Lamichhane Dirga Kumar, Leem Jong Han, Kim Hwan Cheol, Park Myung Sook, Lee Ji Young, Moon So Hyun, Ko Jung Keun
a Departments of Social and Preventive Medicine , School of Medicine, Inha University , Incheon , Korea.
b Departments of Occupational and Environmental Medicine , School of Medicine, Inha University , Incheon , Korea.
Paediatr Int Child Health. 2016 Nov;36(4):260-269. doi: 10.1080/20469047.2015.1109281. Epub 2016 Feb 10.
Childhood undernutrition remains a highly influential risk factor in terms of the global burden of disease. Increasing evidence links infant and young child feeding (IYCF) practices to undernutrition. However, the results are inconsistent, and more country-specific studies are needed.
To determine the associations between IYCF practices and nutritional outcomes among children aged 0-23 months using a nationally representative dataset.
The study used data from the 2011 Nepal Demographic and Health Survey, and the data were analysed for children aged 0-23.9 months who had corresponding data for the outcome variables of interest (n = 890). Multiple linear and logistic regressions were undertaken and adjusted for the complex design of the survey, controlling for child, maternal, household and community characteristics.
Of the 890 children included in the study, 83% received age-appropriate breastfeeding but only 48% were breastfed within 1 hour of birth. Exclusive breastfeeding under 6 months of age was associated with a higher weight-for-age Z-score (WAZ) and a lower probability of wasting, but the estimated effects were of borderline significance. A significant negative association was found between continued breastfeeding at 1 year and WAZ and weight-for-height Z-score (WHZ). Timely introduction of complementary feeding in children aged 6-8 months was associated with a higher WAZ [effect size (ES) 0.6, P < 0.01] and higher WHZ (ES 0.6, P < 0.05). Higher dietary diversity index (DDI) was associated with higher height-for-age Z-score (ES 0.1, P < 0.05 for each DDI point). Children who achieved minimum meal frequency had a higher WAZ (ES 0.3, P < 0.05).
This is the first study to relate the wide ranges of IYCF indicators with child nutritional outcomes in Nepal, and it underscores the need to improve age-appropriate complementary feeding practices with a sustained focus on exclusive breastfeeding to reduce undernutrition in infants and young children.
儿童营养不良在全球疾病负担方面仍然是一个极具影响力的风险因素。越来越多的证据表明婴幼儿喂养（IYCF）方式与营养不良有关。然而，结果并不一致，需要更多针对具体国家的研究。
使用具有全国代表性的数据集确定0至23个月儿童的婴幼儿喂养方式与营养结果之间的关联。
该研究使用了2011年尼泊尔人口与健康调查的数据，并对年龄在0至23.9个月且具有相关感兴趣结局变量数据的儿童（n = 890）进行了分析。进行了多元线性和逻辑回归，并针对调查的复杂设计进行了调整，同时控制了儿童、母亲、家庭和社区特征。
在纳入研究的890名儿童中，83%接受了适龄母乳喂养，但只有48%在出生后1小时内进行了母乳喂养。6个月以下纯母乳喂养与较高的年龄别体重Z评分（WAZ）以及较低的消瘦概率相关，但估计效果具有临界显著性。1岁时继续母乳喂养与WAZ和身高别体重Z评分（WHZ）之间存在显著负相关。6至8个月儿童及时引入辅食与较高的WAZ（效应量[ES] 0.6，P < 0.01）和较高的WHZ（ES 0.6，P < 0.05）相关。较高的饮食多样性指数（DDI）与较高的年龄别身高Z评分相关（每个DDI点的ES为0.1，P < 0.05）。达到最低进餐频率的儿童WAZ较高（ES 0.3，P < 0.05）。
这是第一项将广泛的婴幼儿喂养指标与尼泊尔儿童营养结果相关联的研究，强调了需要改善适龄辅食喂养方式，并持续关注纯母乳喂养，以减少婴幼儿营养不良。
