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Mohammed KAA, Salih EMM, Alamr F, Alzahrani MMM, Khallufah ASA, Alghamdi KAK, Alzahrani YFY, Alzahrani YMS. Complementary Feeding for Children Aged 6-24 Months: Impact and Maternal Awareness in Al Baha City, Saudi Arabia. Cureus 2024; 16:e53086. [PMID: 38414687 PMCID: PMC10897635 DOI: 10.7759/cureus.53086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2024] [Indexed: 02/29/2024] Open
Abstract
Background Breastfeeding and complementary feeding are essential for baby health and nutrition. Concerning these feeding habits, there is a dearth of information on mother awareness and behaviors in Saudi Arabia. This study intends to evaluate maternal knowledge of breastfeeding and complementary feeding in Al Baha City, Saudi Arabia. Methodology This cross-sectional prospective study was conducted among mothers in Al Baha City, Saudi Arabia. Data were collected using a structured electronic questionnaire and analyzed using descriptive statistics and a chi-square test. Results We received 524 responses. The majority of participants (358, 68.2%) were found to have sufficient understanding of breastfeeding and complementary feeding. Four hundred and forty participants (84%) were aware that breastfeeding should begin immediately after birth, but only 250 (47.7%) participants knew the proper time to start complementary feeding. Three hundred and ninety-six (75.6%) participants were aware of the proper duration of exclusive breastfeeding, whereas 128 (24.4%) of them did not know. The study showed that factors such as occupation, family economic status, and educational level influence maternal knowledge of complementary feeding. Conclusions The study revealed that the majority of participants had good knowledge about breastfeeding and complementary feeding. The study highlights effective training and public awareness initiatives aimed at improving mothers' knowledge and practices regarding feeding. Additionally, it sheds light on the healthcare providers' exemplary knowledge and attitudes toward appropriate feeding practices among mothers in Al Baha City.
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Affiliation(s)
| | - Elfatih Mirghani M Salih
- Department of Pediatrics, Dongola University, Dongola, SDN
- Department of Pediatrics, Al Baha University, Al Baha, SAU
| | - Fahad Alamr
- Faculty of Medicine, Al Baha Univeristy, Al Baha, SAU
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Białek-Dratwa A, Kowalski O. Complementary Feeding Methods, Feeding Problems, Food Neophobia, and Picky Eating among Polish Children. CHILDREN (BASEL, SWITZERLAND) 2023; 11:45. [PMID: 38255359 PMCID: PMC10814245 DOI: 10.3390/children11010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024]
Abstract
Proper nutrition during the first period of life is primarily related to meeting energy needs and providing essential nutrients that ensure the infant's normal physical and psychomotor development. Improper nutrition during this period, inadequate amounts of nutrients, inappropriate timing and manner of introduction of individual foods, can permanently alter metabolism and the course of physiological processes, increasing the risk of diseases such as obesity, allergic diseases, and cardiovascular diseases. This study aimed to verify how the method of complementary feeding influences the occurrence of food neophobia between 2 and 7 years of age, as well as to assess the different nutritional aspects resulting from the process of starting feeding other than breast milk and milk formula. In this study, 490 mothers and their children aged 2-7 years participated. The research tool was a questionnaire consisting of a child's dietary assessment and standardized questionnaires assessing food neophobia among children: Food Neophobia Scale for Children (FNSC) and the Montreal Children's Hospital-Pediatric Feeding (MCH-FS). In the study group of children, 238 (48.57%) had no Baby-Led Weaning Method (no BLW) method used during complementary feeding (CF), and 252 (51.42%) children used Baby-Led Weaning Method (BLW). According to the FNSC questionnaire, a high risk of food neophobia was found in 32.65% of the children studied and a medium risk in 39.80%. The medium risk of feeding problem occured in 11.63% of children, the high risk in 6.73% of children, and the highest risk in 6.94% (MCH-FS). No statistically significant differences were observed between the BLW and NoBLW groups. High risk of food neophobia occured in 1/3 of the children studied, but there was no relationship in the study group between the mode of CF (BLW/NoBLW) and the risk of food neophobia.
