北京、合肥、包头三市社区6~12月龄婴儿喂养和营养状况研究

目的 了解城市地区社区管理的6~12月龄婴儿喂养和营养状况,为完善儿童保健和健康管理政策措施提供依据。方法 采用横断面研究,于2017年4-9月对在北京、合肥、包头三城市共6家社区卫生服务中心常规健康管理的共1 447名婴儿进行身高、体重和血红蛋白等检测以及喂养情况等问卷调查,计算相应的Z评分,综合评价被调查婴儿喂养和营养状况。结果 调查社区婴儿平均6月龄纯母乳喂养率为13.5%,辅食添加及时率为94.2%,最小膳食多样性为54.7%,贫血患病率为17.4%。 结论 三城市被调查社区婴儿生长发育总体状况较好,但仍存在营养不良的情况,应重视婴儿期社区健康管理工作,降低婴儿营养不良发生率。     

基于8月龄婴儿的喂养行为评价方法与结果分析

目的 使用两种评价方法对调查地区户籍和流动8月龄婴儿的喂养行为进行分析,发现不合理喂养行为,为制定研究地区婴儿的喂养指导策略提供依据,同时对两种指标评价方法的优劣进行对比。方法 采用横断面研究,选取2014年在北京某社区接受常规儿童保健服务,排除早产、低出生体重、出生先天缺陷及心、肝、肾、血液系统疾病的所有8月龄婴儿为调查对象,并通过问卷收集婴儿喂养情况进行统计分析。结果 调查地区本市和流动8月龄婴儿在6月龄内辅食添加率分别为52.0%和65.1%(P<0.05)。8月龄婴儿喂养指数得分均值本市和流动分别为12.42±2.24和11.41±2.18(P<0.001)。喂养指数合格率本市大于流动(P=0.001)。喂养指数各分项中,过去24 h奶瓶喂养指数本市小于流动(P<0.001),过去1周食物添加频率中,奶类、鱼虾类、禽畜肉类、蔬菜水果类喂养指数本市大于流动(P<0.01)。婴儿早开奶率、最小膳食多样性、曾经母乳喂养率,本市均好于流动人口(P<0.05)。所有母乳喂养婴儿的最小合理膳食率均明显低于人工喂养婴儿(P<0.01)。结论 调查地区8月龄婴儿喂养情况本市好于流动,但整体状况不容乐观;两种评价方法各有千秋。     

北京市农村部分4～12月龄婴儿喂养状况调查分析

目的了解北京市农村4~12月龄婴儿喂养现状。方法采取随机抽样与整群抽样相结合的方法,选择北京市中等收入经济发展水平的4个乡镇,结合乡镇卫生院的母子健康档案,选取4~12月龄的婴儿及其主要喂养人进行问卷调查,调查婴儿的母乳喂养以及辅食、调味品等的使用情况。结果共调查北京市农村4个乡镇137名婴儿,其中128名婴儿为部分或纯母乳喂养,婴儿母乳喂养率为93.43%,4个月内纯母乳喂养率为43.07%。自觉乳汁不足、因上班不能保证哺乳时间和因病不能喂养是非纯母乳喂养的主要原因,分别占71.79%(56/78)、10.26%(8/78)和7.69%(6/78)。16.06%的婴儿辅食添加时间不当,其中分别有8.76%、7.30%的婴儿辅食开始添加时间过早或过晚。有36.3%(45/124)的婴儿经常食用盐和香油等调味品。结论北京市农村部分4~12月龄婴儿的4个月内纯母乳喂养率较低,辅食添加时间不当及过多食用调味品是婴儿喂养的主要问题,应该大力宣传婴幼儿喂养知识,通过实施健康干预项目,改善北京农村地区婴儿喂养中存在的问题。     

