Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, Beijing, China.
Matern Child Nutr. 2013 Jan;9(1):118-29. doi: 10.1111/j.1740-8709.2012.00447.x. Epub 2012 Oct 1.
Inappropriate complementary feeding practices have led to, in part, significant disparities in growth and nutritional status between rural and urban children in China. A cluster-randomised, controlled trial was implemented in Laishui, China to assess the effectiveness of an educational intervention on caregivers' feeding practices and children's growth. Eight townships were randomly assigned to the intervention or control. Five hundred ninety-nine healthy infants were enrolled at 2-4 months old, and were followed up at ages 6, 9, 12, 15 and 18 months. The intervention group received information on enhanced home-prepared recipes and food preparation and hygiene through group training, counselling and home visit. Key outcomes were children's physical growth, caregivers' knowledge and behaviours on complementary feeding, and the infant and child feeding index (ICFI). Analysis was by intention to treat. The intervention group achieved better knowledge and practices related to complementary feeding, and significantly higher ICFI scores at each follow-up point. Children in the intervention group achieved higher z-scores for weight-for-age (WAZ) and weight-for-height (WHZ) than the control (0.18 vs. 0.01 and 0.49 vs. 0.19, respectively) at 18 months old, and were less likely to have stunted growth (odds ratio = 0.71, 95% confidence interval: 0.53-0.94). Mixed model showed that the intervention group achieved significantly better linear growth over time, including WAZ (P = 0.016), WHZ (P = 0.030) and HAZ (P = 0.078). These results indicated that an educational intervention delivered through local health services can enhance caregivers' knowledge and practices of complementary feeding and ultimately improve children's growth.
不当的补充喂养实践导致中国农村和城市儿童的生长和营养状况存在显著差异。在中国涞水实施了一项整群随机对照试验，以评估针对照顾者喂养实践和儿童生长的教育干预的效果。将 8 个乡镇随机分配到干预组或对照组。在 2-4 个月大时招募了 599 名健康婴儿，并在 6、9、12、15 和 18 个月时进行随访。干预组通过小组培训、咨询和家访获得关于增强家庭自制食谱和食品制备及卫生的信息。主要结局是儿童的体格生长、照顾者对补充喂养的知识和行为以及婴幼儿喂养指数（ICFI）。分析采用意向治疗。干预组在补充喂养方面的知识和实践均得到改善，并且在每个随访点的 ICFI 评分均显著升高。干预组儿童的体重与年龄比值（WAZ）和体重与身高比值（WHZ）在 18 个月时高于对照组（分别为 0.18 比 0.01 和 0.49 比 0.19），并且生长迟缓的可能性更低（比值比=0.71，95%置信区间：0.53-0.94）。混合模型显示，干预组在整个随访期间的线性生长情况更好，包括 WAZ（P=0.016）、WHZ（P=0.030）和 HAZ（P=0.078）。这些结果表明，通过当地卫生服务提供的教育干预可以增强照顾者对补充喂养的知识和实践，最终改善儿童的生长。