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Affiliation(s)
- Agnieszka Białek-Dratwa
- Department of Human Nutrition, Department of Dietetics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland
| | - Oskar Kowalski
- Department of Human Nutrition, Department of Dietetics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland
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Sanini Belin CH, Nunes LM, Ficagna CR, Neves RO, Moreira PR, Bernardi JR. Adherence to different complementary feeding methods in the first year of life: A randomized clinical trial. PLoS One 2023; 18:e0289696. [PMID: 37917730 PMCID: PMC10621984 DOI: 10.1371/journal.pone.0289696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 07/25/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Infant-guided methods, such as Baby-Led Introduction to SolidS (BLISS), encourage children to feed themselves from the same food consumed by their family since the beginning of the introduction of complementary foods, in opposition to the Parent-Led Weaning (PLW) method, which proposes foods mashed with a fork and given by parents. Adherence to child-guided methods is low due to a lack of confidence in the children's ability to feed themselves. This study aimed to assess adherence to three methods of food introduction: PLW, BLISS, or mixed (PLW and BLISS) at seven, nine, and 12 months of age. METHODS A randomized clinical trial was conducted with mother-infant pairs undergoing intervention at 5.5 months of age. Data were presented in absolute numbers and percentages and analyzed using the Chi-Square test. RESULTS The sample was constituted of 139 mother-infant pairs: 45 (32%) used PLW, 48 (35%) used BLISS, and 46 (33%) used the mixed method. Adherence to the method at seven, nine, and 12 months of age children was 34.1% (n = 45), 28.5% (n = 37), and 34.1% (n = 46), respectively. The mixed method presented significantly higher adherence results: 69.0% (n = 29) at seven months, 55.8% (n = 24) at nine months, and 78.6% (n = 33) at 12 months (p<0.001). Among the sample that unfollowed the proposed method, those who used PLW and BLISS migrated mostly to the mixed method at 12 months, 60.0% (n = 27) and 72.9% (n = 35) of them, respectively, because of the feeding mode and 97.8% (n = 44) and 100.0% (n = 48) because of food consistency. CONCLUSION Complementary feeding in a mixed method presented higher adherence at seven, nine, and 12 months of age of children, which shows the feasibility of this approach to guide families in the introduction of complementary feeding.
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Affiliation(s)
- Christy Hannah Sanini Belin
- The Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Leandro Meirelles Nunes
- The Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Cátia Regina Ficagna
- The Graduate Program in Food, Nutrition and Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Renata Oliveira Neves
- The Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | | | - Juliana Rombaldi Bernardi
- The Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- The Graduate Program in Food, Nutrition and Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Song G, Chang J, Guan H, Zhang Y, Zhang T, Zhang Z. Professional Feeding Guidance Improved Infants' Self-Feeding Proportion during Complementary Foods Introduction in Beijing, China: An Exploratory Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1740. [PMID: 38002831 PMCID: PMC10670357 DOI: 10.3390/children10111740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023]
Abstract
An exploratory study was undertaken to examine the prevalence of infants' feeding patterns in Beijing, China, as well as the factors linked to infants' self-feeding proportion during the introduction of complementary foods, and the impact of professional feeding guidance on this proportion. A total of 122 families with infants aged 6-11 months from Beijing were included in the study. A descriptive analysis was employed to assess the prevalence of infants' feeding patterns, while generalized linear model analysis was utilized to investigate the factors associated with these patterns. All families were provided with comprehensive and personalized professional guidance regarding the introduction of complementary foods for infants. However, 64 families were lost to follow-up, leaving 58 families who were re-evaluated and queried after one month. To exclude the influence of infants aging, both the 64 families prior to receiving feeding guidance, and the 58 families after receiving feeding guidance, were included in the analysis. The families with infants aged 6-8 months and 9-11 months were compared separately based on the presence or absence of feeding guidance. Statistical tests, including the Wilcoxon rank-sum test and χ2 test, were conducted to assess any significant differences. The study revealed that the proportion of infants engaging in self-feeding was found to be remarkably low (10% [0%, 40%]). Furthermore, a significant positive association was observed between the proportion of infants engaging in self-feeding and their age (p < 0.001). Notably, after receiving professional feeding guidance, the proportion of infants engaging in self-feeding significantly increased (from 1% [0%, 20%] to 30% [10%, 50%], p < 0.001 for infants aged 6-8 months; from 20% [10%, 50%] to 40% [30%, 50%], p < 0.001 for infants aged 9-11 months). These findings contribute valuable insights for improving postnatal care practices during the introduction of complementary foods for infants.
