Effects of Nutrient Fortified Complementary Food Supplements on Anemia of Infants and Young Children in Poor Rural of Gansu

Objective To assess the effectiveness of complementary food supplements with protein and multi-micronutrients on hemoglobin and anemia in infants and young children. Methods In 5 poor counties of Gansu, 984 children aged 6-12 months were enrolled and divided into two groups. In addition to the usual home-made complementary food, all the children were fed one sachet of either Formula Ⅰ or Formula Ⅱ supplements each day. Protein and micronutrients were provided in Formula Ⅰ, while the same energy intake was secured in Formula Ⅱ as in Formula Ⅰ. A massive dose of vitamin A was supplemented to all the children every 6 months. Hemoglobin test was done at the same time. Results Prevalence of anemia was about 35% in both Formula Ⅰ and Formula Ⅱ group at baseline, and there were no differences in hemoglobin concentration between the two groups, During the 6-month and 12-month supplementation, hemoglobin of children in Formula Ⅰ group was higher than that in Formula Ⅱ group （P〈0.05）, and hemoglobin increase in Formula Ⅰ group was significantly higher than that in Formula Ⅱ group （P〈0.001）. After 6- and 12-mouth supplementation, the prevalence of anemia in Formula Ⅰ group dropped to 19.1% and 8.2% respectively, and it was 28.0% and 12.4% in Formula 2 group. The prevalence of anemia in Formula Ⅰ group was significantly lower than that in Formula Ⅱ group （P〈0.05）. After adjusting age and hemoglobin level at baseline, the hemoglobin increase at age of 24 months in formula 1 group was higher （10.7 g/L vs 7.9 g/L, P〈0.0001）. Conclusion Micronutrient fortified complementary food supplements, with large-dose vitamin A, is effective for children aged 6-12 months in terms of iron deficiency prevention.

Complementary Feeding and Growth of Infant and Young Child in China

Objective To understand the status and problems of complementary feeding and to explore the strategy of improving complementary feeding for infants and young children in China. Method Data of urban and rural children were selected from the China Food and Nutrition Surveillance System （CFNSS） dataset to describe the status of complementary feeding and growth of children. Logistic Regression was used to analyze the relationship between child growth and the complementary feeding pattern. Results Applications of foods that come from animals, vegetable/fruit and dairy product in complementary feeding were negatively correlated to the prevalence of stunting and underweight. Attributable risk （AR） of no application of vegetable/fruit in complementary feeding to stunting was 30.2%, to underweight 35.4%; AR of no application of foods from animal products in complementary feeding to stunting was 28.2%, to underweight 11.7%; and the AR of no application of diary products in complementary feeding to stunting was 27.4%, to underweight was 15.9%. Conclusion Complementary feeding contributed to the improvement of infants and young children growth in China. There is an urgent need to develop health education in the public on infants and young children complementary feeding, in the mean time, it is pressing to pay attention and take actions to develop and promote affordable, acceptable, and accessible fortified complementary food in rural areas of China.

Availability, Accessibility and Contribution of Infant Flours to the Diet of Children Aged 6-59 Months in Benin

This study assesses the nutritional composition as well as the availability and affordability of infant flour found on the market and in the households of Benin. To do that assessment, a two-step cross-sectional survey based on food ethnography methods was used. A total of 61 marketplaces were visited in seven towns and rural districts as part of the availability and affordability survey, while 400 children (aged 6 to 59 months) were surveyed to track the uses of infant flours at the household level. The results obtained reveal that pre-manufactured infant flour is sold more in urban areas (Cotonou, Porto-Novo and Parakou) than in rural ones. The average infant flours price did not vary (p = 0.985) in any given year (regardless of abundance or lean periods) nor does it vary (p = 0.133) from one point of sale to another (drugstore or supermarkets). However, the average price is found to be expensive considering the purchasing power of the households surveyed. On the other hand, the amount of ingredients used in the production of the flour types found on the market complies with the recommendations of the Codex Alimentarius, unlike the homemade ones. Pre-manufactured infant flour is found to be outside of the economic reach of most households (92%) who rely heavily on the homemade ones to feed their children. In light of the above, public authorities should help improve geographic access and pricing affordability to quality infant flour for low-income households in urban and remote areas. Moreover, awareness should be raised among mothers relative to the importance of complementary feeding through education on good nutrition practices.

