title: Feeding Patterns and Predictors of Malnutrition in Infants from Poor Socioeconomic Areas in Pakistan: A Cross-sectional Survey.
abstract: BACKGROUND
  Malnutrition, a state of under or over nutrition caused by improper food intake, causes significant morbidity and mortality in developing countries. It leads to a number of diseases which can be further divided into those caused by protein-caloric malnutrition and those caused by vitamin deficiencies, micronutrient, and mineral deficiencies. The purpose of this study was to identify the factors which contribute to malnutrition and to assess the dietary pattern in the pediatric population from birth up to five months belonging to poor socioeconomic areas. The children in this sample presented to a tertiary care hospital in the district of Sargodha, Pakistan. The findings in this cohort will support the development of an effective plan to tackle these issues.
  
  
  METHODS
  This cross-sectional study was undertaken between June 2014 and December 2014 at the inpatient pediatric department of District Headquarter Hospital Sargodha. Data were collected and recorded on a predesigned form which consisted of four sections to record 1) demographics: parents' level of education, monthly income, number of dependent household members, and birth interval; 2) anthropometric and personal history, birth history, and degree of malnutrition; 3) any secondary causes of malnutrition; and 4) feeding history. The data were analyzed in SPSS v. 20. Chi-squared, phi statistics, and logistic regression analysis were run to analyze the data.
  
  
  RESULTS
  A total of 294 participants were included in the study. Logistic regression analysis showed that the degree of malnutrition was associated negatively with increasing age and positively with family size. A majority of children (144, 49%) were being breastfed for less than 5 minutes followed by 38 (13%) > 5 minutes to 15 minutes, and 2 (0.7%) > 15 minutes while 110 (37 %) infants were not breastfed. Children who were breastfed were less likely to have severe malnutrition than those who were given formula, fresh cow's or goat's milk, or more than one type of food.
  
  
  CONCLUSIONS
  Children who were breastfed were less likely to have severe malnutrition. The degree of malnutrition was negatively associated with age and positively associated with family size.
authors.affiliation: Medical Student, Yusra Medical and Dental College, Islamabad, Pakistan.
authors.forename: Muhammad Umer
authors.initials: MU
authors.lastname: Nisar
authors.affiliation: District Headquarter Hospital, Sargodha, Pakistan.
authors.forename: Malik Muhammad
authors.initials: MM
authors.lastname: Anwar Ul Haq
authors.affiliation: Dow Medical College, Karachi, Pakistan.
authors.forename: Saad
authors.initials: S
authors.lastname: Tariq
authors.affiliation: Combined Military Hospital, Mangla, Pakistan.
authors.forename: Madiha
authors.initials: M
authors.lastname: Anwar
authors.affiliation: District Headquarter Hospital, Sargodha, Pakistan.
authors.forename: Anam
authors.initials: A
authors.lastname: Khawar
authors.affiliation: Final year MBBS Student, CMH Lahore Medical College and Institute of Dentistry, Lahore Cantt, Pakistan.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Waqas
authors.affiliation: POF Hospital, Wah Cantt, Pakistan.
authors.forename: Anam
authors.initials: A
authors.lastname: Nisar
keywords: breast feeding; children; malnutrition; nutrition