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Maternal and Pediatric Nutrition Highlights Original Article

Poor complementary feeding practices and high anaemia prevalence among infants and young children in rural central and western China

European Journal of Clinical Nutrition volume 68, pages 916–924 (2014)Cite this article

Subjects

Abstract

Background/Objectives:

Infant and young child feeding (IYCF) has not been documented in central and western China, where anaemia is prevalent. To support policy advocacy, we assessed IYCF and anaemia there using standardized methods.

Subjects/Methods:

A community-based, cross-sectional survey of 2244 children aged 6–23 months in 26 counties of 12 provinces. Analysis of associations between haemoglobin concentration (HC), IYCF indicators and other variables using crude and multivariate techniques.

Results:

Only 41.6% of those surveyed consumed a minimum acceptable diet. Fewer still-breastfeeding than non-breastfeeding children consumed the recommended minimum dietary diversity (51.7 versus 71.9%; P<0.001), meal frequency (57.7% v. 81.5%; P<0.001) or iron-rich food (63.3% v. 78.9%; P<0.001). Anaemia (51.3% overall) fell with age but was significantly associated with male sex, extreme poverty, minority ethnicity, breastfeeding and higher altitude. Dietary diversity, iron intake, growth monitoring and being left behind by out-migrating parents were protective against anaemia. A structural equation model demonstrated associations between IYCF, HC and other variables. Meal frequency, iron intake and altitude were directly and positively associated with HC; dietary diversity was indirectly associated. Health service uptake was not associated. Continued breastfeeding was directly associated with poor IYCF and indirectly with reduced HC, as were having a sibling and poor maternal education.

Conclusion:

Infant and young child anaemia is highly prevalent and IYCF is poor in rural central and western China. Continued breastfeeding and certain other variables indicate risk of poor IYCF and anaemia. Major policy commitment to reducing iron deficiency and improving IYCF is needed for China’s rural poor.

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Acknowledgements

We gratefully acknowledge the provincial, county and township health bureaux in the surveyed locations for their kind assistance. We also thank Sant-Reyn Pasricha of the University of Melbourne for very helpful comments and suggestions during preparation of the manuscript. All opinions expressed are those of the authors only, not their institutions. This survey was funded by UNICEF China. All authors were funded by their parent institutions.

AUTHOR CONTRIBUTIONS

SG, YW, DBH, XW and HZ designed the research. HZ, XW, YW and SG participated in conduct of the research. XF, YJ, SG and DBH performed statistical analysis. SG, DBH, XF, YJ, HZ, SC and RWS analyzed and interpreted the results. DBH and SG wrote the paper. DBH and SG had primary responsibility for the final content. All authors have read and approved the final manuscript.

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Authors and Affiliations

  1. Health Section, UNICEF, New York, NY, USA

    D B Hipgrave

  2. Health, Nutrition and WASH Section, UNICEF Office for China, Beijing, China

    D B Hipgrave, X Fu, Y Jin, S Chang, R W Scherpbier & S Guo

  3. Division of Maternal and Child Health, School of Public Health, Peking University, Beijing, China

    H Zhou, X Wang & Y Wang

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  1. D B Hipgrave
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Correspondence to D B Hipgrave or Y Wang.

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Hipgrave, D., Fu, X., Zhou, H. et al. Poor complementary feeding practices and high anaemia prevalence among infants and young children in rural central and western China. Eur J Clin Nutr 68, 916–924 (2014). https://doi.org/10.1038/ejcn.2014.98

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