This study aims to identify the contexts, environments, and nurturing care predictors that determine whether a child is developmentally on track in Ceará, Brazil. We analysed data from a cross-sectional study conducted with caregivers of 6,447 children aged 0–59 months during a vaccination campaign in Ceará in October 2019. The validated Child Development Assessment Questionnaire was used to assess early childhood development (ECD) and children with a z-score ≥ –1 SD were considered developmentally on track. We conducted logistic regression models to understand the effects of contexts, environments, and nurturing care domains on ECD. Children in the early years (< 36 months) were more likely to meet the ECD milestones if they were not born with low birth weight (AOR: 0·64; 95% CI: 0·42–0·97), were exposed to manufactured toys in their house (2·68; 1·97–3·66), their heads of household were employed (1·61; 1·16–2·23), and their caregivers had read the Child Health Handbook (1·42; 1·13–1·77) and engaged them in stimulating activities (1·71; 1·26–2·32). Children aged 36–59 months were more likely to meet the ECD milestones if they were breastfed (never: ref. / < 3 months: 3·72; 1·91–7·26 / 3–5 months: 3·21; 1·74–5·93 / 6–11 months: 3·73; 1·95–7·16 / ≥ 12 months: 3·89; 2·25–6·72), had books at home (0: ref / 1–3: 1·71; 1·22–2·40 / 4–6: 2·24; 1·27–3·94 / 7+: 2·71; 1·05–7·00), and their caregivers received information about ECD (1·49; 1·11–2·01) and engaged them in stimulating activities (1·80; 1·27–2·56). Children aged 36–59 months were less likely to meet developmental milestones if they watched TV or used tablets/smartphones for more than two hours per day (0·61; 0·44–0·84), played with household objects (0·62; 0·41–0·92), participated in governmental early childhood programmes aimed at vulnerable families (0·62; 0·45–0·86), had families that participated in income transfer programmes (0·68; 0·47–0·99) (families living in poverty or extreme poverty), and their caregivers considered slapping (0·67; 0·48–0·94) a necessary disciplinary method. Having favourable socioeconomic conditions, breastfeeding, the absence of harsh discipline, caregivers who provide responsive care, and the provision of opportunities for early learning are the key factors that increase the likelihood of a child achieving their full developmental potential in Ceará, Brazil. This study was supported by the Maria Cecília Souto Vidigal Foundation (F0245), Brazil. The funder had no role in the design, analysis, or writing of this article

A nationally generalisable cohort (n 5770) was used to determine the prevalence of non-timely (early/late) introduction of complementary food and core food groups and associations with maternal sociodemographic and health behaviours in New Zealand (NZ). Variables describing maternal characteristics and infant food introduction were sourced, respectively, from interviews completed antenatally and during late infancy. The NZ Infant Feeding Guidelines were used to define early (≤ 4 months) and late (≥ 7 months) introduction. Associations were examined using multivariable multinomial regression, presented as adjusted relative risk ratios and 95 % confidence intervals (RRR; 95% CI). Complementary food introduction was early for 40·2 % and late for 3·2 %. The prevalence of early food group introduction were fruit/vegetables (23·8 %), breads/cereals (36·3 %), iron-rich foods (34·1 %) and of late were meat/meat alternatives (45·9 %), dairy products (46·2 %) and fruits/vegetables (9·9 %). Compared with infants with timely food introduction, risk of early food introduction was increased for infants: breastfed < 6months (2·52; 2·19–2·90), whose mothers were < 30 years old (1·69; 1·46–1·94), had a diploma/trade certificate v. tertiary education (1·39; 1·1–1·70), of Māori v. European ethnicity (1·40; 1·12–1·75) or smoked during pregnancy (1·88; 1·44–2·46). Risk of late food introduction decreased for infants breastfed < 6 months (0·47; 0.27–0·80) and increased for infants whose mothers had secondary v. tertiary education (2·04; 1·16–3·60) were of Asian v. European ethnicity (2·22; 1·35, 3·63) or did not attend childbirth preparation classes (2·23; 1·24–4·01). Non-timely food introduction, specifically early food introduction, is prevalent in NZ. Interventions to improve food introduction timeliness should be ethnic-specific and support longer breast-feeding.

