Smith Taryn J, Fortune Alice, Gladstone Melissa J
Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, UK.
Matern Child Nutr. 2025 Jun 16:e70058. doi: 10.1111/mcn.70058.
Research on early childhood development has focused on child health, nutrition and stimulation. However, less attention has been given to the role of caregiver nutrition in shaping caregiving behaviours. Suboptimal caregiver nutrition may impair the ability to provide responsive and nurturing care. This scoping review aimed to summarise the existing evidence on the link between caregiver nutrition and nurturing care, specifically responsive caregiving and early learning opportunities. Database (Medline) and citation searches yielded 23 articles meeting inclusion criteria (n = 17 observational; n = 6 randomised controlled trials [RCTs]). The majority (n = 15) were conducted in low- and middle-income countries. Observational studies measured caregiver anthropometry (n = 8), dietary intakes/diversity/quality (n = 6), anaemia (n = 6) and vitamin B6 status (n = 1). RCTs supplemented pregnant and/or postpartum women with iron (n = 2), multiple micronutrients (n = 2), fish oil (n = 1) and food-based snacks (n = 1). Most articles (n = 18) measured caregiving through live or videotaped observations of caregiver-child interactions; the remaining used caregiver self-reported measures of stimulation or caregiver-child bonding/relationship. Overall, suboptimal diets, food insecurity, caregiver under- and overnutrition, anaemia and low vitamin B6 status were associated with less responsive caregiving and fewer opportunities for early learning. Providing anaemic or food-insecure caregivers with iron or food-based supplements positively altered caregiver-child interactions. Supplementation trials that did not specifically target undernourished caregivers found no effects on caregiving behaviours. More research specifically targeting undernourished caregivers is needed to understand how nutritional interventions might benefit caregiving. Interventions aimed at enhancing nurturing care should consider both caregiver and child nutrition as potential targets to improve outcomes for both children and their caregivers.
幼儿发展研究主要集中在儿童健康、营养和刺激方面。然而，照顾者营养在塑造照顾行为中的作用却较少受到关注。照顾者营养状况欠佳可能会损害其提供敏感且关爱的照顾的能力。本综述旨在总结关于照顾者营养与关爱照顾之间联系的现有证据，特别是敏感的照顾方式和早期学习机会方面的证据。通过数据库（Medline）检索和文献引用检索，共筛选出23篇符合纳入标准的文章（17篇观察性研究；6篇随机对照试验[RCT]）。大多数研究（15篇）在低收入和中等收入国家开展。观察性研究测量了照顾者的人体测量指标（8篇）、饮食摄入量/多样性/质量（6篇）、贫血情况（6篇）以及维生素B6水平（1篇）。随机对照试验中，有2项试验给孕妇和/或产后妇女补充了铁剂，2项补充了多种微量营养素，1项补充了鱼油，1项补充了以食物为基础的零食。大多数文章（18篇）通过对照顾者与儿童互动的现场观察或录像观察来衡量照顾行为；其余文章则采用照顾者自我报告的刺激措施或照顾者与儿童之间的情感联系/关系来衡量。总体而言，饮食不均衡、粮食不安全、照顾者营养不足和营养过剩、贫血以及维生素B6水平偏低与较少敏感的照顾行为和较少的早期学习机会相关。给贫血或粮食不安全的照顾者补充铁剂或食物补充剂能积极改变照顾者与儿童之间的互动。未专门针对营养不良照顾者的补充试验未发现对照顾行为有影响。需要开展更多专门针对营养不良照顾者的研究，以了解营养干预如何能使照顾行为受益。旨在加强关爱照顾的干预措施应将照顾者和儿童营养都视为改善儿童及其照顾者结局的潜在目标。
