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Article(id=1324078237361516840, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202505339, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1748188800000, receivedDateStr=2025-05-26, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614451971, onlineDateStr=2026-11-02, pubDate=1769270400000, pubDateStr=2026-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614451971, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614451971, creator=13701087609, updateTime=1793614451971, updator=13701087609, issue=Issue{id=1324078175000605624, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='1769270400000', pubDateStr='2026-01-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614437103, creator='13701087609', updateTime=1793614526046, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078548130082942, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078548130082943, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=267, endPage=273, ext={EN=ArticleExt(id=1324078237579620649, articleId=1324078237361516840, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Trends and associated factors of complementary feeding practices among children aged 6-23 months in rural areas of Liuzhou, 2017-2024, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the trends and associated factors of complementary feeding practices (CFPs) among infants and young children (IYC) aged 6-23 months in rural areas of Liuzhou from 2017 to 2024.

Methods

Children nutrition improvement program monitoring data of 5 020 IYC in Liuzhou between 2017 and 2024 were retrospectively analyzed. The trends of CFPs were analyzed by trend χ2test, and the influencing factors of CFPs delivery by logistic regression analysis.

Results

The prevalence of minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), egg and/or flesh food consumption (EFF), and zero vegetable or fruit consumption (ZVF) were 64.40%, 82.45%, 53.17%, 90.86%, and 15.14%, respectively. The prevalence of MDD and MAD decreased from 71.92% and 53.82% to 59.17% and 49.70% over the 8 year period, respectively (, 11.912, all P<0.01). The prevalence of MMF and ZVF increased from 77.20% and 9.75% in 2017 to 82.01% and 16.33% in 2024, respectively (, 33.036, all P<0.01). Multivariate logistic regression analysis showed that children of mothers with Miao ethnic group were negatively associated with MMF (OR=1.38, 95% CI: 1.06-1.79) and MAD (OR=1.37, 95% CI: 1.11-1.68). Mothers of senior high school/technical secondary school and above education were positively associated with MDD (OR=0.72, 95% CI: 0.58-0.88), MMF (OR=0.70, 95% CI: 0.55-0.90), and MAD (OR=0.70, 95% CI: 0.57-0.87). Fathers with Miao ethnic group were negatively associated with MMF (OR=2.04, 95% CI: 1.56-2.67) , and positively associated with ZVF (OR=1.44, 95% CI: 1.16-1.80). Fathers with Dong ethnic group were negatively associated with MMF (OR=1.84, 95% CI: 1.43-2.36). Employed fathers showed a significant association with a higher prevalence of MDD (OR=0.86, 95% CI: 0.74-0.99), MAD (OR=0.78, 95% CI: 0.68-0.90) and EFF (OR=0.70, 95% CI: 0.56-0.88), and lower prevalence of ZVF (OR=0.62, 95% CI: 0.52-0.74). The score for caregiver’s knowledge of feeding and nutrition were positively associated with MDD (OR=0.94, 95% CI: 0.89-0.98), MMF (OR=0.86, 95% CI: 0.80-0.91), MAD (OR=0.86, 95% CI: 0.82-0.90), and EFF (OR=0.89, 95% CI: 0.82-0.97). Children aged 12-23 months were more likely to have MDD (OR=0.35, 95% CI: 0.30-0.41), MAD (OR=0.59, 95% CI: 0.51-0.69), and EFF (OR=0.13, 95% CI: 0.10-0.16) but less likely to have ZVF (OR=0.22, 95% CI: 0.18-0.26). Children with a birth order of being third or greater were negatively associated with MAD (OR=1.26, 95% CI: 1.06-1.50). Multiple children were positively associated with MMF (OR=0.28, 95% CI: 0.14-0.58) and MAD (OR=0.58, 95% CI: 0.41-0.83). Children with diarrhea in the last 2 weeks were positively associated with MMF (OR=0.45, 95% CI: 0.26-0.76). Taking nutrient supplements were positively associated with MDD (OR=0.82, 95% CI: 0.71-0.94), MMF (OR=0.82, 95% CI: 0.68-0.98) and EFF (OR=0.72, 95% CI: 0.58-0.90).

Conclusion

Improvement in CFPs among children aged 6-23 months in rural areas of Liuzhou is unsatisfactory, specifically MDD and MAD. Attention needs to be paid to ethnic minorities, mothers with low education, fathers without job, children with young age and high birth order, and strengthening caregiver’ education on IYC feeding practices, in order to improve CFPs.

, authors=Min HU1, Liu LIU1, Yu ZHANG1, 2, Zheng NONG1, Zi-juan HUANG1, Dan-hao QIN1, Ning-ning PENG1, Ting ZENG1, 2, Ding-yuan ZENG1, 2, authorsList=Min HU, Liu LIU, Yu ZHANG, Zheng NONG, Zi-juan HUANG, Dan-hao QIN, Ning-ning PENG, Ting ZENG, Ding-yuan ZENG, authorCompany=null, correspAuthors=Ding-yuan ZENG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324078241069281598, articleId=1324078237361516840, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=2017—2024年柳州市农村地区6～23月龄婴幼儿喂养状况及影响因素分析, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

分析2017—2024年柳州市农村地区6～23月龄婴幼儿喂养状况及趋势，探讨婴幼儿喂养的影响因素。

方法

对柳州市儿童营养改善项目2017—2024年监测评估的5 020名婴幼儿数据进行回顾性分析，采用趋势χ2检验分析婴幼儿喂养的时间变化趋势，采用logistic回归分析探讨婴幼儿喂养的影响因素。

