城市婴幼儿喂养行为干预效果分析

目的对城市婴幼儿喂养行为的干预效果进行分析,为探索改善城市婴幼儿营养喂养行为、提高儿童健康水平的有效方法提供依据。方法选取北京等15个城市(区)为研究现场,对所有0~18月龄儿童进行为期一年的干预,方法包括发放宣传折页、制作宣传墙报、举办家长讲座、观看光盘、指导浏览育儿网站等,内容包括母乳喂养及辅食添加、婴幼儿喂养技术、儿童营养评价及喂养指导、饮食行为问题的预防和矫正、儿童常见营养性疾病的防治方法、常见婴幼儿营养与喂养问题及解答等。通过比较干预前后儿童的饮食种类、喂养环境、喂养技能等的变化判断干预效果。结果 0~6月龄儿童中开始添加辅食的平均时间(4.4月)比干预前(4.2月)有所延后,添加的第一种辅食(59.3%为米粉,29.1%为蛋黄)及喝果汁的情况(60.5%的儿童没喝果汁,仅16.8%常喝果汁)与干预前有显著性差异。7~12月龄儿童开始添加辅食(5.0月)、断母乳的平均时间(5.2月)均有所延后,添加的第一种辅食(58.9%为米粉,28.4%为蛋黄)、动物性食物的摄入(37.8%每周吃3次以上瘦肉、48.6%每周1次以上肝脏或血)、喝果汁的情况(仅33.5%常喝果汁)、进食方式(74.1%的儿童为面对面喂饭)、诱导进食方式(54.9%通过表扬诱导吃饭,儿童拒绝时49.9%会继续鼓励尝试)比干预前显著改善。13~30月龄儿童动物性食物的摄入(50.9%每周吃3次以上瘦肉、56.9%每周1次以上肝脏或血)、喝果汁的情况(仅29.5%常喝果汁)、进食方式(90.1%单独做饭、45.3%面对面喂饭并鼓励儿童自己吃)、诱导进食方式(64.2%通过表扬诱导吃饭,儿童拒绝时47.2%会继续鼓励尝试)、进食技能的训练(84.1%进行用勺吃饭训练)等也比干预前显著改善。由于方便、实用性高,讲座(35.7%)和宣传折页(36.0%)成为最受欢迎的干预方式。结论城市婴幼儿的喂养行为通过干预得到了显著改善,接受度最高的干预方式为讲座和宣传折页,今后应尽量多采用这两种方式进行相关干预。     

婴幼儿喂养障碍的气质和喂养行为研究

【目的】探讨婴幼儿喂养障碍患儿的气质和喂养行为特点,为临床干预提供科学依据。【方法】选择儿保门诊婴幼儿喂养障碍患儿和正常对照各80例,进行病例对照研究。气质问卷调查气质类型,自行设计问卷调查喂养行为。采用χ2检验进行统计学分析。【结果】喂养障碍婴幼儿中难养型和启动缓慢型所占比例为28.25%,高于对照组(χ2=5.378,P0.05)。喂养行为两组有明显差异,依次为:有否固定就餐时间(χ2=25.157,P0.001),有否固定就餐地点(χ2=14.925,P0.001),是否餐次过频(χ2=12.333,P0.001),是否添加辅食过晚(χ2=12.269,P0.001),是否总是拒绝新食物(χ2=4.902,P0.05),是否主要由祖辈喂养(χ2=4.514,P0.05)。【结论】婴幼儿喂养障碍与喂养行为及儿童气质特点密切相关,治疗时应综合考虑。     

大庆市城区婴幼儿营养与喂养状况调查及干预研究

目的掌握大庆市城区2岁以内婴幼儿营养与喂养现状、存在的主要问题;探索城市婴幼儿营养与喂养健康教育的有效方法。方法按照随机抽样原则,从儿童保健门诊抽取常规体检的0～18个月健康儿童400人为研究对象,进行基线调查,对儿童主要看护人实施为期半年的干预后再次进行终末调查。所有数据资料应用SPSS10.0软件进行统计分析。结果 6月龄内婴儿母乳喂养率86.0%。家长在儿童营养与喂养知识方面存在误区,家长对此方面的知识有广泛需求。结论经对家长举办培训,家长喂养行为与喂养方法得到改善,项目开发的宣传资料及宣教方式干预效果良好,基本满足家长和医生的需求,可广泛推广应用。     

