目的 评估喂养困难儿童进食技能和喂养行为的相关因素,为临床干预提供科学依据.方法 采用直接问询法,通过问询父母了解189名6个月～4岁喂养困难儿童的喂养史,对其进行体格检查评估、膳食调查评估、喂养行为及进食技能发育水平评估,并运用多元逐步回归分析喂养困难儿童进食技能发育水平与喂养行为的关系.结果 189名儿童中进食技能发育落后者占50.3%(95/189).儿童进食行为问题依次为:进食不专心占91.0%(172/189),进食时间过长占54.5%(103/189),1～4岁嗜好零食占41.1%(60/146),进食恶心占27.0%(51/189).喂养人喂养行为问题包括:食物质地制备不合理,引入泥糊状或固体食物的时间延迟占36.0%(68/189);强迫进食占77.8%(147/189);长期追喂占78.8%(115/146);未能适时提供餐具训练为27.5%(52/189).经相关分析显示,儿童进食技能发育落后与不同质地食物及其引入时间延迟、未能适时进行餐具训练、进食不专心、家长喂养知识欠缺显著相关(F分别为11.892、10.256、3.601、5.007,均P<0.05).结论 喂养困难儿童存在多种喂养行为问题,食物的引入时间和质地、未能适时进行餐具训练、进食不专心、父母喂养知识欠缺对儿童进食技能发育产生显著影响.%Objective To evaluate eating skills of infants with feeding difficulty and feeding behavior so as to provide scientific basis for clinical interventions. Methods In direct inquiry method,the parents of 189 children aged 6 months to 4 years were investigated for feeding history of their children with feeding difficulty. The physical examination results, physical development, diet investigation results and feeding behavior and eating skill development of the children were evaluated. The relationship between eating skill development and their parents' feeding behaviors was analyzed with multiple stepwise regression analysis. Results In 189 children,50.3％ (95/189) of children had retardation in eating skills development( including sucking, swallowing, chewing, the ability of intaking solid diet, drinking and using mess kit). The children' s eating behavior disorders included eating distraction (91.0％, 172/189), prolonged eating time (54.5％, 103/189), prefering socks foods in their 1 year to 4 years of age (41.1％ ,60/146), nausea in eating(27.0％ ,51/189). The parents feeding behavior disorders included unsuitable food texture, delay in adding paste or semisolid foods for their children( 36.0％ ,68/189 ), forced feeding (77.8％, 147/189 ), long term following feeding(78.8％, 115/146)and failing to provide timely their children proper training table wares (27.5％52/189). Correlatory analysis showed that development retardation of infant' s eating skill was associated with unsuitable food textures and delay in introduction of the foods with different textures ( F ＝ 11. 892, P ＜ 0.01 ), failing to training by different table wares(F ＝ 10. 256, P ＜ 0.01 ), eating distraction ( F ＝ 3. 601, P ＜ 0. 05 ) and parents' lack in feeding knowledge ( F ＝ 5. 007, P ＜0.05). Conclusion The children with feeding difficulty have many feeding behavioral problems. Children' s eating skill development is impacted greatly by introduction time and texture of complementary foods, failing to provide timely training table wares, eating distraction of the children and parents' lack in feeding knowledge.
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