结果

2017—2024年柳州市农村地区6～23月龄婴幼儿达到最低膳食多样性（MDD）、最低膳食摄入频率（MMF）和最低可接受膳食（MAD）的比例分别为64.40%、82.45%和53.17%，蛋类和/或肉类摄入（EFF）、蔬菜或水果零摄入（ZVF）的比例分别为90.86%和15.14%。8年间MDD、MAD分别从71.92%、53.82%下降至59.17%、49.70%（、11.912，均P<0.01），MMF、ZVF分别从77.20%、9.75%上升至82.01%、16.33%（、33.036，均P<0.01）。多因素logistic回归分析显示：母亲苗族的儿童MMF（OR=1.38，95% CI：1.06～1.79）、MAD（OR=1.37，95% CI：1.11～1.68）不合格的风险更高；母亲高中/中专及以上学历的儿童更可能达到MDD（OR=0.72，95% CI：0.58～0.88）、MMF（OR=0.70，95% CI：0.55～0.90）和MAD（OR=0.70，95% CI：0.57～0.87）；父亲苗族的儿童MMF（OR=2.04，95% CI：1.56～2.67）不合格、ZVF（OR=1.44，95% CI：1.16～1.80）的风险更高，父亲侗族的儿童MMF（OR=1.84，95% CI：1.43～2.36）不合格的风险更高；父亲就业的儿童更可能达到MDD（OR=0.86，95% CI：0.74～0.99）、MAD（OR=0.78，95% CI：0.68～0.90）、EFF（OR=0.70，95% CI：0.56～0.88），ZVF（OR=0.62，95% CI：0.52～0.74）风险更低；喂养与营养知识得分与MDD（OR=0.94，95% CI：0.89～0.98）、MMF（OR=0.86，95% CI：0.80～0.91）、MAD（OR=0.86，95% CI：0.82～0.90）和EFF（OR=0.89，95% CI：0.82～0.97）正相关；12～23月龄儿童更可能达到MDD（OR=0.35，95% CI：0.30～0.41）、MAD（OR=0.59，95% CI：0.51～0.69）和EFF（OR=0.13，95% CI：0.10～0.16），ZVF（OR=0.22，95% CI：0.18～0.26）的风险更低；孩次≥3的儿童MAD（OR=1.26，95% CI：1.06～1.50）不合格的风险更高；多胎的儿童更可能达到MMF（OR=0.28，95% CI：0.14～0.58）和MAD（OR=0.58，95% CI：0.41～0.83）；过去两周有腹泻病史的儿童更可能达到MMF（OR=0.45，95% CI：0.26～0.76）；服用营养素补充剂的儿童更可能达到MDD（OR=0.82，95% CI：0.71～0.94）、MMF（OR=0.82，95% CI：0.68～0.98）和EFF（OR=0.72，95% CI：0.58～0.90）。

结论

柳州市农村地区6～23月龄婴幼儿喂养状况改善不理想，尤其是MDD和MAD。关注少数民族、母亲低学历、父亲无业、低月龄和高孩次的儿童，普及婴幼儿喂养知识以改善农村地区儿童喂养状况。

, authors=胡敏1, 刘柳1, 张玉1, 2, 农铮1, 黄子娟1, 覃单浩1, 彭宁宁1, 曾婷1, 2, 曾定元1, 2, authorsList=胡敏, 刘柳, 张玉, 农铮, 黄子娟, 覃单浩, 彭宁宁, 曾婷, 曾定元, authorCompany=null, correspAuthors=曾定元, authorNote=

胡敏（1984—），女，硕士，副主任医师，研究方向：儿童群体保健

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曾定元，E-mail:
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胡敏（1984—），女，硕士，副主任医师，研究方向：儿童群体保健

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胡敏（1984—），女，硕士，副主任医师，研究方向：儿童群体保健

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Nutrients, 2024, 16(2): 202., articleTitle=The effects of Ying yang Bao on nutritional status of children aged 6-60 months in underdeveloped rural areas of China, refAbstract=null)], funds=[Fund(id=1324078246823866756, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, awardId=Z-B20241363, language=CN, fundingSource=广西卫健委自筹经费科研课题(Z-B20241363), fundOrder=null, country=null), Fund(id=1324078248484811141, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, awardId=桂科AB18126056, language=CN, fundingSource=广西科技重点研发计划(桂科AB18126056), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324078241283191103, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, xref=1., ext=[AuthorCompanyExt(id=1324078241304162624, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, companyId=1324078241283191103, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Maternal and Child Health Hospital, Liuzhou, Guangxi 545001, China), AuthorCompanyExt(id=1324078241312551233, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, companyId=1324078241283191103, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.柳州市妇幼保健院，广西 柳州 545001)]), AuthorCompany(id=1324078241379660098, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, xref=2., ext=[AuthorCompanyExt(id=1324078241388048707, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, companyId=1324078241379660098, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.广西卫健委高龄孕产妇出生队列研究重点实验室)])], figs=[ArticleFig(id=1324078245989200252, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, language=EN, label=Fig.1, caption=Food groups consumed among infant and young children by age in months, 2017-2024 (%), figureFileSmall=4KLbT+0FTZ5nqXPk/ozzog==, figureFileBig=GMUknwSDizjfBhyyKSaTeQ==, tableContent=null), ArticleFig(id=1324078246056309117, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, language=CN, label=图1, caption=2017—2024年不同月龄婴幼儿食物摄入情况(%), figureFileSmall=4KLbT+0FTZ5nqXPk/ozzog==, figureFileBig=GMUknwSDizjfBhyyKSaTeQ==, tableContent=null), ArticleFig(id=1324078246320550270, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, language=EN, label=Table 1, caption=

Prevalence of complementary feeding practices in rural areas of Liuzhou, 2017—2024[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
年MDDMMFMADEFFZVF
2017612(71.92)657(77.20)458(53.82)784(92.13)83(9.75)
2020505(65.50)656(85.08)427(55.38)707(91.70)113(14.66)
2021594(71.14)703(84.19)489(58.56)780(93.41)95(11.38)
2022487(58.39)673(80.70)409(49.04)728(87.29)152(18.23)
2023535(60.52)757(85.63)466(52.71)770(87.10)179(20.25)
2024500(59.17)693(82.01)420(49.70)792(93.73)138(16.33)
合计3 233(64.40)4 139(82.45)2 669(53.17)4 561(90.86)760(15.14)
44.280a9.411b11.912b2.45333.036a
), ArticleFig(id=1324078246396047743, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, language=CN, label=表1, caption=

2017—2024年柳州市农村地区6~23月龄婴幼儿喂养状况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
年MDDMMFMADEFFZVF
2017612(71.92)657(77.20)458(53.82)784(92.13)83(9.75)
2020505(65.50)656(85.08)427(55.38)707(91.70)113(14.66)
2021594(71.14)703(84.19)489(58.56)780(93.41)95(11.38)
2022487(58.39)673(80.70)409(49.04)728(87.29)152(18.23)
2023535(60.52)757(85.63)466(52.71)770(87.10)179(20.25)
2024500(59.17)693(82.01)420(49.70)792(93.73)138(16.33)
合计3 233(64.40)4 139(82.45)2 669(53.17)4 561(90.86)760(15.14)
44.280a9.411b11.912b2.45333.036a
), ArticleFig(id=1324078246463156608, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, language=EN, label=Table 2, caption=