喂养人喂养行为对婴幼儿喂养困难影响的研究

目的 研究婴幼儿喂养困难发生相关的喂养人喂养行为因素,为干预提供科学依据。方法 采用多阶段分层整群随机抽样的方法,选取4 017名来自全国69 个市(县、区)年龄在6~24月龄婴幼儿,采用标化的中国婴幼儿喂养困难评分量表评估其喂养困难发生情况,并对喂养人的喂养行为进行问卷调查,使用单因素和Logistic回归分析筛选与婴幼儿喂养困难发生相关的喂养人喂养行为因素。结果 6~24月龄中国婴幼儿喂养困难发生率为21.41%;不同月龄及不同性别间婴幼儿喂养困难的发生率差异无统计学意义;对婴幼儿喂养困难发生有保护作用的喂养人喂养行为有根据儿童的饥饿饱足信号进行喂养,进餐时与儿童的言语性鼓励和情感交流,鼓励儿童自行进食和积极应对儿童进食困难。 结论 婴幼儿期为喂养困难的易发阶段,喂养人适时喂养、多鼓励儿童自行进食、重视进餐过程中亲子互动和交流及积极应对儿童喂养困难有助于降低婴幼儿喂养困难的发生。     

拉萨农村藏族婴幼儿母亲喂养知识和行为调查

目的 了解西藏自治区拉萨市农村藏族婴幼儿母亲喂养知识和行为,为指导婴幼儿科学喂养提供依据。方法 采用自行设计调查表对抽取的拉萨市城关区3个农业乡共386名藏族0～24月龄婴幼儿母亲的喂养知识和行为进行调查。结果 386名农村藏族婴幼儿母亲的母乳喂养率为88.6%;从出生至4月龄,>80%婴幼儿主要添加的辅食为糌粑糊;至6月龄时,>60%婴幼儿添加的主要辅食为酥油茶,鸡蛋、肉类、蔬菜和水果的添加比例<30%;至12月龄后,>50%的婴幼儿开始添加鸡蛋、肉类、蔬菜和水果,但肉类的添加仅60%左右;有关婴幼儿喂养知识的7个问题中,除哺乳时两侧乳房应经常更换的回答正确率为85.9%外,其他6个问题的回答正确率均<50%;在婴幼儿日常照料行为的2个问题中,61.9%的母亲能够经常带孩子晒太阳,77.2%的孩子外表看起来干净。结论 拉萨市农村地区婴幼儿母亲喂养知识普遍欠缺,辅食添加不合理。     

贫困地区婴幼儿喂养健康教育路径效果评估

目的 研究在贫困地区有效推广科学喂养婴幼儿的理念和方法的路径效果, 改善喂养人的喂养技能, 达到提高婴幼儿健康水平的目的。方法 为完成国家“消除婴幼儿贫血行动”健康教育任务, 依托国家项目的政策、管理、技术平台, 采用临床路径及成人培训方法, 对基层业务人员及婴幼儿家长进行多轮培训;用婴幼儿喂养指数及喂养困难两个指标评价培训效果。结果 1)培训前后婴幼儿喂养指数各年龄组改善显著。培训前, 各年龄组均低于城市样本, 6~8个月龄低于农村样本, 9~11月龄与农村样本相似, 12~24月龄高于农村样本;培训后, 各年龄组均高于培训前的水平。2)培训前后喂养困难9~11月龄组改善不显著, 其余各年龄组改善显著。9~11月龄组喂养困难显示出涉及面宽、警示度低的特点, 依据是:问卷共14个项目, 该组有8个项目差异不显著;问卷每项最高分为7分, 该组干预前后分值分别为2.61±1.154、2.51±1.115。结论 临床路径的健康教育方法, 可全面、有效改善家长的婴幼儿喂养水平;但对于喂养困难, 需要更加系统和有针对性的措施。     

浅谈婴幼儿喂养指导对婴幼儿喂养状况的促进

目的 浅谈婴幼儿喂养指导对婴幼儿的喂养状况的促进.方法 选取婴幼儿及母亲88例进行系统的分析讨论,随机将其分为两组,一组患者实施常规的护理措施为对照组,另一组患者给予有效的婴幼儿喂养指导为观察组,比较两组喂养成功率以及婴幼儿体重增长.结果 观察组婴幼儿的喂养成功率以及婴幼儿的体重增长明显优于对照组,差异显著(P＜0.05),具有统计学意义.结论 对于婴幼儿的喂养状况直接影响到婴幼儿的生长发育,因此有效的婴幼儿喂养指导能够明显地促进婴幼儿的喂养情况,有助于婴幼儿生长发育.     

