Flax Valerie L, Ashorn Ulla, Phuka John, Maleta Kenneth, Manary Mark J, Ashorn Per
School of Public Health, Tampere University, Tampere, Finland.
Matern Child Nutr. 2008 Jan;4(1):65-73. doi: 10.1111/j.1740-8709.2007.00098.x.
Fortified spread (FS), containing dry food particles embedded in edible fat, offers a convenient means for nutrition rehabilitation. To describe how caregivers feed FS to their undernourished children at home, and how FS use affects other feeding patterns, we conducted a longitudinal observational study in rural Malawi. Sixteen 6- to 17-month-old underweight children (weight-for-age z-score < -2.0; -3.0 < weight-for-height z-score < 0) received FS for 12 weeks. Twelve-hour observations were conducted before supplementation and during weeks 1, 4, 8 and 12 of FS use. FS was fed to children about two times per day; each serving was 15-20 g. The spread was first used mainly alone as a between-meal snack, and then became integrated into the typical complementary feeding pattern by being mixed with porridge. Introduction of FS reduced the number of plain porridge meals, but did not decrease the total number of meals or breastfeeds per day and did not change the daily mean time caregivers spent on feeding. Children accepted the FS well, but more FS was wasted when it was offered mixed with porridge than when given alone (23.6% vs. 1.2%, 95% CI for the difference 13.2% to 31.6%). FS supplementation is feasible for community-based nutrition interventions in Malawi because it easily becomes part of the feeding routine, does not replace other foods and does not take extra caregiver time. To limit wastage, caregivers should be advised to serve FS plain or to mix it with only a small quantity of porridge.
强化涂抹酱（FS），即在食用脂肪中嵌入干粮颗粒，为营养康复提供了一种便捷的方式。为了描述照顾者如何在家中给营养不良的孩子喂食FS，以及FS的使用如何影响其他喂养模式，我们在马拉维农村进行了一项纵向观察研究。16名6至17个月大的体重不足儿童（年龄别体重Z评分＜-2.0；身高别体重Z评分-3.0＜Z评分＜0）接受了12周的FS喂养。在补充前以及使用FS的第1、4、8和12周进行了12小时的观察。FS每天大约喂给孩子两次；每份为15至20克。这种涂抹酱最初主要单独用作两餐之间的零食，然后通过与粥混合融入典型的辅食喂养模式。FS的引入减少了单纯粥餐的次数，但没有减少每日餐食总数或母乳喂养次数，也没有改变照顾者每天平均花费在喂养上的时间。孩子们对FS接受良好，但与单独喂食相比，与粥混合喂食时浪费的FS更多（23.6%对1.2%，差异的95%置信区间为13.2%至31.6%）。在马拉维，FS补充剂对于基于社区的营养干预是可行的，因为它很容易成为喂养常规的一部分，不会替代其他食物，也不会占用照顾者额外的时间。为了减少浪费，应建议照顾者单独提供FS或将其仅与少量粥混合。
