Associations of plasma total phospholipid fatty acid patterns with feeding practices,growth, and psychomotor development in 6‐month‐old South African infants

The objective of this study was to assess plasma fatty acid (FA) patterns of 6‐month‐old South African infants and to determine their association with feeding practices, growth, and psychomotor development. Plasma total phospholipid FA composition (% of total FAs) of 6‐month‐old infants (n = 353) from a peri‐urban township was analysed, and principal component and factor analysis were performed to identify plasma FA patterns. Feeding practices, anthropometric measurements, and psychomotor development scores were determined. Four major plasma phospholipid FA patterns were identified: A plant‐based C18 FA, a high n‐6 long‐chain polyunsaturated fatty acids (LCPUFA), a C16:1 and long‐chain saturated fatty acid (SFA), and a high n‐3 and low n‐6 LCPUFA pattern. Formula feeding was associated with higher, whereas breastfeeding was associated with lower scores for the plant‐based C18 FA and C16:1 and long‐chain SFA patterns. On the other hand, breastfeeding, the consumption of cow's milk, and the consumption of semisolid foods were associated with higher scores, whereas formula feeding was associated with lower scores for the high n‐6 LCPUFA pattern. Breastfeeding and the consumption of semisolids were also associated with higher high n‐3 and low n‐6 LCPUFA pattern scores. The C16:1 and long‐chain SFA and high n‐3 and low n‐6 LCPUFA patterns were positively associated with psychomotor development scores. In 6‐month‐old South African infants, we identified distinct plasma FA patterns that presumably represent the FA quality of their diet and that are associated with psychomotor development. Our results suggest that breast milk is an important source of n‐6 LCPUFAs and formula‐fed infants may be at risk of inadequate LCPUFA intake.     

Bed‐sharing among six‐month‐old infants in western Sweden

Aim: In spite of several reports of an increased risk of sudden infant death syndrome (SIDS) in connection with bed‐sharing, it is not an uncommon practice. The aim of this study was to examine bed‐sharing at 6 months of age and the factors that are associated with bed‐sharing. Methods: Our cohort comprised 8176 randomly chosen families. At 6 month of age, the families received an invitation to the study, with a questionnaire, which was completed by 5605 families (response rate 68.5%). Results: Of the families, 19.8% bed‐shared. In the multivariate analysis, we found a correlation between breast‐feeding and bed‐sharing (breast‐feeding at 6 months: OR 1.94; 95% CI 1.56, 2.41). Moreover, we found an association with 3+ nightly awakenings at 6 months (2.70; 2.20, 3.32). It was more common to share a bed if the parent was single (2.04; 1.19, 3.51) and less common if the infant was bottle‐fed in the first week (0.70; 0.54, 0.90). Never using a pacifier was associated with a higher frequency of bed‐sharing. Conclusion: We found a correlation between breast‐feeding and bed‐sharing as well as between sleeping problems and a single parent. A lower percentage of infants sleeping in the parental bed were seen in association with formula feeding in the first week after birth.     

Infant feeding practices in a South African birth cohort—A longitudinal study

Childhood malnutrition is highly prevalent in low‐ and middle‐income countries. The choices of complementary foods, which are important in infant nutrition, are poorly described in this setting. We investigated infant feeding practices in a South African birth cohort, the Drakenstein Child Health Study. Longitudinal feeding data were collected from March 2012 to March 2015. Feeding practices at birth, 6–10 and 14 weeks and 6, 9, and 12 months, were investigated using food frequency questionnaires. Anthropometry was measured at birth and 12 months. The quality of the diet was analyzed using the World Health Organization infant and young child feeding indicators. Regression models were used to explore associations between feeding and growth outcomes at 1 year. Exclusive breastfeeding for 6 months was low (13%), and 19% of infants were introduced to solid foods before 4 months. There was high daily consumption of processed meat (56%) and inappropriate foods such as fruit juice (82%), soft drinks (54%), and refined sugary foods (51%) at 1 year. Dietary diversity and consumption of iron rich foods were low at 6 months (5% and 3%, respectively) but higher by 12 months (75% and 78%). Longer duration of exclusive breastfeeding was associated with a lower height‐for‐age z‐score at 1 year. Several dietary deficits and a rising trend in the consumption of inappropriate nutritionally poor foods were identified. These findings raise concern about poor dietary practices and the impact on child and long‐term health.     

