Infant and Young Child Feeding Practices among Mothers in Lahore, Pakistan: A Cross-Sectional Study

Background: Inadequate child feeding practices lead to malnutrition, higher under-five mortality rates and adverse effects on quality of life. This study aimed to assess the breastfeeding and complementary feeding practices of mothers as well as the influence of various sociodemographic factors on them in local families of Lahore. Methods: This is a cross-sectional, descriptive study. It was conducted in CMH (Combined Military Hospital), Lahore in 2018. It comprises a sample of 203 mothers with children of at least two years of age, from various urban areas of Lahore. The subjects were selected on the basis of the inclusion criteria. Mothers with psychiatric illnesses and children with congenital anomalies were excluded from the study. Mothers were approached in the paediatric outpatient departments of four tertiary care hospitals of Lahore. Responses were recorded using a modified version of the Action Contre La Faim (ACF) questionnaire. Independent sample t-test and chi-square test were applied for analysis of the data. Results: Early initiation of breastfeeding within one hour from birth was observed in 83.3% children. Most children were administered colostrum (69.5%). The rate of exclusive breastfeeding for the first six months was 45.3%.  A child was being breastfed 8.21 ± 6.67 (mean ± SD) times a day. Maternal educational status, total number of adults in a household, and access to free healthcare were identified as important factors influencing the practice of breastfeeding. Porridge, khichdi, eggs, fruit and yoghurt were the most frequently used complementary foods. Conclusions: A high rate of an early start of breastfeeding and a low rate of exclusive breastfeeding for at least six months were predominant in our population. Administration of colostrum was observed in approximately two-thirds of the study participants. Education of the mother, type of the family system (nuclear or combined), and access to free healthcare strongly influence the breastfeeding practices.

Pathological Effects of Natural and Experimental Lead Pb Toxicity in Lohi Sheep at Jhang, Pakistan

Heavy metal toxicity is increasing due to increasing trends of urbanization and industrialization. Lead poisoning has been recognized as a major public health risk, particularly in developing countries. It is nephrotoxic, hepatotoxic, neurotoxic, carcinogenic and mutagenic for animals and human. Sewerage water, fertilizers, leaded-gasoline and lead based batteries are the sources of lead contamination in soil and forage. The lead particles are taken up by animals from contaminated forages and excreted in animal products like milk and meat. The presence of Pb in drinking water, waste water, plant products and animal products has been studied which is a serious risk for animal and public health. The legislations for the disposal of household wastes and industrial effluents are very poor in Pakistan. The calculation of safe Pb levels in different products is still to be needed. Pathological effects of higher Pb levels have not been studied in Pakistan. The present study was aimed to unveil the toxic effects at constant dose of Pb over a period of three months in a local sheep breed of Pakistan. The status of Pb toxicity was also investigated in a polluted area around sewage drain and mutton slaughter house at District Jhang, Pakistan. The Pb concentration in soil, forage and irrigating water was found to be below the permissible limits and was safe for agriculture but long-term ingestion of low Pb concentration may have cumulative effect. The serum Pb concentration was found to be above the recommended safe limits for producing Pb toxicity in animals. The different tissues like kidney, liver and skeletal muscles also contained higher Pb level from the permissible limits and found to be unsafe for public use. Kidney showed the highest Pb concentration and the muscle contained the least Pb level in the present study. The erythrocyte count, hemoglobin concentration and packed cell volume showed inverse correlation with Pb concentration and mean values were below the normal range in Pb treated sheep but anemia was not developed. The erythrocyte sedimentation rate was also influenced by given dose of lead acetate during third month of treatment. The white blood cells also revealed no effect on given dose of lead acetate in Lohi sheep in this study. The biochemical parameters of field and treatment group showed higher concentration as compared to control group of Lohi sheep but their means were falling within the normal range of reference values. The disturbed biochemical parameters in apparently healthy sheep with higher serum Pb concentration were indicative for liver and kidney damage. Lohi sheep exhibited less effect on given dose of lead acetate during first two months but more pronounced changes of chronic Pb toxicity were observed during last month of trial. The histological changes were not observed on early period in lead acetated treated sheep. The characteristic histological changes were observed on last slaughtering at day 90 in kidney and liver including degeneration and focal areas of necrosis, dilatation of blood vessels with accumulation of red blood cells and fibrosis in some areas. The nuclear changes were more typical with intranuclear inclusion bodies in renal tubular epithelial cells but less distinguishable in hepatocytes. It was concluded that soil, forage and water contained low Pb levels in the study area. The ingestion of low Pb level for longer period had cumulative effect in animals. The animals might be resistant to low Pb level but their products are a severe risk for public health. So the necessary measures should be adopted to minimize the heavy metal contamination in animal products.