Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, Akademicka 15, 20-950 Lublin, Poland.
Faculty of Medicine, Medical University of Lublin, Chodźki 19, 20-093 Lublin, Poland.
Nutrients. 2020 Dec 28;13(1):61. doi: 10.3390/nu13010061.
Adequate nutrition in the first year of life is the key prerequisite for a child's healthy growth and development. The success of complementary feeding is influenced by various factors, including the family's socioeconomic status, maternal age, place of residence and educational level, older children and duration of breastfeeding. Modified infant feeding guidelines were introduced in Poland in 2016. The aim of this study was to identify the factors that exert the greatest influence on infant feeding practices in the Polish population. A thorough understanding of maternal factors that are responsible for undesirable feeding practices is required to improve the mothers' knowledge and to promote healthy feeding practices. This study was carried out in March-June 2018 and between November 2018 and March 2019 in the Region of Lublin in southeastern Poland. The mothers of children aged 9-14 months, who had introduced complementary foods, were invited to the study. A total of 441 mothers agreed to participate, and 289 of them fully and correctly completed the questionnaires. Logistic regression models were developed to assess the association between maternal factors, such as age, educational level and the nutrition knowledge score, and introduction of solid foods. The infant's sex and birth weight and the mother's place of residence had no significant influence on the duration of breastfeeding. The mother's age and educational level, the number of children in the family and maternal nutrition knowledge scores contributed to significant differences in breastfeeding duration. Older mothers (30-34 years vs. 25-29 years, = 0.001), better educated mothers (university vs. secondary school education = 0.002) and mothers with one or two children exclusively breastfed their children for longer (17 weeks vs. 11 weeks, = 0.002) than younger mothers with secondary school education and more than three children. Exclusive formula feeding was significantly correlated with untimely introduction of solid foods compared to exclusive breastfeeding (13 weeks vs. 19.7 weeks, = 0.001). Mothers with nutrition knowledge scores in the upper tertile were more likely to adapt food consistency to the skills manifested by the child (88%) (OR = 1.88; Cl: 1.53-2.26, < 0.05) and were less likely to delay the introduction of new foods that required chewing and biting (84%) (OR = 0.22; Cl: 0.09-0.34, < 0.05) than mothers with nutrition knowledge scores in the bottom tertile. Maternal age, educational level and nutrition knowledge significantly increased the age at which infants were introduced to solid foods and the correct identification of the signs indicative of the child's readiness to explore new tastes and foods with a new consistency. The above factors contributed to delayed, but not untimely, introduction of complementary foods (6 months of age or later), including gluten.
生命的头一年中摄入充足的营养是儿童健康成长和发育的关键前提。辅食添加的成功受到多种因素的影响,包括家庭的社会经济地位、母亲的年龄、居住地和教育水平、年龄较大的儿童以及母乳喂养的持续时间。波兰于 2016 年引入了改良的婴儿喂养指南。本研究旨在确定对波兰人群婴儿喂养实践影响最大的因素。为了改善母亲的知识并促进健康喂养实践,需要深入了解导致不良喂养行为的母亲因素。该研究于 2018 年 3 月至 6 月和 2018 年 11 月至 2019 年 3 月在波兰东南部卢布林地区进行。邀请了 9-14 个月大的已经开始添加补充食物的儿童的母亲参加研究。共有 441 位母亲同意参加,其中 289 位母亲完全正确地填写了问卷。建立了逻辑回归模型,以评估母亲年龄、教育水平和营养知识评分等因素与固体食物引入之间的关联。婴儿的性别和出生体重以及母亲的居住地对母乳喂养时间没有显著影响。母亲的年龄和教育水平、家庭中儿童的数量以及母亲的营养知识评分导致母乳喂养时间存在显著差异。年龄较大的母亲(30-34 岁与 25-29 岁, = 0.001)、受教育程度较高的母亲(大学与中学教育 = 0.002)和只有一个或两个孩子的母亲母乳喂养时间更长(17 周与 11 周, = 0.002),而年龄较小、受教育程度较低、有三个以上孩子的母亲母乳喂养时间更短。与纯母乳喂养相比,配方奶喂养的婴儿固体食物引入时间明显延迟(13 周与 19.7 周, = 0.001)。营养知识评分处于上三分位数的母亲更有可能根据孩子表现出的技能调整食物的稠度(88%)(OR = 1.88;Cl:1.53-2.26, < 0.05),并且不太可能延迟引入需要咀嚼和咬的新食物(84%)(OR = 0.22;Cl:0.09-0.34, < 0.05),而营养知识评分处于下三分位数的母亲则不然。母亲的年龄、教育水平和营养知识显著增加了婴儿引入固体食物的年龄以及正确识别婴儿准备探索新口味和具有新稠度的新食物的迹象。上述因素导致辅食添加延迟,但不会过早(6 个月或更大年龄),包括含麸质的辅食。