| [Objectives]Young children aged from0to2years are the critical period for physical and mental development, which would build a foundation for lifetime. Home care and home environment, as well as parenting have been recognized as the important factors related to early childhood development. Not many studies on home care and parenting were carried out so far in China. Understanding the current situation of home care and home environment will be useful and valuable to find the appropriate ways to improve parents’ knowledge and skills of parenting. Therefore, a study on home care and parenting was carried out. The aim of the study was to investigate the current situation of home care and home environment, and to find the potential areas of parenting, which could be improved in the near future.[Methods]The children and their families to be investigated in this study were from five cities, including Beijing, Changzhi (Shanxi province), Huanggang (Hubei province), Suzhou (Jiangsu province), Nanning (Guangxi province). The age of the children was from0to24months. The methods of questionnaire, focus group discussion, home visiting and laboratory tests of bacteria were carried out in this study.Survey contents included:①Socio-demographic characteristics of the participants, including age, sex, home sites, and maternal education level.②feeding, including breastfeeding, complementary feeding.③Sleep, including night sleep time, sleep location, sleep habit.④States of health, vaccination, physical examination, parents’ knowledge about common childhood symptom.⑤Injuries, including the overall injury prevalence rate, categories of injuries.⑥Diaper practice, including type of diaper, frequency of diaper change, diaper dermatitis and its risk factors. Bacteria and PH of skin were tested to compare the influence of different diapers.⑦Skin cleaning, including frequency of shower, skin cleansing and agents.The participants were underwent interview face-to-face by trained child health workers. All analyses were completed by using SPSS for WINDOWS14.0(SPSS Inc, Chicago). Descriptive statistics was used to describe the epidemiological characteristics of study factors of participants. Chi-square test, ANOVE and T-test were used to compare the difference between group, for categorical and numeric variables, respectively. Univariate and multivariate logistic regression analysis were used to test association between diaper dermatitis and risk factors for children aged0to24months. Values were considered significant at P=0.05.[Results]①Total of1036children and their families were recruited in the study. Of them,58.3%(604) were boys,and41.7%(432).were girls.29.2%(303) were age from0to6months,31.1%(322) were from7to12months of age,22.9%(237) were from13to18months of age and19.2%(174) were from19to24months of age. The average age of these children was11.35±6.50months. Of1036recruited children,197were in the rural areas,640were in the urban areas and migrant population were199.②Feeding:The rate of exclusive breastfeeding in first4months was55.2%, but the rate of exclusive breastfeeding quickly decreased to19.0%at the age of6months. The median of weaning age was at8months. The main reasons of early weaning were "insufficient breast milk secretion","parents’misunderstanding of weaning time","mothers returning to work" and "early complementary food supplement".29.9%of infants aged0-5months had received complementary food,93.5%of infants aged6months and99.6%of infants aged7-24months. The most popular complementary foods were eggs, cereals, fruits and vegetables. Comparing with rural and migrant infants, urban infants were significantly higher on eating meat and fishes (P<0.05).③The sleep time at night of infants aged0to24months was9.74±1.12hours. There was no difference between the rural and urban (P>0.05). Also, no differences were detected for night sleep time according to the infants’sex and age.81.5%of infants shared bed with parents, and there was a statistically significant difference among rural, urban and migrant infants. In sleep habit,39.8%of infants slept without help.④General state of health:Vaccination rate and physical examination rate were96.6%and87.7%respectively. Parents’ knowledge on common childhood symptom was accordance with infants’ health states.⑤Injuries:The overall injury prevalence rate of children aged0to24months was36.4%. There was no significant difference between boys (37.6%) and girls (34.7%), and also no difference between the urban (39.1%) and the rural (40.1%). The prevalence rate of injury increased with age. The overall injury prevalence rate at the age group of0-6months was10.9%and was significantly lower than the age group of7-12months (41.3%); the rate at the age group of13-18months was51.1%, and the highest rate was found at the age group of19-24months (51.7%)(P<0.05). The results showed the highest frequency was at19to24months of age group. The prevalence of categories of injuries from high to low were fall (86.2%), crash (19.4%), bums (8.5%), cutting and piercing (5.0%), others (0.5%).⑥Diaper practice:43.8%of infants had experienced diaper dermatitis. Univariate analysis showed that the following factors related to dermatitis, including age, home sites, solid foods (cereals, fish, and eggs), diarrhea, type of diaper worn, and frequency of diaper change, skin cleansing agents, and frequency of shower. Subsequently, multivariate analysis showed the risk of diaper dermatitis was significantly decreased by solid foods (eggs)(OR,0.419;95%CI,0.187-0.941) and frequency of diaper change (OR,0.718;95%CI,0.568-0.909), whereas the risk was increased for diarrhea (OR,2.443;95%CI,1.464-4.076) and living area. The results of tests of skin bacterial colony and pH in babies using different types of diapers showed that the mean number of total bacterial colony and Staphylococcus aurous of babies wearing cloth diapers were higher than those wearing disposable diapers. Significantly higher pH value was detected at the suprapubic area in infants wearing disposable diapers than cloth diapers. No differences were noticeable for pH value according to the infants’.[Conclusions]①The rate of exclusive breastfeeding in study areas was still lower, and the duration of breastfeeding was shorter. The reasons of those, shown by this study, included skills of breastfeeding, early complementary food supplement, shorter maternal leaving and less community supports.②Problems of complementary feeding included introducing complementary foods in improper time or feeding low-energy-density foods, and further effort would be needed to reinforce complementary feeding with nutrition-enhanced weaning food. Inappropriate complementary feeding, for example, too early or too late, is also harm to the growth of children.③High coverage of vaccination and routine health examination were indicated by this study that means that those programs have been successfully implemented in China and accepted by most of parents. ④The night sleep time of infants aged0-24months was9.74±1.12hours, and the rate of bed-sharing was high. For infants under2years of age, sleep not only has effects on physical growth but intellectual development. To improve infants sleep quality, the sleep problems should be recognized early and paid more attention to by the pedestrians, the child health care staff and children’s parents.⑤The overall injury prevalence rate of children aged0-24months was still at a high level. The main categories of unintentional injury were fall, crash and burns. Effective interventions for unintentional injury should be explored to reduce the prevalence of it. Parents and caregivers should be provided education to increase the awareness of prevention and cognition to control the injury.⑥Diaper dermatitis was still a problem among young babies. Diarrhea was a major risk factor of diaper dermatitis. Incidence of diaper dermatitis was significantly decreased by diapering children more than6times everyday. Confirmation of these risk factors could lead to better understand the etiology of diaper dermatitis and propose new strategies of diaper dermatitis prevention for infants in China. The use of disposable diapers could keeps skin drier resulted in numbers of organisms closer to those of undiapered skin. Infants wearing cloth diaper had a higher pH value. pH value is one of the physiology parameters of skin. Maintaining an appropriate physiological skin surface pH is effective approach for keeping skin healthy and prevention and treatment of some skin disorders.⑦The results of this study indicated that more attention of home care should be paid to babies’ personal sanitation, such as bath, hand washing, skin cleaning, and frequent change of diaper. Limitation of parenting knowledge and skills is still one of the problems related to home care and home environment. It is strongly suggested by this study that to develop training materials and family education programs of parenting would be one of the most important strategy of child health care. |
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