| Background2years or less is the key period of growth and development. Height and weight increased rapidly while the function of digestive system, immune system and some other organization organs gradually developed to perfect.The World Health Assembly held on2001adopted a resolution that recommended exclusive breastfeeding to6months old, and continue breastfeeding to2years old. After6months old, the nutrition store is running out while the nutritions contained in breast milk can not meet the need of infants growth and development. The intruction of complementary food is needed. The complementary feeding are influenced by the environment, family eating habits, customs and other factors. And the basic principle of adding complementary feeding is to ensure the quantity, quality, and given at proper time, satisfy the need of infant growth and development. The main feeding problems in china are category inadequate and adding time too early or late. The complementary feeding involved many factors and feeding behavior is one of the most important controled factors. Most existing studies focused on the single index, such as the rate of breast feeding, bottle use, the adding time and quality of complementary feeding.This study has certain sense in assessing children feeding status, but can not comprehensively evaluate the feeding behavior. In2002, Ruel and Menon proposed the use of infant and child feeding index (ICFI). ICFI composites the breast feeding, bottle feeding, meal frequency, food varities and eating frequency into one single index, to evaluate the feeding behavior.ObjectivesThe subject is to perfect the ICFI of infants aged6-23months old. Analysis the assosiation between ICFI and growth and development levels to evaluate the practicality and constructability of ICFI. The difference of ICFI and feeding statues between urban and rural will be tested. And offer evidance for intervention strategy and infant feeding status survey. Subjects and methodsOur survey base on the concept established by scholars in2005, cononsidering the concept set up by Ruel and Menon, the WHO and UNICEF feeding recommendation and the dietary guidelines of Chinese children aged0-6years old. The ICFI contains six parts:breastfeeding, bottle using, dietary diversity, food frequency, frequency of feeding and intruction time of complementary food, the highest scores were20.A totle of1738young children, aged6～23months, from Shijiazhuang(urban and rural), Chengdu and Qigihar (urban and rural) were enrolled, using multistage random sampling. Information on24-h food consumption, the number of foods consumed during the preceding week, the number of meals during the preceding day were recalled and intruction time of complementary food was investigated by questionnaire. The infants and mothers were tested for physique for the information of height and weight.Adopting single factor analysis to compare the difference of feeding status and ICFI scores in urban and rural.The general linear model was used for multivariate analysis of the relation between ICFI and height-for-age(HAZ) or weight-for-age(WAZ) or weight-for-height(WHZ). Logistic regression analysis was performed to compare the relativity between wasting, obesity, underweight and stunting and both scores of ICFI and each of its components.ResultsA total of1738infants took part in the survey (934boys,804girls). The first food mostly given to newborns was infant formula milk (40.3%.). Egg yolk stand for the highest percentage of the first intructed complementary food (36.7%). HAZ was negatively associated with agemonth(F=13.18,P<0.001).The frequency of feeding was positively associated with age(P<0.05). The frequency of feeding has significant difference between urban and rural(P<0.05). The difference of food freqnency in the past week of many foods as infant formula milk, grains, tubers, vegetables, fruits, aquatic products, meat and beverage were significant(P<0.05).The average score of ICFI is (12.7±3.4),(63.5%of the full score), in urban (13.1±3.4), and in rural (11.8±3.2). The difference between urban and rural is statically significant(*=7.46, P<0.001). The average score of ICFI of6～months of age,9-months of age and12-23months of age are (12.5±3.4),(13.2±3.1) and (12.5±3.4). The difference between different agegroup is statically significant(F=8.16, P<0.001). The qualified rate is62.6%. The excellence rate is6.9%. The difference between urban and rural is statically significant (x2=23.02, intruction time of complementary food are all statically significant (P<0.05) between urban and rural, and among different age groups. The score of bottle using are significant different between urban and rural (P<0.001). The score of frequency of feeding are significantly different between age groups (P<0.001).Adjustment was made for birth weight of infants, mother pregnancy age and height of mothers, median household income, infants mean month spent on food, and thereafter the ICFI in urban has significant negative correlation with WAZ and WHZ(P<0.05). The ICFI in rural has significant negative correlation with WHZ (P<0.001). The ICFI scores of infants aged6～months has significant negative correlation with WHZ(P<0.01). The ICFI scores of infants aged12～23months has significant negative correlation with WAZ, WHZ (P<0.01).The ICFI score of wasting, underweight and stunting are lower than the normal children(P<0.05). The main feeding problem of wasting, underweight and stunting are low feeding frequency of aquatic products, meat and beverage, infant formula milk and insufficient dietary diversity. The obseity group has the feeding problem of low feeding frequency of grains and tubers, insufficient dietary diversity and unreasonable introduction time of solid foods. The maternal and household characteristics such as education of the mother, median household income, the mean month spent on food of infants all have significant effect on ICFI (P<0.05).Conclusions1. The infant feeding status in urban is batter than rural. And many problems such as adding food earlier or later or inadequacy types still exist.2. Low ICFI score can prompt wasting, obesity, underweight, stunting, and other nutritional problems.3. ICFI is correlated with education of the mother, median household income, infants mean month spent on food.4. ICFI can simply and rapidly evaluate the feeding feeding behavior of individuals and reflect the infants feeding condition of the whole group.So ICFI is an effective tool for evaluating infant feeding status aged6-23months old. |
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