이유기 보충식 현황과 어머니 인식 조사

염혜원,박혜숙,최광해,장주영,류일,양혜란,김재영,서지현,김용주,문경래,강기수,박기영,이성수,심정옥,서정완 대한소아청소년과학회 2009 Clinical and Experimental Pediatrics (CEP) Vol.52 No.10

Purpose:To evaluate current feeding practices and maternal nutritional knowledge on complementary feeding. Methods:Mothers of babies aged 9-15 months who visited pediatric clinics of 14 general hospitals between September and December 2008 were asked to fill questionnaires. Data from 1,078 questionnaires were analyzed. Results:Complementary food was introduced at 4-7 months in 89% of babies. Home-made rice gruel was the first complementary food in 93% cases. Spoons were used for initial feeding in 97% cases. At 6-7 months, <50% of babies were fed meat (beef, 43%). Less than 12–month-old babies were fed salty foods such as salted laver (35%) or bean-paste soup (51%) and cow's milk (11%). The following were the maternal sources of information on complementary feeding: books/ magazines (58%), friends (30%), internet web sites (29%), relatives (14%), and hospitals (4%). Compared to the 1993 survey, the incidence of complementary food introduction before 4 months (0.4% vs. 21%) and initial use of commercial food (7% vs. 39%) had decreased. Moreover, spoons were increasingly used for initial feeding (97% vs. 57%). The average maternal nutritional knowledge score was 7.5/10. Less percentage of mothers agreed with the following suggestions: bottle formula weaning before 15-18 months (68%), no commercial baby drinks as complementary food (67%), considering formula (or cow's milk) better than soy milk (65%), and feeding minced meat from 6-7 months (57%). Conclusion:Complementary feeding practices have considerably improved since the last decade. Pediatricians should advise timely introduction of appropriate complementary foods and monitor diverse information sources on complementary feeding. 목적:이유기의 영양은 영유아의 성장과 발달 뿐 아니라 성인 건강에도 장기적으로 영향을 미친다. 또한 이 시기의 영양섭취는 전적으로 보호자에게 의존하므로 보호자의 이유기 보충식에 대한 인식이 중요하다. 이에 본 영양위원회에서는 이유기 보충식 현황을 조사하여 과거 영양위원회 보고와 비교하고, 어머니의 이유기 보충식에 대한 인식 수준을 조사분석하여 문제점을 파악하고 영유아 영양 상담의 방향과 개선책을 제시하고자 하였다. 방법:2008년 9월에서 12월까지 전국 14개 종합병원 소아청소년과를 방문한 9-15개월 영유아의 어머니를 대상으로 본 위원회에서 만든 설문지를 작성하도록 하였다. 총 1,078매 설문지를 SAS 9.1 통계프로그램을 이용하여 분석하였다. 결과:이유기 보충식을 4-7개월에 89.3%에서 시작하였다. 93.3 %에서 처음 준 음식은 쌀미음이었고, 96.5%에서 숟가락으로 주기 시작하였다. 12-15개월 영유아를 대상으로 식품 도입 시기를 보면 6-7개월에 쇠고기를 준 경우는 43.2%였고 12개월 이전 소금 뿌린 김을 준 경우 35.3%, 된장국을 준 경우는 50.7 %, 생우유를 준 경우는 10.7%였다. 이유기 보충식에 대한 정보원은 육아 책이나 잡지(57.9%), 친구나 또래 엄마(29.9%), 인터넷(28.7%), 부모나 친지(14.1%), 의료인(4.4%) 순이었다. 영양위원회에서 시행한 1993년 조사와 비교하면 4개월 이전 이유기 보충식을 시작한 경우(0.4% vs. 20.6%)와 시판 이유기 보충식으로 시작한 경우(6.7% vs. 38.8%)가 현저히 감소하였다. 숟가락으로 시작한 경우(96.5% vs. 57%)는 현저히 증가하였다. 어머니의 이유기 보충식에 대한 인식 수준에 대한 10문항을 점수화 하였을 때 평균 인식 점수는 7.5±2.1였고 다음 4문항에서 동의율이 낮았다: 고기를 이유기 초기에 도입해야 한다(57.4%), 분유(우유)가 두유보다 좋다(65.1%), 아기에게 이온음료를 먹일 필요가 없다(66.6%), 분유병은 15-18개월에 떼야 한다(67.5%). 인식 점수는 출생 순서가 빠른 경우, 어머니의 나이가 30대인 경우, 학력이 대졸 이상인 경우, 거주 지역이 서울과 경기 지역인 경우, 이유기 보충식에 대한 정보원이 의료인과 책이나 잡지인 경우에 가장 높았다. 결론:이유기 보충식 실행 방법은 과거와 비교하여 현저하게 개선되었다. 소아청소년과 의사는 어떤 음식을 언제 도입하는지에 대한 체계적인 이유기 보충식 스케줄을 제공해야 하며 다양한 이유기 보충식에 대한 정보원을 관리 감독 해야 할 것이다.

