School of Public Health, 33014 University of Tampere, Finland.
Appetite. 2010 Jun;54(3):504-11. doi: 10.1016/j.appet.2010.02.003. Epub 2010 Feb 11.
The way caregivers use supplementary food for undernourished children and integrate it into feeding patterns may influence the benefits achieved by supplementation. We studied feeding patterns and behaviors in 170 underweight 6-17-month-olds who received either lipid-based nutrient supplements (LNS) (n=85) or corn-soy blend (CSB) (n=85) during a 12-week intervention trial in southern Malawi. Observational data were collected during one 11h home visit per participant. Differences were assessed by study group and by mode of serving LNS. Associations between selected caregiver behaviors and child growth were also tested. We found no difference between the CSB and LNS groups in mean number of feeding episodes per day or mean daily feeding time. Caregivers fed the child with a spoon, washed their hands before feeding, and there were leftovers significantly more often in the CSB than LNS group and when LNS mixed with porridge and plain LNS were compared. This suggests that differences between the groups were linked to the mode of serving LNS. Presence of leftovers was negatively associated with change in child's WAZ. Programs promoting LNS in Malawi should consider behaviors related to mode of serving and provide advice to caregivers in order to minimize leftovers during supplement use.
照料者喂养营养不良儿童的辅食方式和喂养模式可能会影响补充的效果。我们在马拉维南部进行了一项为期 12 周的干预试验，研究了 170 名体重不足 6-17 个月的儿童的喂养模式和行为，他们分别接受了脂基营养补充剂（LNS）（n=85）或玉米-大豆混合物（CSB）（n=85）。每个参与者在一次为期 11 小时的家庭访问中收集观察数据。通过研究组和 LNS 的供应方式评估差异。还测试了选定的照顾者行为与儿童生长之间的关联。我们发现 CSB 组和 LNS 组每天的平均喂养次数或平均每日喂养时间没有差异。照顾者用勺子喂孩子，在喂养前洗手，CSB 组比 LNS 组和比较时与粥混合的 LNS 组剩饭剩菜的情况明显更多。这表明组间差异与 LNS 的供应方式有关。剩饭剩菜的存在与儿童 WAZ 的变化呈负相关。在马拉维推广 LNS 的项目应考虑与供应方式相关的行为，并向照顾者提供建议，以尽量减少补充剂使用过程中的剩饭剩菜。
