FEEDING BOTTLES HYGIENE IN SOUTHERN PUNJAB HOSPITALS: A MICROBIOLOGICAL EVALUATION
Main Article Content
Keywords
Infants, feeding bottles, hospitals, diarrhea, caregiver’s hygiene
Abstract
Bottle feeding, a longstanding practice for supplementing infant nutrition, poses a significant of food-borne pathogens transmission and subsequent gastroenteritis among infants, whose immature immune systems make them more vulnerable to these infections. It is responsible for 2.5 billion cases of diarrhea and 1.3 million deaths annually with severe cases leading to meningitis brain abscesses, and necrotizing enterocolitis (mortality rate:33%-80%). This study investigated the hygiene status of ready to use infant feeding bottles, and extent of facilities provided at Southern Punjab hospitals. Our analysis targeted potential sources of contamination and cross-contamination including formula milk/cow milk, water, and handler's hands. The findings revealed poor hygiene practices among caregivers, inadequate hospital facilities and high prevalence of bacteria (above acceptable limits by FDA) on 84% of targeted sources. However improved hygiene status was observed following food safety training for caregivers. To ensure safe feeding practices, we recommend hospitals adopt guidelines for proper sterilization, preparation, and handling of associated infant feeding bottles. These research findings will enable healthcare providers to develop targeted treatments, significantly reducing the spread of food-borne diseases and ultimately protecting infant health.
References
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21. Maturin, L., & Peeler, J. T. (2001). BAM: Aerobic plate count. US Food and Drug Administration: Silver Spring, MD, USA.
22. Mohanna, M. A. B., & Al-Sonboli, N. (2018). Prevalence of diarrhoea and related risk factors among children aged under 5 years in Sana'a, Yemen. Hamdan Medical Journal, 11(1), 29-33.
23. Mukhtar, A., Izham, M. I. M., & Pathiyil, R. S. (2011). A survey of mothers' knowledge about childhood diarrhoea and its management among a marginalised community of Morang, Nepal. The Australasian medical journal, 4(9), 474.
24. Mohanna, M. A. B., & Al-Sonboli, N. (2018). Prevalence of diarrhoea and related risk factors among children aged under 5 years in Sana'a, Yemen. Hamdan Medical Journal, 11(1), 29-33.
25. Mosisa, D., Aboma, M., Girma, T., & Shibru, A. (2021). Determinants of diarrheal diseases among under five children in Jimma Geneti District, Oromia region, Ethiopia, 2020: a case-control study. BMC pediatrics, 21, 1-13.
26. Musa, H. A., Holi, M. A., Hussein, M. E., & Shikeiri, A. B. (2009). Faecal contamination of feeding bottles contents, among artificially fed children. Sudan Journal of Medical Sciences, 4(2)
27. Nasrul, N., Hafid, F., Ramadhan, K., Suza, D. E., & Efendi, F. (2020). Factors associated with bottle feeding in children aged 0–23 months in Indonesia. Children and Youth Services Review, 116, 105251.
28. Negassa, B., Ashuro, Z., & Soboksa, N. E. (2022). Hygienic food handling practices and associated factors among food handlers in Ethiopia: a systematic review and meta-analysis. Environmental Health Insights, 16, 11786302221105320.
29. Nolan, T., Angos, P., Cunha, A. J., Muhe, L., Qazi, S., Simoes, E. A., ... & Pierce, N. F. (2001). Quality of hospital care for seriously ill children in less-developed countries. The Lancet, 357(9250), 106-110.
30. O’Ryan, M., Prado, V., & Pickering, L. K. (2005). A millennium update on pediatric diarrheal illness in the developing world. Paper presented at the Seminars in pediatric infectious diseases.
31. Organization, W. H. (2018). Implementation guidance: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: the revised baby-friendly hospital initiative.
32. Parra-Flores, J., Cabal-Rosel, A., Daza-Prieto, B., Chavarria, P., Maury-Sintjago, E., Rodriguez-Fernández, A., ... & Ruppitsch, W. (2022). Are Enterobacteriaceae and Enterococcus Isolated from Powdered Infant Formula a Hazard for Infants? A Genomic Analysis. Foods, 11(22), 3556.
33. Qurayshah, M. A. A., Al Qirad, M. S. H., Alsharyah, H. M., Hussenalkanfari, M. A., Alkenfari, A. M. H., Alghaty, S. S. H., ... & Al Muammar, H. S. (2023). Infection Control Education And Training: Ensuring Compliance And Competency Among Healthcare Workers An Evaluation. Journal of Namibian Studies: History Politics Culture, 39, 401-412.
