OBJECTIVETo examine the relationship between complementary feeding behaviors (CFB) and anemia for infants and young children in Sichuan, Yunnan and Guizhou province of China.

METHODSA total 3 410 children aged 6-24 months were recruited from 12 survey sites in the urban and rural areas of Sichuan, Yunnan and Guizhou provinces by stratified random cluster sampling in 3 age groups (6-8 months, 9-11 months and 12-24 months) from March to July in 2011. The information of CFB for them was collected through a specific questionnaire. According to the comprehensive evaluation method of CFB(including content of food preparation and selection, caregivers' behavior, infants' behavior, feeding environment and environmental hygiene), the scores of CFB were calculated and grouped as low ( < 60% of total score), moderate (60%-80% of total score) and high level ( > 80% of total score). Twenty microliter of fingertip blood was extracted to measure the hemoglobin concentration and anemia rate was calculated. Distribution of CFB level and rate of anemia were compared between urban/rural areas and different age groups. Difference of anemia rate for infants and young children between low/moderate/high CFB level groups was compared.

RESULTS8.0% (273/3 410) of the children were in low CFB level group, and 56.9% (1 940/3 410) and 35.1% (1 197/3 410) in moderate and high CFB level group respectively. The difference of CFB levels between urban and rural areas was significant (Z = -21.17, P < 0.05), the proportion of high level in urban area was 53.0% (829/1 565) , which was higher than that in rural area (20.0% (368/1845) ). The difference of CFB levels between different age groups was also significant (H = 43.82, P < 0.05). The proportion of high level decreased by increasing age, which was 41.0% (417/1 017) and 29.9% (389/1 300) in 6-8 months and 12-24 months respectively. The average hemoglobin concentration for infants was (119.3 ± 13.8)g/L, and the total anemia rate was 22.4% (765/3 410) . The hemoglobin concentration for infants in urban area ( (123.3 ± 11.3) g/L) was higher than rural area ((115.9 ± 14.8) g/L) (t = 16.75, P < 0.05) and the rate of anemia in urban area (10.5% (165/1 565)) was lower than that in rural area (32.5% (600/1845) ) (χ² = 235.03, P < 0.05) significantly. The rate of anemia was decreased by increasing CFB level(χ² = 73.94, P < 0.05). The rate of anemia in the low CFB level group was the highest (33.7% (92/273) ) while in the high CFB level group was 14.5% (174/1 197), which was the lowest.

CONCLUSIONThe level of complementary feeding behavior for infants and young children in Sichuan, Yunnan and Guizhou province of China is relatively low and their prevalence of anemia is relatively serious. Complementary feeding behavior is closely associated with anemia for infants and young children.