河北省城乡地区6~24月龄婴幼儿喂养状况研究

目的 了解河北省城乡地区6~24月龄婴幼儿的喂养状况,并应用婴幼儿喂养指数(infant and child feeding index,ICFI)评价城乡地区不同月龄组婴幼儿的喂养行为,为指导婴幼儿喂养提供科学的参考依据。 方法 数据来自2015年中国居民食物消费状况调查。选取6~24月龄婴幼儿作为研究对象,应用ICFI对喂养行为(24 h母乳喂养、24 h奶瓶喂养、24 h膳食种类、1周辅食添加天数)进行评分。 结果 本研究共纳入婴幼儿861名,ICFI平均得分为(10.58±3.18)分,不同月龄组间ICFI平均得分的差异有统计学意义(F=141.119,P=0.000),在6~8月龄组中,城市ICFI平均得分为(7.61±3.15)分,显著高于农村的(5.44±3.04)分(F=11.859,P=0.001)。喂养总合格率为54.94%(473/861),各月龄组的喂养合格率分别为14.16%、38.78%、66.56%,不同月龄组间喂养合格率的差异均有统计学意义(χ²=124.181,P=0.000)。婴幼儿辅食添加满分率较高的为蛋类、谷薯类、水果、蔬菜,较低的为豆类及其制品、奶类及其制品。 结论 河北省农村地区的低月龄婴幼儿喂养较差,建议加强对辅食添加时间、种类及添加频率等方面婴幼儿喂养知识的宣传。     

贵州省贫困农村地区婴幼儿辅食喂养及体格发育调查

目的了解贵州省贫困农村地区6~23月龄婴幼儿辅食添加情况及对体格发育的影响,探讨改善婴幼儿辅食喂养的途径。方法采用分层多阶段整群随机抽样的方法,进行横断面调查,调查对象为贵州贫困农村地区6~23月龄婴幼儿及其看护人。通过膳食回顾法调查过去24小时婴幼儿食物摄入情况,分析辅食添加时间、辅食种类、喂养频率等。用年龄别身高Z值(HAZ)和年龄别体重Z值(WAZ)判断婴幼儿体格发育水平,分析辅食添加与生长迟缓、低体重的相关关系。结果辅食及时添加率为91.1%;首次添加辅食以谷类泥糊状食物为主,约占75%;摄入频率最高的是谷物、根茎、块茎类食物(94.1%),摄入频率最低的是其他蔬菜水果(30.5%),动物性食物(肉类)摄入率仅33.8%;母乳喂养婴幼儿频次合格率63.8%,种类合格率64.8%,频次和种类同时合格率(即辅食合格)仅43.5%,18~23月龄辅食合格率最高(56.7%);非母乳喂养婴幼儿频次合格率22.5%,种类合格率71.5%,频次和种类同时合格率(即辅食合格)仅16.7%,18~23月龄辅食合格率最高(20.2%)。母乳喂养婴幼儿,辅食不合格者生长迟缓率、低体重率高于辅食合格者,二者差异有统计学意义(P0.05);非母乳喂养婴幼儿,辅食不合格者生长迟缓率高于辅食合格者,二者差异有统计学意义(P0.05);辅食不合格者低体重率略高于辅食合格者,但二者差异无统计学意义。结论贵州省贫困农村地区婴幼儿辅食喂养存在问题,部分婴幼儿辅食添加时间不合理,辅食合格率较低。不合格辅食是导致生长迟缓和低体重的重要原因,应改善辅食营养状况。     

流动儿童2 055例婴幼儿喂养现状研究

目的 了解研究地区流动儿童婴幼儿喂养现状,以发现存在的主要喂养问题。 方法 采用横断面调查设计,两阶段随机整群抽样方法,以及联合国儿童基金会标准问卷,分别对广东和浙江两省各一个流动人口密集的区市的2 055名2岁以下儿童看护人进行问卷调查,对8个婴幼儿喂养指标进行了描述与分析。结果 调查地区流动儿童婴幼儿早开奶率为18.0%、纯母乳喂养率为13.6%、1岁时持续母乳喂养率为17.0%、2岁时持续母乳喂养率为5.2%、辅食及时添加率为81.1%、辅食添加种类合格率53.9%、辅食添加频率合格率为26.9%、辅食合理添加率为16.9%。 结论研究地区流动儿童母乳喂养和辅食添加的情况水平差,提示流入地应加强对流动人口中婴幼儿喂养的健康促进,改善保健服务利用。     

