Symptoms of postpartum depression and early interruption of exclusive breastfeeding in the first two months of life

This study evaluates the association between postpartum depression and interruption of exclusive breastfeeding in the first two months of life. Cohort study of 429 infants < or = 20 days of age to four primary health care units in Rio de Janeiro, Brazil. Interruption of exclusive breastfeeding (outcome) was defined as the introduction of water, other types of liquids, milk, or formulas or any food. Postpartum depression was assessed using the Edinburgh Post-Natal Depression Scale. Associations between variables were expressed as prevalence ratios (baseline) and risk ratios (follow-up), with their respective 95% confidence intervals, estimated by Poisson regression with robust variance. Children of mothers with postpartum depressive symptoms were at higher risk of early interruption of exclusive breastfeeding in the first and second months of follow-up (RR = 1.46; 95%CI: 0.98-2.17 and RR = 1.21; 95%CI: 1.02-1.45, respectively). Considering mothers that were exclusively breastfeeding at the first month, postpartum depression was not associated with interruption of exclusive breastfeeding in the second month (RR = 1.44; 95%CI: 0.68-3.06). The results indicate the importance of maternal mental health for the success of exclusive breastfeeding.     

2015-2016年湖北省十堰市6月龄儿童营养性贫血现状调查及相关因素分析

目的 探讨湖北省十堰市6月龄儿童营养性贫血发生状况及其危险因素,为预防婴儿贫血、制定保健策略提供依据。方法 以2015年1月-2016年12月在儿童保健门诊体检的出生满6个月左右正常儿童为调查对象,采用多阶段整群随机抽样对其进行血红蛋白及红细胞检查,并问卷回顾性调查母亲孕期疾病和贫血状况、出生体格指标以及6月龄以来喂养状况等信息。建立二元Logistic回归模型分析6月龄儿童营养性贫血的危险因素。 结果 913例6月龄儿童营养性贫血检出率为33.41%;不同喂养方式营养性贫血检出率差异有统计学意义(χ²=45.152,P<0.001),进一步χ²分割检验结果显示混合喂养和人工喂养的婴儿贫血患病率差异无统计学意义(P>0.012 5),但均显著低于母乳喂养婴儿(P<0.012 5);家庭收入低(OR=6.05, 95%CI:2.70~13.55)、低出生体重(OR=3.59, 95%CI:1.90~6.76)、母亲孕期贫血(OR=2.62, 95%CI:1.16~5.94)、孕周<37周(OR=2.60, 95%CI:1.51~4.47)、未添加辅食(OR=7.64, 95%CI:1.83~31.85)、辅食种类少(OR=8.16, 95%CI:3.52~18.91)是贫血发生的危险因素。结论 2015-2016年湖北省十堰市6月龄儿童营养性贫血率较高,今后儿保部门应加强孕期及门诊儿童营养的宣传,提高家长的儿童保健知识,提示关注婴儿期的喂养方式、多样性辅食添加来有效预防婴幼儿营养性贫血。     

新疆农牧区哈萨克族学龄前儿童家长喂养行为与儿童贫血的关联

目的 了解新疆农牧区哈萨克族学龄前儿童家长喂养行为和认知状况,为预防该地区学龄前儿童贫血提供参考.方法 2019年5月采用分层整群抽样方法在新疆农牧区共抽取1 846名哈萨克族学龄前儿童,对其贫血状况进行检测,对其家长进行喂养行为调查.结果 新疆农牧区哈萨克族学龄前儿童贫血检出率为49.19％,其中轻度、中重度贫血检出...     

Prevalence and factors associated with iron deficiency in infants treated at a primary care center in Belém, Pará, Brazil

The objective was to verify the occurrence of iron deficiency and associated factors in infants. This cross-sectional study included 365 infants (defined here as 6-24 months of age) treated at a primary care center in Belém, Pará, Brazil. Iron-deficiency anemia (hemoglobin < 11 g/dl and ferritin < 12 microg/l) was diagnosed in 55.1% of the sample, depletion of body iron reserves (hemoglobin < 11 g/dl and ferritin < 12 microg/l) in 15.3%, and iron sufficiency (hemoglobin < 11 g/dl and ferritin < 12 microg/l) in 18.1%. The results of the logistic regression model showed associations between iron deficiency (ferritin < 12 microg/l) and: 6-12 month age group, OR (odds ratio) = 3.67 and 95% CI: 1.93-7.04; non-utilization of iron-fortified formula as the first milk used after interrupting breastfeeding, OR = 1.93 and 95%CI: 1.04-3.60; and per capita income < or = 1 minimum wage, OR = 2.69 and 95%CI: 1.30-5.59. The occurrence of iron deficiency was high, showing the need to adopt effective measures to prevent this important public health problem.     