OBJETIVO: Identificar e mapear de forma sistemática os estudos que envolvem a Caderneta da Criança (CC) no Brasil. MÉTODOS: Revisão de escopo utilizando a metodologia proposta pelo Instituto Joanna Briggs. Foram consultadas as bases de dados PubMed, BVS Regional, Biblioteca Digital Brasileira de Teses e Dissertações, Periódicos Capes e Google Scholar. Incluíram-se estudos primários e secundários que mencionavam o uso da CC, sem restrições quanto ao delineamento, ano de publicação ou população, publicados em português, inglês ou espanhol e literatura cinzenta (teses e dissertações). RESULTADOS: Foram incluídos 129 estudos, em sua maioria descritivos, publicados como artigos científicos. A região Nordeste, a população de cuidadores das crianças e o cenário da atenção primária foram observados na maioria dos estudos; 47% dos estudos utilizou a CC como fonte de dados, a maioria sobre vacinação. Apesar dos diferentes critérios para definir adequação de preenchimento da CC, os estudos identificaram fragilidades no preenchimento de todos os seus itens, com exceção da vacinação. Características contextuais (como a disponibilidade da CC), das crianças (sexo, idade, prematuridade e consultas de puericultura), dos familiares e cuidadores (idade, escolaridade, renda, paridade, trabalho, pré-natal, ler, fazer anotações e levar a CC nas consultas) e dos profissionais (local de atuação, especialidade médica, comunicação no trabalho, conhecimentos sobre a CC, solicitar, orientar sobre e realizar anotações na CC) foram relacionadas ao uso e/ou preenchimento da CC. CONCLUSÕES: Os resultados reforçam a necessidade de melhor compreender quais fatores afetam a distribuição da CC à população, assim como apontam para a necessidade de compreender o seu uso e preenchimento pelos diversos pontos de atenção. Fica clara a necessidade de estudos de intervenção para que a implementação desse instrumento seja aprimorada e de incluir capacitações sobre a caderneta no contexto da educação permanente em saúde.

The maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) influence maternal and infant outcomes. This study identified patterns of habitual dietary intake in 385 pregnant women in São Paulo and explored their associations with excessive weight gain (EGWG). Weight at the first visit ( 35 years (p = 0.03), while subjects overweight at baseline had a higher probability of EGWG (p = 0.02), suggesting that the identification of dietary and weight inadequacies should be observed from the beginning of pregnancy, accompanied by nutritional intervention and weight monitoring throughout the gestational period to reduce risks to the mother and child’s health.

Objective: To evaluate the sociodemographic and lifestyle factors associated with insufficient and excessive use of folic acid supplements (FAS) among pregnant women.Design: A pregnancy cohort to which multinomial logistic regression models were applied to identify factors associated with duration and dose of FAS use.Setting: The Growing Up in New Zealand child study, which enrolled pregnant women whose children were born in 2009–2010.Subjects: Pregnant women (n 6822) enrolled into a nationally generalizable cohort.Results: Ninety-two per cent of pregnant women were not taking FAS according to the national recommendation (4 weeks before until 12 weeks after conception), with 69 % taking insufficient FAS and 57 % extending FAS use past 13 weeks’ gestation. The factors associated with extended use differed from those associated with insufficient use. Consistent with published literature, the relative risks of insufficient use were increased for younger women, those with less education, of non-European ethnicities, unemployed, who smoked cigarettes, whose pregnancy was unplanned or who had older children, or were living in more deprived households. In contrast, the relative risks of extended use were increased for women of higher socio-economic status or for whom this was their first pregnancy and decreased for women of Pacific v. European ethnicity.Conclusions: In New Zealand, current use of FAS during pregnancy potentially exposes pregnant women and their unborn children to too little or too much folic acid. Further policy development is necessary to reduce current socio-economic inequities in the use of FAS.