密云县农村婴儿喂养行为与营养状况调查

目的了解密云县农村地区婴儿的喂养行为和营养现状,为政府制定营养规划政策提供可靠依据。方法 多阶段分层抽取密云县农村4-12月龄婴儿130名,对其喂养行为现状进行入户问卷调查,对身高体重进行现场测量。结果四个月内婴儿纯母乳喂养率为47.1%;婴儿添加辅食开始时间平均为（4.3±1.8）月龄,添加的时间顺序由早到晚依次为：配方奶粉、营养素补充剂、蛋类、谷类、水果蔬菜、肉类、豆类;64.6%的婴儿在4月龄前添加了辅食,16.6%的婴儿晚于9月龄添加辅食;婴儿到12月龄,谷类、蛋类、水果类、蔬菜类添加率均达到100%;肉类、豆类添加率分别为91.3%和45.7%;有94.5%的婴儿添加了营养素补充剂,以添加钙制剂和维生素D制剂为主。结论密云县农村地区婴儿喂养存在问题,母乳喂养率低,辅食存在添加过早和不及时并存。应该继续普及母乳喂养观念,加强婴儿喂养知识宣传,适时添加辅食,增加肉类和豆类添加率。     

合肥市6月龄婴儿纯母乳喂养现状及影响因素研究

目的 调查合肥市6月龄婴儿喂养现状并研究纯乳母喂养影响因素,为提高纯母乳喂养行为提供科学依据。方法 以2020年1—10月在合肥某医院产科分娩的单胎活产儿及其母亲为研究对象,在婴儿出生后满6个月时通过医院分娩记录获取其母亲/父亲联系方式对婴儿母亲进行6月龄婴儿喂养现状及影响因素调查,采用描述性流行病学分析方法对6月龄婴儿喂养现状进行分析,并采用单、多因素分析方法对纯母乳喂养影响因素进行分析。结果 共2 537名婴儿纳入研究,纯母乳喂养724例,占28.54%,优势母乳喂养298例,占11.75%,补充喂养356例,占14.03%,母乳喂养819例,占32.28%,奶瓶喂养340例,占13.40%。多因素Logistic回归分析结果显示婴儿母亲年龄越大（OR=0.441）、婴儿母亲乳头凹陷/扁平（OR=0.360）、婴儿母亲开奶时间≥30 min（OR=0.431）的6月龄婴儿纯母乳喂养可能性较小,婴儿母亲学历越高（OR=2.499）、职业为事业单位工作人员（OR=1.806）、个体经营者（OR=1.730）、农民/无业者（OR=2.018）、婴儿父母支持母乳喂养（OR=2.392）的6月龄婴儿纯母乳喂养可能性较大。结论 合肥市6月龄婴儿纯母乳喂养率低,其受到母亲年龄、学历、职业、乳头凹陷/扁平、开奶时间以及父亲是否支持母乳喂养等多种因素影响,应当针对现状及影响因素加强纯母乳喂养知识宣教及干预措施,改善该地区婴儿母乳喂养情况。     