Breastfeeding modifies the impact of diarrhoeal disease on relative weight: a longitudinal analysis of 2–12 month‐old Filipino infants

Undernutrition and diarrhoeal disease are major causes of infant mortality. We investigated the combined roles of breastfeeding and diarrhoea on infant size in 2940 infants from the Cebu Longitudinal Health and Nutrition Survey. The study aimed to assess whether breastfeeding status modified the deficits associated with diarrhoeal disease. The primary exposures were combinations of current breastfeeding status (yes/no), the presence of diarrhoeal disease in previous week (yes/no) and a categorical survey variable (six surveys taken at bimonthly intervals when infants were 2–12 months of age). Relative weight (weight‐for‐length z‐scores), calculated using the WHO growth standards, was estimated using sex‐stratified, fixed‐effects longitudinal models that also adjusted for energy from complementary foods. Post‐estimation Wald tests were conducted to identify subgroup differences in relative weight. Diarrhoea was associated with reduced relative weight in both breastfed and non‐breastfed infants of 6–12 months. Diarrhoea‐related deficits in relative weight were significantly exacerbated in non‐breastfed girls of 6 and 8 months. Importantly, in infants <6 months, being breastfed and having diarrhoea was still associated with greater relative weight compared with being non‐breastfed and diarrhoea‐free. Breastfeeding emerged as a strong contributor to relative weight in younger infants (<6 months) while diarrhoeal disease strongly contributed to deficits in relative weight in older infants (6–12 months). These findings underscore the importance of breastfeeding for promoting infant nutritional status in infants with or without diarrhoea from birth to 12 months.     

The importance of early complementary feeding in the development of oral tolerance: Concerns and controversies

Rising rates of food allergies in early childhood reflect increasing failure of early immune tolerance mechanisms. There is mounting concern that the current recommended practice of delaying complementary foods until 6 months of age may increase, rather than decrease, the risk of immune disorders. Tolerance to food allergens appears to be driven by regular, early exposure to these proteins during a 'critical early window' of development. Although the timing of this window is not clear in humans, current evidence suggests that this is most likely to be between 4 and 6 months of life and that delayed exposure beyond this period may increase the risk of food allergy, coeliac disease and islet cell autoimmunity. There is also evidence that other factors such as favourable colonization and continued breastfeeding promote tolerance and have protective effects during this period when complementary feeding is initiated. This discussion paper explores the basis for concern over the current recommendation to delay complementary foods as an approach to preventing allergic disease. It will also examine the growing case for introducing complementary foods from around 4 months of age and maintaining breastfeeding during this early feeding period, for at least 6 months if possible.     

Dissimilarities across age groups in the associations between complementary feeding practices and child growth: Evidence from rural Togo

Adequate complementary feeding (CF) practices are essential for achieving optimal growth but challenging to measure comprehensively. This paper describes CF practices in 2,034 children aged 6–23 months and investigates their relationships with length‐for‐age z‐score (LAZ) and stunting, using cross‐sectional data collected from May to July 2014 in rural Northern Togo. The World Health Organization infant and young child feeding indicators were computed, along with ancillary indicators on feeding style and timing of introduction of complementary foods. The associations between those indicators and children's LAZ and stunting were assessed using linear and logistic regressions after stratification by age group and adjustment for children, maternal, and household characteristics. CF practices were suboptimal, and their associations with child's growth varied across indicators and age groups. In children aged 6–11 months, reaching the minimum dietary diversity and the minimum acceptable diet was associated with higher LAZ (p < .05). In 18‐ to 23‐month‐old children, only the consumption of iron‐rich food was associated with both LAZ (p = .02) and stunting (p = .05). The late introduction of family foods was associated with higher odds of being stunted and lower LAZ in children aged 12–17 months (p < .001). The untimely introduction of porridge was associated with higher odds of stunting in children aged 9–23 months (p < .05). Unexpectedly, helping the child to eat was negatively associated with linear growth in all age groups. These findings nurture the ongoing process of review of the World Health Organization infant and young child feeding indicators showing that, in their current version, they hardly capture the links between CF and child's growth at different ages.     