Asociación entre lactancia materna y probabilidad de obesidad en la infancia en tres países latinoamericanos

ObjectiveTo determine if breastfeeding for at least the first six months of life is associated with overweight and obesity in children 2 to 5 years old.MethodCross sectional analysis of data from national demographic and health surveys conducted in Bolivia, Colombia and Peru. Overweight and obesity were defined using World Health Organization standard definitions. Odds ratios (OR) were calculated using multinomial logistic regression.ResultsThe prevalence of obesity in children 2 to 5 years old was 10.4% (95% confidence interval [95%CI]: 8.2-12.6) in Bolivia, 4.9% in Colombia (95%CI: 4.0-5.8), and 6.4% (95%CI: 5.2-8.0) in Peru. Prevalence of exclusive breastfeeding for at least the first 6 months in the study population was 89.9% (95%CI: 87.8-91.9) in Bolivia, 73.9% (95%CI: 72.2-75.6) in Colombia, and 92.8% (95%CI: 91.2-92.4) in Peru. Exclusive breastfeeding was associated with a decreased risk of obesity in children as compared to no breastfeeding or breastfeeding for less than 6 months in Bolivia (OR = .30; 95%CI: .16-.57) and a marginal association in Colombia (OR = .71; 95%CI: .47-1.06) and Peru (OR = .49; 95%CI: 0.23-1.04). No association between breastfeeding and overweight was found.ConclusionExclusive breastfeeding for at least the first six months of life decreases the risk of obesity in children 2 to 5 years old in Bolivia. A similar but weaker pattern was observed for children in Colombia and Peru.     

Attitudes and practices of breastfeeding mothers regarding fasting in Ramadan

OBJECTIVE: To investigate the attitudes and practices of breastfeeding mothers regarding fasting in Ramadan. DESIGN: Cross-sectional observational survey. SETTING: Well-child care clinic at Ankara University Medical School and a health station serving an impoverished population in Ankara, Turkey. PARTICIPANTS: Breastfeeding mothers of infants aged 12 months or younger. MAIN OUTCOME MEASURES: Fasting during Ramadan. RESULTS: Of the 164 participating mothers, 61 (37%) were from the health station and 103 (63%) from the university clinic. Most mothers were older than 25 years of age (55%), had more than primary school education (64%), a single child (53%), were living in a nuclear family setting (70%), supplementing breastfeeding (73%) and fasting (52%). Among the 129 mothers of infants aged 6 months or younger, 22% perceived a decrease in their breast milk and 23% an increase in the amount of solid supplements the infant was receiving. Belief that breastfeeding mothers should fast (RR = 6.45, 95% CI: 2.44-17.06), that fasting does not decrease breast milk (RR = 6.24, 95% CI: 1.85-21.05), receiving well-child care at the health station (RR = 3.14, 95% CI: 1.33-7.44), giving supplements (RR = 2.82, 95% CI: 1.09-7.27) and having multiple children (RR = 2.78, 95% CI: 1.23-6.28) were associated with fasting, in a logistic regression model. CONCLUSIONS: Fasting by breastfeeding mothers of infants is common during Ramadan, and rates are affected by beliefs of mothers on the effects of fasting on breastfeeding. We believe that child health care providers need to be knowledgeable about religious and cultural phenomena, study the effects of Ramadan fasting and form links with Islamic teachings to find religiously and culturally appropriate methods to combat the possible unfavourable effects for infants and children.     