重庆市南岸区婴儿喂养及影响因素分析

【目的】 了解重庆市南岸区婴儿母乳喂养及辅食添加现状,并探索其影响因素,为加强科学喂养提供依据。 【方法】 通过整群随机抽样方式抽取两社区卫生服务中心,对来两中心进行儿童保健的0~12月婴儿母亲或看护人进行婴儿喂养及其影响因素调查。采用非条件Logistic回归分别分析母乳喂养和辅食添加影响因素。 【结果】 <4月婴儿母乳喂养率为76.56%,纯母乳喂养率占45.63%。4~6月婴儿喂养方式以部分母乳喂养和人工喂养为主,分别为52.8%、42.23%;7月~和10~12月,婴儿喂养方式以人工喂养为主,分别占69.66%、87.00%。辅食添加基本从4月龄开始,米粉/米糕和菜泥/果泥添加率分别在5、6月龄达到最高,分别为84%、84.5%;到7月以后粥/面条、碎菜/水果、蛋类和肉类添加率逐渐增加,到12月时基本能达到90%左右。辅食添加顺序大致为米粉/米糕、菜泥/果泥、碎菜/水果、蛋黄、粥/面条、蛋羹、肉类。 【结论】 该区婴儿母乳喂养情况有待改善,辅食添加情况可观。妇幼保健等相关部门应做好普及科学喂养知识的宣传工作,提高人群母乳喂养意识,从而改善婴儿母乳喂养情况和辅食添加行为。     

2002年北京市2岁以内婴幼儿营养与喂养状况调查

目的了解北京市2岁以内婴幼儿出生时营养、母乳喂养与辅食添加状况,为政府制定儿童营养政策提供依据。方法采取分层整群随机抽样方法,于2002年8至11月在北京市18个区县进行抽样调查。在取得知情同意的情况下,对422名2岁以内婴幼儿的家长进行面对面询问调查。结果北京市平均婴儿出生体重为3325g,低体重出生率和巨大儿出生率分别为2．8％和13．0％;4月龄内婴儿母乳喂养率、混合喂养率和人工喂养率分别为56．6％、33．9％和9．5％,城区混合喂养率明显高于郊区;婴幼儿平均断奶月龄为7．4个月;6月龄及以上婴幼儿的辅食添加率为99．4％,城区和郊区婴幼儿各类辅食的添加顺序一致,但郊区婴幼儿的辅食添加时间晚于城区,且蔬菜水果、水产品、食用油的添加频率低于城区。结论北京地区新生儿体格发育良好,应在社区加强婴幼儿喂养的健康教育,提高母乳喂养率,适当延长母乳喂养时间,并适时添加各类辅食。     

中国部分地区婴幼儿喂养状况及国际比较研究

【目的】 了解我国研究地区婴幼儿喂养现状,比较该地区与全球发展中国家的婴幼儿喂养水平,探索我国婴幼儿喂养中存在的问题。 【方法】 采用横断面调查设计和多阶段分层随机抽样的方法,使用联合国儿童基金会(UNICEF)标准化问卷对我国中西部40个县3 708名2岁以下儿童看护人的喂养情况进行调查,分析世界卫生组织(WHO)2008年版《婴幼儿喂养评估指标》中的8个指标并与世界卫生组织 2010年公布的46个发展中国家的数据进行比较。 【结果】 调查地区早开奶率、6个月以下儿童纯母乳喂养率、1岁和2岁时持续母乳喂养率均低于发展中国家平均水平,在47个国家中分别位列第34、39、44和45名。辅食及时添加率、辅食添加种类合格率位列前20%,辅食添加普遍过早。 【结论】 调查地区婴幼儿喂养中主要存在开奶不及时、母乳喂养伴随喂水、过早添加辅食和母乳喂养持续时间短的问题。加强健康宣教,传播喂养知识,对婴幼儿喂养状况的改善具有积极作用。     

Factors Associated with Early Introduction of Formula and/or Solid,Semi-Solid or Soft Foods in Seven Francophone West African Countries

