Department of Integrated Early Childhood Development, Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China.
Beijing KidsHome Children Development Centre, Beijing, China.
J Glob Health. 2024 Mar 8;14:04043. doi: 10.7189/jogh.14.04043.
Appropriate infant and young child feeding (IYCF) plays a crucial role in promoting the healthy growth of children. Currently, many Chinese urban parents are seeking care of children from the early childhood education (ECE) institutions, however, little is known about the feeding practices of infants and young children in ECE institutions. This study aims to investigate the complementary feeding practices for Chinese urban children aged 6-23 months in ECE institutions and explore potential factors influencing their feeding practices.
This cross-sectional study was conducted among primary caregivers of children aged 6-23 months in ECE institutions across 31 provinces in China from 1 March to 30 April 2023. Convenience sampling was used to recruit caregivers from centres of Gymboree Play & Music (an ECE institution). Self-administered questionnaires were designed using the online survey tool Sojump and distributed through WeChat platform, which collected information on 1) children's complementary feeding practices; 2) food frequency of seven food groups; 3) caregivers' feeding knowledge and practices; 4) frequency of children attended ECE classes and the primary caregivers' daily nurturing care time; 5) source of information on complementary feeding.
A total of 2731 children and their caregivers were surveyed, with 416 children aged 6-11 months and 2315 children aged 12-23 months. The prevalence of minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) was 59.4, 60.6, and 39.2%, respectively. Only 17.3% caregivers believed that continued breastfeeding should be at two years or above, and 29.5% children were continuously breastfed at 12-23 months (CBF). The proportion of non-responsive feeding practices among caregivers ranged from 28 to 64%. Except for CBF, the prevalence of other key complementary feeding practices was higher among children who attending ECE classes than those not attending ECE classes (all P < 0.05). Moreover, children aged 12-23 months who received long-nursing care time (≥4h/d) had significantly higher MMF and MAD prevalence than those in short-nursing care time group (MMF = 66.2 vs. 58.8%, P = 0.0003; MAD = 44.2 vs. 38.3%, P = 0.0047).
The complementary feeding practices of children aged 6-23 months in ECE institutions in urban China remained suboptimal, and non-responsive feeding practices among caregivers were common. The attendance of ECE classes and the caregivers' daily nurturing care time could be beneficial in ensuring children to comply with complementary feeding recommendations.
适当的婴幼儿喂养（IYCF）在促进儿童健康成长方面起着至关重要的作用。目前，许多中国城市父母都选择将孩子送到幼儿教育（ECE）机构进行照顾，但对于 ECE 机构中婴幼儿的喂养实践知之甚少。本研究旨在调查中国城市 6-23 个月龄儿童在 ECE 机构中的补充喂养实践，并探讨影响其喂养实践的潜在因素。
这是一项横断面研究，于 2023 年 3 月 1 日至 4 月 30 日期间在中国 31 个省的 ECE 机构中招募 6-23 个月龄儿童的主要照顾者。使用便利抽样法从 Gymboree Play & Music（一家 ECE 机构）中心招募照顾者。使用在线调查工具 Sojump 设计了自填式问卷，通过微信平台进行分发，收集了以下信息：1）儿童补充喂养实践；2）七种食物组的食物频率；3）照顾者的喂养知识和实践；4）儿童参加 ECE 课程的频率和主要照顾者的日常养育护理时间；5）补充喂养信息来源。
共调查了 2731 名儿童及其照顾者，其中 416 名儿童年龄为 6-11 个月，2315 名儿童年龄为 12-23 个月。最低饮食多样性（MDD）、最低进餐频率（MMF）和最低可接受饮食（MAD）的流行率分别为 59.4%、60.6%和 39.2%。只有 17.3%的照顾者认为持续母乳喂养应持续到两岁或以上，29.5%的儿童在 12-23 个月时持续母乳喂养（CBF）。非响应喂养实践在照顾者中的比例在 28%至 64%之间。除 CBF 外，其他关键补充喂养实践在参加 ECE 课程的儿童中比不参加 ECE 课程的儿童更为普遍（均 P<0.05）。此外，接受长时间护理（≥4 小时/天）的 12-23 个月龄儿童的 MMF 和 MAD 流行率明显高于接受短时间护理的儿童（MMF=66.2%比 58.8%，P=0.0003；MAD=44.2%比 38.3%，P=0.0047）。
中国城市 ECE 机构中 6-23 个月龄儿童的补充喂养实践仍不理想，照顾者中常见非响应喂养实践。参加 ECE 课程和照顾者的日常养育护理时间可能有助于确保儿童遵守补充喂养建议。
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