Suchergebnisse

Growing up is never easy. For children separated not only from their birth families but from their countries of origin, it can be a long, hard struggle to achieve even the basic levels of good health that are so often taken for granted. Mary Mather and Marko Kerac focus on the health needs of two particular groups of young people: intercountry adoptees and unaccompanied refugee and asylum-seeking children. They discuss the limitations of Department of Health Guidance and identify in some detail the range of health problems which frequently go unrecognised in intercountry adopted children. Although the same problems apply to refugee and asylum-seeking children, these already traumatised young people carry the double burden of the problems they arrive with and the problems that arise once they are in the UK. The authors provide practical suggestions towards easing this burden in the effort to make health care for this group in particular, at once ethical, humane and acceptable. They end with a plea for tolerance and sensitivity, and the need to recognise that health goes way beyond the remit of the National Health Service. The aspiration to and attainment of health is determined by education, politics, the micro-climate of attitudes and the very fabric of our society.

BACKGROUND: Inappropriate marketing of human milk substitutes negatively influences efforts to protect breastfeeding. Although healthcare professionals can positively influence infant feeding decisions, government regulations permit manufacturers to communicate messages to them through advertising. RESEARCH AIMS: (1) To identify the extent of human milk substitute advertising in publications aimed at United Kingdom healthcare professionals and (2) to describe compliance with the International Code of Marketing of Breast-Milk Substitutes and United Kingdom Formula and Follow-on Formula Regulations. METHODS: This was a cross-sectional observational study. We reviewed publications targeting healthcare professionals working with families in the United Kingdom (N = 19). Quantity and type of human milk substitute advertisements, as a proportion of all advertising, in each publication were recorded. All unique advertisements were double assessed for compliance. RESULTS: Human milk substitute advertising was found in nine (47%) of the 19 publications (four affiliated with professional associations), making up 10.3% (n = 196) of these publications' total advertising. Of human milk substitute advertisements found, 65.4% (n = 110) were for products used to manage cows' milk protein allergy. Of the 32 unique human milk substitute advertisements found, none complied with the International Code of Marketing of Breast Milk Substitutes or United Kingdom Formula and Follow-on Formula Regulations. CONCLUSIONS: Many healthcare professionals' publications had non-compliant human milk substitute advertisements. There is an urgent need to ensure full compliance with international and local regulation in future advertisements and to consider whether advertisements are justified at all.

In recent years, community-based management of acute malnutrition (CMAM) has revolutionized the care for children by increasing treatment coverage. Critical to the success of CMAM is early case identification. Mid-upper arm circumference (MUAC) measurement is a widely used, practical anthropometric measure used at the community level for the identification and admission of cases to appropriate treatment services. Globally, many organizations and government services use MUAC tapes for early case detection. However, there is no one universal MUAC tape specification, and it has been observed that using different MUAC tapes results in different measurements. In this article, we aim to: (1) present the measurement discrepancies; (2) discuss design specifications and their effect on case identification and admissions; (3) present a call to action to agree on common design specifications and standardized reporting. We hope this article will catalyze discussion and practical actions among nutrition and health stakeholders to ensure we have common MUAC tape design specifications so that all eligible at-risk children will get an equal chance to be identified early for critical treatment.