Intimate partner violence and infant feeding practices in India: a cross‐sectional study

Intimate partner violence (IPV) is widespread; yet research is thin and equivocal regarding its potential adverse effects on infant feeding practices. With a national sample of 3552 mothers and infants aged 180 days or younger from the 2005–2006 National Family Health Survey for India, we used logistic regression to estimate the unadjusted and adjusted associations of maternal reported lifetime exposure to any IPV and to physical or sexual IPV with feeding practices at birth and in the prior 24 h. Compared with their unexposed counterparts, mothers exposed to any IPV and to any physical or sexual IPV had higher adjusted odds of giving their infant liquids [aOR 1.32, 95% confidence interval (CI) 1.04–1.66; aOR 1.37, 95% CI 1.08–1.75, respectively], and thus lower adjusted odds of exclusively breastfeeding their infant in the prior 24 h (aOR 0.78, 95% CI 0.62–0.98; aOR 0.74, 95% CI 0.58–0.95). Mothers exposed to physical or sexual IPV also had higher adjusted odds of feeding their infant solids in the prior 24 h (aOR 1.50, 95% CI 1.01–2.23). Exposure to IPV was not significantly associated with breastfeeding immediately after birth or with bottle feeding in the prior 24 h. Perinatal screening for IPV, and addressing IPV and feeding practices in exposed mothers, may improve maternal health and infant nutrition in similar settings.     

Nutritional status and complementary feeding among HIV‐exposed infants: a prospective cohort study

Complementary feeding is crucial for improving child survival and promoting growth and development, particularly among HIV‐exposed children who have higher risk of morbidity and mortality than their un‐exposed peers. This prospective study employed an infant and child feeding index (ICFI) to measure complementary feeding and determine its association with nutritional status among 2092 HIV‐exposed infants followed from 6 to 24 months of age in Dar es Salaam, Tanzania. The ICFI measured both quality and quantity of complementary feeding, including current breastfeeding status, food consistency, dietary diversity scores (DDS), food group frequency score, and meal frequency. The ICFI score ranged from 0 to 9; the median score was 6 (Inter‐Quartile Range, IQR= 4–7). After adjusting for potential confounders, high ICFI scores were associated with reduced risk of stunting (high vs. low tertile hazard ratio, HR: 0.72; 95% confidence interval, CI: 0.57, 0.91; P< 0.01) and underweight (high vs. low tertile HR: 0.79; 95% CI: 0.61, 1.02; P= 0.07). Low DDS were associated with higher risk of stunting (low vs. high tertile HR: 1.59; 95% CI: 1.23, 2.07; P< 0.01) and underweight (low vs. high tertile HR: 1.48; 95% CI: 1.12, 1.96; P= 0.01). In this setting, high DDS and ICFI scores were protective of stunting and underweight. We recommend for nutrition programs in low‐income countries to emphasize educating HIV‐exposed children's caregivers on the importance of dietary diversity and optimal complementary feeding to improve nutritional status in this important subpopulation.     

Poor dietary diversity and low nutrient density of the complementary diet for 6‐ to 24‐month‐old children in urban and rural KwaZulu‐Natal,South Africa

Infants and toddlers have high nutritional requirements relative to body size but consume small amounts of food and therefore need nutrient‐dense complementary foods. A cross‐sectional study included children aged 6–24 months, stratified in three age categories (6–11 months, 12–17 months and 18–24 months) and randomly selected from an urban (n = 158) and a rural (n = 158) area, both of low socio‐economic status, in the KwaZulu‐Natal Province of South Africa. Dietary diversity and nutrient density of the complementary diet (excluding breast milk and formula milk) based on a repeated 24‐h dietary recall was assessed. For breastfeeding children, nutrient density of the complementary diet was adequate for protein, vitamin A and vitamin C; and inadequate for 100% of children for zinc, for >80% of children for calcium, iron and niacin; and between 60% and 80% of children for vitamin B6 and riboflavin. Urban/rural differences in density for animal and plant protein, cholesterol and fibre occurred in 18–24‐month‐old children. Fewer than 25% of children consumed ≥4 food groups, with no urban/rural differences. Higher dietary diversity was associated with higher nutrient density for protein and several of the micronutrients including calcium, iron and zinc. The poor nutrient density for key micronutrients can probably be ascribed to lack of dietary variety, and little impact of mandatory fortification of maize meal/wheat flour on infants/toddlers' diet. Targeted strategies are needed to enable mothers to feed their children a more varied diet.     