喂养人心理干预对婴幼儿喂养困难的影响

目的 探讨喂养人心理干预对婴幼儿喂养困难的影响.方法 将99例6个月至3岁喂养困难婴幼儿分成干预组和对照组.对照组(49例)的婴儿喂养人接受常规营养教育及喂养指导方法,干预组(50例)的婴儿喂养人在对照组基础上接受个体化的心理干预.干预前后采用抑郁自评量表(SDS)和焦虑自评量表(SAS)对喂养人进行问卷调查,并评估干预前后婴幼儿的年龄体质量Z值(WAZ),比较干预前后两组喂养人抑郁焦虑不良情绪及婴幼儿营养改善情况.结果 ①两组喂养人干预前抑郁和焦虑评分比较差异无统计学意义(P＞0.05);经心理干预后,干预组抑郁评分为(43.64±7.10)分,低于对照组(51.80±6.79)分,差异有统计学意义(t=5.870,P＜0.001);干预组焦虑评分为(43.32±6.42)分,低于对照组(49.32±6.51)分,差异有意义(t=4.462,P＜0.001);②干预前两组喂养困难婴幼儿WAZ比较差异无统计学意义(P＞0.05);经心理干预后,两组差异有统计学意义(t =2.449,P＜0.05).结论 心理干预可以缓解喂养人焦虑和抑郁,有助于改善喂养困难婴幼儿的营养状况.     

婴幼儿喂养行为与生长发育的相关性研究

[目的] 研究婴幼儿期喂养行为与生长发育的关系,及时正确的给与家长指导. [方法] 选取2004年1月～2007年12月在本院出生的1 309名健康儿童(0～36月龄),对他们的生长速率及喂养行为进行回顾性分析.[结果] 喂养行为中的各个因素(食物制备,喂养人行为,婴幼儿行为、喂养环境)与0～36月龄儿童生长速率密切相关(P<0.05). [结论] 喂养行为影响儿童生长发育,建立合理的喂养行为,及时对家长进行行为指导.     

婴幼儿喂养困难研究进展

婴幼儿喂养困难是存在于婴幼儿期的一种常见喂养问题,临床表现多样,但目前尚缺乏统一的诊断分类标准。引起婴幼儿喂养困难的原因多样,涉及婴幼儿、喂养者和喂养环境及其之间的复杂相互作用。对婴幼儿喂养困难的评估应包括一个全面的,跨学科的评价。统一婴幼儿喂养困难的诊断分级、评估和治疗标准是婴幼儿喂养困难研究的重点。     

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.     

Association between Mother’s Education and Infant and Young Child Feeding Practices in South Asia

The association between mother’s education and the World Health Organization’s (WHO’s) eight Infant and Young Child Feeding (IYCF) core indicators has yet to be explored in South Asia (SA). This study aimed to explore the association between mother’s education and the WHO’s eight IYCF core indicators in SA. We analyzed data from the most recent nationally representative Demographic and Health Surveys of six South Asian Countries (SACs)—Afghanistan, Bangladesh, India, Maldives, Nepal, and Pakistan. We found significantly higher odds (adjusted odds ratio, AOR, 1.13 to 1.47) among mothers who completed secondary or higher education than among mothers with education levels below secondary for the following seven IYCF indicators: early initiation of breastfeeding (EIBF), exclusive breastfeeding under 6 months (EBF), the introduction of solid, semisolid or soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), and consumption of iron-rich or iron-fortified foods (CIRF); the exception was for the indicator of continued breastfeeding at one year. Country-specific analyses revealed significantly higher odds in EIBF (AOR 1.14; 95% CI: 1.11, 1.18) and EBF (AOR 1.27; 95% CI: 1.19, 1.34) among mothers with secondary or higher education levels in India. In contrast, the odds were lower for EIBF in Bangladesh and for EBF in Pakistan among mothers with secondary or higher education levels. For country-specific analyses for complementary feeding indicators such as ISSSF, MDD, MMF, MAD, and CIRF, significantly higher odds (AOR, 1.15 to 2.34) were also observed among mothers with secondary or higher education levels. These findings demonstrate a strong positive association between mother’s education and IYCF indicators. Strengthening national policies to educate women at least to the secondary level in SACs might be a cost-effective intervention for improving IYCF practices.     

