Background: To assess whether monthly home visits from trained volunteers could improve infant feeding practices at age 12 months, a randomised controlled trial was carried out in two disadvantaged inner city London boroughs. Methods: Women attending baby clinics with their infants (312) were randomised to receive monthly home visits from trained volunteers over a 9-month period (intervention group) or standard professional care only (control group). The primary outcome was vitamin C intakes from fruit. Secondary outcomes included selected macro and micro-nutrients, infant feeding habits, supine length and weight. Data were collected at baseline when infants were aged approximately 10 weeks, and subsequently when the child was 12 and 18 months old. Results: Two-hundred and twelve women (68%) completed the trial. At both follow-up points no significant differences were found between the groups for vitamin C intakes from fruit or other nutrients. At first follow-up, however, infants in the intervention group were significantly less likely to be given goats' or soya milks, and were more likely to have three solid meals per day. At the second follow-up, intervention group children were significantly less likely to be still using a bottle. At both follow-up points, intervention group children also consumed significantly more specific fruit and vegetables. Conclusions: Home visits from trained volunteers had no significant effect on nutrient intakes but did promote some other recommended infant feeding practices. Trial registration: Current Controlled Trials ISRCTN55500035Nutrition in early life is a key determinant of growth, development and health status, both in childhood and later adult life. Current UK recommendations advise all mothers to exclusively breastfeed for 6 months, and to delay introducing solids until at least 6 months. [3][4][5] Data from national surveys show that infant feeding practices in the UK are, however, highly variable.6 7 The 2005 Infant Feeding Survey indicated some encouraging trends with 76% of mothers across the UK initiating breastfeeding. However, rates fell steeply after a few weeks and less than 1% of mothers were exclusively breastfeeding at 6 months.6 Stark social inequalities were evident, with breastfeeding rates highest amongst older, middle-class and educated mothers. The 2005 survey also reported that 51% of mothers had introduced solids by 4 months and only 2% had delayed introducing solids until 6 months. Mothers giving solids when babies were 4-6 months were more likely to provide commercially prepared foods (85%) than home prepared (51%), and only 46% had given fruit. 6A substantial body of research has evaluated interventions aimed at increasing the initiation, and to lesser extent, the duration of breastfeeding.8 9 In contrast, very few well-designed studies have evaluated interventions focusing on the later stages of infant feeding beyond breastfeeding. 10Recent National Institute of Health and Clinical Excellence (NICE) guidance has highlighted the paucity o...
poor vitamin D status of older people continues to be a public health problem in England. Hypovitaminosis D is associated with many risk factors and poor health outcomes. There is now an urgent need for a uniform policy on assessment and dietary supplementation of vitamin D in older people to prevent poor vitamin D status and its negative consequences.
Objective: To describe the process of establishing and implementing a social support infant feeding intervention.Design: This paper outlines the initial stages of a randomised controlled trial which assessed the effectiveness of a social support intervention on a range of infant feeding outcomes. Details are presented of the processes involved in recruiting, training and supporting a group of volunteers who provided support to the study sample. Setting: Camden and Islington, London, UK. Results: Initial networking with local agencies and organisations provided invaluable information and contacts. Employing a dedicated volunteer co-ordinator is vitally important in the recruitment, training and support of volunteers. Providing child care and travel expenses is an essential incentive for volunteers with young children. Advertisements placed in local newspapers were the most successful means of recruiting volunteers. Appropriate training is needed to equip volunteers with the necessary knowledge and skills to provide effective support. Particular emphasis in the training focused upon developing the necessary interpersonal skills and selfconfidence. The evaluation of the training programme demonstrated that it improved volunteers' knowledge and reported confidence. The provision of ongoing support is also essential to maintain volunteers' interest and enthusiasm. The retention of volunteers is, however, a key challenge. Conclusions: The processes outlined in this paper have demonstrated the feasibility of successfully establishing, implementing and maintaining a community-based social support infant feeding programme. The experiences described provide useful insights into the practical issues that need to be addressed in setting up a social support intervention.
Background Dental attendance provides an important opportunity for dental teams to explore with parents the oral health behaviours they undertake for their young children (0–5 years old). For these discussions to be effective, dental professionals need to be skilled in behaviour change conversations. The current evidence suggests that dental teams need further support, training and resources in this area. Therefore, the University of Leeds and Oral-B (Procter & Gamble Company) have worked with the local community and dental professionals to co-develop “Strong Teeth” (an oral health intervention), which is delivered in a general dental practice setting by the whole dental team. The protocol for this early phase study will explore the feasibility and acceptability of the Strong Teeth intervention to parents and the dental team, as well as explore short-term changes in oral health behaviour. Methods Forty parents (20 of children aged 0–2 years old, and 20 of children aged 3–5 years old) who are about to attend the dentist for their child’s regular dental check-up will be recruited to the study. Parents and children will be recruited from 4 to 8 different dental practices. In the home setting, consent and baseline oral health behaviour data will be collected. The researchers will ask parents questions about their child’s oral health behaviours, including toothbrushing and diet. Three different proxy objective measures of toothbrushing will be collected and compared with self-report measures of parental supervised toothbrushing (PSB). Discussion The parent and child will then attend their dental visit and receive the Strong Teeth intervention, delivered by the dental team. This intervention should take 5–15 min to be delivered, in addition to the routine dental check-up. Furthermore, children aged 0–2 years old will receive an Oral-B manual children’s toothbrush, and children aged 3–5 years old will receive an Oral-B electric rechargeable children’s toothbrush. At 2 weeks and 2–3 months following the Strong Teeth intervention, further self-report and objective measures will be collected in the parent/child’s home. This data will be supplemented with purposively sampled qualitative interviews with parents (approximately 3 months following the intervention) and dental team members (following delivery of the intervention). Trial registration ISRCTN Register, ( ISRCTN10709150 ) Electronic supplementary material The online version of this article (10.1186/s40814-019-0483-9) contains supplementary material, which is available to authorized users.
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