喂养习惯与婴儿出生后前6个月按身长体质量增加的相关性

目的 探讨导致婴儿出生早期生长过快,尤其是按身长体质量增长过快的相关喂养习惯,包括婴儿的喂养方式、喂养环境以及喂养者的一般情况和喂养行为等,方法以上海市控江社区医疗服务中心常规健康体检的200例足月、单胎、正常出生体质量的健康5～6月龄婴儿及其主要喂养者作为研究对象.有关婴儿喂养习惯的调查问卷,包括婴儿喂养模式、喂养环境、以及喂养者的行为等,由研究小组成员在现场对婴儿的主要喂养者进行一对一调查.记录婴儿的出生体质最,并在婴儿6月龄时测量其体质量和身长.结果 200例婴儿中有70例超重(BAZ>+1),占35%.男婴超重多于女婴(40.0%对30.9%,x2=1.798,P=0.180).超重婴儿和体质量正常婴儿的出生体质量一致(3.30±0.35 kg对3.35±0.32 kg,t=1.010,P=0.314),6月龄时两组婴儿的身长也一致(67.64±2.10 cm对67.91±1.97cm,t=0.896,P=0.371).超重婴儿在出生后前6个月内按身长体质量增加速度明显快于正常体质量婴儿,6月龄时超重婴儿的体质量以及BMI显著高于正常体质量婴儿(9.16±0.67对7.94±0.64,t=12.324,P<0.01;19.86±1.24对17.41±0.80,t=14.953,P<0.01).两组婴儿中纯母乳喂养时间至少4个月,6月龄时持续母乳喂养、辅助食品稠厚度和喂养次数差异无统计学意义(x2=0.723～2.701,P均>0.05).祖父母在上海婴儿的喂养照料中扮演着重要的角色,39.0%的婴儿完全由祖父母承担喂养和照料的责任,而23.0%的婴儿则由父母与祖父母共同承担.两组婴儿的主要喂养者、喂养者学历、婴儿喂养知识掌握差异无统计学意义(x2=0.175、0.446,t=0.949,P均>0.05).超重婴儿喂养者的喂养速度明显快于正常体质量婴儿(Z=2.753,P<0.01),超重婴儿喂养者在喂养过程中与婴儿的语言交流明显较少(Z=2.932,P<0.01).在超重婴儿中,喂养者的过度喂养行为与超重婴儿的BAZ呈显著正相关(r=0.281,P<0.05).结论 上海婴儿出生早期按身长体质量增长过快与某些婴儿喂养习惯相关.婴儿出生后前6个月按身长体质量增加过快是否会增加儿章期肥胖的风险值得进一步观察和研究.     

Spoonfeeding is associated with increased infant weight but only amongst formula‐fed infants

Infant feeding experiences are important for the development of healthy weight gain trajectories. Evidence surrounding milk feeding and timing of introduction to solids is extensive; however, the impact of the method of introducing solids on infant growth has been relatively underexplored. Baby‐led weaning (where infants self‐feed family foods) is proposed to improve appetite regulation, leading to healthier weight gain and a reduced risk of obesity. However, the evidence is mixed and has methodological inconsistencies. Furthermore, despite milk being a large part of the infant diet during the period infants are introduced to solid foods, its influence and interaction with introductory style have not been considered. The aim of this study was to explore growth among infants aged 3–12 months according to both style of introduction to solid foods and milk feeding; 269 infants were weighed and measured, and body mass index (BMI) computed. The results showed that overall, infants who were spoon‐fed (compared with self‐fed) at introduction to complementary feeding (CF) had greater length (but not weight or BMI). However, when milk feeding was accounted for, we found that infants who were both spoon‐fed and fully formula fed had greater weight compared with spoon‐fed, breastfed infants. There was no significant difference in weight among self‐fed infants who were breastfed or formula fed. The results highlight the importance of considering infant feeding as a multicomponent experience in relation to growth, combining both milk feeding and method of CF. This relationship may be explained by differences in maternal feeding style or diet consumed.     

Iron status in low birth weight infants on breast and formula feeding

Iron status in 15 low birth weight infants, 1000–2499 g, on breast feeding was studied longitudinally for the first 6 months of age, and the findings compared to those of 30 low birth weight infants receiving a proprietary iron-fortified formula. The two groups received no iron supplement until they developed iron deficiency. The incidence of iron deficiency at 6 months was significantly greater in the breast-fed group than in the formula-fed group (86% v 33%). The breast-fed group had significantly lower serum ferritin and hemoglobin values after 4 months of age. The findings indicate that breast-fed low birth weight infants have a higher risk of developing iron deficiency and should receive iron supplementation from 2 months of age.Abbreviations TIBC total iron-binding capacity - MCV mean corpuscular volume     

Serum 25 hydroxyvitamin D status in 6‐month‐old infants in Guangzhou,China: A paired longitudinal follow up study

