PEMBERIAN DAN PERILAKU MAKAN PADA BALITA STUNTING DAN NON-STUNTING DI PUSKESMAS PERAWATAN MEKARSARI

Stunting merupakan salah satu permasalahan gizi di negara berkembang. Prevalensi kejadian stunting di Kalimantan Timur mencapai 30,6%, sedangkan prevalensi di Kota Balikpapan mencapai 30,3% pada tahun 2019. Salah satu faktor yang memengaruhi stunting adalah keluarga terutama orang tua dalam hal pola asuh anak. Pola asuh anak tersebut berupa pola pemberian makan dan perilaku makan anak yang berhubungan dengan asupan nutrisi yang diterima oleh anak. Tujuan penelitian ini untuk mengetahui pengaruh pemberian dan perilaku makan anak terhadap kejadian stunting pada balita usia 24-59 bulan di wilayah kerja Puskesmas Perawatan Mekarsari Balikpapan. Penelitian ini adalah studi case control dengan rasio kasus kontrol sebesar 1:1 dengan total sampel 54 responden, yaitu 27 balita yang terkategori stunting dan 27 balita yang terkategori tidak stunting. Instrumen yang digunakan Child Feeding Questionnaire (CFQ), Child Eating Behaviour Questionnaire (CEBQ) dan data sekunder hasil pengukuran antropometri. Analisis data menggunakan uji chi-square dengan tingkat kepercayaan (CI) 95%. Hasil penelitian menunjukkan ada pengaruh antara pemberian makan (nilai p = 0,003) dan perilaku makan anak (nilai p = 0,000) dengan kejadian stunting pada balita usia 24-59 bulan. Kedua variabel merupakan faktor protektif dari terjadinya stunting (OR < 1). Disimpulkan pemberian dan perilaku makan anak berpengaruh terhadap terjadinya stunting. Oleh karenanya diperlukan pelatihan terhadap orang tua melalui posyandu dan Bina Keluarga Balita terkait pemberian dan perilaku makan anak.

Maternal perception, concern and dissatisfaction with child weight and their association with feeding practices in the Generation XXI birth cohort

What a mother thinks about her child’s weight status, perceiving healthy or overweight might influence concern about child weight and in turn what and how she feeds her child. We examined the association between maternal perception, concern and dissatisfaction with child weight alongside feeding practices. Participants were from the Generation XXI birth cohort (n=3233). A validated version of the Child Feeding Questionnaire and the Overt/Covert Control scale were used. Mothers self-reported perception, level of concern and dissatisfaction with child weight using a Likert scale. Associations were evaluated cross-sectionally at ages 4 and 7 years by linear regression models (β̂ coefficients and 95% confidence intervals (95%CI) with Bonferroni correction). Perceived underweight was associated with practices promoting food intake, such as higher pressure to eat at ages 4 and 7 years (β̂=0.229;95%CI:0.059,0.398 and β̂=0.190;95%CI:0.005,0.376, respectively) and lower restriction at age 4 (β̂=-0.175;95%CI:-0.0310,-0.039). At age 7, perceived overweight was associated with higher covert control (β̂=0.203;95%CI:0.029,0.376). Mothers who were concerned about child weight reported higher restriction (β̂=0.226;95%CI:0.142,0.310 at 4y and β̂=0.261;95%CI:0.169,0.353 at 7y) and covert control (β̂=0.183;95%CI:0.083,0.282 at 4y and β̂=0.171;95%CI:0.073,0.269 at 7y). Maternal desire for a heavier child was associated with higher pressure to eat at both ages (β̂=0.285;95%CI:0.163,0.406 at 4y and β̂=0.393;95%CI:0.266,0.520 at 7y), while the desire for a thinner child was related to higher covert control at 7 years of age (β̂=0.158; 95%CI:0.001,0.316). Maternal perceptions and concern for child weight status are associated with feeding practices independently of actual weight status.

Caregivers' feeding practices in Ethiopia: association with caregiver and child characteristics

Feeding is a source of interaction and communication. It affects children's physical and psychological/emotional development. The present study aims to examine the association between caregiver and child characteristics and caregivers' feeding practices among preschools in Addis Ababa. We conducted a cross-sectional study among 542 caregivers of children aged between 3 and 6 years old in selected preschools. We used the Child Feeding Questionnaire (CFQ) to measure caregivers' feeding practices. Multiple linear regression was used for analysis. Caregivers who had higher levels of perceived feeding responsibility (β 0⋅20, P < 0⋅001), who were more concerned about their child being overweight (β 0⋅11, P < 0⋅001) and who had more depressive symptoms (β 0⋅23, P 0⋅05) were associated with food restriction practice. Caregivers who were less concerned about their child being overweight (β −0⋅10, P < 0⋅001) and who had higher levels of perceived feeding responsibility (β 0⋅25, P < 0⋅001) were associated with pressure to eat practice. Caregivers who had higher education (β 0⋅29, P < 0⋅05), who had higher levels of perceived feeding responsibility (β 0⋅47, P < 0⋅001), who were more concerned about their child being overweight (β 0⋅15, P < 0⋅001) and who were less concerned about their child underweight (β −0⋅06, P < 0⋅05) were associated with monitoring feeding practice. In addition, as the children have gotten older (β 0⋅08, P < 0⋅05), there is increased use of monitoring feeding practice. This study is one of few studies that show the association between caregiver and child characteristics and feeding practices in developing countries such as Ethiopia. It is essential to include responsive feeding components in national nutritional programmes to improve preschool children's nutritional status in Ethiopia.

