The ongoing COVID-19 has had a huge worldwide influence. Vaccinations are a crucial component of illness prevention. Thailand's vaccination program for children above the age of five is in its initial stages. Many Thai parents are still unwilling to vaccinate their children with the COVID-19 vaccine. The purpose of this study was to analyze the rate of parental hesitancy and influential variables among Thai parents and guardians living in Thailand. This was a cross-sectional survey in Thailand during October and November of 2021. Through online social media networks, an online survey (REDcap) was distributed. Thai parents and guardians with at least one child under the age of 18 were invited to participate. A total of 1064 responses for analysis. One thousand and sixty-four were available for analysis with 74.4% of those who participated being female. The results found that the parental COVID-19 vaccination hesitancy rate was higher among parents with children under the age of 12 than among parents with children over the age of 12. (56.9% vs 17.1%, p-value < 0.001). Parents were more concerned about vaccination side effects (82.5%), safety (60.0%), and vaccine efficacy (37.2%). Low vaccine reluctance among parent with children age less than 12 years old was associated with higher education (aOR = 0.35, 95 %CI = 0.13–0.93, p-value = 0.036) and a favorable attitude regarding covid-19 immunizations (aOR 0.16, 95% CI 0.04–0.67, p-value 0.012) The majority of Thai parents with children under the age of 12 were hesitant to vaccinate against COVID-19. To minimize Thai parent vaccination hesitancy and increase vaccine uptake among children, the government and health care providers should target this population with evidence-based information, promote positive attitudes toward COVID-19 vaccinations, and encourage educated parents to vaccinate their children at first.

A COVID-19 lockdown and restrictive order has had a large impact on the lives of people. This cross-sectional study was conducted to identify factors affecting breastfeeding among mothers living in Thailand during the lockdown. Data were collected from 903 mothers with infants ages 0–12 months from 17 July 2020 to 17 October 2020 after the first nationwide COVID-19 lockdown period by an online platform and interview questionnaire survey. Multivariable logistic regression analysis was used to investigate the association between the effect of lockdown and breastfeeding practices with potential confounder adjustment including maternal age, ethnicity, newborn age <6 months, family income below $16,130 per annum, education below undergraduate level, and working status. Mothers changed breastfeeding practices in this period (n = 39, 4.32%) including having changed from exclusive breastfeeding to combined breastfeeding with formula milk (n = 22, 2.44%), and having reduced the frequency when compared to before the pandemic (n = 13, 1.44%). The associated factors of changing breastfeeding practices were “contact with healthcare services” (aOR = 0.46, 95% CI 0.22 to 0.96, p = 0.04), “infant feeding support from health personnel” (aOR = 0.39, 95% CI 0.16 to 1.94, p = 0.035), and “lack family support and help with feeding your baby after lockdown” (aOR = 7.04, 95% CI 1.92 to 25.84, p = 0.003). In conclusion, this study showed a slight decrease in breastfeeding in the sampled mothers during the COVID-19 lockdown in Thailand. A long-term national surveillance system for maintenance of breastfeeding should be established. Health care service interventions and additional information are needed to support mothers and families for breastfeeding during pandemics.

Background: An extended duration of breastfeeding of up to two years is encouraged by many health authorities, but information regarding the composition of milk after one year postpartum is limited. The goal of this study was to determine the association between the duration of lactation and macronutrient contents, immunoglobulin A (IgA) levels and total antioxidant capacity (TAC) in human milk (HM), from 1 to 24 months postpartum.Methods: Cross-sectional milk samples were collected between January and April 2019 from mothers with healthy full-term children who had been lactating for 1 to 24 months. The HM was biochemically analyzed for protein and carbohydrate contents by colorimetric assays. The fat content was determined by capillary centrifugation, and the energy content was calculated from the results of centrifugation assays. IgA levels and TAC were determined by ELISA and a Trolox equivalent antioxidant capacity (TEAC) assay, respectively. Pearson’s correlation coefficient and Spearman’s rank correlation coefficient were used to determine associations between months of lactation and milk composition, and multiple regression analysis was used to assess associations between months of lactation and milk composition adjusted for relevant covariates. Differences were considered significant atp < 0.05.Results: One hundred eighty-four milk samples were analyzed. The month of lactation was positively associated with the fat concentration (B = 0.31, SE = 0.09,p = 0.001), energy content (B = 3.11, SE = 0.92, p = 0.001), and IgA (B = 4.17, SE = 1.08,p < 0.001) but negatively associated with the carbohydrate concentration (B = − 0.22, SE = 0.01,p = 0.04). No association was observed between the month of lactation and the protein concentration or TAC after adjustment for maternal age, maternal BMI, birth order, and breastfeeding frequency.Conclusion: The duration of lactation was found to be positively associated with the fat, energy, and IgA content in HM for up to two years postpartum, and negatively associated with carbohydrate concentration. More prospective cohort studies are needed to obtain evidence-based knowledge regarding the changes in HM composition throughout the course of lactation.