To assess the vitamin D status in healthy 6‐month‐old infants, as well as vitamin D supplementation and feeding patterns in Guangzhou, China, serum 25‐hydroxyvitamin D (25OHD) concentrations of 202 infants were measured at birth (cord blood) and at 6 months of age in Guangzhou, China. Questionnaires acquiring demographic characteristics, maternal and infantile vitamin D supplementation during pregnancy and first 6 months after birth, and feeding patterns during the first 6 months were completed by participating mothers. Physical examinations and blood sampling were carried out among infants at 6 months of age. The majority of infants (93.6%) were supplemented with vitamin D during the first 6 months of life on a voluntary basis. The M ± SD of cord serum 25OHD concentration was 46.2 ± 16.4 nmol/L, whereas the M ± SD of 25OHD concentration at 6 months was 82.9 ± 24.9 nmol/L. Serum 25OHD concentrations <30 nmol/L were seen in 34 (16.8%) infants at birth but only one (0.5%) at 6 months. Only 11 (5.4%) infants had concentrations >75 nmol/L at birth, whereas the majority of infants (n = 131, 64.9%) had concentrations >75 nmol/L at 6 months. The main predictors of 25OHD levels at 6 months included season, vitamin D supplementation, parental education level, and feeding patterns. To conclude, serum 25OHD concentrations were low at birth in a southern Chinese population, and infantile supplementation is an effective way to improve 25OHD status. Exclusively breastfed infants might need greater vitamin D supplementation, and individualized vitamin D supplementation plans might be needed.     

Caregiver–infant's feeding behaviours are associated with energy intake of 9‐11 month‐old infants in rural Ethiopia

Inappropriate complementary feeding, both in quantity and quality, is a major determinant of undernutrition. However, little is known about how infant–caregiver's feeding behaviours affect infants' energy intake. Therefore, the objective of this study was to characterize infant–caregiver feeding behaviours and investigate their association with infants' energy intake. The study involved 106 mother–child pairs recruited from seven randomly selected kebeles of Mecha district, West Gojam, Ethiopia. The feeding styles were assessed through observations of 1‐day, in‐home, feeding episodes that were videotaped and coded into self‐feeding, responsive, active, distracting, and social feeding behaviours. Infants' haemoglobin and anthropometric measurements were taken. The association between feeding behaviour scores and energy intake per meal was investigated. The mean food intake of the infants was very low (11.4 ± 7.0 g/kg body weight per meal) compared to the minimum theoretical gastric capacity (30 g/kg body weight per meal). Infants' haemoglobin concentration was negatively associated with energy intake (ρ = 0.178, p = .03). Infants' responsive and active positive feeding styles were positively associated with energy intakes (ρ = 0.258 and 0.432, p = .004 and p < .001, respectively) as well as caregivers' responsive positive feeding styles (ρ = 0.237, p = .007). Both haemoglobin concentrations and feeding styles were associated with infant's energy intake. Anaemia prevention and control measures should be reinforced. Current nutrition education programmes should give emphasis on ways to effectively incorporate culturally adapted responsive feeding messages in this and similar settings.     

Differences in eating behaviour,well‐being and personality between mothers following baby‐led vs. traditional weaning styles

Baby‐led weaning, where infants self‐feed family foods in place of traditional spoon‐feeding of purees, is continuing to grow in popularity. Evidence is emerging which suggests that the method may promote healthier eating behaviour and weight gain in children, but the research is in its infancy. One issue is the self‐selecting nature of participants to the approach. Although those who follow a baby‐led approach are known to have a higher education and more professional occupation, little is known about wider maternal characteristics, which might affect either adoption of or outcomes of the method. The aim of this study was to explore differences in maternal characteristics between those adopting a baby‐led or traditional approach. Six hundred four mothers with an infant aged 6–12 months completed a questionnaire including a copy of the Dutch Eating Behaviour Questionnaire (DEBQ), Brief Symptom Inventory (BSI) (anxiety, obsessive–compulsive and depression scales) and Ten Item Personality Questionnaire (TIPQ) alongside details of weaning approach (baby‐led vs. traditional). Mothers who adopted a baby‐led weaning style scored significantly lower on restrained eating (DEBQ), anxiety and introversion (TIPQ) and anxiety and obsessive–compulsive symptoms (BSI). Mothers who currently adopt a baby‐led approach are therefore significantly different in personality, eating behaviour and well‐being characteristics compared with those adopting a traditional approach. These characteristics may affect likelihood of choosing a baby‐led approach or indirectly affect outcomes for infants weaned using the approach. Further research exploring baby‐led weaning in a wider population sample is needed.     

