农村地区婴幼儿离乳食的干预研究

Study on intervention of infant weaning feeding in rural area

目的探索我国农村地区2岁以下婴幼儿离乳期家庭膳食改善方法，观察离乳食干预对预防儿童营养性贫血的短期效果。方法本研究对赵县农村6～11月龄儿童家长进行增加瘦肉摄入和增加蔬菜摄入的健康教育，评估干预措施改善婴幼儿的喂养行为和升高血红蛋白（Hb）浓度的效果。结果干预组和对照组分别有149和114名儿童完成了6个月的干预和随访。相对于人选时，3个月随访时干预组的儿童自身Hb浓度升高值为（2．65±14．38）g／L，高于对照组[（-0．18±11．21）g／L]，差异无统计学意义（P=0．074）；6个月随访时干预组升高为（8．33±15．85）g／L，高于对照组[（4．32±14．00）g／L]，差异有统计学意义（P=0．034）。3个月随访时干预组的儿童的食物种类多样率（89．9％）高于对照组（78．9％），差异具有统计学意义（P=0．014）；而6个月随访时，干预组（83．1％）与对照组（86．8％）的差异元统计学意义（P=0．405）。干预组的儿童3个月和6个月随访时24h瘦肉食人量[依次为（6．94±9．07）g和（7．96土13．90）g5皆高于对照组[依次为（2．42±6．10）g和（4．54±9．19）g3，差异具有统计学意义（P=0．000和P=0．024）。结论通过家庭膳食干预，离乳期儿童的食物种类和瘦肉食人增加，Hb水平显著提高，营养性贫血患病率降低。儿童24h瘦肉食人量有所增加，虽然仍低于我国和发达国家的推荐量，但是营养改善效果已经明确初显。

Objective To explore the effects of inventions on home-made weaning food for infants since 6 to 11 months after birth to improve feeding and infants＇ nutrition status. Methods A total of 263 children aged 6～11 months old were enrolled and assigned to the intervention group （n= 149） and the control group （n= 114） ,and completed 6 months of inves- tigation. In the intervention group, the child caregivers received health education on in-time meat introduction,dietary diversi- ty in term of vegetable and anemia source food via village health workers conducting. The effects were evaluated via Hb and feeding practices indicators （WHO 2008 version）. Results The paired t test showed that the main effects of Hb increas- ing were higher in the intervention group than the control group after 3 months [- （ 2.65 ± 14.38） g/L vs （-0.18 ± 11.21 ） g/L, P= 0. 074）] and significantly after 6 months [（8.33 ± 15.85）g/L vs （4. 32±14.00）g/L, P= 0. 034]. The proportion of minimum dietary diversity was remarkable higher in the intervention groups than the control group after 3 month （89.9 % vs 78.9% ,P=0. 014） ,but not significantly after 6 months （83.1% vs 86.8% ,P=0. 405）. The estimated amount of meat in- take in the previous day was higher in the intervention group than those in the control group [,（6.94 4±9.07） g vs （2.42 ± 6.10） g,P=0. 000] after three months and six months [-（7.96±13.90） g vs （4.47±9. 194.54±-9.19） g,P=0. 024]. Conclusions There are effects on Hb increasing and nutritional anemia decreasing by improvement of home-made food and weaning feeding since 6～ 11 months after birth,in term of increasing meat intake and dietary diversity. The increase of meat intake in the previous day indicated nutritional effect clearly, though less than the recommendation by national and aboard guidelines.