A study on the role of parental involvement in control of nutritional anemia among children of free primary schools in a rural area of West Bengal

An intervention study was conducted among students of three randomly selected free primary schools in rural West Bengal to assess the effect of health-nutrition education for behavior modification of parents on nutritional anemia of children. Clinically anemic students were school-wise randomized into 'groups of two' and intervened with anthelminthic, iron-folic acid (IFA) pediatric tablet and health-nutrition education by reoriented teachers. Parents of study group were involved in behavior change processes. Baseline overall prevalence of anemia was 64.4%. After IFA therapy, prevalence of anemia was not found to differ between two groups (χ2 = 2.68, P > 0.05, RR= 0.48, 95% C.I 0.2 < RR < 1.19) while reducing 52.2% of relative risk. Reassessment after six months showed significantly lower prevalence in study group (χ2 = 18.14, P < 0.05, RR = 0.20, 95% C.I. 0.08 < RR < 0.49). Parental involvement for life style and dietary modification may curb childhood anemia.     

母乳喂养对3岁儿童乳牙患龋病的影响

目的探讨喂养方式和母乳喂养时间对3岁儿童乳牙龋的影响,以寻求母乳喂养对乳牙龋患病的关键点,尽早给予父母合理的喂养指导。方法采用横断面研究的方法,对北京市海淀区588名幼儿园小班儿童进行口腔检查,并由其监护人完成调查问卷。结果母乳喂养时间小于6个月、6～12个月和大于12个月三组儿童乳牙患龋率分别为40.4%、48.2%和54.4%。随着母乳喂养时间增长,乳牙患龋率显著增高(P趋势=0.017);在混合喂养方式下,母乳喂养时间6～12个月和大于12个月的儿童乳牙患龋率均显著高于喂养时间小于6个月的儿童(49.7%,54.3%和36.1%;P=0.026和P=0.010)。Logistic回归分析,调整了传统的危险因素后,母乳喂养时间6～12个月和大于12个月的儿童,患龋风险分别是喂养时间小于6个月的1.770倍(OR=1.770,95%CI:1.046～2.995)和2.549倍(OR=2.549,95%CI:1.420～4.579),选择母乳喂养方式的儿童比人工喂养的儿童患龋风险减少近60%(OR=0.406,95%CI:0.167～0.990)。结论母乳喂养能够有效降低儿童患龋的风险,且纯母乳喂养时间在6个月内为佳,尽早给予家长专业喂养指导,同时做好儿童牙齿护理和培养良好的口腔行为习惯,综合控制乳牙患龋的危险因素。     

陕南贫困农村幼儿社会情感发展的影响因素

目的对影响陕南贫困农村儿童社会情感发展的可疑因素进行分析,旨在探讨陕南贫困农村幼儿社会情感发展滞后的危险因素,为提高贫困农村儿童早期发展干预策略提供科学依据。方法于2015年4月至10月在陕西省11个国家贫困县开展幼儿社会情感发展的现况调查,采用分层随机抽样的方法抽取12~24月龄幼儿共1330名,以幼儿看护人为调查对象,调查问卷由结构式问卷和幼儿社会情感量表组成,并进行面对面访谈式调查。记录幼儿的社会情感发展现状,分析幼儿社会情感发展的影响因素。结果社会情感发展迟缓的阳性检出率为48.65%。单因素分析显示,在过去的6个月母亲不在家照看幼儿(OR=1.322,95%CI:1.032~1.694)、常给幼儿拿书讲故事(OR=0.482,95%CI:0.259~0.899)及幼儿无贫血(OR=0.774,95%CI:0.618~0.969)3个因素与幼儿社会情感发展有关,具有统计学意义(均P<0.05)。多因素分析结果显示,在过去6个月里母亲不在家照看的幼儿出现社会情感发展迟缓是无此因素者的1.330倍(95%CI:1.033~1.713,P<0.05),即该因素是幼儿社会情感发展迟缓的危险因素。常给幼儿拿书讲故事和幼儿无贫血两个因素的参数估计值为负数,OR值分别为0.491(95%CI:0.251~0.958,P<0.05)和0.771(95%CI:0.615~0.968,P<0.05),均是防止幼儿社会情感发展迟缓的保护因素。结论陕南贫困农村地区幼儿社会情感问题的发生率较高,母亲在过去6个月不在家照看的幼儿发生社会情感发展迟缓的风险较高,常给幼儿拿书讲故事、幼儿无贫血是其社会情感发展的保护因素,建议全社会要提高对以上因素的重视,积极营造适合幼儿成长的社会文化氛围,降低幼儿社会情感问题的发生。     

