Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
United Nations Children's Fund (UNICEF) Programme Division, New York, New York.
Matern Child Nutr. 2018 Nov;14 Suppl 4(Suppl 4):e12650. doi: 10.1111/mcn.12650.
Although there has been a focus on preventing stunting over the past decade, wasting has received less policy and programmatic attention. Recent national surveys from six South Asian countries were pooled to generate a dataset of 62,509 children aged 0 to 59 months to explore associations between low birthweight (LBW) and suboptimal infant and young child feeding (IYCF) practices with child wasting, severe wasting, and the co-occurrence of wasting and stunting. Logistic regression models accounted for the surveys' clustered designs and adjusted for a potential confounding factors. Children with reported LBW had significantly higher odds of being wasted (adjusted odds ratio [95% CI]: 1.60 [1.45, 1.76]) or severely wasted (1.57 [1.34, 1.83]), compared with non-LBW children. Similarly, children aged 0 to 23 months who were not breastfed within the first hour post-partum, those who were provided prelacteal feeds, and those aged 0 to 5 months who were not exclusively breastfed, were more likely to be wasted (P < 0.05 for all three feeding practices). In India, not achieving minimum diet diversity and minimum adequate diet were significantly associated with the co-occurrence of stunting and wasting. In other words, many key domains of concern to development agents who seek to address stunting are also of direct concern to those focused on wasting. The co-occurrence of wasting and stunting requires more integrated interventions. That is, programmes aimed at preventing LBW and poor IYCF to avert stunting should be linked more effectively with actions aimed at the management of wasting.
尽管过去十年一直关注预防发育迟缓问题，但消瘦问题得到的政策和方案关注较少。最近，来自六个南亚国家的全国性调查数据被汇总，生成了一个包含 62509 名 0 至 59 个月大儿童的数据组，以探讨低出生体重（LBW）与婴幼儿喂养不足（IYCF）做法与儿童消瘦、严重消瘦和消瘦与发育迟缓同时存在之间的关联。逻辑回归模型考虑到了调查的聚类设计，并针对潜在的混杂因素进行了调整。与非 LBW 儿童相比，报告有 LBW 的儿童消瘦（调整后的优势比[95%CI]：1.60[1.45，1.76]）或严重消瘦（1.57[1.34，1.83]）的可能性显著更高。同样，出生后第一个小时内未进行母乳喂养、给予代乳品或 0 至 5 个月大的儿童未进行纯母乳喂养的儿童，消瘦的可能性更高（所有三种喂养方式的 P 值均<0.05）。在印度，未实现最低饮食多样性和最低充足饮食与发育迟缓与消瘦同时存在显著相关。换句话说，寻求解决发育迟缓问题的发展代理人关注的许多关键领域，也直接关系到那些关注消瘦问题的人。消瘦与发育迟缓同时存在需要更综合的干预措施。也就是说，旨在预防 LBW 和不良 IYCF 以避免发育迟缓的方案，应更有效地与旨在管理消瘦的行动联系起来。
