Applying Rank Sum Ratio (RSR) to the Evaluation of Feeding Practices Behaviors, and Its Associations with Infant Health Risk in Rural Lhasa, Tibet

To evaluate the status of feeding practices and analyze the association between feeding practice and health status among Tibetan infants, a cross-sectional survey of 386 women with children aged under 24 months was conducted in rural areas surrounding Lhasa, Tibet. All participants were selected using simple random sampling and were interviewed face-to-face by trained interviewers. Mothers were interviewed to collect information on their feeding practices. A feeding practices index was created using the rank sum ratio method. Most of the infants had been or were being breastfed at the time of the interview. The feeding practices index was significantly and inversely associated with the prevalence of acute upper respiratory infection, and the odds ratio for the qualified feeding practices index vs. the non-qualified feeding practices index was 0.43 (95% confidence interval: 0.20-0.94). There were no measurable associations observed between acute upper respiratory infection, diarrhea, and the feeding practices index after controlling for selected factors. The method of rank sum ratio provides a flexible way to evaluate feeding practices and is easy to understand. Furthermore, appropriate infant feeding practices might play a protective role in Tibetan infants' health.