Saaka Mahama, Wemakor Anthony, Abizari Abdul-Razak, Aryee Paul
University for Development Studies, School of Medicine and Health Sciences, P O Box TL 1883, Tamale, Ghana.
BMC Public Health. 2015 Nov 23;15:1157. doi: 10.1186/s12889-015-2494-7.
Though the World Health Organization (WHO) recommended Infant and Young Child Feeding (IYCF) indicators have been in use, little is known about their association with child nutritional status. The objective of this study was to explore the relationship between IYCF indicators (timing of complementary feeding, minimum dietary diversity, minimum meal frequency and minimum acceptable diet) and child growth indicators.
A community-based cross-sectional survey was carried out in November 2013. The study population comprised mothers/primary caregivers and their children selected using a two-stage cluster sampling procedure.
Of the 1984 children aged 6-23 months; 58.2 % met the minimum meal frequency, 34.8 % received minimum dietary diversity (≥4 food groups), 27.8 % had received minimum acceptable diet and only 15.7 % received appropriate complementary feeding. With respect to nutritional status, 20.5 %, 11.5 % and 21.1 % of the study population were stunted, wasted and underweight respectively. Multiple logistic regression analysis revealed that compared to children who were introduced to complementary feeding either late or early, children who started complementary feeding at six months of age were 25 % protected from chronic malnutrition (AOR = 0.75, CI = 0.50 - 0.95, P = 0.02). It was found that children whose mothers attended antenatal care (ANC) at least 4 times were 34 % protected [AOR 0.66; 95 % CI (0.50 - 0.88)] against stunted growth compared to children born to mothers who attended ANC less than 4 times. Children from households with high household wealth index were 51 % protected [AOR 0.49; 95 % CI (0.26 - 0.94)] against chronic malnutrition compared to children from households with low household wealth index. After adjusting for potential confounders, there was a significant positive association between appropriate complementary feeding index and mean WLZ (β = 0.10, p = 0.005) but was not associated with mean LAZ.
The WHO IYCF indicators better explain weight-for-length Z-scores than length-for-age Z-scores of young children in rural Northern Ghana. Furthermore, a composite indicator comprising timely introduction of solid, semi-solid or soft foods at 6 months, minimum meal frequency, and minimum dietary diversity better explains weight-for-length Z-scores than each of the single indicators.
尽管世界卫生组织（WHO）推荐的婴幼儿喂养（IYCF）指标已在使用，但对于这些指标与儿童营养状况之间的关联却知之甚少。本研究的目的是探讨IYCF指标（辅食添加时间、最低饮食多样性、最低进餐频率和最低可接受饮食）与儿童生长指标之间的关系。
2013年11月开展了一项基于社区的横断面调查。研究人群包括通过两阶段整群抽样程序选取的母亲/主要照料者及其子女。
在1984名6 - 23个月大的儿童中，58.2%达到了最低进餐频率，34.8%的儿童饮食具有最低多样性（≥4个食物类别），27.8%的儿童接受了最低可接受饮食，只有15.7%的儿童接受了适当的辅食添加。在营养状况方面，研究人群中分别有20.5%、11.5%和21.1%的儿童发育迟缓、消瘦和体重不足。多因素逻辑回归分析显示，与辅食添加过晚或过早的儿童相比，6个月开始添加辅食的儿童患慢性营养不良的风险降低25%（调整后比值比[AOR]=0.75，可信区间[CI]=0.50 - 0.95，P = 0.02）。结果发现，与母亲产前检查（ANC）次数少于4次的儿童相比，母亲至少进行4次ANC的儿童发育迟缓的风险降低34%[AOR 0.66；95%CI（0.50 - 0.88）]。与家庭财富指数低的家庭的儿童相比，家庭财富指数高的家庭的儿童患慢性营养不良的风险降低51%[AOR 0.49；95%CI（0.26 - 0.94）]。在对潜在混杂因素进行调整后，适当的辅食添加指数与平均WLZ之间存在显著正相关（β = 0.10，p = 0.005），但与平均LAZ无关。
在加纳北部农村地区，WHO的IYCF指标对幼儿身长别体重Z评分的解释力优于年龄别身长Z评分。此外，一个综合指标，包括6个月时及时引入固体、半固体或软食、最低进餐频率和最低饮食多样性，对身长别体重Z评分的解释力优于每个单一指标。