Univariate analysis of complementary feeding practices in rural areas of Liuzhou, 2017—2024 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量nMDDMMFMADEFFZVF
母亲民族
汉族1 5791 072(67.89)1 362(86.26)917(58.07)1 442(91.32)197(12.48)
壮族744491(65.99)662(88.98)443(59.54)679(91.26)108(14.52)
苗族974592(60.78)713(73.20)429(44.05)878(90.14)169(17.35)
侗族1 286849(66.02)1 059(82.35)702(54.59)1 168(90.82)209(16.25)
其他437229(52.40)343(78.49)178(40.73)394(90.16)77(17.62)
χ2值43.692100.03088.7261.41515.983
P值<0.001<0.001<0.0010.8420.003
母亲年龄(岁)
<25900541(60.11)720(80.00)456(50.67)808(89.78)139(15.44)
25～342 7081 782(65.81)2 262(83.53)1 477(54.54)2 469(91.17)409(15.10)
≥351 412910(64.45)1 157(81.94)736(52.12)1 284(90.93)212(15.01)
χ2值9.5546.1715.1461.6000.085
P值0.0080.0460.2620.4490.958
母亲学历
小学及以下771442(57.33)557(72.24)309(40.08)693(89.88)141(18.29)
初中3 0491 968(64.55)2 557(83.86)1 649(54.08)2 786(91.37)438(14.37)
高中/中专及以上1 200823(68.58)1 025(85.42)711(59.25)1 082(90.17)181(15.08)
χ2值26.00767.01273.5442.5507.374
P值<0.001<0.001<0.0010.2790.025
母亲职业
家务2 2621 443(63.79)1 850(81.79)1 156(51.11)2 036(90.01)383(16.93)
就业2 7581 790(64.90)2 289(82.99)1 513(54.86)2 525(91.55)377(13.67)
χ2值0.6671.2557.0813.56210.297
P值0.4140.2630.0290.0590.001
父亲民族
汉族1 7011 148(67.49)1 515(89.07)1 004(59.02)1 544(90.77)225(13.23)
壮族550362(65.82)476(86.55)313(56.91)508(92.36)66(12.00)
苗族981605(61.67)723(73.70)451(45.97)882(89.91)181(18.45)
侗族1 406941(66.93)1 141(81.15)769(54.69)1 290(91.75)210(14.94)
其他370170(45.95)274(74.05)125(33.78)329(88.92)75(20.27)
χ2值69.642129.371105.3915.61525.088
P值<0.001<0.001<0.0010.230<0.001
父亲年龄(岁)
<25418247(59.09)335(80.14)208(49.76)371(88.76)72(17.22)
25～342 4861 611(64.80)2 082(83.75)1 347(54.18)2 255(90.71)389(15.65)
≥352 1041 368(65.02)1 712(81.37)1 107(52.61)1 927(91.59)296(14.07)
χ2值5.6676.1355.9393.6403.796
P值0.0590.0470.1820.1620.150
父亲学历
小学及以下609352(57.80)448(73.56)255(41.87)551(90.48)115(18.88)
初中3 1952 059(64.44)2 662(83.32)1 718(53.77)2 914(91.21)464(14.52)
高中/中专及以上1 194807(67.59)1 011(84.67)683(57.20)1 078(90.28)177(14.82)
χ2值16.86438.98541.7951.0377.688
P值<0.001<0.001<0.0010.5950.021
父亲职业
家务1 113683(61.37)917(82.39)544(48.88)984(88.41)217(19.50)
就业3 8852 535(65.25)3 204(82.47)2 112(54.36)3 559(91.61)539(13.87)
χ2值5.6950.00411.04110.70021.307
P值0.0170.9500.0030.001<0.001
喂养与营养知识得分（）2.68±1.27
儿童性别
男2 7001 739(64.41)2 243(83.07)1 452(53.78)2 453(90.85)419(15.52)
女2 3201 494(64.40)1 896(81.72)1 217(52.46)2 108(90.86)341(14.70)
χ2值0.0001.5711.5850.0000.653
P值0.9940.2100.4530.9900.419
儿童年龄(月)
6～8974439(45.07)831(85.32)425(43.63)730(74.95)323(33.16)
9～11728472(64.84)554(76.10)359(49.31)650(89.29)111(15.25)
12～233 3182 322(69.98)2 754(83.00)1 885(56.81)3 181(95.87)326(9.83)
χ2值203.86926.53063.925399.292319.199
P值<0.001<0.001<0.001<0.001<0.001
孩次
11 502994(66.18)1 251(83.29)850(56.59)1 361(90.61)226(15.05)
22 4101 563(64.85)2 006(83.24)1 289(53.49)2 201(91.33)359(14.90)
≥31 062645(60.73)845(79.57)505(47.55)958(90.21)169(15.91)
χ2值8.5097.86721.0161.2920.614
P值0.0140.020<0.0010.5240.736
低出生体重
否4 7303 039(64.25)3 892(82.28)2 512(53.11)4 301(90.93)714(15.10)
是290194(66.90)247(85.17)157(54.14)260(89.66)46(15.86)
χ2值0.8351.5762.4170.5350.125
P值0.3610.2090.2670.4650.724
早产
否4 7463 043(64.12)3 904(82.26)2 510(52.89)4 310(90.81)716(15.09)
是271188(69.37)233(85.98)158(58.30)248(91.51)44(16.24)
χ2值3.0892.4525.8180.1510.264
P值0.0790.1170.0480.6980.608
胎数
单胎4 8233 092(64.11)3 958(82.07)2 541(52.69)4 381(90.84)738(15.30)
多胎148108(72.97)140(94.59)100(67.57)137(92.57)16(10.81)
χ2值4.91915.57112.6470.5202.251
P值0.027<0.0010.0020.4710.134
过去两周发烧病史
无4 6823 016(64.42)3 848(82.19)2 485(53.08)4 253(90.84)706(15.08)
有334216(64.67)289(86.53)184(55.09)306(91.62)52(15.57)
χ2值0.0094.0638.3610.2290.058
P值0.9250.0440.0130.6320.809
过去两周腹泻病史
无4 8393 120(64.48)3 978(82.21)2 569(53.09)4 403(90.99)730(15.09)
有175110(62.86)158(90.29)98(56.00)154(88.00)29(16.57)
χ2值0.1937.6311.9031.8230.290
P值0.6600.0060.3200.1770.590
是否服用营养素补充剂
是3 8292 539(66.31)3 185(83.18)2 100(54.84)3 527(92.11)550(14.36)
否1 189692(58.20)953(80.15)568(47.77)1 032(86.80)210(17.66)
χ2值26.0225.75824.42930.8667.678
P值<0.0010.016<0.001<0.0010.006
), ArticleFig(id=1324078246555431297, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, language=CN, label=表2, caption=