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Affiliation(s)
- Guochao Song
- Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing 100020, China;
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Beijing 100020, China; (J.C.); (H.G.)
| | - Jiahui Chang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Beijing 100020, China; (J.C.); (H.G.)
- Children’s Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China
| | - Hongyan Guan
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Beijing 100020, China; (J.C.); (H.G.)
- Nurturing Care Research and Guidance Center, Capital Institute of Pediatrics, Beijing 100020, China
| | - Yanfeng Zhang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing 100020, China;
| | - Ting Zhang
- Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing 100020, China;
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Beijing 100020, China; (J.C.); (H.G.)
- Children’s Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China
| | - Zhaofeng Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
- Beijing’s Key Laboratory of Food Safety Toxicology Research and Evaluation, Beijing 100191, China
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Nantel A, Gingras V. Are Complementary Feeding Practices Aligned with Current Recommendations? A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050794. [PMID: 37238342 DOI: 10.3390/children10050794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023]
Abstract
The complementary feeding introduction period (introduction of solid foods alongside breastmilk or formula) is defining in children's health; however, it appears that many parents do not follow complementary feeding guidelines. Our aim was to describe current parental feeding practices during complementary feeding in relation to current recommendations and explore determinants of adherence to guidelines. We included any relevant studies published within the last decade in French or English and summarized findings by recommendation category. The timing of complementary food introduction varied widely across and within continents (earlier in North America and often delayed in Asia). The introduction of allergenic foods tended to be delayed globally. Although some parents now begin complementary feeding with solid foods (i.e., baby-led weaning), delayed introduction of lumpy textures was still prevalent in the United States and in Europe. The consumption of iron-rich foods was predominantly low in Africa. Added sugars were globally introduced early, especially in America. Evidence for the prevalence of responsive feeding practices among parents is unclear due to the small number of studies. Determinants of complementary feeding practices included parental characteristics, such as age, education, socio-economic status, and race/ethnicity. Interventions aiming to increase adherence to complementary feeding guidelines must account for parental characteristics.
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Affiliation(s)
- Audrey Nantel
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada
- Research Center of the Sainte-Justine University Hospital, Montreal, QC H3T 1C5, Canada
| | - Véronique Gingras
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada
- Research Center of the Sainte-Justine University Hospital, Montreal, QC H3T 1C5, Canada
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Pearce J, Rundle R. Baby-led weaning: A thematic analysis of comments made by parents using online parenting forums. J Hum Nutr Diet 2022; 36:772-786. [PMID: 35996924 DOI: 10.1111/jhn.13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Baby-led weaning (BLW) centres on making the baby an active partner, rather than a passive recipient of complementary feeding. Key features of BLW include self-feeding foods in their natural form, eating with the rest of the family and consuming family foods. This differs from traditional weaning (TW) where parents initially spoon feed purees, alongside finger foods, before graduating to more textured food. Previous research, however, has suggested parents may not fully adhere to one weaning style. This study aimed to explore how the meaning and interpretation of BLW may contribute to the weaning style used. METHODS Messages and responses posted on three UK parenting forums, and relating to complementary feeding, were analysed using an interpretive thematic approach. RESULTS The characterisation of BLW by parents was varied but they described BLW having an ethos which included trusting the baby, role modelling, developing confidence with food and sharing the social aspects of mealtimes. BLW also offered an alternative to those actively seeking something different or a default for those whose baby refused purees or spoon feeding. BLW felt like a natural progression, with low parental effort for some, and a source of anxiety, stress, choking risk and mess for others. Many parents struggled to find a process (what to eat and when) within BLW, that they could follow. Finger foods were used synonymously with BLW but many mixed/blurred aspects of both TW and BLW. CONCLUSIONS The interpretation of BLW varies considerably between parents and a broader definition of BLW may be required, along with guidance on the process and purpose of BLW. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jo Pearce
- Food & Nutrition Subject Group, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB
| | - Rachel Rundle
- Food & Nutrition Subject Group, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB
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Białek-Dratwa A, Soczewka M, Grajek M, Szczepańska E, Kowalski O. Use of the Baby-Led Weaning (BLW) Method in Complementary Feeding of the Infant-A Cross-Sectional Study of Mothers Using and Not Using the BLW Method. Nutrients 2022; 14:nu14122372. [PMID: 35745102 PMCID: PMC9227137 DOI: 10.3390/nu14122372] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 02/01/2023] Open
Abstract
Baby-led weaning (BLW) is an increasingly popular way of expanding a baby’s diet. It is based on the baby becoming physically ready to feed himself, effectively supplementing his diet, which until now has been based on breast milk or modified milk. The aim of the study was to assess mothers’ knowledge about the use of the BLW method to expand the diet of a young child. The essence of the study assumed the analysis of the advantages and disadvantages of using this method indicated by mothers. Materials and Methods: A total of 320 mothers participated in the study. Data for the study were collected anonymously using the CAWI method. The research tool was the original questionnaire relating to the knowledge about the BLW method and the application of the BLW method in practice. Results: The BLW method was used by 240 (75%) women. The reasons for not using the BLW method were: the child did not cooperate n = 30 (37.5%) and was not ready to use the BLW method n = 20 (25%). In total, 182 (75.8%) mothers using BLW and 63 (78.8%) mothers not using BLW started extending the diet before the child was 6 months old. According to 270 (84.4%) mothers, including 205 (85.4%) using BLW, stable sitting in a highchair/on the lap is a decisive factor for starting the dietary expansion with the BLW method. Conclusions: Mothers’ knowledge of the BLW method as a way of expanding a young child’s diet was insufficient. It seems important to implement appropriate educational activities on the methods of expanding children’s diets to broaden parents’ knowledge of the influence of nutrition on infant development.
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Affiliation(s)
- Agnieszka Białek-Dratwa
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland; (E.S.); (O.K.)
- Correspondence: ; Tel.: +48-(0-32)-275-51-95
| | - Monika Soczewka
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 60-512 Poznan, Poland;
- Doctoral School, Poznan University of Medical Sciences, Fredry St. 10, 61-701 Poznan, Poland
| | - Mateusz Grajek
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, ul. Piekarska 18, 41-902 Bytom, Poland;
| | - Elżbieta Szczepańska
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland; (E.S.); (O.K.)
| | - Oskar Kowalski
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland; (E.S.); (O.K.)
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Białek-Dratwa A, Kowalski O, Szczepańska E. Traditional complementary feeding or BLW (Baby Led Weaning) method? - A cross-sectional study of Polish infants during complementary feeding. Front Pediatr 2022; 10:992244. [PMID: 36340726 PMCID: PMC9634407 DOI: 10.3389/fped.2022.992244] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Baby-led weaning (BLW) is an increasingly well-known method of complementary feeding for infants. The BLW method is based on the fact that the baby becomes physically ready to eat on its own and can henceforth effectively supplement its diet, which was previously based on breast milk or formula milk. The aim of the study was to compare complementary feeding among mothers using and not using the BLW method. The study took into account, among other things, the frequency of spoon feeding, eating from the family table, and eating meals with a pulpy consistency. The study also determined the frequency of the risk of choking/gagging, food regurgitation or the occurrence of vomiting during a meal in the study groups. Material and method: a cross-sectional survey was conducted among mothers of children from 6 months to 36 months of age residing throughout Poland. RESULTS The study group was divided into three subgroups: mothers using BLW (M-BLW), mothers not familiar with the BLW method (M-NoBLW)), mothers not using the BLW method - mothers using the spoon-feeding method) (M-TS). Among the mothers surveyed, 413 women (63.93%) used the BLW method, 222 mothers (34.36%) did not use the BLW method of which 50 (7.73%) of these were unfamiliar with the method, and 172 (26.62%) simply did not use it. Among M-TS mothers, the child was most often entirely or mostly spoon-fed by an adult (73.84%), and the same was true for the M-NoBLW group (70.0%). In the M-BLW group, 58.60% of children were half-fed by an adult with a spoon. half ate independently. CONCLUSIONS Infants fed by the BLW method were more likely to have their diets expanded after 6 months of age, they were also more likely to be given products from the family table than children fed traditionally with a spoon. Full BLW was implemented by only 29% of children in the BLW group. The vomiting reflex, spitting food out of the mouth, and gagging, were more common among children fed by the BLW method. In contrast, choking occurred comparably often in both groups - in 5.4% of spoon-fed children and 6.9% of BLW-fed children.
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Affiliation(s)
- Agnieszka Białek-Dratwa
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Oskar Kowalski
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Elżbieta Szczepańska
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Zabrze, Poland
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