 3024 (SD = 654.5) grams. A total of 12.1% (95% Confidence interval (CI); 10.6%-13.7%) children had low birth weight (<2500 grams) at the time of birth. Attending antenatal care was found to be consistently associated with low birth weight for the pooled survey data, and both 2006 and 2011 survey data, respectively. Not attending antenatal care increased the odds of having a LBW infant by more than two times [OR 2.301; 95% CI (1.526-3.471)]. Iron supplementation, which is an integral part of antenatal care in Nepal, was also significantly associated with birth weight for combined and individual surveys. Mothers not consuming iron supplementation during their pregnancy were more likely to have LBW infants [OR 1.839; 95% CI (1.282-2.363)]. Residing in the Far-western and Eastern region were also significant risk factors for LBW in the pooled dataset and in 2011 survey.ConclusionsThe current study indicated there was no significant decrease in the LBW prevalence and there is a need of targeted interventions aimed at decreasing the high rate of LBW through increasing antenatal care and consumption of iron supplementation during pregnancy.

BackgroundThe global Low Birth Weight (LBW) rate is reported to be 15.5% with more than 95% of these LBW infants being from developing countries. LBW is a major factor associated with neonatal deaths in developing countries. The determinants of low birth weight in Nepal have rarely been studied. This study aimed to identify the factors associated with small size at birth among under-five children.MethodsData from the 2011 Nepal Demographic and Health Survey (NDHS) were used. The association between small size at birth and explanatory variables were analysed using Chi-square tests (χ2) followed by logistic regression. Complex Sample Analysis was used to adjust for study design and sampling.ResultsA total of 5240 mother- singleton under five child pairs were included in the analysis, of which 936 (16.0%) children were reported as small size at birth. Of 1922 infants whose birth weight was recorded, 235 (11.5%) infants had low birth weight (<2500 grams). The mean birth weight was 3030 grams (standard deviation: 648.249 grams).The mothers who had no antenatal visits were more likely (odds ratio (OR) 1.315; 95% confidence interval (CI) (1.042-1.661)) to have small size infants than those who had attended four or more antenatal visits. Mothers who lived in the Far-western development region were more likely to have (OR 1.698; 95% CI (1.228-2.349)) small size infants as compared to mothers from the Eastern development region. Female infants were more likely (OR 1.530; 95% CI (1.245-1.880)) to be at risk of being small than males.ConclusionOne in every six infants was reported to be small at birth. Attendance of antenatal care programs appeared to have a significant impact on birth size. Adequate antenatal care visits combined with counselling and nutritional supplementation should be a focus to reduce adverse birth outcomes such as small size at birth, especially in the geographically and economically disadvantaged areas such as Far-western region of Nepal.

Issue addressed: Food insecurity in remote Western Australian (WA) Indigenous communities. This study explored remote community store managers' views on issues related to improving food security in order to inform health policy. Method: A census of all remote WA Indigenous community store managers was conducted in 2010. Telephone interviews sought managers' perceptions of community food insecurity, problems with their store, and potential policy options for improving the supply, accessibility, affordability and consumption of nutritious foods. Descriptive analyses were conducted using SPSS for Windows version 17.0. Results: Managers stated that freight costs and irregular deliveries contributed to high prices and a limited range of foods. Poor store infrastructure, compromised cold chain logistics, and commonly occurring power outages affected food quality. Half of the managers said there was hunger in their community because people did not have enough money to buy food. The role of nutritionists beyond a clinical and educational role was not understood. Conclusions: Food security interventions in remote communities need to take into consideration issues such as freight costs, transport and low demand for nutritious foods. Store managers provide important local knowledge regarding the development and implementation of food security interventions.So what? Agencies acting to address the issue of food insecurity in remote WA Indigenous communities should heed the advice of community store managers that high food prices, poor quality and limited availability are mainly due to transport inefficiencies and freight costs. Improving healthy food affordability in communities where high unemployment and low household income abound is fundamental to improving food security, yet presents a significant challenge.

Comprehensive assessment of a range of fine motor skills in children with PAE is important to ensure an accurate FASD diagnosis and develop appropriate therapeutic interventions for children with PAE-related fine motor impairments.

Health professionals need to distinguish between religious and cultural practices in order to develop appropriate health education programs to reduce the unnecessary use of early additional feeds. Understanding the barriers related to the initiation of breastfeeding after cesarean section is also important.

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