Early Childhood Development Publications

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Early Childhood Development Publications

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Journal Articles

The Relationship Between Birth Season and Early Childhood Development: Evidence from Northwest Rural China

Yu Bai, Guanminjia Shang, Lei Wang, Yonglei Sun, Annie Osborn, Scott Rozelle
PLoS ONE , 2018
Objective: To examine the correlation between birth season and early childhood development. Background: Almost all previous studies that examine the effect of birth season on early childhood development were conducted in developed countries with a limited sample size. The present study was conducted in poor, rural areas of western China, a developing region with a continental monsoon climate. Method: We administered a hemoglobin test to 650 infants (52% boys), aged 8–10 months, using a Hemocue Hb 201+ finger prick system, and assessed the cognitive and psychomotor development of sample infants using Bayley Scales of Infant Development. Results: Infants born in winter have higher Hb concentrations (t = 3.63, p < 0.001) compared to infants born in summer. Similarly, cognitive development scores (t = 5.17, p < 0.001) and psychomotor development scores (t = 10.60, p < 0.001) were significantly higher among winter-born infants. Conclusion: The findings point to the involvement of birth season in early childhood development and suggest that aspects of the environment shape the experiences that contribute to early childhood development. Policy suggestions such as providing infants with ample opportunities for movement and stimulation during the cold season are discussed.
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Journal Articles

Do Infant Feeding Practices Differ Between Grandmothers and Mothers in Rural China? Evidence From Rural Shaanxi Province

Ai Yue, Nianrui Zhang, Xueyang Liu, Lei Tang, Renfu Luo, Meredith Yang, Scott Rozelle, Alexis Medina
Family & Community Health , 2018
The overall goal of this study is to examine whether infant feeding practices differ between mothers and grandmothers in rural China. We randomly sampled 1383 caregivers of infants aged 18 to 30 months living in 351 villages across 174 townships in nationally designated poverty counties in rural areas. Results show that a high fraction of caregivers of 18- to 30-month-old children living in low-income areas of rural China do not regularly engage in positive infant feeding practices. Only 30% of children in our sample achieved adequate dietary diversity. Only 49% of children in our sample were fed meat in the day prior to survey administration. Few caregivers reported giving any vitamin supplements (such as calcium or iron supplements) to their children. We find that 33% of the children were cared for by grandmothers rather than mothers, and that grandmothers feed a less diversified diet to children than do mothers. Most (84%) caregivers rely solely on their own experiences, friends, and family members in shaping their feeding behaviors. Overall infant feeding practices are poor in rural China. Grandmothers engage in poorer feeding practices than do mothers. Grandmothers have improved their feeding practices compared to when their own children were young. Our results suggest shortcomings in the quality of infant feeding practices, at least in part due to an absence of reliable information sources. Key words: child development, feeding practices, information sources, rural China
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Journal Articles

China's Invisible Crisis: Cognitive Delays among Rural Toddlers and the Absence of Modern Parenting

Ai Yue, Yaojiang Shi, Renfu Luo, Jamie Chen, James Garth, Jimmy Zhang, Sarah Kotb, Alexis Medina, Scott Rozelle
2018

This article explores the problem of cognitive delays among toddlers in rural China and the role of their caregivers in producing low levels of cognition (i.e., low IQ). According to the results of a well-tested international scale of child development, the Bayley Scales of Infant Development (BSID), cognitive delays are alarmingly common, and nearly half the toddlers in our sample score an IQ of less than 84 on the BSID test (more than one standard deviation below the mean).

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Journal Articles

The effect of a micronutrient powder home fortification program on anemia and cognitive outcomes among young children in rural China: a cluster randomized trial

Renfu Luo, Ai Yue, Huan Zhou, Yaojiang Shi, Linxiu Zhang, Reynaldo Martorell, Alexis Medina, Scott Rozelle, Sean Sylvia
BMC Public Health , 2017

Background: Anemia early in life has been associated with delayed cognitive and motor development. The WHO recommends home fortification using multiple micronutrient powders (MNPs) containing iron as a strategy to address anemia in children under two. We evaluated the effects of a program freely distributing MNP sachets to caregivers of infants in rural China.

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Working Papers

The Effect of Maternal Migration on Early Childhood Development in Rural China

Ai Yue, Sean Sylvia, Yaojiang Shi, Renfu Luo, Scott Rozelle
Working Paper , 2016

Nearly a quarter of all children under the age of two in China are left behind in the countryside as parents migrate to urban areas for work. We use a longitudinal survey following young children and their caregivers from 6 to 30 months of age to estimate the effects of maternal migration on development, health, and nutritional outcomes in the critical first stages of life.We find significant negative effects on cognitive development and indicators of dietary quality.

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Working Papers

Parental Behavior and Social-Emotional Development among Infants in Rural Shaanxi Province, China

Ai Yue, Shan Li, Meini Shi, Yaojiang Shi, Renfu Luo, Kaleigh Kenny, Scott Rozelle
Working Paper , 2016

The first years of life comprise a critical period for social-emotional development that has implications for lifelong outcomes. One factor that is thought to impact infant socialemotional development is parenting behavior and practices, such as reading to, singing to, and playing with their child. In this study we examine the situation of parenting practices and infant social-emotional development among a sample of 1,350 infants aged 18-30 months in rural Shaanxi Province, China.

