Ha Pham Bich, Bentley Margaret E, Pachón Helena, Sripaipan Teerada, Caulfield Laura E, Marsh David R, Schroeder Dirk G
Save the Children, Hanoi, Viet Nam.
Food Nutr Bull. 2002 Dec;23(4 Suppl):95-100.
Style of child feeding may be an important determinant of child nutrition and health outcomes. Responsive feeding refers to the level and kind of interaction between caregiver and child that lead to a positive feeding experience, adequate dietary intake, and enhanced developmental opportunities. Responsive feeding behaviors may include active physical help and verbalization during feeding, role-playing, persistence, and positive feeding strategies. The aim of this study was to investigate styles of feeding among Vietnamese children 12 or 17 months of age from a rural province in northern Viet Nam. Forty child/mother pairs were videotaped during two, two-hour feeding episodes. Caregiver and child behaviors were coded at the level of the "intended bite" as observed through the videotape analysis of feeding episodes to assess caregiver behavior and the child's interest and acceptance of food. We found it feasible to use videotape and the modified coding and analysis scheme, originally developed for work in Peru, in Viet Nam. In Viet Nam, caregivers provided physical help to eat nearly all of the time for the younger children, and about 70% of the time among 17 month olds. Caregivers verbalized during only 30% of intended bites, and only half of these verbalizations were responsive in tone or words. Positive caregiver behaviors were significantly associated with higher child acceptance of food, while non-responsive feeding behaviors were associated with child rejection of food. Future analyses of this data set will evaluate the degree to which an integrated nutrition program positively modified caretaker behaviors. More research is needed to demonstrate the relationships among the promotion of responsive feeding behaviors, acceptance of food, and improved nutrition and health status of children.
儿童喂养方式可能是儿童营养和健康状况的一个重要决定因素。响应式喂养是指照顾者与儿童之间互动的程度和方式，这种互动会带来积极的喂养体验、充足的饮食摄入以及更多的发展机会。响应式喂养行为可能包括在喂养过程中的积极身体协助和言语表达、角色扮演、坚持以及积极的喂养策略。本研究的目的是调查越南北方一个农村省份12或17个月大的越南儿童的喂养方式。在两次两小时的喂养过程中，对40对儿童/母亲进行了录像。通过对喂养过程的录像分析，在“预期咬食”层面记录照顾者和儿童的行为，以评估照顾者的行为以及儿童对食物的兴趣和接受度。我们发现在越南使用最初为秘鲁的研究开发的录像以及改进后的编码和分析方案是可行的。在越南，照顾者几乎一直都会为年幼的孩子提供身体协助，在17个月大的孩子中，这一比例约为70%。照顾者在仅30%的预期咬食过程中有言语表达，而且这些言语表达中只有一半在语气或用词上是响应式的。照顾者的积极行为与儿童对食物的较高接受度显著相关，而非响应式喂养行为则与儿童拒绝食物相关。对该数据集的未来分析将评估综合营养计划对照顾者行为产生积极改变的程度。还需要更多研究来证明促进响应式喂养行为、食物接受度以及改善儿童营养和健康状况之间的关系。