34. Rao, G. S., Sudershan, R. V., Rao, P., Rao, M. V. V., & Polasa, K. (2007). Food safety knowledge, attitudes and practices of mothers—Findings from focus group studies in South India. Appetite, 49(2),
35. Redmond, E. C., & Griffith, C. J. (2009). The importance of hygiene in the domestic kitchen: implications for preparation and storage of food and infant formula. Perspectives in Public Health, 129(2), 69-76.
36. Redmond, E., & Griffith, C. (2009). Disinfection methods used in decontamination of bottles used for feeding powdered infant formula; this study by Dr Elizabeth Redmond and Professor Christopher Griffith shows that four commonly used methods of" sterilising" infant feeding bottles are effective, but health professionals need to advise parents and carers on using these methods correctly. Journal of Family Health Care, 19(1), 26-32.
37. Szewczak, A., Bąk, J., Węgorowski, P., & Zarzycka, D. (2018). The knowledge of mothers on prevention of diarrhea in infancy. Journal of Education, Health and Sport, 8(11), 156-164.
38. Sheth, M., & Obrah, M. (2004). Diarrhea prevention through food safety education. The Indian Journal of Pediatrics, 71, 879-882
39. Sudershan, R. V., Rao, G. S., Rao, P., Rao, M. V. V., & Polasa, K. (2008). Food safety related perceptions and practices of mothers–A case study in Hyderabad, India. Food control, 19(5), 506-513.
40. Swanson, K., Busta, F., Peterson, E., Johnson, M., Vanderzant, C., & Splittstoesser, D. (1992). Compendium of methods for the microbiological examination of foods. Washington, DC: Apha.
41. Sudershan, R. V., Rao, G. S., Rao, P., Rao, M. V. V., & Polasa, K. (2008). Food safety related perceptions and practices of mothers–A case study in Hyderabad, India. Food control, 19(5), 506-513.
42. Steele, C., & Short, R. (2008). Centralized infant formula preparation room in the neonatal intensive care unit reduces incidence of microbial contamination. Journal of the American Dietetic Association, 108(10), 1700-1703
43. Were, L., Were, G., & Aduol, K. O. (2020). Hygiene Practices and Microbial Contamination of Street vended Foods in Kenyatta University’s Environs.
44. Workie, G. Y., Akalu, T. Y., & Baraki, A. G. (2019). Environmental factors affecting childhood diarrheal disease among under-five children in Jamma district, South Wello zone, Northeast Ethiopia. BMC infectious diseases, 19, 1-7.
45. Zaidi, S. H., & Smith-Morris, C. (2015). Diapers in war zones: Ethnomedical factors in acute childhood gastroenteritis in Peshawar, Pakistan. PLoS One, 10(3), e0119069.
2. Al-Mamari, T., Al-Ghafri, M., Al-Wahaibi, M., Ambusaidi, S., & Hassan, H. S. (2017). Breast feeding and bottle (formula) feeding habits among Omani babies. Madridge J Nurs, 2(2), 81-6.
3. Alqurashi, N. A., Priyadarshini, A., & Jaiswal, A. K. (2019). Evaluating food safety knowledge and practices among foodservice staff in Al Madinah Hospitals, Saudi Arabia. Safety, 5(1), 9.
4. Ayaz, F., Ayaz, S. B., Furrukh, M., & Matee, S. (2017). Cleaning practices and contamination status of infant feeding bottle contents and teats in Rawalpindi, Pakistan. Pakistan Journal of Pathology, 28(1), 13–20.
5. Ahmed, R., Ahmad, N., Nasir, F., & Khoso, I. (2014). Patients’ satisfaction and quality health services: an investigation from private hospitals of Karachi, Pakistan. Research Journal of Recent Sciences, ISSN, 2277-2502.
6. Bani, I. A., Saeed, A. A. W., & Al Othman, A. A. M. (2002). Diarrhoea and child feeding practices in Saudi Arabia. Public Health Nutrition, 5(6), 727-731.
7. Brugger, S. D., Baumberger, C., Jost, M., Jenni, W., Brugger, U., & Mühlemann, K. (2012). Automated counting of bacterial colony forming units on agar plates. PloS one, 7(3), e33695.
8. Choube, A., Bahal, S. P., Srivastava, A., & Sharma, M. (2014). Knowledge and child care practices regarding childhood diarrhoea-A cross sectional study. Indian journal of community health, 26(3), 285-291.
9. Chaudhary, P., Basu, S., Dzeyie, A. K., Gulla, S., Khade, S., Patel, A., ... & Shrivastava, A. (2014). Knowledge, attitude and practice of mothers regarding diarrhoeal illness in children under five years of age: a cross sectional study in an Urban Slum of Delhi, India. J Commun Dis, 46(3), 13-21.
10. Irfan, S. M., Ijaz, A., & Shahbaz, S. (2011). An assessment of service quality of private hospitals in Pakistan: a patient perspective. Indian Journal of Commerce and Management Studies, 2(2), 20-34.
