Kalanda B F, Verhoeff F H, Brabin B J
Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK.
Eur J Clin Nutr. 2006 Mar;60(3):401-7. doi: 10.1038/sj.ejcn.1602330.
The objective of this study was to compare growth, morbidity incidence and risk factors for undernutrition between infants receiving complementary feeding early, before 3 months of age, with those receiving complementary foods after 3 months in a poor rural Malawian community.
A cohort of babies was enrolled at birth for follow-up to 12 months of age. Weight, length, morbidity and feeding patterns were recorded at 4 weekly intervals from birth to 52 weeks.
Mean age at introduction of water was 2.5 months (range 0-11.8), complementary foods 3.4 months (range, 1.0-10.7) and solids 4.5 months (range 1.2-13.8). Over 40% of infants had received complementary foods by 2 months and 65% by 3 months. The proportion of exclusively breast-fed infants, which included those receiving supplemental water, was 13% at 4 months, 6.3% at 5 months and 1.5% at 6 months. Infants with early complementary feeding had lower weight for age at 3 and 6 months (P<0.05), and at 9 months (P=0.07) and at 2 months they were approximately 200 g lighter. Early complementary feeding was significantly associated with increased risk for respiratory infection (P<0.05), and marginally increased risk for eye infection and episodes of malaria. Maternal illiteracy was associated with early complementary feeding (OR=2.1, 95% CI 1.3, 3.2), while later complementary feeding was associated with reduced infant morbidity and improved growth.
Breast-feeding promotion programmes should target illiterate women. Greater emphasis is required to improve complementary feeding practices.
本研究的目的是比较在马拉维农村贫困社区中，3个月龄前开始接受辅食的婴儿与3个月龄后开始接受辅食的婴儿之间的生长情况、发病率以及营养不良的风险因素。
一组婴儿在出生时登记入组，随访至12个月龄。从出生到52周，每4周记录一次体重、身长、发病率和喂养模式。
开始喂水的平均年龄为2.5个月（范围0 - 11.8个月），开始添加辅食的平均年龄为3.4个月（范围1.0 - 10.7个月），开始添加固体食物的平均年龄为4.5个月（范围1.2 - 13.8个月）。超过40%的婴儿在2个月时已接受辅食，65%在3个月时已接受辅食。纯母乳喂养婴儿（包括接受补充水的婴儿）的比例在4个月时为13%，5个月时为6.3%，6个月时为1.5%。早期添加辅食的婴儿在3个月、6个月时年龄别体重较低（P<0.05），9个月时（P = 0.07）也是如此，且在2个月时体重约轻200克。早期添加辅食与呼吸道感染风险增加显著相关（P<0.05），眼部感染和疟疾发作风险略有增加。母亲文盲与早期添加辅食相关（OR = 2.1，95% CI 1.3，3.2），而较晚添加辅食与婴儿发病率降低和生长改善相关。
母乳喂养促进项目应以文盲妇女为目标人群。需要更加强调改善辅食添加做法。