다문화 가정의 이유기 보충식 현황과 외국인 어머니의 인식 연구: 한국인 어머니를 대상으로 한 연구와 비교해서

양누리,김혜실,김미경 대한소아소화기영양학회 2011 Pediatric gastroenterology, hepatology & nutrition Vol.14 No.3

Purpose: To evaluate current complementary feeding and maternal nutritional knowledge of a multicultural family in Korea. Methods: Foreign mothers of babies aged 9∼24 months, who visited pediatric clinics or attended a meeting on a multicultural family party between December 2010 and April 2011, were asked to fill out questionnaires. Data from 146 questionnaires were analyzed. Results: Complementary food was introduced at 4∼7 months in 78% of babies. The following were the sources of information on complementary feeding: friends (34%), relatives (27%), books/magazines (19%), multicultural family educational support center (8%), mass media (4%), and hospitals (3%). The cases of complementary food introduction after 8 months (21% vs. 10%, p<0.001), initial use of commercial food (26% vs. 6%, P<0.001) and initial use of bottle feeding (15% vs. 3%, p<0.001) were more frequent compared to the 2009 Korean survey. Mothers agreeing with the following suggestions were relatively fewer: feeding minced meat from 6∼7 months (61%), No mixed cereal powder as complementary food (61%), feeding egg white after 12 months (63%), no adding salt or sugar to the complementary food (64%), bottle weaning before 15∼18 months (66%) and considering formula better than soy milk (68%). Conclusion: Complementary feeding practices of multicultural families showed many points of improvement compared with the 2009 Korean survey. Pediatricians should make more of an effort to consult with families of multicultural infants about nutrition and complementary feeding. Also, the government and the pediatrics academy need to institute policies to support the nutrition of multicultural infants. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 286∼298)

Effectiveness of Nutrition Education in Improving Maternal Knowledge and Attitudes towards Complementary Feeding Practices: A cluster-randomized controlled trial in Ondo State, Nigeria

Akinrinmade, Remilekun,NJOGU, Eunice,OGADA, Irene Awuor,KESHINRO, Olufunke Oluremi Korea FoodHealth Convergence Association 2019 식품보건융합연구 (KJFHC) Vol.5 No.4

Significant low knowledge and poor attitudes on complementary feeding undermine the practices. This study was a cluster randomized controlled trial in which 284 study participants were assigned into two groups. One intervention group and a control group in a ratio of 1:1. Nutrition education on complementary feeding was carried out among the caregivers in the intervention group but the caregivers in the control group were not educated. To determine complementary feeding knowledge and attitudes, data was collected from caregiver at baseline, midline and at endline using researcher-administered questionnaires. Quantitative data were analyzed using SPSS version 22.0. From the analysis, there was a significant difference in complementary feeding knowledge of the caregivers after the intervention. The baseline difference was -0.06, the midline difference was 3.85 the endline difference was 4.00 and the DID of the baseline and endline was 4.06 which was significant at p=0.001. There was a significant difference in the attitude of the caregivers towards complementary feeding at baseline (-0.14), midline (2.09), endline (3.82) and the DID of baseline and endline was 3.96 which was significant at p=0.001. The intervention improved the caregivers' knowledge on complementary feeding and it improved the attitudes of the caregivers towards adequate complementary feeding.