11. Emea, M. K., & Lawal, S. A. (2023). Effect of Health Education Intervention On Diarrhea Prevention Practices Among Mothers of Under-5 Children in Abia State, Nigeria. International Journal of Public Health, Pharmacy and Pharmacology, 8(2), 28-43.
12. Feleke, Y., Legesse, A., & Abebe, M. (2022). Prevalence of diarrhea, feeding practice, and associated factors among children under five years in Bereh District, Oromia, Ethiopia. Infectious Diseases in Obstetrics and Gynecology, 2022.
13. Imada, K. S., Araújo, T. S. D., Muniz, P. T., & Pádua, V. L. D. (2016). Socioeconomic, hygienic, and sanitation factors in reducing diarrhea in the Amazon. Revista de saude publica, 50, 77.
14. ISO. (2018). ISO 18593: 2018 (E) Microbiology of the Food Chain‐Horizontal Methods for Surface Sampling.
15. Ejemot-Nwadiaro, R. I., Ehiri, J. E., Arikpo, D., Meremikwu, M. M., & Critchley, J. A. (2021). Hand‐washing promotion for preventing diarrhoea. Cochrane database of systematic reviews(1).
16. Garg, N., Kikon, S., Ramesh, R., & Garg, S. C. (2019). Knowledge, attitude and practices of childhood diarrhoea among mothers of children under five years of age: a cross sectional study. Int J Community Me
17. Jalali, M., Sabzghabaee, A. M., Badri, S. S., Soltani, H. A., & Maracy, M. R. (2009). Bacterial contamination of hospital-prepared enteral tube feeding formulas in Isfahan, Iran. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 14(3), 149.
18. Khaliq, A., Amreen, Jameel, N., & Krauth, S. J. (2022). Knowledge and practices on the prevention and management of diarrhea in children under-2 years among women dwelling in urban slums of Karachi, Pakistan. Maternal and child health journal, 26(7), 1442-1452.
19. Lakshman, R., Ogilvie, D., & Ong, K. K. (2009). Mothers’ experiences of bottle-feeding: a systematic review of qualitative and quantitative studies. Archives of disease in childhood, 94(8), 596-601.
20. Marege, A., Regassa, B., Seid, M., Tadesse, D., Siraj, M., & Manilal, A. (2023). Bacteriological quality and safety of bottle food and associated factors among bottle-fed babies attending pediatric outpatient clinics of Government Health Institutions in Arba Minch, southern Ethiopia. Journal of Health, Population and Nutrition, 42(1), 46.
21. Maturin, L., & Peeler, J. T. (2001). BAM: Aerobic plate count. US Food and Drug Administration: Silver Spring, MD, USA.
22. Mohanna, M. A. B., & Al-Sonboli, N. (2018). Prevalence of diarrhoea and related risk factors among children aged under 5 years in Sana'a, Yemen. Hamdan Medical Journal, 11(1), 29-33.
23. Mukhtar, A., Izham, M. I. M., & Pathiyil, R. S. (2011). A survey of mothers' knowledge about childhood diarrhoea and its management among a marginalised community of Morang, Nepal. The Australasian medical journal, 4(9), 474.
24. Mohanna, M. A. B., & Al-Sonboli, N. (2018). Prevalence of diarrhoea and related risk factors among children aged under 5 years in Sana'a, Yemen. Hamdan Medical Journal, 11(1), 29-33.
25. Mosisa, D., Aboma, M., Girma, T., & Shibru, A. (2021). Determinants of diarrheal diseases among under five children in Jimma Geneti District, Oromia region, Ethiopia, 2020: a case-control study. BMC pediatrics, 21, 1-13.
26. Musa, H. A., Holi, M. A., Hussein, M. E., & Shikeiri, A. B. (2009). Faecal contamination of feeding bottles contents, among artificially fed children. Sudan Journal of Medical Sciences, 4(2)
27. Nasrul, N., Hafid, F., Ramadhan, K., Suza, D. E., & Efendi, F. (2020). Factors associated with bottle feeding in children aged 0–23 months in Indonesia. Children and Youth Services Review, 116, 105251.
28. Negassa, B., Ashuro, Z., & Soboksa, N. E. (2022). Hygienic food handling practices and associated factors among food handlers in Ethiopia: a systematic review and meta-analysis. Environmental Health Insights, 16, 11786302221105320.
29. Nolan, T., Angos, P., Cunha, A. J., Muhe, L., Qazi, S., Simoes, E. A., ... & Pierce, N. F. (2001). Quality of hospital care for seriously ill children in less-developed countries. The Lancet, 357(9250), 106-110.