Risk Factors for Discontinuing Breastfeeding in Southern Brazil: A Survival Analysis

To identify risk factors for discontinuing breastfeeding during an infant's first year of life. A cohort study recruited mothers in a hospital in S?o Leopoldo, Brazil, which mainly serves the low-income population. In order to obtain socioeconomic, environmental, and behavioral information, face-to-face interviews with mothers were conducted after birth, and when their infants were 6 and 12 months old. The duration of breastfeeding was investigated at 6 and 12 months, and recorded separately for each month. Depressive symptoms were assessed using the Beck Depression Inventory. The multivariate model for predicting the discontinuation of breastfeeding, adjusted Kaplan-Meier survival curves and Cox regression were used. Of the 360 participants, 201 (55.8%) discontinued breastfeeding within the first 12 months. A multivariate Cox regression model revealed that symptoms of maternal depression (low levels: RR = 1.59, 95% CI 1.02-2.47; moderate to severe: RR = 2.03, 95% CI 1.35-3.01), bottle feeding (RR = 2.07, 95% CI 1.31-3.28) and pacifier use in the first month of life (RR = 3.12, 95% CI 2.13-4.57) were independently associated with the outcomes after adjusting for confounders. Breastfeeding cessation rates were lower for children who did not use bottle feeding or a pacifier in the first month of life and for the children whose mothers presented with minimal depression. Early pacifier use and bottle feeding must be strongly discouraged to support long-term breastfeeding. In addition, screening maternal depression at a primary care service can be a step forward in promoting a longer duration of breastfeeding.     

Factors associated with exclusive breastfeeding: the role of primary health care

The aim of this study was to assess the association between promotion, protection, and support for breastfeeding in primary health care services and prevalence of exclusive breastfeeding in the first six months of life. A cross-sectional study was conducted in a representative sample of 1,029 mothers of infants younger than six months treated at primary health care facilities in the city of Rio de Janeiro, in southeastern Brazil. Prevalence ratios (PR) were estimated by Poisson regression. Prevalence of exclusive breastfeeding was 58.1%. Factors associated with increased prevalence of exclusive breastfeeding were: white skin color (PR = 1.20; 95% CI: 1.05-1.36); schooling (PR = 1.19; 95% CI: 1.05-1.35); marital status (married or in common-law marriage) (PR = 1.72; 95% IC:1.02-2.90); previous breastfeeding (PR = 1.27; 95% CI: 1.08-1,49); exclusive breastfeeding at the time of hospital discharge (PR = 2.01; 95% CI: 1.20-3.36); group support for the mother (PR = 1.14; 95% CI: 1.01-1.28); and orientation on breastfeeding (PR = 1.20; 95% CI: 1.08-1.33). Prevalence of exclusive breastfeeding decreased 17% per month in the infant's life. Support groups and orientation by primary health care for breastfeeding were associated with increased exclusive breastfeeding prevalence.     

Adequacy of prenatal care as a major determinant of folic acid, iron, and vitamin intake during pregnancy

This study aimed to quantify the association between adequacy of prenatal care and prevalence of folic acid, iron, and multivitamin intake during pregnancy. Data were obtained on socio-demographics, prenatal care, pregnancy complications, and use of vitamin/mineral supplements for 836 women, using a postpartum interview. Associations with the use of vitamin/mineral supplements were quantified with risk ratios (RR), computed by generalized binomial regression. A high proportion of women reported the use of folic acid (81.9%), iron (55.4%), and multivitamins (76.2%) as supplements during pregnancy. Use of supplements was independently associated with adequacy of prenatal care (adequate vs. inadequate: folic acid, RR = 2.28; 95%CI: 1.58-3.29; iron, RR = 1.99; 95%CI: 1.57-2.52, multivitamins, RR = 1.97; 95%CI: 1.54-2.51). Higher schooling was also associated with increased use of folic acid (RR = 1.42; 95%CI: 1.18-1.70), but not multivitamins (RR = 0.87; 95%CI: 0.77-0.98). Use of folic acid was less prevalent in single women (RR = 0.67; 95%CI: 0.48-0.95) and during unplanned pregnancies (RR = 0.81; 95%CI: 0.71-0.92). Adequacy of prenatal care is a major determinant of vitamin/mineral intake during pregnancy.     