Breastfeeding and Red Meat Intake Are Associated with Iron Status in Healthy Korean Weaning-age Infants

홍지나,장주영,신수,오소희 대한의학회 2017 Journal of Korean medical science Vol.32 No.6

The present study investigated risk factors for iron deficiency (ID) and iron deficiency anemia (IDA) during late infancy, including feeding type and complementary feeding (CF) practice. Healthy term Korean infants (8–15 months) were weighed, and questionnaires regarding delivery, feeding, and weaning were completed by their caregivers. We also examined levels of hemoglobin, serum iron/total iron-binding capacity, serum ferritin, and mean corpuscular volume (MCV). Among 619 infants, ID and IDA were present in 174 infants (28.1%) and 87 infants (14.0%), respectively. The 288 infants with exclusively/mostly breastfeeding until late infancy (BFL) were most likely to exhibit ID (53.1%) and IDA (28.1%). The risk of ID was independently associated with BFL (adjusted odds ratio [aOR], 47.5; 95% confidence interval [CI], 18.3–122.9), male sex (aOR, 1.9; 95% CI, 1.2–2.9), fold weight gain (aOR, 2.6; 95% CI, 1.5–4.6), and perceived inadequacy of red meat intake (aOR, 1.7; 95% CI, 1.0–2.7). In addition to the risk factors for ID, Cesarean section delivery (aOR, 1.9; 95% CI, 1.1–3.2) and low parental CF-related knowledge (aOR, 2.8; 95% CI, 1.5–5.2) were risk factors for IDA. In conclusion, prolonged breastfeeding and perceived inadequacy of red meat intake may be among the important feeding-related risk factors of ID and IDA. Therefore, more meticulous education and monitoring of iron-rich food intake, such as red meat, with iron supplementation or iron status testing during late infancy if necessary, should be considered for breastfed Korean infants, especially for those with additional risk factors for ID or IDA.

Complementary Feeding Practices and Influencing Factors Among Children Under 2 Years of Age: A Cross-Sectional Study in Indonesia

Nurrizka, Rahmah Hida,Wenny, Dwi Muthia,Amalia, Rizki The Korean Society of Pediatric Gastroenterology 2021 Pediatric gastroenterology, hepatology & nutrition Vol.24 No.6

Purpose: This study aimed to analyze the practice of complementary feeding and its influencing factors in children under 2 years of age in Indonesia. Methods: This cross-sectional study used data obtained from the 2017 National Socioeconomic Survey. The sample totaled 1,751 households with children under 2 years of age, who received complementary feeding in urban and rural communities. Furthermore, the practice of complementary feeding was evaluated on the basis of the variations in provided food grouped into two categories: complete and incomplete. This study applied bivariate and multivariate analytical methods. Multivariate analysis was performed using binary logistic regression. Results: The proportion of children under 2 years of age who received complementary feeding with complete variant food was 15.9%, while that with incomplete variant food was 84.1%. Furthermore, the factor influencing the practice of complementary feeding among the children was the mother's educational level (odds ratio: 1.481, 95% confidence interval: 0.245-0.943). Conclusion: Complete complementary feeding, which involves a variety of food sources, is the best approach to improve the nutritional status of infants. Therefore, the source of food for complementary feeding must be accessible to all communities.

