Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27516, USA.
Matern Child Nutr. 2013 Jul;9(3):369-80. doi: 10.1111/j.1740-8709.2011.00377.x. Epub 2011 Nov 24.
Caregiver and child behaviours during feeding have been used to measure responsiveness, which has been recognised as important for child growth and development. The aims of this study were to understand how caregiver and child behaviours differ when feeding lipid-based nutrient supplements (LNS) vs. local complementary food and to detect associations between behaviours and child interest in food. Sixteen moderately underweight 6-17-month-old Malawian children receiving 50 g/day of supplementary LNS for 12 weeks were videotaped during LNS (n = 32) and local complementary feeding (n = 28) episodes. Behaviours were coded at the level of the intended bite (1674 total bites). The analysis used regression models adjusted for within-subject correlation. Caregivers were less likely to allow children to self-feed and more likely to use physical pressure during LNS vs. complementary food bites. Positive caregiver verbalization was infrequent and did not differ by type of food. Higher odds of accepting a bite were associated with the bite containing LNS, odds ratio (OR) 3.05; 90% confidence interval (CI) (1.98, 4.71), the child self-feeding, OR 5.70; 90% CI (2.77, 11.69), and positive caregiver verbalization, OR 2.46; 90% CI (1.26, 4.80), while lower odds of acceptance were associated with negative child verbalization during feeding, OR 0.27; 90% CI (0.17, 0.42). In this sample, caregivers used more responsive feeding practices during bites of local complementary food and were more controlling when feeding LNS. Responsive caregiver behaviours predicted child acceptance of food. These results could be used to design interventions in Malawi to improve responsive feeding practices in general and during LNS use.
在喂养过程中，照顾者和儿童的行为被用来衡量反应能力，这已被认为对儿童的生长和发育很重要。本研究的目的是了解在喂养脂基营养素补充剂（LNS）与当地补充食物时，照顾者和儿童行为的差异，并发现行为与儿童对食物的兴趣之间的关联。16 名中度体重不足的 6-17 个月大的马拉维儿童，在 12 周内每天接受 50 克补充 LNS，在 LNS（n=32）和当地补充喂养（n=28）期间被录像。行为按预期的一口（1674 总口）进行编码。分析使用了调整了个体内相关性的回归模型。与补充食物相比，照顾者更不可能允许儿童自己进食，更有可能在 LNS 喂食时使用身体压力。积极的照顾者言语表达很少见，且与食物类型无关。接受一口的几率更高与包含 LNS 的一口有关，比值比（OR）为 3.05；90%置信区间（CI）（1.98，4.71），儿童自己进食，OR 为 5.70；90%CI（2.77，11.69），积极的照顾者言语表达，OR 为 2.46；90%CI（1.26，4.80），而接受几率较低与喂食时儿童负面言语有关，OR 为 0.27；90%CI（0.17，0.42）。在这个样本中，照顾者在当地补充食物的喂食过程中使用了更具反应性的喂养方式，在喂食 LNS 时则更具控制性。反应性的照顾者行为预测了儿童对食物的接受程度。这些结果可用于在马拉维设计干预措施，以改善一般情况下的反应性喂养实践和使用 LNS 时的喂养实践。