2017—2024年柳州市农村地区6~23月龄婴幼儿喂养情况影响因素的单因素分析[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量nMDDMMFMADEFFZVF
母亲民族
汉族1 5791 072(67.89)1 362(86.26)917(58.07)1 442(91.32)197(12.48)
壮族744491(65.99)662(88.98)443(59.54)679(91.26)108(14.52)
苗族974592(60.78)713(73.20)429(44.05)878(90.14)169(17.35)
侗族1 286849(66.02)1 059(82.35)702(54.59)1 168(90.82)209(16.25)
其他437229(52.40)343(78.49)178(40.73)394(90.16)77(17.62)
χ2值43.692100.03088.7261.41515.983
P值<0.001<0.001<0.0010.8420.003
母亲年龄(岁)
<25900541(60.11)720(80.00)456(50.67)808(89.78)139(15.44)
25～342 7081 782(65.81)2 262(83.53)1 477(54.54)2 469(91.17)409(15.10)
≥351 412910(64.45)1 157(81.94)736(52.12)1 284(90.93)212(15.01)
χ2值9.5546.1715.1461.6000.085
P值0.0080.0460.2620.4490.958
母亲学历
小学及以下771442(57.33)557(72.24)309(40.08)693(89.88)141(18.29)
初中3 0491 968(64.55)2 557(83.86)1 649(54.08)2 786(91.37)438(14.37)
高中/中专及以上1 200823(68.58)1 025(85.42)711(59.25)1 082(90.17)181(15.08)
χ2值26.00767.01273.5442.5507.374
P值<0.001<0.001<0.0010.2790.025
母亲职业
家务2 2621 443(63.79)1 850(81.79)1 156(51.11)2 036(90.01)383(16.93)
就业2 7581 790(64.90)2 289(82.99)1 513(54.86)2 525(91.55)377(13.67)
χ2值0.6671.2557.0813.56210.297
P值0.4140.2630.0290.0590.001
父亲民族
汉族1 7011 148(67.49)1 515(89.07)1 004(59.02)1 544(90.77)225(13.23)
壮族550362(65.82)476(86.55)313(56.91)508(92.36)66(12.00)
苗族981605(61.67)723(73.70)451(45.97)882(89.91)181(18.45)
侗族1 406941(66.93)1 141(81.15)769(54.69)1 290(91.75)210(14.94)
其他370170(45.95)274(74.05)125(33.78)329(88.92)75(20.27)
χ2值69.642129.371105.3915.61525.088
P值<0.001<0.001<0.0010.230<0.001
父亲年龄(岁)
<25418247(59.09)335(80.14)208(49.76)371(88.76)72(17.22)
25～342 4861 611(64.80)2 082(83.75)1 347(54.18)2 255(90.71)389(15.65)
≥352 1041 368(65.02)1 712(81.37)1 107(52.61)1 927(91.59)296(14.07)
χ2值5.6676.1355.9393.6403.796
P值0.0590.0470.1820.1620.150
父亲学历
小学及以下609352(57.80)448(73.56)255(41.87)551(90.48)115(18.88)
初中3 1952 059(64.44)2 662(83.32)1 718(53.77)2 914(91.21)464(14.52)
高中/中专及以上1 194807(67.59)1 011(84.67)683(57.20)1 078(90.28)177(14.82)
χ2值16.86438.98541.7951.0377.688
P值<0.001<0.001<0.0010.5950.021
父亲职业
家务1 113683(61.37)917(82.39)544(48.88)984(88.41)217(19.50)
就业3 8852 535(65.25)3 204(82.47)2 112(54.36)3 559(91.61)539(13.87)
χ2值5.6950.00411.04110.70021.307
P值0.0170.9500.0030.001<0.001
喂养与营养知识得分（）2.68±1.27
儿童性别
男2 7001 739(64.41)2 243(83.07)1 452(53.78)2 453(90.85)419(15.52)
女2 3201 494(64.40)1 896(81.72)1 217(52.46)2 108(90.86)341(14.70)
χ2值0.0001.5711.5850.0000.653
P值0.9940.2100.4530.9900.419
儿童年龄(月)
6～8974439(45.07)831(85.32)425(43.63)730(74.95)323(33.16)
9～11728472(64.84)554(76.10)359(49.31)650(89.29)111(15.25)
12～233 3182 322(69.98)2 754(83.00)1 885(56.81)3 181(95.87)326(9.83)
χ2值203.86926.53063.925399.292319.199
P值<0.001<0.001<0.001<0.001<0.001
孩次
11 502994(66.18)1 251(83.29)850(56.59)1 361(90.61)226(15.05)
22 4101 563(64.85)2 006(83.24)1 289(53.49)2 201(91.33)359(14.90)
≥31 062645(60.73)845(79.57)505(47.55)958(90.21)169(15.91)
χ2值8.5097.86721.0161.2920.614
P值0.0140.020<0.0010.5240.736
低出生体重
否4 7303 039(64.25)3 892(82.28)2 512(53.11)4 301(90.93)714(15.10)
是290194(66.90)247(85.17)157(54.14)260(89.66)46(15.86)
χ2值0.8351.5762.4170.5350.125
P值0.3610.2090.2670.4650.724
早产
否4 7463 043(64.12)3 904(82.26)2 510(52.89)4 310(90.81)716(15.09)
是271188(69.37)233(85.98)158(58.30)248(91.51)44(16.24)
χ2值3.0892.4525.8180.1510.264
P值0.0790.1170.0480.6980.608
胎数
单胎4 8233 092(64.11)3 958(82.07)2 541(52.69)4 381(90.84)738(15.30)
多胎148108(72.97)140(94.59)100(67.57)137(92.57)16(10.81)
χ2值4.91915.57112.6470.5202.251
P值0.027<0.0010.0020.4710.134
过去两周发烧病史
无4 6823 016(64.42)3 848(82.19)2 485(53.08)4 253(90.84)706(15.08)
有334216(64.67)289(86.53)184(55.09)306(91.62)52(15.57)
χ2值0.0094.0638.3610.2290.058
P值0.9250.0440.0130.6320.809
过去两周腹泻病史
无4 8393 120(64.48)3 978(82.21)2 569(53.09)4 403(90.99)730(15.09)
有175110(62.86)158(90.29)98(56.00)154(88.00)29(16.57)
χ2值0.1937.6311.9031.8230.290
P值0.6600.0060.3200.1770.590
是否服用营养素补充剂
是3 8292 539(66.31)3 185(83.18)2 100(54.84)3 527(92.11)550(14.36)
否1 189692(58.20)953(80.15)568(47.77)1 032(86.80)210(17.66)
χ2值26.0225.75824.42930.8667.678
P值<0.0010.016<0.001<0.0010.006
), ArticleFig(id=1324078246635123074, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, language=EN, label=Table 3, caption=