Risk factors for anemia among 6- to 12-month-old children in Brazil]

OBJECTIVE: To estimate the prevalence of anemia and to determine associated risk factors among infants receiving routine health care in public clinics in Brazil. METHOD: This cross-sectional study included 2,715 infants between 6 and 12 months old in 12 cities, in all five of the geographic regions of Brazil. Information regarding the child and its feeding habits was obtained from the mother or other caregiver, using a questionnaire. Nutritional status was determined based on height and weight measurements. The hemoglobin concentration was measured using the HemoCue portable hemoglobinometer. Anemia was defined as hemoglobin < 11 g/dL. The infants' eating habits were assessed based on what they were eating around the time of the questionnaire interviews. The association between anemia and the different variables was evaluated through bivariate analysis, followed by multiple logistic regression using a hierarchical selection model. RESULTS: The prevalence of anemia for the entire group was 65.4%. Multiple regression analysis identified the following risk factors for anemia: living in the Southeastern Region of Brazil (odds ratio (OR) = 1.57, 95% confidence interval (95% CI) = 1.25- 1.99), maternal age < 20 years (OR = 1.58, 95% CI = 1.21-2.07), birthweight < 2,500 g (OR = 2.09, 95% CI = 1.48-2.95), not being breast-fed (OR = 1.28, 95% CI = 1.02-1.61), receiving both breast milk and other foods (OR = 1.40, 95% CI = 1.10-1.78), and male gender (OR = 1.24, 95% CI = 1.06-1.46). CONCLUSIONS: The high proportion of anemic children indicates the need to emphasize, in prenatal and infant health programs, intervention measures for anemia control. Our results could guide these measures, focusing on the groups at greatest risk, such as low birthweight babies and the children of adolescent mothers.     

Predictors of anticipated breastfeeding in an urban, low-income setting

BACKGROUND: Although the proportion of women who breastfeed is known to vary by demographic group, breastfeeding practices have not been sufficiently studied among urban, lower income African American populations seen in family medicine centers. METHODS: A cross-sectional design was used to examine demographic, clinical, and attitudinal factors that affect anticipated infant feeding practices reported by postpartum women from a low-income, urban family practice setting. Data was analyzed using chi-square, odds ratios (OR), and multiple logistic regression techniques. RESULTS: Among 66 respondents, only 3 subjects (4.5%) indicated that they planned to breastfeed exclusively, while an additional 11 subjects (16.7%) reported plans to use a combination of bottle-feeding and breastfeeding. Based on univariate analyses, women with less than 12 years of education were less likely to report anticipated breastfeeding. Otherwise, breastfeeding plans were not associated with subject demographic features or with reproductive characteristics. Respondents planning to bottle-feed noted that breastfeeding was too complicated. Logistic regression demonstrated an inverse relationship between level of maternal education and anticipated breastfeeding (OR=0.13, 95% confidence interval [CI], 0.05-0.35), and a direct association for encouragement from the baby's father or the woman's mother to breastfeed and anticipated breastfeeding (OR=12.4; 95% CI, 4.92-31.4). CONCLUSIONS: This study reports unique data regarding anticipated infant feeding practices among patients from an urban, low-income community served by a family medicine center. Findings from this study will be used to develop a family-centered educational intervention involving the mothers, grandmothers, and partners of pregnant patients to promote the benefits of breastfeeding in this community.     

老年跌倒干预措施效果的Meta分析

[目的]评价各种锻炼、家居环境危险因素调整和多因素评估与干预在预防老年跌倒上的效应大小。[方法]通过检索Medline、Cochrane Database of Systematic Reviews、Cochrane Central Register of Controlled Trials、《中国生物医学文献数据库》(CBMdisc)与其他数据库及追溯参考文献收集与老年跌倒预防有关的随机对照试验,按入选标准筛选后提取其中的数据进行Meta分析。[结果]共有25篇文献收录。Meta分析显示,锻炼在预防老年跌倒发生上,总RR为0.885,95%CI为(0.808,0.970);在预防创伤性跌倒的发生上,总RR(95%CI)为0.675(0.511,0.892)。家居环境危险因素调整在预防全老年人群上总RR(95%CI)为0.854(0.751,0.972);在预防有跌倒史的老年人群上总RR(95%CI)为0.659(0.537,0.808)。多因素评估及干预在预防老年跌倒和创伤性跌倒上,总效应RR(95%CI)分别为0.817(0.688,0.969)和0.764(0.595,0.981)。[结论]锻炼、家居环境危险因素调整和多因素评估及干预都可以减少老年跌倒或创伤性跌倒的发生。     

