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Objective: To explore the relevant factors of behavioral development among 30-month-old infants in rural area, Shaanxi Province. Methods: The behavioral development among 977 infants aged 30-month-old was evaluated in Changwu and Binxian of Shaanxi province from July 2006 to August 2008. The inclusion criteria included single live birth between January 2004 and February 2006, mother had participated in a community-based intervention study named "Impact of multi-micronutrient supplementation during pregnancy on low birth weight and premature delivery" . Infants who had obvious deformity or other birth defects, infants who could not complete the questionnaire survey, physical examination were excluded from the study. The self-designed questionnaire was used to investigate the information of feeding patterns, disease status, physical development, and immunization status of the infants, and their behavioral development were assessed by Bayley scales of infant development (BSID). General Linear Model was used to adjust the possible confounding factors, and the analysis of variance was performed to explore the effects on the behavioral development among infants aged 30-month-old. Results: Among the infants in the study, the average age was (30.6±0.6) months old, the mean birth weight was (3 199.1±405.9)g. After adjusted the mothers' age of delivery, educational level and occupation of the parents, family ecnomic conditions and the number of children, infants whose mother exposed to toxic chemicals during pregnancy had lower score in activity (-0.179±0.961) and lower score in concentration (-0.177±1.099) compared with infants with unexposed mother (0.058±1.006, P= 0.001; 0.057±0.960, P= 0.003). Similarly, infants whose mother took drugs during pregnancy had lower score in persistent behaviors (-0.070±1.000) compared with infants whose mother did not(0.085±1.006, P= 0.017). Compared with normal birth infants(0.043±0.981, P= 0.007; 0.021±0.984, P= 0.034), infants less than gestational age and low birth weight had lower score in concentration(-0.198±1.063 and-0.389±1.285, respectively). After adjusted the delivery gestational age of mothers, the months of infants, the mothers' age of delivery, educational level and occupation of the parents, family ecnomic conditions, the number of children, and the main orderlies of infants, the score of activity of infants suffered from diseases in early month age was-0.049±0.992, which was lower than those who did not(0.207±1.011, P= 0.001). The infants with Rickets signs had lower score in motor coordination (-0.218±0.896) than normal infants (0.031±1.011, P= 0.013). Infants whose mother with adequate micronutrient supplementation in pregnancy had higher score in concentration (0.066±0.966) than those whose mother with insufficient supplementation (-0.062±1.027, P= 0.043). Furthermore, infants with fine protein added and minerals and vitamins added had higher score in activity and concentration compared with those insufficient, who scored 0.078±1.013 and 0.496±0.872 (-0.254±0.924, P< 0.001; 0.001±0.997, P= 0.033), respectively. Conclusion: Micronutrient supplementation during pregnancy and reasonable nutrition added during childhood could affect behavioral development among infants.

Objective: Using infant and child feeding index (ICFI) to evaluate the relationship between infant feeding and physical development indicators in rural areas of Lhasa., Methods: In July and August 2010 in the rural areas of Lhasa, the multi-stage cluster random sampling method was adopted to select 540 Tibetan children who were between 6 to 35 months of age. There were 70, 79 and 391 cases in 6 to 8, 9 to 11 and 12 to 35-month-old group respectively. The basic status of infants, information about breastfeeding and complementary feeding were collected by using designed questionnaires. Their height and weight were measured to calculate the children's weight for age Z-score (WAZ), height for age Z-score (HAZ) and weight for height Z-score (WHZ) and assess feeding index score (out of 17 scores) and analyze the relationship between feeding index and HAZ, WAZ and WHZ., Results: The mean ICFI score of 540 cases was 8.90 ± 2.82.It was 6.84 ± 3.16, 8.16 ± 2.78 and 9.41 ± 2.55 for 6 to 8, 9 to 11 and 12 to 35-month-old infants respectively. There was significant difference between the different month group (F = 30.99, P < 0.05).For the three month groups, the scores of WAZ were 0.10 ± 1.18, -0.09 ± 1.20 and -0.38 ± 0.96; HAZ were -0.60 ± 1.68, -1.02 ± 1.72 and -1.30 ± 1.30; WHZ were 0.62 ± 1.23, 0.69 ± 0.96 and 0.43 ± 0.95 respectively. The ICFI scores of 9 to 11, 12 to 35 and 6 to 35-month-old infants were positively correlated with HAZ (correlation coefficients were 0.25,0.12 and 0.09 respectively, all P values <0.05). There was no correlation with WAZ (correlation coefficients were 0.15,0.08 and 0.03 respectively, all P values >0.05) and WHZ (correlation coefficients were -0.08, -0.02, and -0.07 respectively, all P values >0.05). There were no correlation between ICFI score with HAZ, WAZ and WHZ for 6 to 8 month-old infants (correlation coefficient were 0.06,0.16 and -0.07 respectively, all P values >0.05)., Conclusion: To some extent, the feeding index can effectively reflect the growth status of these infants and can serve as a comprehensive assessment of feeding situations among Tibetan children in rural areas of Lhasa.

Objective: To understand the growth and malnutrition status of Tibetan children aged 0 to 35 months in rural Lhasa in 2010., Methods: Cross-sectional study and multistage sampling design were used to randomly select sampling units. A total of 640 children were studied. Height and weight were measured and nutritional status was evaluated with WHO reference in 2006 using Z-scores. Z-scores of weight-for-age (WAZ), Z-scores of height-for-age (HAZ) and Z-scores of weight-for-height (WHZ) were analyzed., Results: At the age of 18 - 35 months, the children in rural Lhasa were 3.0 cm shorter as compared to the China national length reference. At the age of 6 - 11, 12 - 17 months, weight ((8.84 ± 1.23) and (10.20 ± 1.08) kg) and length ((70.45 ± 4.46) and (76.73 ± 4.78) cm) of boys were significantly higher than girls (weight: (8.42 ± 1.30) and (9.59 ± 1.26) kg; length: (67.61 ± 3.98) and (74.25 ± 4.50) cm) (all P values < 0.05). WAZ and HAZ were -0.17 ± 1.11 and -1.11 ± 1.46, respectively. The HAZ of 18 - 23 months children (-1.51 ± 1.24) was significantly different from the HAZ of 0 - 5, 6 - 11, 12 - 17 months children (HAZ: -0.75 ± 1.50, -0.83 ± 1.72, -1.07 ± 1.55, respectively) (all P values < 0.05), comparison with the HAZ of 24 - 29, 30 - 35 months children (HAZ: -1.41 ± 1.25, -1.24 ± 1.05), the results showed that there were no significant difference (all P values > 0.05), HAZ of 18 - 23 months children was the lowest. The prevalence of stunting, underweight, and wasting were 24.6% (155/630), 5.4% (33/616) and 1.0% (6/608), respectively. The malnutrition of boys was more serious than that of girls, the stunting of 18 - 23 and 24 - 29 months children had reached 35.0% (36/103) and 29.1% (25/86), respectively., Conclusion: The growth and development status of children in rural Lhasa under 3 years old was poor, and the malnutrition of local children should not be ignored with variations by gender and months of age.