OBJECTIVE: The purpose of this study was to evaluate the psychometric properties of the IIFAS among a multiethnic population in Singapore.

METHODS: A cross-sectional research design was used on a sample of 417 antenatal women. The internal consistency and stability of the IIFAS were evaluated using Cronbach's α and test-retest reliability. Known-group comparisons discriminated certain group differences in a predictable way. A series of exploratory factor analyses (EFAs) was conducted to test the factor structure of the IIFAS using the maximum likelihood and principal axis factoring. The number of factors was selected according to theoretical and statistical considerations. A confirmatory factor analysis (CFA) was further performed to validate the factor structure constructed in the prior EFA.

RESULTS: The IIFAS had a Cronbach's α and Pearson correlation of 0.79 and 0.85, respectively. The known-group comparisons among certain groups were supported. The EFA results showed that the 3-factor structure produced the most interpretable and theoretical sense. A second-order CFA was conducted to confirm the construct dimensionality of the 15-item IIFAS, with satisfactory fit indices found.

RESEARCH AIMS: To (1) describe exploratory estimates of greenhouse gas emission factors for all infant and young child milk formula products and (2) estimate national greenhouse gas emission association with commercial milk formulas sold in selected countries in the Asia Pacific region.

METHOD: We used a secondary data analysis descriptive design incorporating a Life Cycle Assessment (LCA) concepts and methodology to estimate kg CO2 eq. emissions per kg of milk formula, using greenhouse gas emission factors for milk powder, vegetable oils, and sugars identified from a literature review. Proportions of ingredients were calculated using FAO Codex Alimentarius guidance on milk formula products. Estimates were calculated for production and processing of individual ingredients from cradle to factory gate. Annual retail sales data for 2012-2017 was sourced from Euromonitor International for six purposively selected countries; Australia, South Korea, China, Malaysia, India, Philippines.

RESULTS: Annual emissions for milk formula products ranged from 3.95-4.04 kg CO2 eq. Milk formula sold in the six countries in 2012 contributed 2,893,030 tons CO2 eq. to global greenhouse gas emissions. Aggregate emissions were highest for products (e.g., toddler formula), which dominated sales growth. Projected 2017 emissions for milk formula retailed in China alone were 4,219,052 tons CO2 eq.

RESEARCH AIM: This study describes the infant feeding experiences of women living with HIV in Malaysia.

METHODS: From August to October 2021, a nationwide, community-based qualitative study was conducted among women living with HIV and who received care from the Malaysian Ministry of Health. Using purposive sampling, participants who met the inclusion criteria were recruited. Interview and focus group transcripts were coded based on a secondary thematic analysis.

RESULTS: Six in-depth interviews and five focus group discussions were conducted among 32 participants. Study participants were mostly Malay secondary school graduates in their 30s and 40s. Due to the fear of vertical transmission, which was explained by healthcare providers to the participants, none of the women breastfed their infants. The three primary themes that emerged from analyzing the women's infant feeding experiences were (1) a human milk substitute was the only option and was encouraged; (2) feeding infants with a human milk substitute made the women feel incomplete as mothers; and (3) the women encountered difficulties in obtaining the subsidized human milk substitute.