The aim of this study was to identify factors associated with early introduction of formula and/or solid, semi-solid or soft foods to infants aged three to five months in seven Francophone West African countries. The sources of data for the analyses were the most recent Demographic and Health Survey datasets of the seven countries, namely Benin (BDHS, 2012), Burkina Faso (BFDHS, 2010), Cote d’Ivoire (CIDHS, 2011–2012), Guinea (GDHS, 2012), Mali (MDHS, 2012–2013), Niger (NDHS, 2012) and Senegal (SDHS, 2010). The study used multiple logistic regression methods to analyse the factors associated with early introduction of complementary feeding using individual-, household- and community-level determinants. The sample was composed of 4158 infants aged between three and five months with: 671 from Benin, 811 from Burkina Faso, 362 from Cote d’Ivoire, 398 from Guinea, 519 from Mali, 767 from Niger and 630 from Senegal. Multiple analyses indicated that in three of the seven countries (Benin, Guinea and Senegal), infants who suffered illnesses, such as diarrhoea and acute respiratory infection, were significantly more likely to be introduced to formula and/or solid, semi-solid or soft foods between the age of three and five months. Other significant factors included infants who: were born in second to fourth position (Benin), whose mothers did not attend any antenatal clinics (Burkina Faso and Niger), were male (Cote d’Ivoire and Senegal), lived in an urban areas (Senegal), or were delivered by traditional birth attendants (Guinea, Niger and Senegal). Programmes to discourage early introduction of formula and/or solid, semi-solid or soft foods in these countries should target the most vulnerable segments of the population in order to improve exclusive breastfeeding practices and reduce infant mortality.     

Understanding the Enablers and Barriers to Appropriate Infants and Young Child Feeding Practices in India: A Systematic Review

Despite efforts to promote infant and young child feeding (IYCF) practices, there is no collective review of evidence on IYCF enablers and barriers in India. This review was conducted using 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Six computerized bibliographic databases, Scopus, PubMed, PsycINFO, CINAHL, Embase, and Ovid MEDLINE, were searched for published studies on factors associated with IYCF practices in India from 1 January 1993, to 30 April 2020. IYCF practices examined were early initiation of breastfeeding, exclusive breastfeeding, continued breastfeeding at one year, introduction to solid semi-solid or soft foods, minimum dietary diversity, minimum meal frequency, minimum acceptable diet, continued breastfeeding at two years, predominant breastfeeding, and bottle feeding. In total, 6968 articles were retrieved, and 46 studies met the inclusion criteria. The common enablers of IYCF were higher maternal socioeconomic status (SES) and more frequent antenatal care visits (ANC) (≥3). Common barriers to IYCF practices were low SES and less frequent ANC. The review showed that the factors associated with IYCF practices in India are largely modifiable and multi-factorial. Improving IYCF practices would require the adoption of both facilities- and community-based policy interventions at the subnational and national levels in India.     

Determinants of Early Introduction of Solid,Semi-Solid or Soft Foods among Infants Aged 3–5 Months in Four Anglophone West African Countries

This study was conducted to explore and identify factors associated with the practice of early introduction of solid, semi-solid or soft foods among infants aged 3–5 months in four Anglophone West African countries. Data sources for the analyses were the latest Demographic and Health Survey datasets of the 4 countries, namely Ghana (GDHS, 2008), Liberia (LDHS, 2007), Nigeria (NDHS, 2013) and Sierra Leone (SLDHS, 2008). Multiple logistic regression methods were used to analyze the factors associated with early introduction of solid, semi-solid or soft foods among infants aged 3–5 months, using individual-, household- and community-level determinants. The sample consisted of 2447 infants aged 3–5 months from four Anglophone West African countries: 166 in Ghana, 263 in Liberia, 1658 in Nigeria and 360 in Sierra Leone. Multivariable analyses revealed the individual factors associated with early introduction of solid, semi-solid or soft foods in these countries. These included increased infant’s age, diarrhea, acute respiratory infection and newborns perceived to be small by their mothers. Other predictors of early introduction of solid, semi-solid or soft foods were: mothers with no schooling, young mothers and fathers who worked in an agricultural industry. Public health interventions to improve exclusive breastfeeding practices by discouraging early introduction of solid, semi-solid or soft foods are needed in all 4 countries, targeting especially mothers at risk of introducing solid foods to their infants early.     

