Hoteit Maha, Ibrahim Carla, Saadeh Danielle, Al-Jaafari Marwa, Atwi Marwa, Alasmar Sabine, Najm Jessica, Sacre Yonna, Hanna-Wakim Lara, Al-Jawaldeh Ayoub
Faculty of Public Health, Section 1, Lebanese University, Beirut 6573, Lebanon.
PHENOL Research Group (Public HEalth Nutrition prOgram Lebanon), Faculty of Public Health, Lebanese University, Beirut 6573, Lebanon.
Children (Basel). 2022 Jun 1;9(6):817. doi: 10.3390/children9060817.
Sub-optimal feeding practices among under-5 children are the major drivers of malnutrition. This study aims to assess the prevalence of malnutrition and the factors affecting exclusive breastfeeding, bottle feeding, and complementary feeding practices among under 5 children amid the COVID-19 pandemic as well as the economic and the political crises in Lebanon. A nationally representative stratified random sample of mother-child dyads ( = 511) was collected from households using a stratified cluster sampling design. The survey inquired about infant's feeding and complementary feeding practices using a valid questionnaire. Anthropometric measurements of the mother and child were collected. Multivariate logistic regression was conducted to explore the determinants associated with under-5 children's practices. The prevalence of underweight, stunting, wasting, overweight and obese children was 0.5%, 8.4%, 6.7%, 16.8% and 8.9%, respectively. In total, among under-5 children, the prevalence of ever breastfeeding, exclusive breastfeeding, and bottle feeding at birth was 95.1%, 59.1% and 25.8%, respectively. Half the children in this study started solid foods between 4 and 6 months. Regression analysis showed that supporting breastfeeding at hospital (aOR = 8.20, 95% CI (3.03-22.17)) and husband's support (aOR = 3.07, 95% CI (1.9-4.92)) were associated with increased breastfeeding odds. However, mother's occupation (aOR = 0.18, 95% CI (0.55-0.58)) was inversely associated with breastfeeding practices. Male children (aOR = 2.119, 95% CI (1.37-3.27), mothers diagnosed with COVID-19 (aOR = 0.58, 95% CI (0.35-0.95)), and bottle feeding at hospital (aOR = 0.5, 95% CI (0.32-0.77)) were more likely to induce early initiation of solid foods at 4 months of age. This study demonstrated non-negligible rates of malnutrition, low prevalence of exclusive breastfeeding, and high rates of early introduction of formula feeding and solid foods among Lebanese under-5-children amid escalating crises.
5岁以下儿童喂养方式欠佳是营养不良的主要原因。本研究旨在评估在新冠疫情以及黎巴嫩经济和政治危机期间，5岁以下儿童营养不良的患病率以及影响纯母乳喂养、奶瓶喂养和辅食喂养方式的因素。采用分层整群抽样设计，从家庭中收集了具有全国代表性的母婴二元组分层随机样本（n = 511）。通过一份有效的问卷对婴儿的喂养和辅食喂养方式进行了调查。收集了母亲和孩子的人体测量数据。进行多因素逻辑回归分析以探究与5岁以下儿童喂养方式相关的决定因素。体重不足、发育迟缓、消瘦、超重和肥胖儿童的患病率分别为0.5%、8.4%、6.7%、16.8%和8.9%。总体而言，在5岁以下儿童中，曾经母乳喂养、纯母乳喂养和出生时奶瓶喂养的患病率分别为95.1%、59.1%和25.8%。本研究中一半的儿童在4至6个月开始添加固体食物。回归分析表明，医院对母乳喂养的支持（调整后比值比 = 8.20，95%置信区间（3.03 - 22.17））和丈夫的支持（调整后比值比 = 3.07，95%置信区间（1.9 - 4.92））与母乳喂养几率增加相关。然而，母亲的职业（调整后比值比 = 0.18，95%置信区间（0.55 - 0.58））与母乳喂养方式呈负相关。男性儿童（调整后比值比 = 2.119，95%置信区间（1.37 - 3.27））、被诊断患有新冠的母亲（调整后比值比 = 0.58，95%置信区间（0.35 - 0.95））以及在医院进行奶瓶喂养（调整后比值比 = 0.5，95%置信区间（0.32 - 0.77））更有可能导致在4个月大时过早开始添加固体食物。本研究表明，在不断升级的危机中，黎巴嫩5岁以下儿童的营养不良率不可忽视，纯母乳喂养率低，配方奶喂养和固体食物过早引入率高。