이유보충식 도입 시기에 따른 유아기 우식증 관련성 연구: 2008~2015년도 국민건강영양조사 자료 이용

연미영,신혜선,이행신 대한지역사회영양학회 2019 대한지역사회영양학회지 Vol.24 No.2

Objectives: This study examined whether the infant feeding type and duration are related to the introduction of complementary feeding, and whether the appropriate introduction of complementary feeding in infancy is related to tooth decay in toddlers. Methods: The subjects were 1,521 toddlers among 2~3 year old children in the Korea National Health and Nutrition Examination Survey from 2008 to 2015. The toddlers were divided into the appropriate group (4~6 months) and delayed group (>6 months) according to the timing of complementary feeding introduction. Results: The delayed group were 26.5% of subjects and the formula feeding period in the appropriate group and delayed group was 8.4 and 10.3 months, respectively (P=0.002). On the other hand, there was no difference in the breastfeeding period between the appropriate group and delayed group (P=0.6955). Early childhood caries was more common in the delayed group (P=0.0065). The delayed introduction of complementary feeding was associated with a risk of early childhood caries according to the logistic models (OR 1.81, 95% CI 1.27-2.57). Conclusions: The introduction of complementary feeding is associated with early childhood caries. Therefore, the importance of the proper introduction of complementary feeding in infancy should be emphasized, and public relations and education for maternal care and breastfeeding should be provided through health care institutions.

Influence of age at complementary food introduction on the development of asthma and atopic dermatitis in Korean children aged 1-3 years

Lee, Jihyun,Shin, Meeyong,Lee, Bora The Korean Pediatric Society 2021 Clinical and Experimental Pediatrics (CEP) Vol.64 No.8

Background: Complementary food in infancy is necessary for human growth, neurodevelopment, and health. However, the role of allergen consumption in early infancy and its effects on the development of food allergy or tolerance remain unclear. Purpose: To investigate the influence of age at the time of complementary food introduction on the development of asthma and atopic dermatitis in Korean children aged 1-3 years. Methods: We combined data from the Korea National Health and Nutrition Examination Survey collected from 2010 to 2014 and analyzed 1619 children aged 1-3 years who were included in the survey. Multivariate regression analysis was used to identify associations among type of feeding, age at the time of complementary food introduction, and doctor-diagnosed atopic dermatitis and asthma. Results: Age at the time of complementary food introduction was not significantly associated with doctor-diagnosed atopic dermatitis and asthma in children aged 1-3 years. In the univariate analysis, children with asthma showed higher water and sodium intake levels than nonasthmatic children. However, this relationship was not significant in the multivariate regression analysis. Conclusion: The present study revealed no statistically significant relationship between age at the time of complementary food introduction and the risk of atopic dermatitis and asthma in young Korean children. A national prospective study is needed to clarify the influence of age at the time of complementary food introduction on the development of allergic diseases.

Prevalence and Predictors of Complementary Feeding Practices Among Children Aged 6-23 Months in Indonesia

Siti Nurokhmah,Lucinda Middleton,Aryono Hendarto 대한예방의학회 2022 예방의학회지 Vol.55 No.6

Objectives: Poor complementary feeding practices have consistently contributed to the burden of child undernutrition in Indonesia. This study aimed to estimate the prevalence and predictors of the time of the introduction of solid, semi-solid, and soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD). Methods: We analyzed 4804 last-born infants aged 6-23 months from the 2017 Indonesia Demographic and Health Survey, which employed multistage cluster random sampling. The outcomes were calculated based on the 2021 World Health Organization/United Nations Children’s Fund guidelines. The predictors of the 4 complementary feeding indicators were assessed using multivariate Poisson regression with robust variance adjusting for potential confounders and study design. Results: The prevalence of ISSSF, MDD, MMF, and MAD was 86.1%, 54.3%, 71.8%, and 37.6%, respectively, with younger children less likely to meet 3 out of the 4 outcomes. Parental education, the presence of a birth attendant, and maternal media consumption were among the predictors of MDD and MAD. Children from families with higher income were more likely to meet MDD than those from low-income households (adjusted prevalence ratio [aPR], 1.16; 95% confidence interval [CI], 1.05 to 1.28). Living in an urban area was positively associated with MMF (aPR, 1.09; 95% CI, 1.04 to 1.15) and MAD (aPR, 1.12; 95% CI 1.02 to 1.24). In eastern regions, the prevalence of children achieving MDD and MAD was lower than in those living in Java and Bali. Conclusions: It is crucial that more attention and efforts are made to improve the recommended practices throughout Indonesia, since the prevalence of adequate complementary feeding practices remains low.

