Abebe Zeweter, Haki Gulelat Desse, Baye Kaleab
Center for Food Science and Nutrition, College of Natural Sciences, POBOX 1176, Addis Ababa University, Addis Ababa, Ethiopia.
Botswana College of Agriculture, Gaborone, Botswana.
Appetite. 2017 Sep 1;116:132-138. doi: 10.1016/j.appet.2017.04.033. Epub 2017 Apr 29.
Little is known about mother-child feeding interactions and how this is associated with food intake and linear growth.
To characterize mother-child feeding styles and investigate their associations with accepted mouthful and linear growth in west Gojam, rural Ethiopia.
SUBJECTS/DESIGN: Two, in-home, meal observations of children aged 12-23 months (n = 100) were video-taped. The number of mouthful accepted was counted and the caregiver/child feeding styles were coded into positive/negative categories of self-feeding, responsive-feeding, active-feeding, social-behavior and distraction. Data on socio-demographic characteristics, child feeding practices, perception about child's overall appetite, and strategies adopted to overcome food refusal were collected through questionnaire-based interviews. Child and mothers' anthropometric measurements were also taken.
Stunting was highly prevalent (48%) and the number of mouthful accepted was very low. Offering breastmilk and threatening to harm were the main strategies adopted to overcome food refusal. Although all forms of feeding style were present, active positive feeding style was dominant (90%) and was positively associated with mouthful accepted. Talking with non-feeding partner (64%), and domestic animals (24%) surrounding the feeding place were common distractions of feeding. Feeding was mostly terminated by caregivers (75%), often prematurely. Overall, caregivers of stunted children had poorer complementary- and breast-feeding practices and were less responsive to child's hunger and satiation cues (P < 0.05). Positive responsive feeding behaviors were associated with child's number of mouthful accepted (r = 0.27; P = 0.007) and stunting (r = 0.4; P < 0.001).
Low complementary food intake in this setting is associated with caregivers' feeding style and stunting. Nutrition interventions that reinforce messages of optimal infant and young child feeding and integrate the promotion of responsive feeding behaviors are needed.
关于母婴喂养互动及其与食物摄入量和线性生长的关联，我们了解甚少。
在埃塞俄比亚农村的西戈贾姆地区，描述母婴喂养方式，并调查其与进食口数及线性生长的关联。
对象/设计：对100名12至23个月大的儿童进行了两次在家进餐观察，并录制了视频。记录接受的口数，并将照顾者/儿童的喂养方式编码为自主进食、响应式喂养、主动喂养、社交行为和分散注意力的积极/消极类别。通过问卷调查收集社会人口学特征、儿童喂养习惯、对儿童总体食欲的看法以及克服食物拒绝所采用策略的数据。还对儿童和母亲进行了人体测量。
发育迟缓非常普遍（48%），接受的口数非常少。提供母乳和威胁伤害是克服食物拒绝所采用的主要策略。尽管存在各种喂养方式，但主动积极的喂养方式占主导（90%），且与接受的口数呈正相关。与非喂养伙伴交谈（64%）以及喂养场所周围的家畜（24%）是常见的喂养干扰因素。喂养大多由照顾者终止（75%），且往往过早终止。总体而言，发育迟缓儿童的照顾者在辅食和母乳喂养方面的做法较差，对儿童的饥饿和饱腹感线索反应较弱（P<0.05）。积极的响应式喂养行为与儿童接受的口数（r=0.27；P=0.007）和发育迟缓（r=0.4；P<0.001）相关。
在这种情况下，辅食摄入量低与照顾者的喂养方式及发育迟缓有关。需要开展营养干预，强化关于婴幼儿最佳喂养的信息，并促进响应式喂养行为。
