Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA; Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
American Academy of Pediatrics, Department of Research, Itasca, IL.
J Nutr Educ Behav. 2020 Jan;52(1):31-38. doi: 10.1016/j.jneb.2019.10.006. Epub 2019 Nov 21.
Assess pediatrician practices around growth and nutrition for children under 2 years.
2017 cross-sectional survey of a national random sample of the American Academy of Pediatrics members.
US.
Practicing primary care pediatricians and residents (n = 698).
World Health Organization growth chart use, solid food introduction recommendations, healthy behaviors discussion.
Descriptive statistics were calculated for nutrition-related questions. McNemar tests compared recommendations on the introduction of different solid foods at <6 months; chi-square tests of independence examined outcomes by pediatrician and practice characteristics.
Most respondents (82.2%) reported using the World Health Organization growth charts at all well visits. Nearly half (45.3%) recommended solid food introduction at 6 months; 48.2% recommended <6 months. Cereals were more frequently recommended at <6 months than fruits/vegetables or meats (P <.001). Topics most frequently discussed were limiting juice (92.3%), and sugar-sweetened beverages (92.0%), avoiding restrictive and permissive food practices (30.7%), and avoiding food as a reward (29.1%) were least discussed. Pediatricians in hospital/clinic settings discussed healthy behaviors less than group or solo/2-physician practices.
For children under 2 years, most pediatricians reported using recommended growth charts and discussing healthy behaviors. Fewer discussed responsive feeding topics. Results for guiding solid food introduction were mixed. Continued efforts to support pediatricians' work could improve the implementation of recommended practices.
评估儿科医生在 2 岁以下儿童生长和营养方面的实践情况。
2017 年对美国儿科学会成员进行的全国随机样本横断面调查。
美国。
从事初级保健儿科工作的医生和住院医师（n=698）。
使用世界卫生组织生长图表、固体食物引入建议、健康行为讨论。
对与营养相关的问题进行了描述性统计分析。McNemar 检验比较了在 6 个月之前引入不同固体食物的建议；卡方检验独立性检验了儿科医生和实践特征的结果。
大多数受访者（82.2%）在所有就诊时都报告使用世界卫生组织生长图表。近一半（45.3%）建议在 6 个月时引入固体食物；48.2%建议在 6 个月之前。在 6 个月之前，谷物比水果/蔬菜或肉类更常被推荐（P <.001）。最常讨论的主题是限制果汁（92.3%）和含糖饮料（92.0%），避免限制和放任的食物行为（30.7%）和避免食物作为奖励（29.1%）讨论最少。在医院/诊所环境中工作的儿科医生比团体或单独/两名医生的实践讨论健康行为的频率更低。
对于 2 岁以下的儿童，大多数儿科医生报告说使用了推荐的生长图表并讨论了健康行为。较少讨论反应性喂养主题。指导固体食物引入的结果喜忧参半。继续努力支持儿科医生的工作可以改善推荐实践的实施。
