Mutoro Antonina N, Garcia Ada L, Kimani-Murage Elizabeth W, Wright Charlotte M
Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK.
Maternal and Child Well-being Unit, African Population and Health Research Center, Nairobi, Kenya.
Matern Child Nutr. 2020 Oct;16(4):e13023. doi: 10.1111/mcn.13023. Epub 2020 May 31.
Child eating and caregiver feeding behaviours are critical determinants of food intake, but they are poorly characterized in undernourished children. We aimed to describe how appetite, food refusal and force-feeding vary between undernourished and healthy children aged 6-24 months in Nairobi and identify potential variables for use in a child eating behaviour scale for international use. This cross-sectional study was conducted in seven clinics in low-income areas of Nairobi. Healthy and undernourished children were quota sampled to recruit equal numbers of undernourished children (weight for age [WAZ] or weight for length [WLZ] Z scores ≤2SD) and healthy children (WAZ > 2SD). Using a structured interview schedule, questions reflecting child appetite, food refusal and caregiver feeding behaviours were rated using a 5-point scale. Food refusal and force-feeding variables were then combined to form scores and categorized into low, medium and high. In total, 407 child-caregiver pairs, aged median [interquartile range] 9.98 months [8.7 to 14.1], were recruited of whom 55% were undernourished. Undernourished children were less likely to 'love food' (undernourished 78%; healthy 90% p = < 0.001) and more likely to have high food refusal (18% vs. 3.3% p = <0.001), while their caregivers were more likely to use high force-feeding (28% vs. 16% p = 0.03). Undernourished children in low-income areas in Nairobi are harder to feed than healthy children, and force-feeding is used widely. A range of discriminating variables could be used to measure child eating behaviour and assess the impact of interventions.
儿童的进食行为和照料者的喂养行为是食物摄入量的关键决定因素，但在营养不良的儿童中，这些行为的特征却鲜为人知。我们旨在描述内罗毕6至24个月大的营养不良儿童和健康儿童在食欲、拒食和强迫喂食方面的差异，并确定可用于国际儿童进食行为量表的潜在变量。这项横断面研究在内罗毕低收入地区的七家诊所进行。通过配额抽样选取健康和营养不良的儿童，以招募数量相等的营养不良儿童（年龄别体重[WAZ]或身长别体重[WLZ]Z评分≤2SD）和健康儿童（WAZ>2SD）。使用结构化访谈时间表，通过五点量表对反映儿童食欲、拒食和照料者喂养行为的问题进行评分。然后将拒食和强迫喂食变量合并以形成分数，并分为低、中、高三个类别。总共招募了407对儿童-照料者，年龄中位数[四分位间距]为9.98个月[8.7至14.1]，其中55%为营养不良儿童。营养不良的儿童“爱吃食物”的可能性较小（营养不良儿童为78%；健康儿童为90%，p =<0.001），拒食程度高的可能性更大（18%对3.3%，p =<0.001），而他们的照料者更有可能采用高强度的强迫喂食方式（28%对16%，p = 0.03）。内罗毕低收入地区的营养不良儿童比健康儿童更难喂养，而且强迫喂食的情况很普遍。一系列有区分性的变量可用于衡量儿童的进食行为并评估干预措施的影响。
