Infant growth and health outcomes associated with 3 compared with 6 mo of exclusive breastfeeding
Infant growth and health outcomes associated with 3 compared with 6 mo of exclusive breastfeeding
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DOI：
10.1093/ajcn/78.2.291
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发表时间：
2003-08-01
影响因子：
7.1
通讯作者：
Bogdanovich, N
中科院分区：
文献类型：
--
作者：
Kramer, MS;Guo, T;Bogdanovich, N
背景资料：关于纯母乳喂养的最佳持续时间的意见和建议一直存在很大分歧，但很少有发表的研究提供了直接的证据，证明不同母乳喂养持续时间对受体婴儿的相对风险和益处。目的：我们研究了3个月纯母乳喂养与6个月纯母乳喂养相比对婴儿生长和健康的影响。设计：我们在白俄罗斯进行了一项大型随机试验，对2862名纯母乳喂养3个月的婴儿进行了观察性队列研究（持续混合母乳喂养至大于或等于6个月），其中621名婴儿纯母乳喂养大于或等于6个月。回归的平均值，群内相关性，集群和个人水平的混杂变量进行了解释，通过使用多层次回归analysis.Results：从3月至6月，体重增加略高于3月组[差异：29克/月（95% CI：13，45 g/mo）]，长度增加[差异：1.1 mm（0.5，1.6 mm）]，但6个月组从9个月到12个月的长度增加更快[差异：0.9 mm/mo（0.3，1.5 mm/mo）]和12个月时头围较大[差异：0.19 cm（0.07，0.3 1 cm）]。在6个月组中，在3至6个月期间观察到胃肠道感染的发病密度显著降低[校正的发病密度比：0.35（0.13，0.96）]，但在呼吸道感染或特应性湿疹的风险方面没有显著差异。纯母乳喂养6个月与胃肠道感染的风险较低相关，并且在生命的第一年中没有明显的不良健康影响。
Background: Opinions and recommendations about the optimal duration of exclusive breastfeeding have been strongly divided, but few published studies have provided direct evidence on the relative risks and benefits of different breastfeeding durations in recipient infants.Objective: We examined the effects on infant growth and health of 3 compared with 6 mo of exclusive breastfeeding.Design: We conducted an observational cohort study nested within a large randomized trial in Belarus by comparing 2862 infants exclusively breastfed for 3 mo (with continued mixed breastfeeding through greater than or equal to6 mo) with 621 infants who were exclusively breastfed for greater than or equal to6 mo. Regression to the mean, within-cluster correlation, and cluster- and individual-level confounding variables were accounted for by using multilevel regression analyses.Results: From 3 to 6 mo, weight gain was slightly greater in the 3-mo group [difference: 29 g/mo (95% CI: 13, 45 g/mo)], as was length gain [difference: 1.1 mm (0.5, 1.6 mm)], but the 6-mo group had a faster length gain from 9 to 12 mo [difference: 0.9 mm/mo (0.3, 1.5 mm/mo)] and a larger head circumference at 12 mo [difference: 0.19 cm (0.07, 0.3 1 cm)]. A significant reduction in the incidence density of gastrointestinal infection was observed during the period from 3 to 6 mo in the 6-mo group [adjusted incidence density ratio: 0.35 (0.13, 0.96)], but no significant differences in risk of respiratory infectious outcomes or atopic eczema were apparent.Conclusions: Exclusive breastfeeding for 6 mo is associated with a lower risk of gastrointestinal infection and no demonstrable adverse health effects in the first year of life.