Assessment of Infant and Young Child Feeding Practices of Caregiver’s in Jashore City, Bangladesh

Since infant and young child feeding practices play an important role in ameliorating childhood nutrition, an exploratory and descriptive study has thus been conducted employing a previously developed questionnaire at Ad-din shisu Hospital, Jashore, Bangladesh to obtain better insights about the breastfeeding and complementary feeding practices among infant and young child feeding caregivers. Out of 260 babies, 54% were female and 46% were male. Nearly all caregivers were found having the idea that breast milk is the best food for newborn babies. Around 81.9% of caregivers think that breast milk contains all the nutrients the baby needs to flourish, but in case of protection from disease, only 18.1% of caregivers think that it protects the baby from certain diseases. Around 46.9% mothers practiced early initiation of breastfeeding and they offered breast milk to their newborn right away (within one hour) after delivery, 53.5% lactating mothers had proper knowledge about breastfeeding methods, 39.6% mothers never practiced burping after breastfeeding, 66.4% mothers had normal delivery, 33.6% mothers had caesarian section, 99% mothers offered colostrums to their babies and only 1% of them didn’t give the colostrums. Besides, 88.8% continued breastfeeding up to 24 months or more along with 83.8% caregivers starting complementary feeding from six months, 55.4% caregivers said baby’s immune system is less developed, so they get attacked by infection easily and 44.6% caregivers said “their tummies are vulnerable to infection”, and 48.8% of the caregivers followed the type of hygiene required. Our findings revealed information on the knowledge, attitude, and practices of the caregiver’s towards breastfeeding and complementary feeding.

婴幼儿辅助食品分阶喂养体系的现状与前景

婴幼儿辅助食品是指适于6~36月龄婴幼儿食用的婴幼儿谷类辅助食品、婴幼儿罐装辅助食品以及辅食营养补充品。文章总结了婴幼儿食品的国家标准现状、婴幼儿配方食品的分阶喂养体系现状,以及婴幼儿辅助食品的产品现状,讨论了婴幼儿辅助食品的特点,并结合国际吞咽障碍食物标准行动委员会(IDDSI)的分级标准,按食品质构提出适合婴幼儿分阶喂养的5个阶段“中度稠、高度稠/细泥型、细馅型、软质型、常规型(容易咀嚼)”,进一步从胃容量、吞咽咀嚼能力、均衡营养等方面定量讨论了婴幼儿辅食分阶喂养体系的建立,并提出婴幼儿零辅食的生产只需适度强化必要的营养素。

婴幼儿辅助食品中配料和膳食补充成分对酪蛋白磷酸肽持钙能力的影响

比较研究婴幼儿辅助食品中肉类、果蔬和谷物等配料以及维生素和蛋白质等膳食补充成分,对三种酪蛋白磷酸肽产品持钙能力强弱的影响。研究结果表明,大米和小麦对婴幼儿辅助食品中酪蛋白磷酸肽的持钙能力有一定的不良影响,但大米和小麦添加量在50%~85%的范围未显著改变酪蛋白磷酸肽的持钙能力。添加3%以上的肉类和果蔬类配料的添加量显著降低了酪蛋白磷酸肽的持钙能力。20 mg/kg的烟酰胺降低了酪蛋白磷酸肽的持钙能力,而其它维生素、乳清蛋白和大豆蛋白则未对其产生显著影响。进一步分析发现,肉类配料中脂肪和蛋白质以及果蔬类配料中的酚类化合物可能是影响酪蛋白磷酸肽持钙能力的关键因素。本文对于明确婴幼儿辅助食品中影响酪蛋白磷酸肽持钙能力的因素,使其更好地发挥功效具有一定的指导意义。

社区婴幼儿贫血状况调查分析

目的调查分析社区婴幼儿贫血状况。方法选择某社区2022年9月至2023年9月进行儿童保健的婴幼儿8950例,均采血检测血常规指标,评估贫血检出情况,并分析喂养方式、母亲贫血状态、年龄等对贫血的影响,制定婴幼儿贫血干预对策。结果8950例婴幼儿贫血发生率为2.85%。在喂养方式方面,贫血组纯母乳喂养、及时添加辅食、添加动物性辅食贫血率均低于正常组,差异有统计学意义(P<0.05)。在母亲贫血状态方面,贫血组母亲孕期贫血、产后贫血率均高于正常组,差异有统计学意义(P<0.05)。贫血组1岁以下占比高于正常组,差异有统计学意义(P<0.05)。结论婴幼儿贫血与喂养方式、母亲贫血状态、年龄等均密切相关。社区在开展儿童保健工作时,应根据以上因素给予针对性指导。

