Pandey Sharada, Tiwari Kalpana, Senarath Upul, Agho Kingsley E, Dibley Michael J
Ministry of Health, Kathmandu, Nepal.
Food Nutr Bull. 2010 Jun;31(2):334-51. doi: 10.1177/156482651003100222.
Childhood undernutrition and mortality are high in Nepal, and therefore interventions on infant and young child feeding practices deserve high priority.
To estimate infant and young child feeding indicators and the determinants of selected feeding practices.
The sample consisted of 1906 children aged O to 23 months from the Demographic and Health Survey 2006. Selected indicators were examined against a set of variables using univariate and multivariate analyses.
Breastfeeding was initiated within the first hour after birth in 35.4% of children, 99.5% were ever breastfed, 98.1% were currently breastfed, and 3.5% were bottle-fed. The rate of exclusive breastfeeding among infants under 6 months of age was 53.1%, and the rate of timely complementary feeding among those 6 to 9 months of age was 74.7%. Mothers who made antenatal clinic visits were at a higher risk for no exclusive breastfeeding than those who made no visits. Mothers who lived in the mountains were more likely to initiate breastfeeding within 1 hour after birth and to introduce complementary feeding at 6 to 9 months of age, but less likely to exclusively breastfeed. Cesarean deliveries were associated with delay in timely initiation of breastfeeding. Higher rates of complementary feeding at 6 to 9 months were also associated with mothers with better education and those above 35 years of age. Risk factors for bottle-feeding included living in urban areas and births attended by trained health personnel.
Most breastfeeding indicators in Nepal are below the expected levels to achieve a substantial reduction in child mortality. Breastfeeding promotion strategies should specifically target mothers who have more contact with the health care delivery system, while programs targeting the entire community should be continued.
尼泊尔儿童营养不良和死亡率很高,因此对婴幼儿喂养方式的干预值得高度重视。
评估婴幼儿喂养指标以及特定喂养方式的决定因素。
样本包括来自2006年人口与健康调查的1906名0至23个月大的儿童。使用单变量和多变量分析,针对一组变量检查选定指标。
35.4%的儿童在出生后1小时内开始母乳喂养,99.5%的儿童曾经接受过母乳喂养,98.1%的儿童目前正在接受母乳喂养,3.5%的儿童使用奶瓶喂养。6个月以下婴儿的纯母乳喂养率为53.1%,6至9个月婴儿的及时添加辅食率为74.7%。进行产前检查的母亲纯母乳喂养率低于未进行产前检查的母亲。居住在山区的母亲在出生后1小时内开始母乳喂养以及在6至9个月时添加辅食的可能性更大,但纯母乳喂养的可能性较小。剖宫产与母乳喂养的及时开始延迟有关。6至9个月时较高的辅食添加率也与受教育程度较高和年龄在35岁以上的母亲有关。奶瓶喂养的危险因素包括居住在城市地区以及由受过培训的卫生人员接生。
尼泊尔的大多数母乳喂养指标低于实现大幅降低儿童死亡率的预期水平。母乳喂养促进策略应特别针对与医疗保健系统接触较多的母亲,同时应继续开展针对整个社区的项目。