Hipgrave D B, Fu X, Zhou H, Jin Y, Wang X, Chang S, Scherpbier R W, Wang Y, Guo S
1] Health Section, UNICEF, New York, NY, USA [2] Health, Nutrition and WASH Section, UNICEF Office for China, Beijing, China.
Health, Nutrition and WASH Section, UNICEF Office for China, Beijing, China.
Eur J Clin Nutr. 2014 Aug;68(8):916-24. doi: 10.1038/ejcn.2014.98. Epub 2014 Jun 4.
BACKGROUND/OBJECTIVES: Infant and young child feeding (IYCF) has not been documented in central and western China, where anaemia is prevalent. To support policy advocacy, we assessed IYCF and anaemia there using standardized methods.
SUBJECTS/METHODS: A community-based, cross-sectional survey of 2244 children aged 6-23 months in 26 counties of 12 provinces. Analysis of associations between haemoglobin concentration (HC), IYCF indicators and other variables using crude and multivariate techniques.
Only 41.6% of those surveyed consumed a minimum acceptable diet. Fewer still-breastfeeding than non-breastfeeding children consumed the recommended minimum dietary diversity (51.7 versus 71.9%; P<0.001), meal frequency (57.7% v. 81.5%; P<0.001) or iron-rich food (63.3% v. 78.9%; P<0.001). Anaemia (51.3% overall) fell with age but was significantly associated with male sex, extreme poverty, minority ethnicity, breastfeeding and higher altitude. Dietary diversity, iron intake, growth monitoring and being left behind by out-migrating parents were protective against anaemia. A structural equation model demonstrated associations between IYCF, HC and other variables. Meal frequency, iron intake and altitude were directly and positively associated with HC; dietary diversity was indirectly associated. Health service uptake was not associated. Continued breastfeeding was directly associated with poor IYCF and indirectly with reduced HC, as were having a sibling and poor maternal education.
Infant and young child anaemia is highly prevalent and IYCF is poor in rural central and western China. Continued breastfeeding and certain other variables indicate risk of poor IYCF and anaemia. Major policy commitment to reducing iron deficiency and improving IYCF is needed for China's rural poor.
背景/目标：中国中西部地区贫血症普遍，但婴幼儿喂养情况尚无记录。为支持政策倡导，我们采用标准化方法评估了该地区的婴幼儿喂养及贫血情况。
对象/方法：对12个省份26个县的2244名6至23个月大的儿童进行了基于社区的横断面调查。运用原始和多变量技术分析血红蛋白浓度（HC）、婴幼儿喂养指标与其他变量之间的关联。
只有41.6%的受调查儿童摄入了最低可接受饮食。纯母乳喂养儿童中摄入推荐的最低饮食多样性（51.7%对71.9%；P<0.001）、进餐频率（57.7%对81.5%；P<0.001）或富含铁食物（63.3%对78.9%；P<0.001）的比例低于非纯母乳喂养儿童。贫血症总体患病率为51.3%，随年龄增长而下降，但与男性、极端贫困、少数民族、母乳喂养及海拔较高显著相关。饮食多样性、铁摄入量、生长监测以及父母外出务工后被留守对贫血症有预防作用。结构方程模型显示了婴幼儿喂养、血红蛋白浓度与其他变量之间的关联。进餐频率、铁摄入量和海拔与血红蛋白浓度直接正相关；饮食多样性间接相关。医疗服务利用情况与之无关。持续母乳喂养与不良的婴幼儿喂养直接相关，与血红蛋白浓度降低间接相关，有兄弟姐妹和母亲教育程度低也有类似情况。
中国中西部农村地区婴幼儿贫血症非常普遍，婴幼儿喂养情况不佳。持续母乳喂养及某些其他变量表明存在不良婴幼儿喂养和贫血症风险。中国农村贫困人口需要在减少缺铁和改善婴幼儿喂养方面做出重大政策承诺。