Multivariate logistic regression analysis of complementary feeding practices in rural areas of Liuzhou, 2017-2024 [OR(95% CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量MDDMMFMADEFFZVF
母亲民族(参照：汉族)
壮族0.78(0.59～1.04)0.93(0.77～1.11)
苗族1.38(1.06～1.79)c1.37(1.11～1.68)b
侗族0.98(0.76～1.26)1.05(0.87～1.27)
其他1.04(0.74～1.45)1.21(0.94～1.57)
母亲文化(参照：小学及以下)
初中0.86(0.72～1.02)0.68(0.56～0.83)a0.76(0.64～0.91)b
高中/中专及以上0.72(0.58～0.88)b0.70(0.55～0.90)b0.70(0.57～0.87)b
父亲民族(参照：汉族)
壮族1.12(0.91～1.39)1.29(0.96～1.73)1.11(0.91～1.35)0.96(0.71～1.29)
苗族1.19(1.00～1.42)2.04(1.56～2.67)a1.20(0.98～1.47)1.44(1.16～1.80)b
侗族0.95(0.81～1.11)1.84(1.43～2.36)a1.06(0.89～1.27)1.02(0.83～1.26)
其他2.14(1.69～2.72)a2.33(1.65～3.28)a2.18(1.65～2.87)a1.64(1.21～2.22)b
父亲职业(参照：家务)
就业0.86(0.74～0.99)c0.78(0.68～0.90)a0.70(0.56～0.88)a0.62(0.52～0.74)a
喂养与营养知识得分0.94(0.89～0.98)b0.86(0.80～0.91)a0.86(0.82～0.90)a0.89(0.82～0.97)b
儿童年龄(月，参照：6～8)
9～110.44(0.36～0.53)a2.03(1.57～2.62)a0.79(0.65～0.96)c0.35(0.26～0.46)a0.35(0.28～0.45)a
12～230.35(0.30～0.41)a1.32(1.07～1.62)b0.59(0.51～0.69)a0.13(0.10～0.16)a0.22(0.18～0.26)a
孩次(参照：1)
21.11(0.97～1.27)
≥31.26(1.06～1.50)b
胎数(参照：单胎)
多胎0.28(0.14～0.58)b0.58(0.41～0.83)b
过去两周腹泻病史(参照：无)
有0.45(0.26～0.76)b
是否服用营养素补充剂 (参照：否)
是0.82(0.71～0.94)b0.82(0.68～0.98)c0.72(0.58～0.90)b
), ArticleFig(id=1324078246719009155, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078237361516840, language=CN, label=表3, caption=

2017—2024年柳州市农村地区6～23月龄婴幼儿喂养多因素logistics回归分析[OR值(95% CI)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量MDDMMFMADEFFZVF
母亲民族(参照：汉族)
壮族0.78(0.59～1.04)0.93(0.77～1.11)
苗族1.38(1.06～1.79)c1.37(1.11～1.68)b
侗族0.98(0.76～1.26)1.05(0.87～1.27)
其他1.04(0.74～1.45)1.21(0.94～1.57)
母亲文化(参照：小学及以下)
初中0.86(0.72～1.02)0.68(0.56～0.83)a0.76(0.64～0.91)b
高中/中专及以上0.72(0.58～0.88)b0.70(0.55～0.90)b0.70(0.57～0.87)b
父亲民族(参照：汉族)
壮族1.12(0.91～1.39)1.29(0.96～1.73)1.11(0.91～1.35)0.96(0.71～1.29)
苗族1.19(1.00～1.42)2.04(1.56～2.67)a1.20(0.98～1.47)1.44(1.16～1.80)b
侗族0.95(0.81～1.11)1.84(1.43～2.36)a1.06(0.89～1.27)1.02(0.83～1.26)
其他2.14(1.69～2.72)a2.33(1.65～3.28)a2.18(1.65～2.87)a1.64(1.21～2.22)b
父亲职业(参照：家务)
就业0.86(0.74～0.99)c0.78(0.68～0.90)a0.70(0.56～0.88)a0.62(0.52～0.74)a
喂养与营养知识得分0.94(0.89～0.98)b0.86(0.80～0.91)a0.86(0.82～0.90)a0.89(0.82～0.97)b
儿童年龄(月，参照：6～8)
9～110.44(0.36～0.53)a2.03(1.57～2.62)a0.79(0.65～0.96)c0.35(0.26～0.46)a0.35(0.28～0.45)a
12～230.35(0.30～0.41)a1.32(1.07～1.62)b0.59(0.51～0.69)a0.13(0.10～0.16)a0.22(0.18～0.26)a
孩次(参照：1)
21.11(0.97～1.27)
≥31.26(1.06～1.50)b
胎数(参照：单胎)
多胎0.28(0.14～0.58)b0.58(0.41～0.83)b
过去两周腹泻病史(参照：无)
有0.45(0.26～0.76)b
是否服用营养素补充剂 (参照：否)
是0.82(0.71～0.94)b0.82(0.68～0.98)c0.72(0.58～0.90)b
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2017—2024年柳州市农村地区6～23月龄婴幼儿喂养状况及影响因素分析
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胡敏 1 , 刘柳 1 , 张玉 1, 2 , 农铮 1 , 黄子娟 1 , 覃单浩 1 , 彭宁宁 1 , 曾婷 1, 2 , 曾定元 1, 2
现代预防医学 | 儿少卫生与妇幼保健 2026,53(2): 267-273
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (2) : 267 -273
2017—2024年柳州市农村地区6～23月龄婴幼儿喂养状况及影响因素分析
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胡敏1, 刘柳1, 张玉1, 2, 农铮1, 黄子娟1, 覃单浩1, 彭宁宁1, 曾婷1, 2, 曾定元1, 2
作者信息
  • 1.柳州市妇幼保健院，广西 柳州 545001
  • 2.广西卫健委高龄孕产妇出生队列研究重点实验室
通讯作者:
曾定元，E-mail:
作者简介:

胡敏（1984—），女，硕士，副主任医师，研究方向：儿童群体保健

Trends and associated factors of complementary feeding practices among children aged 6-23 months in rural areas of Liuzhou, 2017-2024
Min HU1, Liu LIU1, Yu ZHANG1, 2, Zheng NONG1, Zi-juan HUANG1, Dan-hao QIN1, Ning-ning PENG1, Ting ZENG1, 2, Ding-yuan ZENG1, 2
Affiliations
  • Maternal and Child Health Hospital, Liuzhou, Guangxi 545001, China
出版时间: 2026-01-25 doi: 10.20043/j.cnki.MPM.202505339
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摘要
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目的

