International Journal of Child Health and Nutrition

Changes in Problematic Mealtime behaviors among 3- to 6-Year-Old Children Following Sapere-Based Sensory Education: A Pre-Post Intervention Study

2026-02-12T11:53:23+00:00

Introduction: Feeding difficulties are commonly observed in children, especially those with developmental concerns. This study aimed to evaluate the effects of Sapere-based sensory education on mealtime behavior and food acceptance in preschool-aged children using a pre-post intervention design.

Methods: A quasi-experimental, multi-site prospective study was conducted with 148 children aged 3 to 6 years. Participants were divided into two groups: 74 children with problematic mealtime behavior (PMB), assessed using the ASD-Mealtime Behavior Questionnaire, and74 age- and sex-matched non-PMB in contrast. Food pickiness and neophobia were evaluated using a validated food rejection scale. The intervention consisted of sensory-based dietary education using the Sapere method, with assessments conducted before and six months after the intervention.

Results: Significant improvements were observed in the PMB group following the intervention. Specifically, reductions were observed in clumsiness/manners (–4.2 ± 0.8, p < 0.001), interest/concentration during eating (–1.7 ± 0.7, p = 0.014), and oral motor function difficulties (–1.0 ± 0.5, p = 0.039). Food pickiness also showed a significant decrease (–1.4 ± 0.4, p =0.002). Although selective eating and food neophobia showed downward trends, the changes were not statistically significant. In contrast, no significant changes were noted in the non-PMB group for any behavioral or food rejection measures.

Conclusion: Sapere-based sensory education may effectively reduce problematic mealtime behaviors and food pickiness among preschool-aged children. These findings support the potential utility of sensory-based interventions for promoting healthy eating behaviors in early childhood.

Healthcare Providers’ Understanding and Performance in Stunting Prevention: A Study from Rural and Urban Primary Healthcare Facilities in Indonesia

2026-02-12T11:53:22+00:00

Background: Reducing stunting globally remains inadequate, with regional disparities persisting between rural and urban areas. This study aims to compare the knowledge and performance of healthcare providers (HCPs) in rural and urban primary healthcare facilities regarding the implementation of stunting prevention using a quantitative approach. It also explores further rural HCPs’ challenges through a qualitative study.

Methods: A cross-sectional quantitative study involved 557 primary HCPs from rural and urban Indonesia from July to October 2023. Data were collected using a self-administered structured questionnaire. Descriptive statistical analysis and the Chi-Square test were conducted with IBM SPSS version 29. Additionally, a descriptive qualitative study was conducted in a rural area in January 2024, employing purposive sampling and semi-structured interviews with eight primary HCPs, which were analyzed using content analysis.

Results: Compared to their urban counterparts, rural HCPs showed less knowledge of nutrition (p = 0.007) and stunting (p = 0.013), higher socio-cultural values that impact stunting (p = 0.009), ineffective implementation of stunting prevention (p = 0.013), and higher barriers in implementing stunting prevention (p < 0.001). Qualitative findings further revealed that weak awareness, capacity issues, and socio-cultural challenges constituted significant obstacles for rural HCPs.

Conclusion: This study underscores the need for policymakers to prioritize the development of targeted intervention programs that enhance rural HCPs' capacity in nutrition, cultural competency, advocacy, and communication. Policymakers must formulate effective policies and standardized, easy-to-implement guidelines for stunting prevention specifically to rural primary care settings.

Fallot’s Disease (Tetrad, Triad, Pentad) in the Structure of Congenital Heart Defects in the Azerbaijani Population

2026-02-12T11:53:21+00:00

Background: The aim of the study was to identify the main factors influencing the development of these heart defects, as well as to assess the demographic and medical characteristics of patients.

Method: A retrospective, multicenter study was conducted across nine regions of Azerbaijan, including Baku and Sumgait, analyzing medical records from maternity hospitals and cardiology centres between 2020 and 2023. Of 2,000 confirmed CHD cases, 994 newborns had complete medical documentation and were included in the analysis. According to regional perinatal statistics, these cases corresponded to an estimated ~165,000 live births, providing population-level denominators. Clinical, demographic, maternal, and perinatal variables were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression, with odds ratios (OR) and 95% confidence intervals (CI).

Results: Of the 994 CHD cases, 7.24% (n=72) had Fallot disease, including 3.82% (n=38) with Fallot triad, 2.11% (n=21) with Fallot tetrad, and 1.31% (n=13) with Fallot pentad. The incidence of CHD varied significantly by region, potentially due to differences in healthcare, genetic predisposition, and socio-economic factors. Risk factors for Fallot disease included maternal chronic diseases (35.1%), complications during pregnancy (such as pre-eclampsia, 25.5%), and obstetric interventions (18.4%). A gender imbalance was observed, with 57.3% of patients being male. The study highlighted the importance of early diagnosis, despite 70.3% of mothers undergoing antenatal check-ups, with no prenatal diagnosis of Fallot disease.

Conclusions: The analysis of demographic indicators showed an imbalance in the sex ratio of patients, which may indicate varying degrees of vulnerability to the development of serious conditions. The study also demonstrated the need to improve screening programmes and expand diagnostic capabilities to detect these cardiac anomalies early. The results provide a basis for further research aimed at developing more effective methods to prevent and treat this condition, as well as to assess the long-term health consequences for patients.

From Artificial Intelligence to Real-Life Practice: Can ChatGPT be a Guide About Pediatric Dysphagia?

