Ghosh Shanti, Kilaru Asha, Ganapathy Saraswathy
Belaku Trust, Bangalore 560078.
J Indian Med Assoc. 2002 Aug;100(8):483-4, 486-8, 490.
Growth faltering and malnutrition are highly prevalent in most South Asian countries. Among the serious consequences of malnutrition are increased risks of morbidity and mortality in children as well as deficits in physical stature and lowered cognitive measures. Childhood malnutrition in poor households has been well documented in India, with the highest rates observed in those aged 12-23 months. Countrywide National Family Health Survey II (NFHS II) data show mean underweight prevalence increases from 11.9% among infants under six months of age to 58.4% at 12-23 months of age. This paper discusses the results of an analysis of a longitudinal community-based study of infant growth feeding and care practices in rural south India, for which data have been collected since 1997 and completed in May 2001. In 1998 an intervention began in which a monthly visit for nutrition counselling was made by a trained worker. Mothers were counselled about the need for exclusive breastfeeding for four to six months, choice of appropriate complementary foods, and feeding frequency. Infants enrolled in the study prior to 1998, did not receive this intervention in the first year of life. Using bivariate analysis and regression modelling, weight velocity and feeding practices for intervention and non-intervention infants, controlling for a range of socio-economic and demographic factors for infants aged 6 to 10 months, are compared. Both descriptive and multivariate analyses show a statistically significant positive association between intervention and weight velocity for female infants. The intervention group as a whole had improved feeding practices such as avoidance of feeding bottle and increased variety of foods. The implication of this association, in a culture where discrimination against females exists, is promising for the development of low-cost educational interventions to improve nutritional status without the need to provide supplementary food.
生长发育迟缓与营养不良在大多数南亚国家极为普遍。营养不良的严重后果包括儿童发病和死亡风险增加，以及身材矮小和认知能力下降。印度贫困家庭儿童营养不良的情况已有充分记录，其中12至23个月大的儿童患病率最高。全国第二次家庭健康调查（NFHS II）数据显示，体重不足的平均患病率从6个月以下婴儿的11.9%升至12至23个月大婴儿的58.4%。本文讨论了一项基于社区的印度南部农村婴儿生长、喂养和护理实践纵向研究的分析结果，该研究自1997年开始收集数据，并于2001年5月完成。1998年开始了一项干预措施，由一名经过培训的工作人员每月进行一次营养咨询访问。向母亲们提供了关于纯母乳喂养四至六个月的必要性、选择合适的辅食以及喂养频率的咨询。1998年之前参加该研究的婴儿在出生后的第一年没有接受这种干预。通过双变量分析和回归模型，比较了干预组和非干预组6至10个月大婴儿的体重增长速度和喂养方式，并控制了一系列社会经济和人口因素。描述性分析和多变量分析均显示，干预措施与女婴体重增长速度之间存在统计学上显著的正相关。干预组总体上改善了喂养方式，如避免使用奶瓶喂养和增加食物种类。在存在对女性歧视的文化背景下，这种关联对于开发低成本的教育干预措施以改善营养状况而无需提供补充食物具有积极意义。