四川省汉、藏和彝族农村地区母乳喂养现状及其影响因素

目的了解四川省汉、藏和彝族农村地区0~18月龄婴幼儿母乳喂养的现状及相关影响因素。方法采用多阶段抽样方法,抽取四川省2个汉族县、2个藏族县和2个彝族县农村地区0~18月龄婴幼儿及其母亲为研究对象,通过问卷调查收集母亲及婴幼儿的社会人口学特征、家庭情况、母乳喂养知识和行为等信息。运用非条件Logistic回归分析母乳喂养的相关影响因素。结果 1087名婴幼儿的早开奶率为22.45%,其中,985名6月龄及以上的婴幼儿纯母乳喂养至6月龄率为35.94%、658名12月龄及以上婴幼儿的持续母乳喂养至12月龄率为34.50%。分娩方式为顺产(OR=2.80,95%CI 1.82~4.30)、母亲的早开奶知识(OR=2.48,95%CI 1.69~3.64)是早开奶的有利因素。母亲是藏族(OR=1.56,95%CI 1.02~2.39)、家庭经济状况非常好(OR=2.70,95%CI 1.47~4.98)、母亲掌握纯母乳喂养知识(OR=1.47,95%CI 1.07~2.02)是纯母乳喂养至6月龄的有利因素。二胎及以上(OR=1.67,95%CI 1.11~2.52)、母亲掌握断奶知识(OR=3.96,95%CI 2.65~5.93)是持续母乳喂养至12月龄的有利因素。结论四川省汉、藏和彝族农村地区的母乳喂养现状不容乐观,母亲的民族、分娩方式、是否掌握相关知识、胎次及家庭经济状况均会影响婴幼儿母亲的母乳喂养行为。     

综合干预对北方农村离乳期营养性贫血儿童的效果研究

目的 观察铁剂补充结合喂养指导的综合干预对离乳期营养性贫血儿童的血红蛋白浓度升高和贫血纠正的效果。方法 对2012年5月河北省赵县两个乡镇体检发现的6~11月龄营养性贫血(Hb<110 g/L)的儿童分别入选干预组和对照组,两组分别有136名和87名儿童完成了全程随访,两组儿童都接受常规补充铁剂3个月。干预组每月由卫生室的医生提供一次家长离乳食指导。分别在1、3、12个月后复查儿童血红蛋白浓度和评估离乳食期喂养。结果 相对于入选时,随访时干预组和对照组的儿童自身血红蛋白浓度上升,3个月随访时分别为(14.85±14.85)g/L和(8.07±12.90)g/L,12个月随访时分别为(17.17±16.44)g/L和(5.77±13.87)g/L;各组每次随访时的上升值皆有统计学意义(P=0.000);两次随访时干预组的上升值高于对照组,皆有统计学意义(P=0.002和0.000)。干预组和对照组儿童的贫血纠正率在3个月随访时分别为52.2%和32.3%(P=0.004),12个月随访时为56.6%和31.0%(P=0.001)。相对于对照组的常规措施,干预组的离乳食干预对纠正儿童贫血的关联强度(RR)在3、12个月时分别为1.62和1.83,归因危险度(AR)分别为19.9%和25.6%。结论 在我国农村地区对离乳期营养性贫血的儿童进行喂养指导干预,短期内能够促进补铁治疗效果,而且通过长久影响儿童的营养状况,在补铁停止之后持续稳定纠正和预防儿童贫血,对婴幼儿营养改善具有长期意义。     

The impact of breastfeeding promotion in women with formal employment

This study focused on programs to promote breastfeeding in order to prevent early weaning of working mothers' infant children. A non-randomized intervention study was conducted using a survey of mothers who had returned to work after childbirth, including both participants and non-participants in a program to promote breastfeeding. The sample consisted of 200 mothers of infants ranging from 6 to 10 months of age. Factors associated with early weaning were analyzed with the chi-square and Fisher's exact tests and multiple logistic regression (α = 0.05). The results showed statistical differences between the groups in relation to exclusive breastfeeding (p < 0.0001) and breastfeeding (p < 0.0001). There was a statistically significant difference (p = 0.0056) between the groups in relation to time between childbirth and return to work. There was no difference between the end of maternity leave and weaning time. Mothers that were unable to nurse their infants during the work shift showed 4.98 times higher odds (95%CI: 1.27-19.61) of weaning them before the fourth month of age.     