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Journal Articles

Impact of Text Message Reminders on Caregivers’ Adherence to a Home Fortification Program Against Child Anemia in Rural Western China: a Cluster-Randomized Controlled Trial

Huan Zhou, Shuai Sun, Renfu Luo, Sean Sylvia, Ai Yue, Yaojiang Shi, Linxiu Zhang, Alexis Medina, Scott Rozelle
AJPH Research , 2016

Objectives: To test whether text message reminders sent to caregivers will improve the effectiveness of a home micronutrient fortification program in western China.

Methods: A cluster-randomized controlled trial was carried out in 351 villages in Shaanxi province in 2013-14. We enrolled children aged 6-12 months in target villages. Each village/cluster was randomly assigned into one of three groups: Free Delivery Group (FDG; caregivers received free micronutrient packets); Text Messaging Group (TMG; FDG treatment plus daily text message); and Control Group. We collected information on compliance with treatments and hemoglobin concentrations from all children at baseline and 6-month follow-up. We estimated the intent-to-treat (ITT) effects on compliance and child anemia using a logistic regression model, controlling for infant, caregiver and household characteristics.

Results: There were 1393 eligible children. We found that assignment to TMG led to an increase full compliance (marginal effect = 0.10, 95% CI = 0.03, 0.16) and decrease in the rate of anemia at endline (marginal effect=-0.07, 95% CI= -0.12, -0.01).

Conclusions: Text messages improved compliance of caregivers to a home fortification program and children’s nutrition.

 
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Journal Articles

Effects of Parental Migration on Mental Health of Left-Behind Children: Evidence from Northwestern China

Yu Bai, Yanni Shen, Yaojiang Shi, Kaleigh Kenny, Scott Rozelle
China & World Economy , 2016

China’s rapid development and urbanization has induced large numbers of rural residents to migrate from their homes in the countryside to urban areas in search of higher wages. It is estimated that there are more than 60 million left behind children (LBCs) remain in the countryside after their parents migrate. This paper examines the changes in mental health before and after the parents of fourth and fifth grade students out- or return-migrate. We draw on a panel dataset collected by the authors of more than 19,000 students from 252 rural primary schools in northwestern China. Using difference-in-difference and propensity score matching approaches, our results indicate that parental out-migration has a significant negative impact on the mental health of LBCs, as they tend to exhibit higher levels of anxiety and lower levels of self-esteem. However, we find that parental return-migration has no significant effect on the mental health of LBCs. 

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Journal Articles

Nutritional Deficiencies, the Absence of Information and Caregiver Failures: A Qualitative Analysis of Infant Feeding Practices in Rural China

Ai Yue, Lauren Marsh, Huan Zhou, Alexis Medina, Renfu Luo, Yaojiang Shi, Linxiu Zhang, Scott Rozelle
PLOS One , 2016

Development during the first two years of life is critical and has a lasting impact on a child’s health. Poor child nutrition can lead to a weakened immune system and deficiencies in essential micronutrients, which in turn have lasting and detrimental impacts on a child’s development. Recent studies in rural Shaanxi Province found an anemia prevalence of 54.3% among rural children aged six to twelve months. While new large-scale, quantitative research has begun to catalogue the extent of child malnutrition and anemia, no effort has yet been made to look more closely at the potential reasons for rural children’s nutritional deficiencies through a more richly textured qualitative analysis. This study aims to elucidate some of the fundamental causes of poor feeding practices that may lead to anemia among children in rural Shaanxi Province, China.

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Journal Articles

Micronutrient Deficiencies and Developmental Delays in Infants: Evidence from a cross-sectional survey in rural China

Renfu Luo, Yaojiang Shi, Huan Zhou, Ai Yue, Linxiu Zhang, Sean Sylvia, Alexis Medina, Scott Rozelle
British Medical Journal , 2015

Research increasingly indicates the importance of the nutritional programming that occurs in the first 2–3 years of life. Quality nutrition during this brief window has been shown to have large and significant effects on health and development throughout childhood and even into adulthood. Despite the widespread understanding of this critical window, and the long-term consequences of leaving nutritional deficiencies unaddressed, little is known about the status of infant nutrition in rural China, or about the relationship between infant nutrition and cognitive development in rural China.

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Journal Articles

Anemia and Feeding Practices among Infants in Rural Shaanxi Province in China

Renfu Luo, Yaojiang Shi, Huan Zhou, Ai Yue, Linxiu Zhang, Sean Sylvia, Alexis Medina, Scott Rozelle
2015

Anemia is one of the most prevalent public health problems among infants and iron deficiency anemia has been related to many adverse consequences. The overall goal of this study is to examine the prevalence of anemia among infants in poor rural China and to identify correlates of anemia. In April 2013, we randomly sampled 948 infants aged 6–11 months living in 351 villages across 174 townships in nationally-designated poverty counties in rural areas of southern Shaanxi Province, China. Infants were administered a finger prick blood test for hemoglobin (Hb). Anthropometric measurement and household survey of demographic characteristics and feeding practices were conducted in the survey. We found that 54.3% of 6–11 month old infants in poor rural China are anemic, and 24.3% of sample infants suffer from moderate or severe anemia. We find that children still breastfed over 6 months of age had lower Hb concentrations and higher anemia prevalence than their non-breastfeeding counterparts (p < 0.01), and that children who had ever been formula-fed had significantly higher Hb concentrations and lower anemia prevalence than their non-formula-fed counterparts (p < 0.01). The results suggest the importance of iron supplementation or home fortification while breastfeeding. 

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