分析2017—2024年柳州市农村地区6～23月龄婴幼儿喂养状况及趋势，探讨婴幼儿喂养的影响因素。

方法

对柳州市儿童营养改善项目2017—2024年监测评估的5 020名婴幼儿数据进行回顾性分析，采用趋势χ2检验分析婴幼儿喂养的时间变化趋势，采用logistic回归分析探讨婴幼儿喂养的影响因素。

结果

2017—2024年柳州市农村地区6～23月龄婴幼儿达到最低膳食多样性（MDD）、最低膳食摄入频率（MMF）和最低可接受膳食（MAD）的比例分别为64.40%、82.45%和53.17%，蛋类和/或肉类摄入（EFF）、蔬菜或水果零摄入（ZVF）的比例分别为90.86%和15.14%。8年间MDD、MAD分别从71.92%、53.82%下降至59.17%、49.70%（、11.912，均P<0.01），MMF、ZVF分别从77.20%、9.75%上升至82.01%、16.33%（、33.036，均P<0.01）。多因素logistic回归分析显示：母亲苗族的儿童MMF（OR=1.38，95% CI：1.06～1.79）、MAD（OR=1.37，95% CI：1.11～1.68）不合格的风险更高；母亲高中/中专及以上学历的儿童更可能达到MDD（OR=0.72，95% CI：0.58～0.88）、MMF（OR=0.70，95% CI：0.55～0.90）和MAD（OR=0.70，95% CI：0.57～0.87）；父亲苗族的儿童MMF（OR=2.04，95% CI：1.56～2.67）不合格、ZVF（OR=1.44，95% CI：1.16～1.80）的风险更高，父亲侗族的儿童MMF（OR=1.84，95% CI：1.43～2.36）不合格的风险更高；父亲就业的儿童更可能达到MDD（OR=0.86，95% CI：0.74～0.99）、MAD（OR=0.78，95% CI：0.68～0.90）、EFF（OR=0.70，95% CI：0.56～0.88），ZVF（OR=0.62，95% CI：0.52～0.74）风险更低；喂养与营养知识得分与MDD（OR=0.94，95% CI：0.89～0.98）、MMF（OR=0.86，95% CI：0.80～0.91）、MAD（OR=0.86，95% CI：0.82～0.90）和EFF（OR=0.89，95% CI：0.82～0.97）正相关；12～23月龄儿童更可能达到MDD（OR=0.35，95% CI：0.30～0.41）、MAD（OR=0.59，95% CI：0.51～0.69）和EFF（OR=0.13，95% CI：0.10～0.16），ZVF（OR=0.22，95% CI：0.18～0.26）的风险更低；孩次≥3的儿童MAD（OR=1.26，95% CI：1.06～1.50）不合格的风险更高；多胎的儿童更可能达到MMF（OR=0.28，95% CI：0.14～0.58）和MAD（OR=0.58，95% CI：0.41～0.83）；过去两周有腹泻病史的儿童更可能达到MMF（OR=0.45，95% CI：0.26～0.76）；服用营养素补充剂的儿童更可能达到MDD（OR=0.82，95% CI：0.71～0.94）、MMF（OR=0.82，95% CI：0.68～0.98）和EFF（OR=0.72，95% CI：0.58～0.90）。

结论

柳州市农村地区6～23月龄婴幼儿喂养状况改善不理想，尤其是MDD和MAD。关注少数民族、母亲低学历、父亲无业、低月龄和高孩次的儿童，普及婴幼儿喂养知识以改善农村地区儿童喂养状况。

婴幼儿喂养  /  辅食添加  /  趋势  /  影响因素
Objective

To analyze the trends and associated factors of complementary feeding practices (CFPs) among infants and young children (IYC) aged 6-23 months in rural areas of Liuzhou from 2017 to 2024.

Methods

Children nutrition improvement program monitoring data of 5 020 IYC in Liuzhou between 2017 and 2024 were retrospectively analyzed. The trends of CFPs were analyzed by trend χ2test, and the influencing factors of CFPs delivery by logistic regression analysis.

Results

The prevalence of minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), egg and/or flesh food consumption (EFF), and zero vegetable or fruit consumption (ZVF) were 64.40%, 82.45%, 53.17%, 90.86%, and 15.14%, respectively. The prevalence of MDD and MAD decreased from 71.92% and 53.82% to 59.17% and 49.70% over the 8 year period, respectively (, 11.912, all P<0.01). The prevalence of MMF and ZVF increased from 77.20% and 9.75% in 2017 to 82.01% and 16.33% in 2024, respectively (, 33.036, all P<0.01). Multivariate logistic regression analysis showed that children of mothers with Miao ethnic group were negatively associated with MMF (OR=1.38, 95% CI: 1.06-1.79) and MAD (OR=1.37, 95% CI: 1.11-1.68). Mothers of senior high school/technical secondary school and above education were positively associated with MDD (OR=0.72, 95% CI: 0.58-0.88), MMF (OR=0.70, 95% CI: 0.55-0.90), and MAD (OR=0.70, 95% CI: 0.57-0.87). Fathers with Miao ethnic group were negatively associated with MMF (OR=2.04, 95% CI: 1.56-2.67) , and positively associated with ZVF (OR=1.44, 95% CI: 1.16-1.80). Fathers with Dong ethnic group were negatively associated with MMF (OR=1.84, 95% CI: 1.43-2.36). Employed fathers showed a significant association with a higher prevalence of MDD (OR=0.86, 95% CI: 0.74-0.99), MAD (OR=0.78, 95% CI: 0.68-0.90) and EFF (OR=0.70, 95% CI: 0.56-0.88), and lower prevalence of ZVF (OR=0.62, 95% CI: 0.52-0.74). The score for caregiver’s knowledge of feeding and nutrition were positively associated with MDD (OR=0.94, 95% CI: 0.89-0.98), MMF (OR=0.86, 95% CI: 0.80-0.91), MAD (OR=0.86, 95% CI: 0.82-0.90), and EFF (OR=0.89, 95% CI: 0.82-0.97). Children aged 12-23 months were more likely to have MDD (OR=0.35, 95% CI: 0.30-0.41), MAD (OR=0.59, 95% CI: 0.51-0.69), and EFF (OR=0.13, 95% CI: 0.10-0.16) but less likely to have ZVF (OR=0.22, 95% CI: 0.18-0.26). Children with a birth order of being third or greater were negatively associated with MAD (OR=1.26, 95% CI: 1.06-1.50). Multiple children were positively associated with MMF (OR=0.28, 95% CI: 0.14-0.58) and MAD (OR=0.58, 95% CI: 0.41-0.83). Children with diarrhea in the last 2 weeks were positively associated with MMF (OR=0.45, 95% CI: 0.26-0.76). Taking nutrient supplements were positively associated with MDD (OR=0.82, 95% CI: 0.71-0.94), MMF (OR=0.82, 95% CI: 0.68-0.98) and EFF (OR=0.72, 95% CI: 0.58-0.90).