An infant and child feeding index is associated with child nutritional status in rural China

Background

Some researchers have developed child feeding indices to summarize child feeding practices so that they can compare child feeding practices across countries and monitor changes over time within a given country.

Aims

An adapted version of the infant and child feeding index (ICFI) developed by Ruel and Menon was used to examine its association with nutritional status of infants living in a rural community in China.

Methods

A cross-sectional survey of 501 children aged 6-11 mo was conducted with their mothers in 8 townships between May 2006 and March 2007. ICFI was developed based on 24-h dietary recall and food frequency information. The associations between ICFI and anthropometric indices including length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) Z-scores were examined separately. General linear regression models were used to adjust for potential confounders including the children's, parents' and households' sociodemographic characteristics.

Results

The ICFI was associated with both WAZ (adjusted WAZ means: 0.39, 0.47, and 0.54 for the 1st, 2nd, and 3rd tercile, respectively, P < 0.05) and WLZ (adjusted WLZ means: 0.47, 0.74, and 0.79 for the 1st, 2nd, and 3rd tercile, respectively, P < 0.05). But it was not associated with children's LAZ. Among the components of ICFI, dietary diversity, meal frequency and bottlefeeding were positively associated with the children's anthropometric indices.

Conclusions

ICFI and its components could be used to assess effect of complementary feeding practices on child growth.     

Maternal pre‐pregnancy body mass index is not associated with infant and young child feeding in low‐income Mexican children 1–24 months old

Pre‐pregnancy overweight and obesity is associated with shorter breastfeeding (BF) duration. Whether pre‐pregnancy overweight and obesity is associated with other aspects of infant and young child feeding (IYCF) has not been investigated. We used data from 370 children born January 1999–September 2001 in a semi‐urban community in Morelos, Mexico, where information on how they were fed was available at 1, 3, 6, 9, 12, 18 and 24 months of age. We modified the World Health Organization's dietary diversity indicator to assess the quality of the complementary foods. An index that included BF, quality of complementary foods and other behaviours was constructed to measure IYCF. We used survival analysis to examine the association of pre‐pregnancy body mass index (pBMI) category and BF duration and mixed models for quality of complementary food and IYCF index. Mean maternal pBMI was 24.4 ± 4.1; 31% were overweight, and 9% were obese. pBMI was not associated with BF duration. Quality of complementary food improved over time (6 months, 1.3 ± 1.3; 24 months, 3.8 ± 1.04). Compared with normal‐weight women, overweight and obese women were more likely to feed from more food groups (0.24 ± 0.11 point, P = 0.03), but this did not improve diet diversity from 6 to 24 months. IYCF index decreased throughout follow‐up (1 month, 7.8 ± 2.4; 24 months, 5.5 ± 1.8), and pBMI was not associated with IYCF (?0.11 ± 0.13 point, P = 0.4). We conclude that heavier women were not engaging in IYCF behaviours that were distinct from those of normal‐weight women from 1 to 24 months post‐partum.     

出生3个月内婴儿的碘营养状态及其对早期生长发育的影响

目的了解出生3个月内婴儿的碘营养状态及其对早期生长发育的影响。方法在非碘缺乏地区的上海随机选取122名出生3个月内的婴儿(母乳喂养儿68名,配方乳喂养儿54名)进行观察性研究。分别于婴儿日龄42d和90d时测定其母乳或配方乳及婴儿尿中的碘浓度,并对婴儿进行身长、体重和头围测量,婴儿90d时行Gesell智力发育评估。结果①42d和90d时婴儿尿碘浓度(中位数)分别为161.0μg/L和184.1μg/L;②母乳和配方乳喂养婴儿在42d和90d日龄时的尿碘浓度(中位数)分别为197.9μg/L、115.4μg/L和219.2μg/L、140.1μg/L;尿碘浓度低于100μg/L的比例分别为12.0%、42.4%和4.4%、33.6%;③母乳和配方乳的乳碘浓度(中位数)分别为109.1μg/L和88.9μg/L,均与婴儿尿碘浓度呈正相关(r=0.523,0.696);④出生3个月内不同碘营养状态的婴儿在体格和智能发育方面差异均无统计学意义。结论①部分婴儿存在碘营养不足或过多,应加强对婴儿碘营养状态的监测;②母乳喂养婴儿的碘营养状态优于配方乳喂养的婴儿,积极鼓励母乳喂养;③出生3个月内不同碘营养状态婴儿间的体格和智能发育尚未见明显差异,有待进一步随访观察。