Tessema Masresha, Belachew Tefera, Ersino Getahun
Institute of Nutrition, Food Science and Technology, Department of Applied Human Nutrition, Hawassa University, Hawassa, Ethiopia.
Pan Afr Med J. 2013 Feb 26;14:75. doi: 10.11604/pamj.2013.14.75.1630. Print 2013.
The period from birth to two years of age is a "critical window" of opportunity for the promotion of optimal growth, health and behavioral development of children. Poor child feeding patterns combined with household food insecurity can lead to malnutrition which is a major public health problem in developing countries like Ethiopia.
A community based cross-sectional study that involved 575 participants from rural Sidama was conducted from February to March 2011. A two-stage stratified sampling procedure was employed to select the required households. Multivariable logistic regression analyses were performed to compare stunting by feeding patterns and other characteristics.
Only 14.4% of mothers fed their children optimally. Prevalence of stunting was higher for infants aged 6 to 8 months (43%) than for those in 0-5 months (26.6%) or 9-23 months (39%) category. Women who did not receive antenatal care (ANC) during pregnancy were 1.5 times more likely to practice pre-lacteal feeding and 2.8 and 1.9 times more likely to feed their children below minimum dietary diversity and minimum meal frequency, respectively (P=0.01). Mothers older than 18 years during the birth of index child were 86% less likely to feed their child below minimum meal frequency than their younger counterparts (P=0.01). Children who started complementary food either before or after the recommended 6 months time, were more likely to be stunted (P=0.01).
The feeding practices of most mothers did not meet WHO recommendations. Behavior change communication about the importance of optimal complementary feeding and ANC attendance should be strengthened through extensive use of the Health Extension Workers to reduce the level of child stunting in the study area.
从出生到两岁是促进儿童最佳生长、健康和行为发展的“关键窗口期”。不良的儿童喂养模式与家庭粮食不安全状况相结合,可能导致营养不良,这在埃塞俄比亚等发展中国家是一个重大的公共卫生问题。
2011年2月至3月进行了一项基于社区的横断面研究,涉及来自锡达马农村的575名参与者。采用两阶段分层抽样程序选择所需家庭。进行多变量逻辑回归分析,以比较不同喂养模式和其他特征下的发育迟缓情况。
只有14.4%的母亲以最佳方式喂养孩子。6至8个月大婴儿的发育迟缓患病率(43%)高于0至5个月(26.6%)或9至23个月(39%)年龄段的婴儿。孕期未接受产前护理(ANC)的妇女进行初乳前喂养的可能性高1.5倍,分别以低于最低饮食多样性和最低进餐频率喂养孩子的可能性高2.8倍和1.9倍(P = 0.01)。在生育指标儿童时年龄超过18岁的母亲,以低于最低进餐频率喂养孩子的可能性比年轻母亲低86%(P = 0.01)。在推荐的6个月之前或之后开始添加辅食的儿童,发育迟缓的可能性更大(P = 0.01)。
大多数母亲的喂养方式未达到世界卫生组织的建议。应通过广泛利用健康推广工作者,加强关于最佳辅食喂养和产前护理重要性的行为改变沟通,以降低研究地区儿童发育迟缓的程度。