The Panum Group, Bethesda, MD.
USDA, Food and Nutrition Service, Alexandria, VA.
Am J Clin Nutr. 2019 Mar 1;109(Suppl_7):990S-1002S. doi: 10.1093/ajcn/nqy276.
As part of the USDA-Department of Health and Human Services Pregnancy and Birth to 24 Months Project, we conducted systematic reviews (SRs) on topics important for health and nutrition of young children.
The purpose of the present SR was to examine the relation between caregiver feeding practices in children from birth to 24 mo and child weight gain, size, and body composition.
A search of articles published from January 1980 to January 2017 in 4 databases identified 8739 references. Nutrition Evidence Systematic Review (NESR) analysts used the Nutrition Evidence Library Risk of Bias Assessment Tool to assess potential bias in the studies, and a Technical Expert Collaborative graded the body of evidence using the NESR grading rubric.
Twenty-seven articles were included in this review (8 controlled trials, 19 longitudinal cohort studies). Moderate evidence from randomized controlled trials suggests that providing responsive feeding guidance to teach mothers to recognize and respond appropriately to children's hunger and satiety cues can lead to "normal" weight gain and/or "normal" weight status in children aged ≤2 y compared with children whose mothers did not receive responsive feeding guidance. Moderate evidence from longitudinal cohort studies indicates an association between maternal feeding practices and the child's weight status and/or weight gain, but the direction of effect has not been adequately studied. Restrictive feeding practices are associated with increased weight gain and higher weight status, and pressuring feeding practices are associated with decreased weight gain and lower weight status. Evidence suggests that a mother's feeding practices are related to concerns about her child's body weight.
This review highlights the importance of the interaction between caregivers and infants and toddlers related to child feeding practices on children's weight outcomes. Research is needed on more diverse populations with consistent methodological app-roaches and objective measures.
作为美国农业部- 美国卫生与公众服务部“怀孕与婴儿至 24 月龄”项目的一部分，我们针对与幼儿健康和营养相关的重要主题开展了系统评价（SR）。
本次 SR 的目的在于研究婴儿至 24 月龄期间照料者喂养行为与儿童体重增加、体型和身体成分之间的关系。
在 4 个数据库中检索 1980 年 1 月至 2017 年 1 月期间发表的文章，共确定了 8739 篇参考文献。营养证据系统评价（NESR）分析师使用营养证据库偏倚风险评估工具评估研究中的潜在偏倚，技术专家协作组使用 NESR 分级标准对证据体进行分级。
本综述纳入了 27 篇文章（8 项对照试验，19 项纵向队列研究）。随机对照试验的中等质量证据表明，提供响应式喂养指导以教导母亲识别并适当回应儿童的饥饿和饱腹感提示，可使 2 岁及以下儿童获得“正常”体重增加和/或“正常”体重状态，而其母亲未接受响应式喂养指导的儿童则不然。来自纵向队列研究的中等质量证据表明，母亲的喂养行为与儿童的体重状态和/或体重增加之间存在关联，但尚未充分研究作用方向。限制喂养行为与体重增加和较高的体重状态有关，而强迫喂养行为与体重减少和较低的体重状态有关。有证据表明，母亲的喂养行为与她对孩子体重的担忧有关。
本综述强调了照料者与婴幼儿之间互动相关的喂养行为对儿童体重结果的重要性。需要在更多样化的人群中开展具有一致方法学方法和客观测量的研究。