婴幼儿回应性喂养实践的研究进展

回应性喂养可满足婴幼儿营养需求,帮助婴幼儿习得良好的进食行为并获得适宜的生长,进而降低婴幼儿营养不足、营养过剩等营养不良的发生风险。虽然我国回应性喂养理论体系日趋成熟,但目前尚未建立统一、标准化的回应性喂养实践体系,且缺乏可广泛应用的回应性喂养评估工具,在回应性喂养实践上仍处于起步阶段。因此,开展以多人群为主体的回应性喂养实践研究、建立回应性喂养实践体系、开发回应性喂养评估工具等对推动我国回应性喂养的实施均具有重要意义。

恒温实时荧光法快速检测婴幼儿辅助食品中胡萝卜成分的研究

为建立婴幼儿辅助食品中胡萝卜成分的恒温实时荧光快速检测方法,根据胡萝卜ITS1-5.8SRNA-ITS2基因序列设计合成恒温实时荧光法(LAMP)的特异性引物,以常见农产品及不同胡萝卜质量分数的白萝卜DNA分别验证方法的特异性和灵敏度,选取不同品系胡萝卜种子验证方法的适用范围,并通过预包装食品检测其实用性。结果表明:所建方法与其他物种无交叉反应,特异性强,能在1 h内检测低至质量分数为0.01%的胡萝卜成分,灵敏度高,适用于不同品系胡萝卜的检测。适用范围广,通过实际样本的检测验证,结果快速、准确。该方法操作简单、成本较低、数据智能判读实时同步、结果准确快速,可用于婴幼儿辅助食品中胡萝卜成分的快速检测,为婴幼儿食品标签管理及食品安全监管提供技术依据。

超声提取结合LC-AFS法测定婴幼儿辅助食品中的无机砷

基于超声辅助提取,建立了不同婴幼儿辅助食品中无机砷的液相色谱-原子荧光光谱联用检测方法。样品首先经超声提取、正己烷净化、过膜,经阴离子柱(PRP-X100,10μm,4.1 mm×250 mm)分离。再以15 mmol/L磷酸氢二铵溶液(pH=6.0)为流动相,等度洗脱后进入原子荧光仪检测。结果表明:在5~100 ng/mL浓度范围内,各形态砷线性关系良好,各组分相关系数在0.999以上。该方法检出限为0.010 mg/kg。三水平加标回收率范围为88.7%~96.3%,相对标准偏差(RSD)为1.8%~4.9%。该方法具有样品前处理过程简单、提取效率高、分析速度快、准确度高和重复性好。因此可以满足婴幼儿辅助食品中不同形态无机砷的检测要求。

上海市市售婴幼儿谷类辅助食品中脱氧雪腐镰刀菌烯醇的膳食暴露评估

利用2018~2022年上海市市售婴幼儿谷类辅助食品中脱氧雪腐镰刀菌烯醇(DON)的风险监测数据,采用点评估法对婴幼儿谷类辅助食品中的DON进行膳食暴露评估。结果表明:在221件婴幼儿谷类辅助食品中DON的检出率为12.2%,平均含量为17.0μg/kg。上海市846名0~36月龄婴幼儿每日婴幼儿谷类辅助食品的食用率为8.6%,且食用人群每日通过婴幼儿谷类辅助食品摄入DON的膳食暴露量平均值和P95值分别为0.048、0.168μg/kg·bw,分别占每日耐受摄入量(TDI)的4.8%和16.8%,总体健康风险较低。

中国儿童营养状况15年变化分析——中国婴幼儿辅食喂养的改善

目的利用中国食物与营养监测数据，描述1992～2005年中国婴幼儿喂养的改善情况。方法以各种辅助食品开始添加的时间和添加频率描述了我国婴幼儿辅助喂养的改善。以logistic回归方法分析了中国儿童各种辅食添加时间和添加频率与生长发育的关系。结果1992年-2005中国婴幼儿，特别是农村婴幼儿辅食喂养的模式有了很大的改善。婴儿6个月龄按时添加奶及其制品、蔬菜，水果、动物性食品与婴幼儿生长迟缓率、低体重率呈负相关。没有按时添加奶及其制品对婴幼儿生长迟缓的相对危险度为1．378，对低体重的相对危险度1．189。每天添加牛奶，动物性食物，蔬菜＼水果对婴幼儿身高增长和体重增长有非常重要的作用。结论15年来中国儿童生长发育的改善，与农民收入增加后婴幼儿辅助喂养的改善有关。