Air pollution exposure has been increasingly linked to adverse pregnancy outcomes. This study aimed to investigate the effects of PM_2.5 exposure throughout pregnancy on preterm birth, low birth weight (LBW), and small for gestational age (SGA). We analyzed a cohort of 16,965 pregnant women living in northern Thailand between 2016 and 2022. PM_2.5 concentration data were collected from two air quality monitoring stations operated by the Pollution Control Department (PCD) of Thailand. Logistic regression models were used to assess the association between daily PM_2.5 exposure and pregnancy outcomes. PM_2.5 exposure at levels exceeding 37.5 μg/m³ throughout pregnancy significantly increased the risk of preterm birth (aOR = 2.19, p < 0.001) and LBW (aOR = 1.99, p < 0.001) compared to the reference group (15.1–37.5 μg/m³). However, exposure at levels ≤15.0 μg/m³ also increased the risk for both outcomes compared to the same reference group. Subgroup analysis of high-risk pregnant women, including women aged > 35 years, with pre-pregnancy BMI (<18.5), pregnancy-induced hypertension, and nulliparous women, showed that the range of the critical PM_2.5 exposure threshold was 32.3–38.4 μg/m³ for preterm birth and 31.2–38.2 μg/m³ for LBW. This study highlights the significant association between PM_2.5 exposure and adverse pregnancy outcomes and suggests the need for targeted interventions to mitigate its effects on maternal and child health.

Background: The percentage of infants receiving frozen human milk (HM) is increasing. The effects of thawing and warming on the secretory immunoglobulin A (SIgA) level and lysozyme activity in frozen HM should be investigated to identify optimal methods for preserving immune factors in frozen HM.Methods: Milk samples were collected from 40 mothers with healthy full-term infants who had been lactating for one to six months. The baseline samples were analyzed within 24 h after collection, and the other samples were frozen at -18 °C before analyses. We compared two methods: placing the container overnight in a refrigerator at 4 °C before warming (slow thawing) and immediately thawing in warm water after removing the sample from the freezer (rapid thawing). Additionally, we investigated the effects of the warming temperature by comparing room temperature (25 °C) and physiological temperature (37 °C). The SIgA concentrations and lysozyme activities in the milk samples were determined using ELISA kits and fluorometric lysozyme activity assay kits, respectively.Results: The SIgA concentrations and lysozyme activity in frozen HM were 16.5–52.1% and 16.8–39.3% lower than those in fresh HM, respectively. The SIgA concentrations in frozen HM were stable during slow thawing at 37 °C (p = 0.072) compared with those in fresh HM. The SIgA concentrations and lysozyme activity were maintained at significantly higher levels during slow thawing than during rapid thawing at 25 °C (p = 0.002 andp < 0.001, respectively). Slow thawing preserved higher SIgA concentrations and lysozyme activity than rapid thawing at 37 °C, but the difference was not significant.Conclusions: The SIgA level in HM frozen at -18 °C for two months was stable after overnight thawing in the refrigerator (4 °C for 12 h) before warming to 37 °C compared with that in fresh milk. The thawing of HM in the refrigerator overnight (and then warming to 25 °C or 37 °C for 30 min) has the potential to preserve the SIgA concentration and lysozyme activity to a greater extent than heating immediately after removal from the freezer. Broader temperature ranges should be analyzed to determine the temperature that minimizes the losses in SIgA concentration and lysozyme activity in HM.

Poor family functioning is linked with poor child ADHD symptoms. However, there are many dimensions of family functioning. Thus, this study aims to find the association between each dimension of family functioning and controlled ADHD symptoms in an Asian culture. This cross-sectional study involved caregivers of 113 Thai children with ADHD ages 4–16 years old who visited the Outpatient Department at Maharaj Nakorn Chiang Mai Hospital between October 2017 and March 2018. The caregivers completed the Chulalongkorn Family Inventory and the SNAP-IV Thai version. Logistic regression was used to examine each dimension of family functioning adjusting for potential confounders. In univariate analyses, six of the seven dimensions of family functioning were associated with controlled ADHD symptoms. In multivariate analyses, findings revealed that good family roles (aOR 7.48, 95% CI = 1.56 to 35.85, p = 0.01) and behavior control (aOR 2.56, 95% CI = 1.08 to 6.03, p = 0.03) were associated with controlled ADHD symptoms. In children with ADHD with poor symptom control, the assessment of family functioning could be helpful. Developing a more specific intervention for caregivers that promotes good family roles and behavioral control may be beneficial.