Cultural adaptation of the Child Feeding Questionnaire for use in Brazil

ABSTRACT Objective A methodological study aimed at performing the cultural adaptation of the Child Feeding Questionnaire for its use in Brazil. Methods We collected data in a city in the northeastern region of the state of São Paulo, between March and September 2018; seven judges assessed its language standardization, and 85 parents of preschool children performed the cultural adaptation. Results The judges’ agreement level was above 80% for 54 of the 55 statements in the questionnaire. For the parents, the questionnaire is very good, they had no difficulties in using it; most of them understood the affirmative sentences and all parents considered the questionnaire important for the knowledge of child´s healthy eating. We estimated the internal consistency by considering the Kuder-Richardson coefficient for dichotomous variables, and the correlation of each item with the total score was also sought. The results showed values between 0.72 and 0.76, indicating a good consistency, which confirms the reliability of the Brazilian version of the questionnaire. Conclusions The Child Feeding Questionnaire was culturally adapted, aided by the parents. Future studies must be conducted in other Brazilian realities to allow the questionnaire to be widely used. It contributes to promoting the implementation of better practices in child feeding that favor healthy growth and development, as well as to encourage healthy habits in Brazilian families, and to reduce overweight and childhood obesity in the country.

Parental feeding practices across child’s weight status: Evidence of the Italian validation of the Child Feeding Questionnaire

Objective: The main aim of this study was to assess the psychometric proprieties of the Child Feeding Questionnaire (CFQ) in Italian mothers. Design: Mothers completed the Italian version of the CFQ, and children’s anthropometric data were collected. Construct validity of the CFQ was assessed by comparing three different models: (a) a seven correlated factors model in which all items were analysed; (b) a seven correlated factors model with composite items based on the Restriction factor and (c) an eight correlated factors model with a separate Reward factor. Measurement invariance using BMI categories and gender was evaluated. Furthermore, discriminant validity with group comparison was performed between BMI categories and gender. Setting: Italy. Participants: A total of 1253 6-year-old Italian children (53·9 % male) attending elementary school (1st grade) and their mothers (mean age = 38·22 years; sd = 4·89) participated in this study. Results: The eight-factor model with a separate reward factor provided the best fit for the data. The strict invariance of the CFQ across child BMI categories and gender was confirmed. The CFQ internal consistency was acceptable for most subscales. However, two subscales showed no adequate values. As expected, the CFQ scales showed significant differences between BMI categories, while no gender-related differences were found. Conclusions: The study indicated the Italian version of the CFQ to be factorially valid for assessing parental feeding practices of 6-year-old children across BMI categories. Future research should address low internal consistency in some of the CFQ subscales.

Epilepsi Hastası Çocuklarda Beslenme Durumunun Saptanması

Amaç: Epilepsi beynin kortikal ve subkortikal bölgelerindeki nöronların uyarımında artma sonucu meydana gelen, anormal bir elektrik yayılımı ile tekrarlayan nöbetlerin oluştuğu klinik bir tablodur. Birçok çalışma, fazla kilo ve obeziteye bağlı komorbiditelerin sıklıkla görülmesi nedeniyle epilepsi tanısı alan çocuklarda besin alımı ve beslenme durumunun araştırılmasının oldukça önemli olduğunu vurgulamaktadır. Bu çalışma epilepsi tanısı almış çocuklarda beslenme durumunu ve bunu etkileyen etmenleri belirlemek amacıyla planlanmış ve yürütülmüştür. Bireyler ve Yöntem: Tanımlayıcı tipte olan bu çalışma Ocak-Mart 2017 tarihleri arasında Gülhane Eğitim Araştırma Hastanesine başvuran yaşları 1-18 yıl arasında değişen ve epilepsi tanısı almış 83 çocuk ve annesi ile tamamlanmıştır. Anket formu 13 tanımlayıcı, 9 hastalık bilgisine yönelik soru, üç günlük besin tüketim kaydı ve Çocuk Besleme Anketi (Child Feeding Questionnaire-CFQ)’nden oluşmaktadır. Anket formu yüz yüze görüşme yöntemi ile uygulanmıştır. Bulgular: Katılımcıların yaş ortalaması 9.94±4.62 yıldır. En sık kullanılan ilaç %60.2 ile Valproattır. Türkiye Beslenme Rehberine (TÜBER-2015) göre katılımcıların yağ tüketimlerinin yüksek, posa ve kalsiyum alımlarının düşük olduğu saptanmıştır. Doğum ağırlığı ile algılanan çocuk vücut ağırlığı arasında pozitif, hastalık süresi ile algılanan sorumluluk, çocuk vücut ağırlığı, izlem ve kısıtlama alt ölçek puanları arasında ters yönlü bir korelasyon olduğu saptanmıştır. Algılanan çocuk vücut ağırlığı puanı ortalamasının erkeklerde, çocuk vücut ağırlığı puanı ortalaması ve yeme baskısı puan ortalamasının ise kızlarda daha yüksek olduğu saptanmıştır (p<0.05). Yaşa göre beden kütle indeksi (BKİ) dağılımlarına göre algılanan çocuk vücut ağırlığı, kısıtlama ve yeme baskısı puan ortalamalarında önemli farklılıklar saptanmıştır (p<0.05). Sonuç: Sonuç olarak hem yetersiz beslenme hem de obezite epilepsili çocuklar için beslenme ile ilişkili önemli sağlık sorunlarındandır. Diyetisyenlerin konu ile ilgili eğitimler düzenleyip ailelerin hastalık hakkındaki bilgi düzeylerini arttırması, çocukların beslenme durumlarını takip ederek erken müdahale etmesi epilepsinin daha etkin tedavi edilmesini sağlayacağı düşünülmektedir.