In 2012, the Baby-friendly Hospital Initiative for Neonatal Wards (Neo-BFHI) began providing recommendations to improve breastfeeding support for preterm and ill infants. This cross-sectional survey aimed to measure compliance on a global level with the Neo-BFHI's expanded Ten Steps to successful breastfeeding and three Guiding Principles in neonatal wards. In 2017, the Neo-BFHI Self-Assessment questionnaire was used in 15 languages to collect data from neonatal wards of all levels of care. Answers were summarized into compliance scores ranging from 0 to 100 at the ward, country, and international levels. A total of 917 neonatal wards from 36 low-, middle-, and high-income countries from all continents participated. The median international overall score was 77, and median country overall scores ranged from 52 to 91. Guiding Principle 1 (respect for mothers), Step 5 (breastfeeding initiation and support), and Step 6 (human milk use) had the highest scores, 100, 88, and 88, respectively. Step 3 (antenatal information) and Step 7 (rooming-in) had the lowest scores, 63 and 67, respectively. High-income countries had significantly higher scores for Guiding Principles 2 (family-centered care), Step 4 (skin-to-skin contact), and Step 5. Neonatal wards in hospitals ever-designated Baby-friendly had significantly higher scores than those never designated. Sixty percent of managers stated they would like to obtain Neo-BFHI designation. Currently, Neo-BFHI recommendations are partly implemented in many countries. The high number of participating wards indicates international readiness to expand Baby-friendly standards to neonatal settings. Hospitals and governments should increase their efforts to better support breastfeeding in neonatal wards.

Objective: To determine trends in prevalence of overweight and obesity in Kuwaiti adults, and to examine their association with selected sociodemographic and lifestyle factors. Design: Analysis of cross-sectional population survey data from the Kuwait National Nutrition Surveillance System. Setting: Social and health facilities in Kuwait. Logistic and linear regression analyses confirmed these temporal changes for both prevalence and BMI in both genders. The odds of obesity increased with age until the fifth decade for both genders and then declined significantly for males. Education level was negatively associated with obesity prevalence in females, while participation in leisure-time exercise was negatively associated with obesity prevalence in males. Conclusions: Although the combined prevalence of overweight and obesity (BMI $ 25 kg/m 2 ) seemed to decrease from 2005 to 2009 among Kuwaiti adults, further research to clarify the identified confounders and continued monitoring are needed to confirm the decrease observed.

A cross-sectional study was carried out to identify the risk factors of anemia and iron deficiency in Kuwaiti pregnant women. Pregnant women (n = 465) aged 18-47 years, of 4-39 weeks at gestation were recruited during antenatal visits from six health facilities in Kuwait. Socio-demographic, pregnancy-related and dietary information were collected. Hemoglobin, serum ferritin and serum C-reactive protein concentrations were determined. Logistic regression analysis revealed that iron deficiency and not taking iron-folate tablets or taking them occasionally were the two most important risk factors associated with anemia. Pregnant women with higher gestational age, short birth spacing ( ≤ 2 years), not taking iron-folate tablets or taking them occasionally, not consuming fruit juice, and consuming brown bread, tea and/or coffee were significant risk factors associated with iron deficiency. In conclusion, various factors including dietary habits appeared to be associated with poor iron status, which is the most important risk factor for anemia among Kuwaiti pregnant women.

BackgroundCurrent prevalence estimates for diabetes in Arabian Gulf countries are some of the world’s highest, yet regional trends and contributing factors are poorly documented. The present study was designed to determine temporal changes in the prevalence of impaired fasting glucose (IFG) and diabetes and associated factors in Kuwaiti adults.MethodsData analysis from the nationally representative cross-sectional Kuwait National Nutrition Surveillance System. 2745 males and 3611 females, aged 20–69 years, attending registration for employment or pensions and Hajj Pilgrimage health check-ups or accompanying children for immunizations from 2002 through 2009 were participated. Socio-demographic and lifestyle information, height and weight, and blood samples were collected.ResultsDuring the 8 years (2002–09), prevalences of IFG in males and females decreased by 7.4% and 6.8% and of diabetes by 9.8% and 8.9% in males and females, respectively. Linear regression for blood glucose level with time, adjusted for age, BMI, blood cholesterol and education level, showed a greater decrease in males than females (1.12 vs 0.93 mmol/L); males also showed an increase in 2002–2003 followed by a marked decrease in 2006–2007 while females showed a significant decrease in 2008–2009. Both males and females showed the largest decrease in the 2nd half of the study accounting for the majority of the overall decrease (1.13 mmol/L for males and 0.87 mmol/l for females for the 4 years). Compared with 2002–03, the OR for IFG in males decreased with time, and becoming significantly lower (OR=0.32; 95% CI: 0.21-0.49) for 2008–09. In females, the OR for IFG decreased significantly with time, except in 2006–07. Similarly, the OR for diabetes in males decreased to 0.34 (95% CI: 0.24-0.49) and in females to 0.33 (95% CI: 0.22-0.50) in 2008–09. For both genders, age and BMI were independently positively associated with IFG and diabetes, while education levels and smoking were negatively associated with IFG and diabetes. No significant association was found for either hypercholesterolemia or exercise in either gender.ConclusionContinued monitoring of blood glucose is needed to see if negative trends observed in 2008–2009 endure and further research of contributing factors is required for development of targeted intervention strategies.

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