Background. There are an estimated 2.7 million children living within institutionalized care worldwide. This review aimed to evaluate currently available data on the nutrition status of children living within institutionalized care. Methods. We searched four databases (Pubmed/Medline, CINHAL Plus, Embase and Global Health Database) for relevant articles published from January 1990 to January 2019. Studies that included information on anthropometry or micronutrient status of children living within institutionalized care were eligible for inclusion. The review is registered on PROSPERO: CRD42019117103. Results. From 3,602 titles screened, we reviewed 98 full texts, of which 25 papers were eligible. Two (8%) studies reported data from multiple countries, nine (36%) were from Asia, four (16%) from Africa, three (12%) from Eastern Europe, four (16%) from the European Union and one (4%) from each of the remaining regions (Middle East, South America and the Caribbean). Twenty-two (88%) were cross sectional. Ten (40%) of the studies focused on children >5 years, seven (28%) on children <5 years, seven (28%) covered a wide age range and one did not include ages. Low birth weight prevalence ranged from 25-39%. Only five (20%) included information on children with disabilities and reported prevalence from 8-75%. Prevalence of undernutrition varied between ages, sites and countries: stunting ranged from 9-72%; wasting from 0-27%; underweight from 7-79%; low BMI from 5-27%. Overweight/obesity ranged from 10-32% and small head circumference from 17-41%. The prevalence of HIV was from 2-23% and anemia from 3-90%. Skin conditions or infections ranged from 10-31% and parasites from 6-76%. Half the studies with dietary information found inadequate intake or diet diversity. Younger children were typically more malnourished than older children, with a few exceptions. Children living within institutions were more malnourished than community peers, although children living in communities were also often below growth standards. High risk of bias was found. Conclusions. This study highlights the limited amount of evidence-based data available on the nutritional status of children in institutions. Of the studies reviewed, children living within institutionalized care were commonly malnourished, with undernutrition affecting young children particularly. Micronutrient deficiencies and obesity were also prevalent. Data quality was often poor: as well as suboptimal reporting of anthropometry, few looked for or described disabilities, despite disability being common in this population and having a large potential impact on nutrition status. Taken together, these findings suggest a need for greater focus on improving nutrition for younger children in institutions, especially those with disabilities. More information is needed about the nutritional status of the millions of children living within institutionalized care to fully address their right and need for healthy development.

Background: There are an estimated 2.7 million children living within institutionalized care worldwide. This review aimed to evaluate currently available data on the nutrition status of children living within institutionalized care. Methods: We searched four databases (Pubmed/Medline, CINHAL Plus, Embase and Global Health Database) for relevant articles published from January 1990 to January 2019. Studies that included information on anthropometry or micronutrient status of children living within institutionalized care were eligible for inclusion. The review is registered on PROSPERO: CRD42019117103. Results: From 3,602 titles screened, we reviewed 98 full texts, of which 25 papers were eligible. Two (8%) studies reported data from multiple countries, nine (36%) were from Asia, four (16%) from Africa, three (12%) from Eastern Europe, four (16%) from the European Union and one (4%) from each of the remaining regions (Middle East, South America and the Caribbean). Twenty-two (88%) were cross sectional. Ten (40%) of the studies focused on children >5 years, seven (28%) on children <5 years, seven (28%) covered a wide age range and one did not include ages. Low birth weight prevalence ranged from 25-39%. Only five (20%) included information on children with disabilities and reported prevalence from 8-75%. Prevalence of undernutrition varied between ages, sites and countries: stunting ranged from 9-72%; wasting from 0-27%; underweight from 7-79%; low BMI from 5-27%. Overweight/obesity ranged from 10-32% and small head circumference from 17-41%. The prevalence of HIV was from 2-23% and anemia from 3-90%. Skin conditions or infections ranged from 10-31% and parasites from 6-76%. Half the studies with dietary information found inadequate intake or diet diversity. Younger children were typically more malnourished than older children, with a few exceptions. Children living within institutions were more malnourished than community peers, although children living in communities were also often below growth standards. High risk of bias was found. Conclusions: This study highlights the limited amount of evidence-based data available on the nutritional status of children in institutions. Of the studies reviewed, children living within institutionalized care were commonly malnourished, with undernutrition affecting young children particularly. Micronutrient deficiencies and obesity were also prevalent. Data quality was often poor: as well as suboptimal reporting of anthropometry, few looked for or described disabilities, despite disability being common in this population and having a large potential impact on nutrition status. Taken together, these findings suggest a need for greater focus on improving nutrition for younger children in institutions, especially those with disabilities. More information is needed about the nutritional status of the millions of children living within institutionalized care to fully address their right and need for healthy development.