Child eating and caregiver feeding behaviours are critical determinants of food intake, but they are poorly characterized in undernourished children. We aimed to describe how appetite, food refusal and force-feeding vary between undernourished and healthy children aged 6-24 months in Nairobi and identify potential variables for use in a child eating behaviour scale for international use. This cross-sectional study was conducted in seven clinics in low-income areas of Nairobi. Healthy and undernourished children were quota sampled to recruit equal numbers of undernourished children (weight for age [WAZ] or weight for length [WLZ] Z scores ≤2SD) and healthy children (WAZ > 2SD). Using a structured interview schedule, questions reflecting child appetite, food refusal and caregiver feeding behaviours were rated using a 5-point scale. Food refusal and force-feeding variables were then combined to form scores and categorized into low, medium and high. In total, 407 child-caregiver pairs, aged median [interquartile range] 9.98 months [8.7 to 14.1], were recruited of whom 55% were undernourished. Undernourished children were less likely to 'love food' (undernourished 78%; healthy 90% p = < 0.001) and more likely to have high food refusal (18% vs. 3.3% p = <0.001), while their caregivers were more likely to use high force-feeding (28% vs. 16% p = 0.03). Undernourished children in low-income areas in Nairobi are harder to feed than healthy children, and force-feeding is used widely. A range of discriminating variables could be used to measure child eating behaviour and assess the impact of interventions.

中文翻译：

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肯尼亚内罗毕低收入地区儿童的饮食和喂养行为。

儿童的饮食和照顾者的喂养行为是食物摄入量的关键决定因素，但它们在营养不良的儿童中表现不佳。我们旨在描述内罗毕 6 至 24 个月的营养不良儿童和健康儿童的食欲、拒绝食物和强迫进食的差异，并确定可用于国际使用的儿童饮食行为量表的潜在变量。这项横断面研究在内罗毕低收入地区的七家诊所进行。对健康和营养不足的儿童进行配额抽样，以招募相等数量的营养不足儿童（年龄别体重 [WAZ] 或身长体重 [WLZ] Z 分数≤2SD）和健康儿童（WAZ > 2SD）。使用结构化的访谈时间表，使用 5 分制对反映儿童食欲、食物拒绝和照顾者喂养行为的问题进行评分。然后将拒绝食物和强制喂食变量结合起来形成分数并分为低、中和高。总共招募了 407 对儿童照顾者，年龄中位数 [四分位距] 9.98 个月 [8.7 至 14.1]，其中 55% 营养不良。营养不良的儿童不太可能“喜欢食物”（营养不良的 78%；健康的 90% p = < 0.001）并且更有可能拒绝食物（18% vs. 3.3% p = <0.001），而他们的照顾者更有可能使用强力喂食（28% vs. 16% p = 0.03）。内罗毕低收入地区营养不良的儿童比健康儿童更难喂养，强制喂养被广泛使用。可以使用一系列判别变量来衡量儿童的饮食行为并评估干预措施的影响。