Background: Parents often express concerns about feeding difficulties in their child. We hypothesized that these parental concerns were associated with adverse growth status in early childhood. We aimed to determine the prevalence of such concerns and whether these concerns were associated with adverse growth status in early childhood. Methods: We performed a cross-sectional study among healthy children aged 12e36 months attending three well-baby clinics in three urban areas in Malaysia and Singapore between December 2016 and February 2017. Parents were interviewed for concerns about their child's feeding and presence of behavioral and organic red flags for feeding difficulties. We defined growth faltering as weight-forage < 3rd centile and short stature as height-forage < 3rd centile according to World Health Organization Growth Standards. Results: Of the 303 children studied (boys Z 160, 52.8%; mean [AE SD] chronological age at interview 21.3 [AE 4.0] months), 13% (n Z 38/292) had growth faltering and 19.5% (n Z 50/ 256) had short stature. Overall, 36.3% (n Z 110) of parents expressed concerns about their child's feeding behavior. Sixty-eight percent (n Z 206) of parents reported presence of at least one behavioral and 18.5% (n Z 56) had at least one organic red flag for feeding difficulties, respectively. 9.9% (n Z 30) had both behavioral and organic red flags for feeding difficulties. Growth faltering was significantly associated with parental concern about feeding (odds ratio [OR] 3.049, p < 0.001), food refusal (OR 4.047, p < 0.001) and presence of at least one organic red flag (OR 2.625, p Z 0.012).

CONClUSIONThe proportion of Malaysian mothers who are positive for HBsAg remains high. The three-shot hepatitis B vaccine, given as part of universal vaccination against hepatitis B, provides adequate anti-HBs in the vast majority of infants in a community setting in Malaysia.

The aims of the study are to: (a) Describe the reactogenicity of WHO-approved two mRNA (Pfizer-BioNTech, Moderna) and two non-RNA (Oxford-AstraZeneca, Sinovac) vaccines among lactating mother and child pairs, and (b) Compare and contrast the reactogenicity between mRNA and non-mRNA vaccines. A cross-sectional, self-reported survey was conducted amongst 1784 lactating women who received COVID-19 vaccinations. The most common maternal adverse reaction was a local reaction at the injection site, and the largest minority of respondents, 49.6% (780/1571), reported experiencing worse symptoms when receiving the second dose compared to the first dose. Respondents reported no major adverse effects or behavioural changes in the breastfed children for the duration of the study period. Among respondents who received non-mRNA COVID-19 vaccines, a majority reported no change in lactation, but those who did more commonly reported changes in the quantity of milk supply and pain in the breast. The more commonly reported lactation changes (fluctuations in breast milk supply quantity and pain in the breast) for the non-mRNA vaccines were similar to those of respondents who received mRNA vaccines. Our study, with a large, racially diverse cohort, further augments earlier reported findings in that the COVID-19 vaccines tested in this study did not cause any serious adverse events in our population for the duration of our survey period, although long-term effects are yet to be studied.

IntroductionUndernutrition in young children is a significant public health problem globally. We determined the prevalence of and factors predisposing to stunting and underweight in children aged 1 to 5 years in Malaysia.Materials and methodsData were extracted from a cross-sectional nationwide campaign involving healthy children aged 1–5 years conducted over a 4-month period in 2019. We obtained information on demography, parental height and risk factors of undernutrition and anthropometric measurements (height and weight) of children enrolled. Age and sex-specific z-score for length/height-for-age (HAZ), weight-for-age (WAZ), body mass index (BMI) z-score (BAZ) and weight-for-height/length (WFH) z-score (WFHZ) were obtained using World Health Organization growth standards. The following definitions were used: (a) HAZ &lt; −2 SD as stunted and −2 to −1 SD as at risk of stunting; (b) WFHZ &lt; −3 SD as severe, −3 to &lt; −2 SD as moderate wasting, and −2 to &lt; +1 SD as normal; (c) WAZ −2 to −1 as at risk of underweight; (d) BAZ +1 to &lt; +2 SD as at risk of and &gt; +2 SD as overweight.ResultsOf the 15,331 children surveyed, prevalence of stunting and at risk of stunting were 16.1 and 20.0%, severe and moderate wasting were 4.0 and 6.1%, while 21.1% was at risk of underweight. Prevalence of at risk of and overweight 14.2 and 7.3%, respectively. One in fifth (25.0%) children had at least one form of undernutrition (stunting and/or underweight/wasting). Of the 1,412 (13.2%) children reported to have risk factors of undernutrition, 47.2% had feeding difficulties, 44.8% had poor dietary intake and 8.0% had both. Boys, paternal height &lt; 156 cm and poor dietary intake were significantly associated with stunting and/or wasting. Compared with children with no risk factors, children with feeding difficulties were more likely to be wasted (AOR: 1.48, 95% CI: 1.18–1.85), and had at least one form of undernutrition (AOR: 1.45, 95% CI: 1.25–1.69).ConclusionsIn Malaysian children aged 1 to 5 years, dual burden of under- and overnutrition are common. Poor dietary intake and feeding difficulties were risk factors for undernutrition.

Aim:To gain insight into nutritional practices and expected growth outcomes of infants born between 34 and 36 gestational weeks defined as late preterm infants (LPT).Methods: An anonymous online survey among paediatricians and neonatologists from Bangladesh, Indonesia, Mexico, Nigeria, Malaysia, Singapore and Taiwan was conducted from March until October 2020. The questionnaire consisted of 40 questions on the nutritional management and expected growth outcomes of LPT in and after-hospital care.Results: Healthcare professionals from low to high Human Development (HDI) countries (n = 322) and very high HDI countries (n = 169) participated in the survey. Human milk was the preferred feeding, resulting in an adequate growth of LPT (weight, length