Conclusion

Improvement in CFPs among children aged 6-23 months in rural areas of Liuzhou is unsatisfactory, specifically MDD and MAD. Attention needs to be paid to ethnic minorities, mothers with low education, fathers without job, children with young age and high birth order, and strengthening caregiver’ education on IYC feeding practices, in order to improve CFPs.

Infant and young child feeding  /  Complementary feeding  /  Trend  /  Associated factors
胡敏, 刘柳, 张玉, 农铮, 黄子娟, 覃单浩, 彭宁宁, 曾婷, 曾定元. 2017—2024年柳州市农村地区6～23月龄婴幼儿喂养状况及影响因素分析. 现代预防医学, 2026 , 53 (2) : 267 -273 . DOI: 10.20043/j.cnki.MPM.202505339
Min HU, Liu LIU, Yu ZHANG, Zheng NONG, Zi-juan HUANG, Dan-hao QIN, Ning-ning PENG, Ting ZENG, Ding-yuan ZENG. Trends and associated factors of complementary feeding practices among children aged 6-23 months in rural areas of Liuzhou, 2017-2024[J]. Modern Preventive Medicine, 2026 , 53 (2) : 267 -273 . DOI: 10.20043/j.cnki.MPM.202505339
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婴幼儿喂养直接影响2岁以下儿童的健康、发育和营养状况，最终影响儿童的生存[1-2]。WHO推荐从出生到6月龄纯母乳喂养，此后继续母乳喂养至2岁或以上，同时自婴儿6月龄开始，及时、合理、适量且安全地添加辅食和进行辅食营养补充，以满足婴幼儿的营养需求[2-3]。然而，全球范围内大多数6～23月龄婴幼儿没有按照全球建议喂养，儿童达到最低膳食多样性、最低膳食摄入频率和最低可接受膳食的比例分别为34%、51%和21%，没有食用过蛋类和/或肉类、水果或蔬菜的儿童分别占53%、38%[4-5]。2016—2017年我国6～23月龄婴幼儿喂养状况虽优于全球水平，但仍不理想，且城市和农村地区存在差异[6]。本研究利用2017—2024年柳州市儿童营养改善项目监测数据，分析2017—2024年柳州市农村地区6～23月龄婴幼儿喂养状况及趋势，探讨婴幼儿喂养的影响因素，为农村地区婴幼儿科学喂养提供相关依据。
1　对象和方法
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1.1　对象
数据来自柳州市儿童营养改善项目2017年基线调查和2020—2024年监测评估，项目覆盖柳州市融安县、融水苗族自治县和三江侗族自治县。采用多阶段抽样、按规模大小成比例的概率抽样（PPS）和随机等距抽样相结合的方法进行样本抽选，每县抽取5 个乡（镇），每乡（镇）抽取3～5个村，每村随机抽取12～20名6～23月龄婴幼儿为监测对象。本研究经柳州市妇幼保健院医学伦理委员会批准（批号：快审-科研-2024-033）。
1.2　方法
从项目数据库提取婴幼儿个人和家庭、辅食喂养情况等数据进行分析。调查数据分别来自儿童出生基本情况调查表、家长喂养和营养知识调查表、儿童24小时食物调查表。
1.3　评价指标
2021年WHO和UNICEF新婴幼儿喂养评价指标[1]共包括17项推荐的2岁以下婴幼儿喂养指标，本文主要利用如下5个指标：最低膳食多样性（minimum dietary diversity，MDD）、最低膳食摄入频率（minimum meal frequency，MMF）、最低可接受膳食（minimum acceptable diet，MAD）、蛋类和/或肉类摄入（egg and/or flesh food consumption，EFF）、蔬菜或水果零摄入（zero vegetable or fruit consumption，ZVF），定义及计算方法见参考文献1。
1.4　质量控制
对现场调查人员进行统一培训，调查结束后审核人员对调查问卷进行审核，发现问题及时复核和纠正。调查数据通过Epidata（2017年）、桂妇儿健康服务信息管理系统（2020—2024年）进行双录入，两次信息录入完全一致方可提交。
1.5　统计学方法
采用SPSS 24. 0软件分析数据。计量资料以（）表示；计数资料以例数（%）表示，组间比较采用χ2检验；采用趋势χ2检验分析婴幼儿喂养指标随年份变化趋势；以婴幼儿喂养是否合格（是=0，否=1）为因变量，以父母和儿童特征为自变量，采用二分类logistic回归进行单因素和多因素分析计算OR值。双侧检验，检验水准α=0.05。
2　结果
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2.1　婴幼儿喂养状况及趋势
2017—2024年柳州市儿童营养改善项目监测评估共调查5 379名婴幼儿，剔除不合格问卷后共5 020名婴幼儿纳入研究。2017—2024年柳州市农村地区6～23月龄婴幼儿达到MDD、MMF和MAD的比例分别为64.40%、82.45%和53.17%，EFF、ZVF的比例分别为90.86%和15.14%。8年间MDD、MAD分别从71.92%、53.82%下降至59.17%、49.70%（、11.912，均P<0.01），MMF、ZVF分别从77.20%、9.75%上升至82.01%、16.33%（、33.036，均P<0.01）。见表1。
2.2　不同类型食物摄入情况
儿童前一天最常食用的食物包括谷类和根茎类（94.70%）、肉类（84.68%）、其他水果蔬菜（73.09%），其次是奶类（66.29%）、富含维生素A的水果蔬菜（60.92%）、蛋类（60.64%），豆类、坚果和种子（23.69%）食用比例较最低。随着儿童月龄的增加，母乳喂养率呈下降趋势，其他各类食物的添加率均呈上升趋势（均P<0.001）。见图1。
2.3　婴幼儿喂养的单因素分析
父母民族、年龄、学历、父亲职业、喂养与营养知识得分、儿童年龄、孩次、胎数、是否服用营养素补充剂与MDD相关。父母民族、年龄、学历、喂养与营养知识得分、儿童年龄、孩次、胎数、过去两周疾病史、是否服用营养素补充剂与MMF相关。父母民族、学历、职业、母亲年龄、喂养与营养知识得分、儿童年龄、孩次、胎数、是否服用营养素补充剂与MAD相关。父亲职业、喂养与营养知识得分、儿童年龄、是否服用营养素补充剂与EFF相关。父母民族、学历、职业、儿童年龄、是否服用营养素补充剂与ZVF相关。见表2。