我国婴幼儿出生与喂养状况调查研究

目的:系统了解、及时掌握我国城乡婴幼儿营养与健康状况的现状、变化趋势及其影响因素,为国家制订相关政策及发展规划提供准确的信息;提高我国婴幼儿的体质及健康水平。方法:采用多阶段分层整群随机抽样方法。为了保证婴幼儿的调查人数,在样本地区适当补充调查人数。调查步骤由询问调查、医学体检、实验室检测和膳食调查四个部分组成。结果:我国婴儿出生体重和身长平均分别为3309g和50.0cm,城市显著高于农村(P<0.001),婴儿低出生体重和巨大儿出生比例以及早产率分别为3.6%、5.3%和12.3%,城乡差别显著(P<0.001);本次调查4个月内婴儿,基本纯母乳喂养率为71.6%,农村显著高于城市(P<0.001)。出生后4个月以内添加辅食的比例累计达到30.4%、4-6个月为57.2%。结论:我国婴幼儿生长发育状况明显改善,新生儿出生后喂养方式仍存在很多不合理现象,随着爱婴医院的创建与完善,我国母乳喂养率有了一定提高,但与提出的目标还有差距。

营养强化辅助食品补充物对甘肃贫困农村婴幼儿体格生长的影响

目的探讨补充含有蛋白质、微量营养素的辅助食品对婴幼儿身长和体重的影响。方法从甘肃省5个贫困县选取1478名4～12个月的婴幼儿分成2组，所有儿童均在保持其家庭习惯辅助食品添加的前提下。每天再补充1包不同配方的营养补充物，其中配方1组补充了蛋白质和微量营养素，配方2组补充了与配方1组同等的能量，每隔6个月对全部儿童补充一次大剂量维生素A。补充期间，每3个月进行一次体格测量，两组儿童观察到满24个月为止。结果基线调查时，配方2组LAZ和WAZ要优于配方1组，配方1组儿童的营养不良率均高于配方2组，但差异无显著性（P〉0．05）。补充12个月以后，配方1组和配方2组儿童LAZ、WAZ和营养不良率已经没有差别。如果比较同一个儿童随访调查与其基线调查时的LAZ差值、WAZ差值的变化．配方1的作用要优于配方2，效用尺度是0．17。对于基线调查不同营养状况的儿童，配方1组均有正的效用。所有儿童满24个月时，儿童身长和体重Z评分的变化值在配方1组和配方2组之间有显著意义（P〈0．05），配方1组婴幼儿身长的变化值要显著大于配方2组（P〈0．05），如果只分析基线调查时月龄小于7个月的儿童。配方1组儿童身长Z评分的变化值要显著优于配方2组（P〈0．005），儿童平均身长要多增加1．3cm（P〈0．005）。结论辅食补充物可以促进婴幼儿的体格发育，家庭水平强化辅食在中国贫困农村是可行的。

辅助食品补充物对婴幼儿贫血的影响

目的 探讨补充含有蛋白质、微量营养素的辅助食品对婴幼儿血红蛋白和贫血的影响。方法 从甘肃省 5个贫困县选取 4～ 12个月的婴幼儿分成两组 ,其中配方 1组补充了蛋白质和微量营养素 ,两组儿童均观察到 2岁为止。补充期间 ,每隔 6个月对儿童进行一次大剂量维生素A补充 ,并进行血红蛋白测量。结果 基线调查时 ,两组儿童的血红蛋白及贫血率没有显著性差别。补充了 12个月后 ,配方 1组儿童血红蛋白的增加值高于配方 2组 (P <0 0 0 0 5 ) ,儿童贫血率明显下降 ,两配方组之间贫血率有显著差别 ;所有儿童至满 2岁时 ,配方 1组的血红蛋白增加值大于配方 2组 ,有统计学显著意义 (P =0 0 0 6 )。结论 补充微量营养素和大剂量的维生素A可以增加婴幼儿的血红蛋白值 ,降低其贫血率。