2026-02-12T11:53:20+00:00

Introduction: The widespread use of Artificial Intelligence (AI)-based tools has significantly simplified access to medical information. Pediatric dysphagia, or difficulty swallowing in children, is among the commonly queried topics because of its close relationship with feeding safety, nutritional intake, and growth outcomes. This study aims to evaluate the reliability, usefulness, and safety of responses generated by Chat Generative Pre-Trained Transformer (GPT) regarding pediatric dysphagia.

Methods: A set of thirty carefully selected questions covering various aspects of pediatric dysphagia, including general information, risk factors, diagnosis, treatment, and follow-up, was prepared based on clinical data, digital trends, and frequently asked questions from health websites. These questions were submitted to ChatGPT (version 4.0), and the responses were independently evaluated by two experts using a 4-point Likert-type scale (1: lowest, 4: highest) to assess reliability, usefulness, and safety. Additionally, the readability of each response was measured using the Flesch-Kincaid Grade Level test, which estimates the educational level required to comprehend the text. The implications of this readability score for caregiver comprehension were also interpreted.

Results: ChatGPT’s responses received high scores overall, with average ratings of 3.73 for reliability, 3.87 for safety, and 3.87 for usefulness. The average Flesch-Kincaid Grade Level was 13.03, indicating suitability for university-level readers. This suggests that while the responses are accurate and informative, their linguistic complexity may limit accessibility for some caregivers.

Conclusion: ChatGPT shows promise as a supportive tool in providing basic information about pediatric dysphagia. However, to ensure accurate and personalized medical evaluation, these AI-generated responses must be verified through professional clinical review. Given that pediatric dysphagia directly affects nutritional intake, growth, and feeding safety, validated AI-based guidance tools could help caregivers recognize feeding problems earlier and seek appropriate medical care promptly.

The Effects of High Protein Supplementary Feeding on the Growth of Stunting Children Aged 6-59 Months in Indonesia

2026-02-12T11:53:19+00:00

Background: Stunting remains a major public health problem in Indonesia, with a national prevalence of 21.6% in 2022 and nearly 30% in Semarang City. Inadequate protein intake is one of the key contributors, whereas animal-source protein supports growth, in part, through its effect on Insulin-like Growth Factor I (IGF-I).

Objective: To evaluate the effect of high-protein supplementary feeding on the growth of stunted children aged 6-59 months using a quasi-experimental pretest-posttest design.

Methods: A quasi-experimental pretest-posttest study was conducted involving stunted children aged 6-59 months who received supplementary food containing an energy-protein ratio of 10-18% for 90 days. Anthropometric outcomes included body weight (BW), height (Ht), weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ), and weight-for-height Z-score (WHZ). Dietary intake, infection incidence, and compliance were also assessed. Paired t-test, Wilcoxon signed-rank test, and correlation analyses were applied as appropriate.

Results: In the 101 study participants, energy (+128 kcal), protein (+6.77 g), fat (+11.8 g), and carbohydrate (+22.6 g) intake increased significantly (all p<0.001). Body weight (median Δ=0.50 kg; p<0.001), height (median Δ=1.90 cm; p<0.001), and WHZ (median Δ=0.06; p<0.001) improved significantly. WAZ increased by 0.17 (95% CI: −0.25 to −0.11; p<0.001), whereas HAZ showed no significant change (median Δ=0.05; p=0.608). Infection incidence was negatively associated with gains in body weight and height.

Conclusion: High-protein supplementary feeding effectively improved nutrient intake and short-term growth indicators (BW, WAZ, WHZ), but did not significantly improve linear growth (HAZ), likely due to the short 90-day intervention period.

Knowledge, Attitudes, Ownership, and Utilization of Mosquito Nets among Mothers/Caregivers of under Five Children in South Sudan

2026-02-12T11:53:19+00:00

Background: Malaria is a leading cause of illness and death in under five and pregnant women. Despite insecticide-treated nets' mass distribution, their utilization is low. ITNs persisted in a preventive intervention and a physical barrier to mosquitoes. We explore fever prevalence, health-seeking, knowledge, attitudes, practices, and ITN ownership and utilization among mothers/caregivers of U-5 children in South Sudan.

Methods: A community-based descriptive cross-sectional survey was implemented in 23 counties with high malaria incidences. Mothers/caregivers of U-5 were recruited. A multi-stage cluster random sampling technique was used. Trained enumerators were employed to administer a questionnaire adopted from the malaria indicator survey. Kobo collects v.2022.2 was used, and SPSS^TM 27 was used for analysis.

Results: A total of 466 interviews were completed, bypassing 460 sample size estimates. Of 466, 89.3% (n=416) were mothers/caregivers of U-5. 73% were females. The majority is 25-34 years old, with 34.3% (95% CI 30 - 39). 60.1% had no formal education, 91.8% (89.5 - 94.2) were employed in the private sector, and Fever prevalence in U-5 was 56.1%. Treatment was sought for 59.2% of U-5 with fever, and 25.1% received timely care. 46% received treatment from a government hospital, 9% from private, and 44.9% received ACT. Utilization of any nets and ITNs was 72% and 69.4%. Overall ownership and usage were 72.3% and 71.9%; 73.1% of females used ITNs, and 72.2% were religious believers. 94% U-5 with at least one ITN slept under an ITN last night.

Conclusion: The majority of respondents had a better understanding of malaria prevention but poor seeking behavior. Low ownership and utilization of ITNs were revealed. Thus, improvement in community education towards early treatment-seeking and ITN usage is required. Our findings would be useful for effective treatment, response to control, and prevention in highly endemic zones of South Sudan.