The Australian Feeding Infants and Toddler Study (OzFITS 2021): Breastfeeding and Early Feeding Practices

The Australian Feeding Infants and Toddler Study 2021 (OzFITS 2021) is a nationwide survey of Australian caregivers’ infant and toddler feeding practices. Here, we describe breastfeeding rates and duration, use of breastmilk substitutes, and introduction of complementary (solid) foods, including common food allergens. Caregivers (n = 1140) were recruited by a digital marketing company and were interviewed using a structured telephone questionnaire to obtain information. Breastfeeding was initiated in 98% of infants, but the duration of exclusive breastfeeding to six months was less than 1%. Nearly 40% of children continued to receive breastmilk beyond one year, with 10% of toddlers receiving breastmilk at two years. One-quarter of infants were introduced to solid foods between 4 to 5 months, and nearly all infants had received solid foods by 7 months. New guidelines encourage the early introduction of potential food allergens to reduce the risk of allergy, and by 12 months, over 90% of children had been given eggs and peanuts. One-third of children received no breastmilk substitutes during their first year. One-third of infants first received breastmilk substitutes following birth and before discharge from the hospital. Of these infants, 30% ceased breastmilk substitute use after discharge. Our findings suggest a high rate of continued breastfeeding with 44% receiving breastmilk beyond 1 year. One approach to increase the duration of exclusive breastfeeding is to reduce breastmilk substitute use while in hospital.     

Associations between Infant Feeding Practice Prior to Six Months and Body Mass Index at Six Years of Age

Rapid growth during infancy is associated with increased risk of overweight and obesity and differences in weight gain are at least partly explained by means of infant feeding. The aim was to assess the associations between infant feeding practice in early infancy and body mass index (BMI) at 6 years of age. Icelandic infants (n = 154) were prospectively followed from birth to 12 months and again at age 6 years. Birth weight and length were gathered from maternity wards, and healthcare centers provided the measurements made during infancy up to 18 months of age. Information on breastfeeding practices was documented 0–12 months and a 24-h dietary record was collected at 5 months. Changes in infant weight gain were calculated from birth to 18 months. Linear regression analyses were performed to examine associations between infant feeding practice at 5 months and body mass index (BMI) at 6 years. Infants who were formula-fed at 5 months of age grew faster, particularly between 2 and 6 months, compared to exclusively breastfed infants. At age 6 years, BMI was on average 1.1 kg/m² (95% CI 0.2, 2.0) higher among infants who were formula fed and also receiving solid foods at 5 months of age compared to those exclusively breastfed. In a high-income country such as Iceland, early introduction of solid foods seems to further increase the risk of high childhood BMI among formula fed infants compared with exclusively breastfed infants, although further studies with greater power are needed.     

Infant and Young Child Feeding Practices among Adolescent Mothers and Associated Factors in India

Adequate infant and young child feeding (IYCF) improve child survival and growth. Globally, about 18 million babies are born to mothers aged 18 years or less and have a higher likelihood of adverse birth outcomes in India due to insufficient knowledge of child growth. This paper examined factors associated with IYCF practices among adolescent Indian mothers. This cross-sectional study extracted data on 5148 children aged 0–23 months from the 2015–2016 India National Family Health Survey. Survey logistic regression was used to assess factors associated with IYCF among adolescent mothers. Prevalence of exclusive breastfeeding, early initiation of breastfeeding, timely introduction of complementary feeding, minimum dietary diversity, minimum meal frequency, and minimum acceptable diet rates were: 58.7%, 43.8%, 43.3%, 16.6%, 27.4% and 6.8%, respectively. Maternal education, mode of delivery, frequency of antenatal care (ANC) clinic visits, geographical region, child’s age, and household wealth were the main factors associated with breastfeeding practices while maternal education, maternal marital status, child’s age, frequency of ANC clinic visits, geographical region, and household wealth were factors associated with complementary feeding practices. IYCF practices among adolescent mothers are suboptimal except for breastfeeding. Health and nutritional support interventions should address the factors for these indicators among adolescent mothers in India.