Compliance of mothers’ breastfeeding and complementary feeding practices with WHO recommendations in Turkey

Gulperi Demir,Hulya Yardimcı,Ay?e Ozfer Ozcelik,Funda Pınar Cakıro?lu 한국영양학회 2020 Nutrition Research and Practice Vol.14 No.6

BACKGROUND/OBJECTIVES: This study aimed to evaluate how breastfeeding and complementary nutrition practices of mothers of 0-24-month-old children comply with the World Health Organization (WHO) recommendations for infant and young child feeding and to compare the results with selected demographic parameters related to the mother and child. SUBJECTS/METHODS: The research sample comprised mothers (n = 250) with children less than 2 years old. Data were obtained via questionnaire and were analyzed using SPSS 20.0 package program. The Pearson χ² or Fisher"s exact tests were used for assessing relationships between categorical variables. The one-sample t-test was used for comparisons with reference values. RESULTS: Most mothers (97.2%) breastfed their babies immediately after birth. The mean time to breastfeeding after delivery was 47.8 ± 14.8 minutes, and 40.8% of the mothers complied with the WHO recommendation. Furthermore, 59.8% of the mothers exclusively breastfed their children for 6 months (mean 5.2 ± 1.5 months). The mean duration to the start of providing complementary food was 5.8 ± 0.6 months, and 76.1% of mothers who complied with the WHO recommendation. Only 12.3% of mothers breastfed their children for at least 12 months (mean 7.7 ± 3.3 months). On average, mothers gave cow milk to their children for the first time at 10.1 ± 1.7 months and honey at 11.8 ± 2.3 months. The mothers" rates of compliance with the WHO recommendations on cow milk and honey feeding were 32.0% and 71.6%, respectively. The rate of mothers who complied with the WHO minimum meal frequency recommendation was 88.3%. CONCLUSIONS: We suggest that the WHO recommendations on this subject will be realized more fully by emphasizing the importance of the positive effects of breastfeeding until the age of 2 years and of a timely start of complementary food provision. Such changes will affect child health over the long term.

Local-food-based complementary feeding for the nutritional status of children ages 6–36 months in rural areas of Indonesia

Tantut Susanto,Syahrul,Lantin Sulistyorini,Rondhianto,Alfi Yudisianto 대한소아청소년과학회 2017 Clinical and Experimental Pediatrics (CEP) Vol.60 No.10

Purpose: This study aimed to evaluate a pilot project of the Nursing Feeding Center “Posyandu Plus” (NFCPP) through local food-based complementary feeding (LFCF) program designed to improve the nutritional status of children aged 6–36 months at community health centers in Indonesia. Methods: A quasi-experimental design was used to obtain data regarding the nutritional status of 109 children who participated in the project from 6 rural areas. The NFCPP was conducted for 9 weeks, comprising 2 weeks of preintervention, 6 weeks of intervention, and one week of postintervention. The LFCF intervention consisted of 12 sets of recipes to be made by mothers and given to their children 4 times daily over 6 weeks. The weight-for-age z score (WAZ), height-for-age z score (HAZ), weight-for-height z score (WHZ), and body mass index-for-age z score (BAZ) were calculated using World Health Organization Anthro Plus version 1.0.3. Results: LFCF intervention significantly increased WHZ, WAZ, and BAZ scores but decreased HAZ scores (P<0.001). Average scores of WHZ (0.96±0.97) and WAZ (0.45±0.72) increased; BAZ increased (1.12±0.93) after 6 weeks of LFCF. WAZ scores postintervention were 50.5% of normal, and WHZ scores were 77.1% of normal. However, the HAZ score decreased by 0.53±0.52, which indicated 57.8% had short stature. Conclusion: The NFCPP program with LFCF intervention can improve the nutritional status of children in rural areas. It should be implemented as a sustained program for better provision of complementary feeding during the period of lactation using local food made available at community health centers.