30. O’Ryan, M., Prado, V., & Pickering, L. K. (2005). A millennium update on pediatric diarrheal illness in the developing world. Paper presented at the Seminars in pediatric infectious diseases.
31. Organization, W. H. (2018). Implementation guidance: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: the revised baby-friendly hospital initiative.
32. Parra-Flores, J., Cabal-Rosel, A., Daza-Prieto, B., Chavarria, P., Maury-Sintjago, E., Rodriguez-Fernández, A., ... & Ruppitsch, W. (2022). Are Enterobacteriaceae and Enterococcus Isolated from Powdered Infant Formula a Hazard for Infants? A Genomic Analysis. Foods, 11(22), 3556.
33. Qurayshah, M. A. A., Al Qirad, M. S. H., Alsharyah, H. M., Hussenalkanfari, M. A., Alkenfari, A. M. H., Alghaty, S. S. H., ... & Al Muammar, H. S. (2023). Infection Control Education And Training: Ensuring Compliance And Competency Among Healthcare Workers An Evaluation. Journal of Namibian Studies: History Politics Culture, 39, 401-412.
34. Rao, G. S., Sudershan, R. V., Rao, P., Rao, M. V. V., & Polasa, K. (2007). Food safety knowledge, attitudes and practices of mothers—Findings from focus group studies in South India. Appetite, 49(2),
35. Redmond, E. C., & Griffith, C. J. (2009). The importance of hygiene in the domestic kitchen: implications for preparation and storage of food and infant formula. Perspectives in Public Health, 129(2), 69-76.
36. Redmond, E., & Griffith, C. (2009). Disinfection methods used in decontamination of bottles used for feeding powdered infant formula; this study by Dr Elizabeth Redmond and Professor Christopher Griffith shows that four commonly used methods of" sterilising" infant feeding bottles are effective, but health professionals need to advise parents and carers on using these methods correctly. Journal of Family Health Care, 19(1), 26-32.
37. Szewczak, A., Bąk, J., Węgorowski, P., & Zarzycka, D. (2018). The knowledge of mothers on prevention of diarrhea in infancy. Journal of Education, Health and Sport, 8(11), 156-164.
38. Sheth, M., & Obrah, M. (2004). Diarrhea prevention through food safety education. The Indian Journal of Pediatrics, 71, 879-882
39. Sudershan, R. V., Rao, G. S., Rao, P., Rao, M. V. V., & Polasa, K. (2008). Food safety related perceptions and practices of mothers–A case study in Hyderabad, India. Food control, 19(5), 506-513.
40. Swanson, K., Busta, F., Peterson, E., Johnson, M., Vanderzant, C., & Splittstoesser, D. (1992). Compendium of methods for the microbiological examination of foods. Washington, DC: Apha.
41. Sudershan, R. V., Rao, G. S., Rao, P., Rao, M. V. V., & Polasa, K. (2008). Food safety related perceptions and practices of mothers–A case study in Hyderabad, India. Food control, 19(5), 506-513.
42. Steele, C., & Short, R. (2008). Centralized infant formula preparation room in the neonatal intensive care unit reduces incidence of microbial contamination. Journal of the American Dietetic Association, 108(10), 1700-1703
43. Were, L., Were, G., & Aduol, K. O. (2020). Hygiene Practices and Microbial Contamination of Street vended Foods in Kenyatta University’s Environs.
44. Workie, G. Y., Akalu, T. Y., & Baraki, A. G. (2019). Environmental factors affecting childhood diarrheal disease among under-five children in Jamma district, South Wello zone, Northeast Ethiopia. BMC infectious diseases, 19, 1-7.
45. Zaidi, S. H., & Smith-Morris, C. (2015). Diapers in war zones: Ethnomedical factors in acute childhood gastroenteritis in Peshawar, Pakistan. PLoS One, 10(3), e0119069.
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Sep 25, 2024
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FEEDING BOTTLES HYGIENE IN SOUTHERN PUNJAB HOSPITALS: A MICROBIOLOGICAL EVALUATION. (2024). Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 1815-1824. https://doi.org/10.53555/n9z09096
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Author Biographies
Rabab Akhtar
Department of Food Science and Technology, Faculty of Food Science and Nutrition Bahauddin Zakariya University Multan- Pakistan
Saeed Akhtar
Department of Food Science and Technology, Faculty of Food Science and Nutrition Bahauddin Zakariya University Multan- Pakistan,
Sobia Zafar
Senior Registrar, Gaye unit-3, Services Hospital Lahore,
Zubair Farooq
Department of Food Science & Human Nutrition, University of veterinary and Animal Sciences, Lahore
How to Cite
FEEDING BOTTLES HYGIENE IN SOUTHERN PUNJAB HOSPITALS: A MICROBIOLOGICAL EVALUATION. (2024). Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 1815-1824. https://doi.org/10.53555/n9z09096