Ferreira Sara Silva, Marchioni Dirce Maria Lobo, Wall Clare Rosemary, Gerritsen Sarah, Teixeira Juliana Araujo, Grant Cameron C, Morton Susan M B, Gontijo de Castro Teresa
Department of Nutrition, School of Public Health, University of Sao Paulo, Brazil.
Nutrition Section, Faculty of Medical Sciences, University of Auckland, New Zealand.
Br J Nutr. 2023 Feb 14;129(3):491-502. doi: 10.1017/S000711452200112X. Epub 2022 Apr 11.
A nationally generalisable cohort ( 5770) was used to determine the prevalence of non-timely (early/late) introduction of complementary food and core food groups and associations with maternal sociodemographic and health behaviours in New Zealand (NZ). Variables describing maternal characteristics and infant food introduction were sourced, respectively, from interviews completed antenatally and during late infancy. The NZ Infant Feeding Guidelines were used to define early (≤ 4 months) and late (≥ 7 months) introduction. Associations were examined using multivariable multinomial regression, presented as adjusted relative risk ratios and 95 % confidence intervals (RRR; 95% CI). Complementary food introduction was early for 40·2 % and late for 3·2 %. The prevalence of early food group introduction were fruit/vegetables (23·8 %), breads/cereals (36·3 %), iron-rich foods (34·1 %) and of late were meat/meat alternatives (45·9 %), dairy products (46·2 %) and fruits/vegetables (9·9 %). Compared with infants with timely food introduction, risk of early food introduction was increased for infants: breastfed < 6months (2·52; 2·19-2·90), whose mothers were < 30 years old (1·69; 1·46-1·94), had a diploma/trade certificate tertiary education (1·39; 1·1-1·70), of Māori European ethnicity (1·40; 1·12-1·75) or smoked during pregnancy (1·88; 1·44-2·46). Risk of late food introduction decreased for infants breastfed < 6 months (0·47; 0.27-0·80) and increased for infants whose mothers had secondary tertiary education (2·04; 1·16-3·60) were of Asian European ethnicity (2·22; 1·35, 3·63) or did not attend childbirth preparation classes (2·23; 1·24-4·01). Non-timely food introduction, specifically early food introduction, is prevalent in NZ. Interventions to improve food introduction timeliness should be ethnic-specific and support longer breast-feeding.
一项具有全国普遍性的队列研究(5770人)被用于确定新西兰非适时(过早/过晚)引入辅食和核心食物组的情况,以及与母亲社会人口统计学和健康行为的关联。描述母亲特征和婴儿食物引入情况的变量分别来自产前访谈和婴儿晚期访谈。新西兰婴儿喂养指南被用于定义过早(≤4个月)和过晚(≥7个月)引入。使用多变量多项回归分析关联,结果以调整后的相对风险比和95%置信区间(RRR;95%CI)呈现。40.2%的婴儿过早引入辅食,3.2%的婴儿过晚引入辅食。过早引入食物组的比例为:水果/蔬菜(23.8%)、面包/谷物(36.3%)、富含铁的食物(34.1%);过晚引入的比例为:肉类/肉类替代品(45.9%)、乳制品(46.2%)和水果/蔬菜(9.9%)。与适时引入食物的婴儿相比,过早引入食物的风险增加的婴儿有:母乳喂养不足6个月(2.52;2.19 - 2.90)、母亲年龄小于30岁(1.69;1.46 - 1.94)、拥有文凭/行业证书 高等教育学历(1.39;1.1 - 1.70)、毛利族 欧洲族裔(1.40;1.12 - 1.75)或孕期吸烟(1.88;1.44 - 2.46)。母乳喂养不足6个月的婴儿过晚引入食物的风险降低(0.47;0.27 - 0.80),而母亲拥有中学 高等教育学历(2.04;1.16 - 3.60)、为亚裔 欧洲族裔(2.22;1.35,3.63)或未参加分娩准备课程(2.23;1.24 - 4.01)的婴儿过晚引入食物的风险增加。非适时引入食物,特别是过早引入食物,在新西兰很普遍。改善食物引入及时性的干预措施应针对不同种族,并支持延长母乳喂养时间。