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.     

Latin American Considerations for Infant and Young Child Formulae

Infant formula is the only acceptable substitute for breastmilk from 0 to 6 months old when human milk cannot be provided in sufficient amounts. Manufacturers have developed options that intend to meet the changing needs of the child aged from six to twelve months (follow-on formulae) and after the age of one year (young child formulae). The international code for marketing breast milk substitute stipulates standards for marketing practices of these products. In Latin America there are local variations of marketing practices. Novel marketing strategies such as advertising through social media and influencers pose new threats for breastfeeding success in Latin America. This review aims to examine variations in local regulations for marketing of infant formulae and to analyze the emerging phenomenon of influencer advertising. We reviewed the local norms for Latin American countries and examined differences and possible gaps. Emerging evidence of influencer marketing was explored. The results indicate that national regulations differ among Latin American countries, particularly with respect to product labelling and the requirement to use a local native language, highlighting the cost of the product, and different regulations prohibiting certain messages and illustrations. Regarding new marketing strategies, there is limited evidence on advertising infant formula through social media influencers, where different categories of marketing strategies can be described. More transparent reporting of social marketing by formula providers and more independent research on novel marketing strategies are needed.     

Recipe Components and Parents’ Infant and Young Child Feeding Concerns: A Mixed-Methods Study of Recipe Posts Shared in Thai Facebook Groups for Parents

Social media is increasingly becoming a significant source of information for parents, including about feeding young children. However, little attention has been given to the characteristics of recipes for infants and young children and how they interact with parental perceptions regarding food decisions shared by users on social media. Building on findings related to shared recipe components and parental food choices, between December 2019 and July 2020, this study retrospectively collected 80 shared recipes each from five Thai Facebook groups. This extraction created 379 shared recipes with 1751 peers’ commentaries on the shared recipes’ posts. The shared recipes were classified and components quantified across child age groups, then the textual contents around the reasons behind the food choices were described qualitatively. The results showed that there were differences in meal types, food ingredients, and seasoning used across child age groups. Further analysis found that food allergy awareness was one driving concern behind parental perceptions on food choices in children’s diets. These concerns resulted in delays in the introduction of animal-source foods. Moreover, peers’ commentaries on shared recipes offered a venue for exchanging experiences with food products. Because of the potential influence on parental beliefs and perceptions, further studies are required to understand the impact of existing online communities on actual feeding practices.     

儿保门诊中婴幼儿喂养困难的分析

目的：分析婴幼儿喂养困难的原因，探讨口腔功能对婴幼儿进食行为的影响以及相关的干预措施。方法：分析儿保门诊中喂养困难的好发年龄及原因。结果：6－24月的婴幼儿为喂养困难的好发年龄，其喂养困难的原因以口腔功能问题为主（51．3％）。结论：造成婴幼儿喂养困难的口腔功能问题主要由家庭环境强化所致，儿童缺乏足够的学习机会去尝试不同质地的新食物。     

Young Child Nutrition: Knowledge and Surveillance Gaps across the Spectrum of Feeding

The first 1000 days is a critical window to optimize nutrition. Young children, particularly 12–24 month-olds, are an understudied population. Young children have unique nutrient needs and reach important developmental milestones when those needs are met. Intriguingly, there are differences in the dietary patterns and recommendations for young children in the US vs. globally, notably for breastfeeding practices, nutrient and food guidelines, and young child formulas (YCFs)/toddler drinks. This perspective paper compares these differences in young child nutrition and identifies both knowledge gaps and surveillance gaps to be filled. Parental perceptions, feeding challenges, and nutrition challenges are also discussed. Ultimately, collaboration among academia and clinicians, the private sector, and the government will help close young child nutrition gaps in both the US and globally.     

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。