Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, London, UK.
Nutrition and Health Services, Holt International, Eugene, Oregon, USA.
Matern Child Nutr. 2022 Jul;18(3):e13352. doi: 10.1111/mcn.13352. Epub 2022 Mar 22.
There is limited information on the feeding practices of 9.42 million children living within institution-based care (IBC) worldwide. Poor feeding practices can predispose or exacerbate malnutrition, illness and disability. Here we describe the feeding practices of children living within IBC based on a retrospective analysis of records from 3335 children, 0-18 years old, participating in Holt International's Child Nutrition Program (CNP), from 36 sites in six countries. Data analysed included demographic information on age, sex, feeding practices, disabilities and feeding difficulties. Descriptive statistics were produced. A generalised linear model explored associations between feeding difficulties and disability and 2 × 2 tables examined feeding difficulties over time. An additional set of feeding observations with qualitative and quantitative data was analysed. At baseline, the median age of children was 16 months (0.66-68 months) with 1650/3335 (49.5%) females. There were 757/3335 (22.7%) children with disabilities; 550/984 (55.9%) were low birth weight; 311/784 (39.7%) were premature; 447/3113 (14.4%) had low body mass index and 378/3335 (11.3%) had feeding difficulties. The adjusted risk of having a feeding difficulty was 5.08 ([95% confidence interval: 2.65-9.7], p ≤ 0.001) times greater in children with disabilities than those without. Many children saw their feeding difficulties resolve after 1-year in CNP, 54/163 (33.1%) for children with disabilities and 57/106 (53.8%) for those without disabilities. Suboptimal hygiene, dietary and feeding practices were reported. In conclusion, feeding difficulties were common in IBC, especially among children with disabilities. Supporting safe interactive mealtimes for children living within IBC should be prioritised, to ensure overall health and development.
全世界有 942 万生活在机构式照顾（IBC）中的儿童，关于他们的喂养实践，信息有限。不良的喂养方式可能导致或加剧营养不良、疾病和残疾。在这里，我们根据 Holt International 的儿童营养计划（CNP）从六个国家的 36 个地点收集的 3335 名 0-18 岁儿童的记录进行了回顾性分析，描述了生活在 IBC 中的儿童的喂养实践。分析的数据包括年龄、性别、喂养方式、残疾和喂养困难等人口统计学信息。制作了描述性统计数据。广义线性模型探讨了喂养困难与残疾之间的关联，2×2 表检查了随时间推移的喂养困难。还对一组具有定性和定量数据的喂养观察进行了分析。在基线时，儿童的中位数年龄为 16 个月（0.66-68 个月），其中女性为 1650/3335（49.5%）。有 757/3335（22.7%）名儿童有残疾；550/984（55.9%）为低出生体重；311/784（39.7%）为早产儿；447/3113（14.4%）的身体质量指数较低，378/3335（11.3%）存在喂养困难。与无残疾的儿童相比，有残疾的儿童发生喂养困难的调整风险高 5.08 倍（95%置信区间：2.65-9.7，p≤0.001）。在 CNP 中，许多儿童的喂养困难在 1 年后得到缓解，有残疾的儿童为 54/163（33.1%），无残疾的儿童为 57/106（53.8%）。报告了一些卫生、饮食和喂养实践不佳的情况。总之，IBC 中存在常见的喂养困难，尤其是残疾儿童。应优先考虑为生活在 IBC 中的儿童提供安全的互动进餐时间，以确保他们的整体健康和发展。
