McCann M F, Bender D E, Rangel-Sharpless M C
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill 27599-7400.
Int J Epidemiol. 1994 Feb;23(1):129-37. doi: 10.1093/ije/23.1.129.
Infant feeding is a multidimensional activity that can be described and analysed in many different ways. The World Health Organization (WHO) has recently issued recommended indicators for assessing infant feeding practices. This paper presents these indicators and demonstrates their applications using the 1989 Demographic and Health Survey (DHS) data for Bolivia. The results indicate that, although most Bolivian infants are breastfed and two-thirds are breastfed for > 1 year, supplementary feeding practices deviate considerably from international recommendations. Only 58% of infants < 4 months old are receiving breastmilk alone (the 'exclusive breastfeeding rate') and a similarly low percentage (54.7%) of 6-9 month olds are receiving the recommended combination of breast milk plus solid or semi-solid foods (the 'timely complementary feeding rate'). Furthermore, almost half of breastfed infants < 12 months old are also receiving bottle feeds. The infant feeding practices of city residents are least likely to conform to the infant feeding recommendations, while practices of mothers who have always lived in the country are most likely to be similar to the WHO guidelines. Mothers who have moved to the city since the age of 12 are most likely to be giving their infants other milks in addition to breast milk and to be bottle feeding their infants. The WHO infant feeding indicators provide a useful framework for quantifying infant feeding practices, and most of the indicators can readily be applied to DHS data. Nonetheless, improvements can be made in both the indicators themselves and the DHS questionnaire to improve reporting of internationally comparable infant feeding information.
婴儿喂养是一项多维度的活动，可以用许多不同的方式来描述和分析。世界卫生组织（WHO）最近发布了评估婴儿喂养方式的推荐指标。本文介绍了这些指标，并利用玻利维亚1989年人口与健康调查（DHS）的数据展示了它们的应用。结果表明，尽管大多数玻利维亚婴儿接受母乳喂养，且三分之二的婴儿母乳喂养时间超过1年，但辅食添加方式与国际推荐有很大偏差。4个月以下的婴儿中只有58%仅接受母乳（“纯母乳喂养率”），6至9个月大的婴儿中接受推荐的母乳加固体或半固体食物组合的比例同样较低（“及时添加辅食率”）。此外，12个月以下接受母乳喂养的婴儿中近一半也在接受奶瓶喂养。城市居民的婴儿喂养方式最不可能符合婴儿喂养建议，而一直生活在农村的母亲的喂养方式最有可能与世界卫生组织的指导方针相似。12岁以后搬到城市的母亲最有可能除了母乳之外还给婴儿喂其他奶类，并使用奶瓶喂养婴儿。世界卫生组织的婴儿喂养指标为量化婴儿喂养方式提供了一个有用的框架，并且大多数指标可以很容易地应用于人口与健康调查数据。尽管如此，在指标本身和人口与健康调查问卷方面都可以做出改进，以改善国际可比的婴儿喂养信息的报告。
