Theory and Clinical Practice in Pediatrics

This study examined breastfeeding knowledge and practices among lactating mothers in Ratnanagar Municipality, Chitwan, Nepal. It focused on colostrum feeding, exclusive breastfeeding, early initiation, breastfeeding frequency, bottle feeding, hygiene, and complementary feeding. A descriptive quantitative design was used. The study included 110 mothers with children aged up to 12 months who visited Ratnanagar Health Post for immunization. Participants were selected through purposive sampling, and data were collected using a structured interview schedule. The data were analyzed using frequencies and percentages. The findings showed that 68.18% of mothers knew about colostrum, while 62.73% reported feeding it to their newborns. Only 41.82% initiated breastfeeding within one hour of birth, and 30.91% correctly understood exclusive breastfeeding. Bottle feeding was reported by 48.18% of mothers, while 72.72% reported that they did not wash their hands and clean their breasts before breastfeeding. In addition, 52.72% introduced complementary foods after six months. Although 94.55% of the mothers were literate, gaps remained in their knowledge of recommended breastfeeding practices. The findings indicate a need for targeted breastfeeding education, counseling during pregnancy and after childbirth, and practical guidance on infant feeding and care. As the study was limited to mothers attending one health post, the findings should be interpreted within this setting.

Background: Vitamin D deficiency has been increasingly recognised among children and adolescents with epilepsy, particularly in low-resource settings, where disease-related factors, antiepileptic treatments, and nutritional deficiencies may contribute to reduced serum levels. This study aimed to assess vitamin D status and identify associated factors in children and adolescents with epilepsy in Watsa health zone, Democratic Republic of the Congo. Methods: A cross-sectional study was conducted among 43 children and adolescents with epilepsy. Sociodemographic, clinical, nutritional, and treatment-related data were collected. Serum 25-hydroxyvitamin D [25(OH)D] and calcium levels were measured. Associations were explored using bivariate analyses, correlation tests, and multivariable linear regression models. Results: The mean age was 11.2 ± 6.3 years, and 55.8% were male. Most participants (60.5%) had uncontrolled seizures. Vitamin D insufficiency was highly prevalent (69.8%), while 25.6% had deficiency; only 4.7% had normal levels. Mean serum 25(OH)D was 23.5 ± 4.3 ng/mL. In bivariate analysis, fish (p = 0.002), milk (p < 0.001), and egg consumption (p = 0.013) were associated with higher vitamin D levels. No associations were found with age, sex, epilepsy characteristics, treatment, or calcium levels. In multivariable analysis, fish (β = 6.51; p < 0.001), milk (β = 4.32; p = 0.001), and eggs (β = 3.62; p = 0.004) remained independent predictors of higher serum 25(OH)D. Conclusion: Vitamin D insufficiency is highly prevalent among children and adolescents with epilepsy in Watsa health zone. Dietary intake of fish, milk, and eggs appears to be the main modifiable determinant of serum 25(OH)D levels, highlighting the importance of targeted nutritional interventions in this population.

Objective: To propose and analyze a playful adaptation of the Forced Expiratory Technique (FET) in children based on a mechanism-oriented framework for airway clearance.
Methods: This is a descriptive theoretical-conceptual study based on the development and analysis of a pediatric clinical protocol incorporating playful strategies into FET execution. The components of the technique were mapped to their underlying physiological mechanisms according to contemporary classifications of airway clearance techniques.
Results: The proposed model suggests that the playful adaptation of FET is theoretically capable of activating key physiological mechanisms involved in airway clearance, including airflow modulation, increased lung volumes, and secretion mobilization. The integration of these components supports a multimodal physiological approache.
Conclusion: The playful adaptation of FET may represent a feasible and physiologically grounded strategy to enhance adherence and facilitate the execution of therapeutic breathing patterns in pediatric patients.