营养强化辅食补充对甘肃贫困农村婴幼儿智力发育的影响

目的初步探讨辅食补充对贫困农村婴幼儿智力发育的影响。方法从甘肃省5个贫困县选取4～12个月的婴幼儿分成两组，所有儿童均在保持其家庭习惯的辅助食品添加的前提下，每天再补充1包不同配方的营养补充物，其中配方1组补充了蛋白质和微量营养素，配方2组补充能量达到配方1组的同等的能量。两组均补充维生素A。补充期间，儿童每3个月进行一次体格测量，每6个月进行一次血红蛋白测量，两组儿童观察到满24个月为止。儿童满24个月龄时进行智力发育的测定。结果24个月时配方1组、配方2组儿童的总发育商分别为97、2、95．5，有显著性差别（P〈0．05），其中大运动区也有显著性差别（P〈0.05）。两配方组儿童在辅食的补充时间、营养状况、性别构成、母亲文化程度等没有显著差别，但是24个月时儿童血红蛋白值两配方组有显著性差别（P=0．011）。结论补充营养素强化的辅助食品有利于贫困农村4～12个月婴儿的智力发育。

辅食补充对贫困农村婴幼儿呼吸道感染和腹泻的影响

目的 探讨强化辅助食品对婴幼儿呼吸道感染和腹泻两周内患病的影响。方法 从甘肃省5个贫困县选取4～12个月的婴幼儿分成两组，所有儿童均在保持其家庭习惯的辅助食品添加的前提下，每天再补充1包不同配方的营养补充物，其中配方Ⅰ组补充了蛋白质和微量营养素。每隔6个月对全部儿童补充一次大剂量的维生素A，两组儿童观察到满24个月为止。补充期间，每3个月进行一次体格测量，记录此期间儿童患呼吸系统疾病和腹泻的情况。结果 补充12个月随访调查时，儿童近两周呼吸系统疾病和腹泻患病率下降明显，与基线调查比较，呼吸系统疾病和腹泻患病率的差异有显著性（P〈0．001），同一次调查两配方组儿童疾病患病率之间差异无显著性；配方Ⅰ组婴幼儿每次患呼吸系统疾病的病程逐渐下降。呼吸系统疾病和腹泻总的医疗费是明显下降的。结论 补充营养素强化的辅食和大剂量维生素A，可以降低儿童腹泻和呼吸道感染的发病率，减少医疗费用。

北京、天津和青岛三市1773例6～12月龄婴幼儿养育现状调查

目的了解中国部分大城市婴幼儿的养育现状,为进一步开展婴幼儿养育方式的营养宣教提供依据。方法在北京、天津及青岛三市的各大医院预防保健门诊,对前来进行预防接种的1773例6～12月龄婴幼儿的家长进行了养育状况的问卷调查,并同时对婴幼儿进行了生长发育指标的测量。结果三市婴幼儿生长发育状况一般;6个月全母乳喂养率为33.6%;78.4%的婴幼儿食物转换不合理。结论三市仍存在着部分婴幼儿养育方式不合理的问题。

辅食喂养热点问题及相关研究进展

科学合理的辅食喂养不仅可以保证婴幼儿良好的生长发育,而且有利于婴幼儿形成健康的饮食习惯。世界卫生组织在2002年提出了婴幼儿全球喂养策略,建议婴幼儿应纯母乳喂养至6个月,然后继续母乳喂养的同时开始添加辅食。2007年国家卫计委出台的《婴幼儿喂养策略》提出了相同的建议。随着婴幼儿辅食喂养与健康相关研究的不断深入,世界各国婴幼儿辅食喂养指南也在不断完善和更新。该文对欧美、澳大利亚、日本和我国最新发布的婴幼儿辅食喂养指南中辅食添加时间、顺序及种类、铁的补充和食物过敏等热点问题的最新建议与相关研究进行综述,为基层开展婴幼儿辅食喂养指导提供参考。

高效液相色谱-电感耦合等离子体质谱联用测定婴幼儿辅食中的无机砷

目的:拟建立婴幼儿辅助食品中无机砷含量的测定方法。方法:以0.15mmol/L硝酸溶液为提取剂,90℃热浸提取婴幼儿辅助食品(米粉类及罐头类)中无机砷,采用Hamilton PRP-X100(250mm×4.1mm,10μm)色谱柱分离,建立高效液相色谱-电感耦合等离子体质谱(high performance liquid chromatography-inductively coupled plasmamass spectrometry,HPLC-ICP/MS)联用技术测定其含量的方法。结果表明:As(Ⅲ)与As(Ⅴ)的线性范围为0.5～400μg/L,线性相关系数(r)优于0.9990,检出限分别为0.06μg/L和0.08μg/L,无机砷的加标回收率在80.5%～1 28.5%之间,相对标准偏差(R SD)<5%。结论:方法简便、准确、灵敏,适用于婴幼儿辅助食品中无机砷含量的测定。