Effect of a fortified maize-meal porridge on anemia, micronutrient status, and motor development of infants

BACKGROUND: Maize-meal porridge is used for infant feeding in many African countries, including South Africa. A low-cost, finely milled, maize-meal porridge was fortified with beta-carotene, iron, and zinc (100% of recommended dietary allowance), as well as ascorbic acid, copper, selenium, riboflavin, vitamin B-6, vitamin B-12, and vitamin E. OBJECTIVE: We assessed whether the fortified porridge could reduce anemia and improve the micronutrient status and motor development of infants. DESIGN: Infants aged 6-12 mo (n = 361) were randomly assigned to receive either the fortified or unfortified porridge for 6 mo. Primary outcomes were hemoglobin and serum retinol, zinc, and ferritin concentrations and motor development. Growth was assessed as a secondary outcome. Primary and secondary outcomes were assessed at baseline and 6 mo. RESULTS: Two hundred ninety-two infants completed the study. The fortified-porridge group had an intervention effect of 9.4 microg/L (95% CI: 3.6, 15.1 microg/L) for serum ferritin and 9 g/L (95% CI: 6, 12 g/L) for hemoglobin concentrations. The proportion of infants with anemia decreased from 45% to 17% in the fortified-porridge group, whereas it remained >40% in the control group. The fortified-porridge group achieved on average 15.5 of the 25 motor development score items, whereas the control group achieved 14.4 items (P = 0.007). Serum retinol concentration showed an inconsistent effect, and no intervention effect was observed for serum zinc concentrations. CONCLUSIONS: This low-cost fortified porridge can potentially have a significant effect in reducing anemia and improving iron status and motor development of infants in poor settings. The formulation needs some adjustment in terms of zinc fortification.     

不同喂养方式和经济收入对婴幼儿贫血发生率的影响

目的了解贫困地区农村6～23月龄婴幼儿的贫血情况,以及出生后0～6个月的喂养方式和家庭经济状况对6～23月龄婴幼儿贫血发生率的影响。方法采用问卷调查方法收集甘肃贫困地区农村6～23月龄婴幼儿的营养与健康状况信息,测定血红蛋白含量。结果 6～23月龄婴幼儿贫血患病率58.2%,男童贫血患病率(61.0%)趋势高于女童(55.1%),但差异无统计学意义。不同月龄组婴幼儿的血红蛋白差异有显著的统计学意义(F=5.206,P<0.01),6月龄开始婴幼儿血红蛋白水平呈明显下降趋势,到12月龄时最低,从15月龄开始血红蛋白水平随月龄的增长开始逐渐升高。血红蛋白含量的变化与贫血患病率是一致的,6!月龄婴儿的贫血患病率较高,12～月龄婴幼儿贫血患病率达到最高,12～月龄后随月龄的增长患病率呈逐渐下降的趋势。不同喂养方式的婴幼儿血红蛋白含量和贫血患病率有显著差异(χ2=9.245,P<0.05),人工喂养儿血红蛋白水平高于混合喂养儿和母乳喂养儿,贫血患病率显著低于母乳喂养儿和混合喂养儿(χ2=8.529和7.173,P<0.05)。家庭经济状况与血红蛋白水平的关系无统计学意义(F=0.637,P值均P>0.05);家庭经济状况较好,贫血患病率趋于较低(χ2=1.666,P>0.05)。结论婴儿12月龄!时血红蛋白含量最低和贫血率最高,人工喂养儿贫血患病率显著低于母乳喂养儿和混合喂养儿,家庭经济状况对贫血患病率的影响不明显。提示应关注和改善6月龄以上婴幼儿的铁营养状况和贫血问题。