2.4　婴幼儿喂养的多因素分析
母亲苗族的儿童MMF、MAD不合格的风险更高；母亲高中/中专及以上学历的儿童更可能达到MDD、MMF和MAD；父亲苗族的儿童MMF不合格、ZVF的风险更高，父亲侗族的儿童MMF不合格的风险更高；父亲就业的儿童更可能达到MDD、MAD、EFF，ZVF的风险更低；喂养与营养知识得分与MDD、MMF、MAD和EFF正相关；大月龄儿童更可能达到MDD、MAD和EFF，ZVF的风险更低，但MMF不合格的风险更高；孩次≥3的儿童MAD不合格的风险更高；多胎的儿童更可能达到MMF和MAD；过去两周有腹泻病史的儿童更可能达到MMF；服用营养素补充剂的儿童更可能达到MDD、MMF和EFF。见表3。
3　讨论
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本研究利用2021年WHO和UNICEF新婴幼儿喂养评价指标分析2017—2024年柳州市儿童营养改善项目地区6～23月龄婴幼儿喂养状况及趋势，结果显示柳州市农村地区6～23月龄婴幼儿达到MDD、MMF和MAD的比例分别为64.40%、82.45%和53.17%，EFF、ZVF的比例分别为90.86%和15.14%，均优于东亚地区和我国平均水平，除了ZVF[4-6]，MDD也低于湖南省[7]、福建省[8]，MAD低于湖南省[7]。2013年我国6～23月龄婴幼儿MDD、MMF、MAD和EFF的比例分别为36.9%、62.9%、24.7%和70.4%，2016—2017年分别增至60.6%、72.4%、43.4%和76.4%，ZVF从29.4%降至9.1%[4-6]，婴幼儿喂养状况持续改善。柳州市农村地区6～23月龄婴幼儿喂养的改善并不理想，仅MMF有所改善，从2017年的77.20%上升至2024年的82.01%，而MDD和MAD分别从71.92%、53.82%下降至59.17%和49.70%，ZVF从9.75%上升至16.33%。基层医疗机构提供面对面健康教育、营养喂养评价和咨询指导的质量亟待提高，还需探索智能手机和互联网等多种信息传递渠道作为补充。
本研究发现母亲苗族的儿童MMF、MAD不合格的风险更高，父亲苗族的儿童MMF不合格、ZVF的风险更高，父亲侗族的儿童MMF不合格的风险更高。Wei[9]、周旭[10]等报道汉族儿童的喂养状况优于维吾尔族、回族、苗族、土家族等少数民族，可能受到不同民族的生活环境、习俗、社会经济水平、教育水平和医疗保健服务情况等因素的影响。本研究结果显示，母亲学历高、父亲就业、家长喂养与营养知识得分高的儿童喂养状况更好，与以往研究结果一致[10-13]，他们可能更有经济能力负担孩子最佳生长和发展所需的各种食物，更可能接受婴幼儿喂养相关信息和教育，更好的利用医疗保健服务资源，更可能遵循推荐的喂养指南。
本研究结果显示6～8月龄儿童更难达到MDD、MAD和EFF，ZVF的风险更高，类似的研究也证明了这一点[12,14]，可能与母亲喂养知识缺乏，对过敏和消化问题的担心而推迟引入多样化食物，且在低龄儿童添加辅食出现不适反应时易放弃添加。本研究中大月龄儿童MMF不合格的风险更高，与Mekonen[12]、Tekeba[15]等的研究结论相反，但与Aboagye[16]、Akanbonga[17]等报道相符，需要关注9～23月龄儿童的喂养频次，通过对看护人的健康教育，使其理解较大月龄儿童需要保证喂养频次以满足营养需求。本研究中第3孩及以上的儿童MAD不合格风险更高，与吴慧丹[8]、Kocagozoglu[18]等的研究结果相似，孩子少的家庭可能因食物供应充足、有足够的时间准备食物而保证提供适当的辅食。但Mekonen等[12]报道相较于家庭第1个孩子，第2～4孩得到适当辅食喂养的可能性更高，多次生育的母亲因以前的喂养经验而改善喂养做法。本研究发现，多胎的儿童更可能达到MMF和MAD，过去两周有腹泻病史的儿童更可能达到MMF。多胎通常是早产儿或低出生体重儿[19-20]，脆弱或患病的婴幼儿更可能获得最佳喂养，这一结果得到了其他研究的支持[10,21-22]。可能原因是在孕产期和儿童成长中更频繁地接触医疗保健服务，接受了婴幼儿喂养与营养咨询和健康教育，从而在儿童患病期及恢复期增加喂养以弥补儿童生病期间的营养损失并进行追赶性生长。本研究结果显示，服用营养素补充剂的儿童更可能达到MDD、MMF和EFF。王帅兵[13]、Feng[23]等报道，相较于对照组，营养包干预组看护人喂养及营养知识得分更高、儿童辅食喂养状况更好。儿童营养改善项目的推广使看护人更加关注儿童的成长过程，并间接提高了看护人的辅食喂养技能。
本研究显示，2017—2024年柳州市农村地区6～23月龄婴幼儿喂养的改善并不理想，仍然是儿童营养改善的重要挑战。父母民族、母亲学历、父亲职业、喂养与营养知识得分、儿童月龄、胎次、胎数、过去两周腹泻病史、是否服用营养素补充剂是婴幼儿喂养的影响因素。应重点关注这些高危儿童，普及婴幼儿喂养知识，增加奶类、蛋类、富含维生素A的水果蔬菜等富含营养素食物的摄入，以改善农村地区儿童喂养状况。
基金
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  • 广西卫健委自筹经费科研课题(Z-B20241363)
  • 广西科技重点研发计划(桂科AB18126056)
文献
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参考文献 引证文献
排序方式：
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2026年第53卷第2期
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doi: 10.20043/j.cnki.MPM.202505339
  • 接收时间：2025-05-26
  • 首发时间：2026-11-02
  • 出版时间：2026-01-25
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  • 收稿日期：2025-05-26
基金
广西卫健委自筹经费科研课题(Z-B20241363)
广西科技重点研发计划(桂科AB18126056)
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    1.柳州市妇幼保健院，广西 柳州 545001
    2.广西卫健委高龄孕产妇出生队列研究重点实验室

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Number of
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total species (%)		 属
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
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