Do infants fed directly from the breast have improved appetite regulation and slower growth during early childhood compared with infants fed from a bottle?
Do infants fed directly from the breast have improved appetite regulation and slower growth during early childhood compared with infants fed from a bottle?
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DOI：
10.1186/1479-5868-8-89
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发表时间：
2011-08-17
期刊：
影响因子：
--
通讯作者：
Davey A
中科院分区：
文献类型：
--
作者：
Disantis KI;Collins BN;Fisher JO;Davey A
行为机制，有助于母乳喂养和降低肥胖风险之间的关联知之甚少。本研究的目的是评估这一假设，即与奶瓶喂养相比，母乳喂养（直接母乳喂养）与随后的儿童食欲调节行为和生长有更佳的关联。回顾性地将3- 6岁的儿童（n = 109）分为直接母乳喂养（仅在乳房处喂养）、母乳喂养或婴儿配方奶粉喂养。通过测量与肥胖风险相关的三个结构（饱腹感反应，食物反应，食物享受），使用儿童饮食行为问卷，检查幼儿的食欲调节。使用多项逻辑回归分析来测试与直接从乳房喂养的儿童相比，母乳或配方奶粉喂养的儿童是否降低了高饱腹感的几率，并增加了高食物反应性和高食物享受的几率。目前的儿童体重状况和6-36个月的生长趋势也进行了检查，以了解其与直接母乳喂养和幼儿期食欲调节行为的关系。在控制了儿童年龄、儿童体重状况、母亲种族/民族和母亲教育程度后，与直接母乳喂养的儿童相比，母乳喂养的儿童产生高饱腹感反应的可能性降低了67%。奶瓶喂养（母乳或配方奶粉）与幼儿的食物反应和食物享受没有关联。直接母乳喂养与当前儿童体重状况没有关联，直接母乳喂养和奶瓶喂养的儿童在6至36个月的生长轨迹上也没有明显差异。婴儿年龄别体重评分的变化更快与儿童后期较低的饱腹感反应性、较高的食物反应性和较高的食物享受有关。虽然与奶瓶喂养相比，直接母乳喂养对婴儿期到儿童期的生长轨迹没有不同的影响，但结果表明，婴儿早期直接母乳喂养与儿童后期更大的食欲调节有关。更好地理解直接母乳喂养和奶瓶喂养之间的行为差异可能会发现减少儿童肥胖流行的新途径。
Behavioral mechanisms that contribute to the association between breastfeeding and reduced obesity risk are poorly understood. The purpose of this study was to evaluate the hypothesis that feeding human milk from the breast (direct breastfeeding) has a more optimal association with subsequent child appetite regulation behaviors and growth, when compared to bottle-feeding. Children (n = 109) aged 3- to 6- years were retrospectively classified as directly breastfed (fed exclusively at the breast), bottle-fed human milk, or bottle-fed formula in the first three months of life. Young children's appetite regulation was examined by measuring three constructs (satiety response, food responsiveness, enjoyment of food) associated with obesity risk, using the Child Eating Behavior Questionnaire. Multinomial logistic regression analyses were used to test whether children bottle-fed either human milk or formula had reduced odds of high satiety and increased odds of high food responsiveness and high enjoyment of food compared to children fed directly from the breast. Current child weight status and growth trends from 6-36 months were also examined for their relation to direct breastfeeding and appetite regulation behaviors in early childhood. Children fed human milk in a bottle were 67% less likely to have high satiety responsiveness compared to directly breastfed children, after controlling for child age, child weight status, maternal race/ethnicity, and maternal education. There was no association of bottle-feeding (either human milk or formula) with young children's food responsiveness and enjoyment of food. There was neither an association of direct breastfeeding with current child weight status, nor was there a clear difference between directly breastfed and bottle-fed children in growth trajectories from 6- to 36-months. More rapid infant changes in weight-for-age score were associated with lower satiety responsiveness, higher food responsiveness and higher enjoyment of food in later childhood While direct breastfeeding was not found to differentially affect growth trajectories from infancy to childhood compared to bottle-feeding, results suggest direct breastfeeding during early infancy is associated with greater appetite regulation later in childhood. A better understanding of such behavioral distinctions between direct breastfeeding and bottle-feeding may identify new pathways to reduce the pediatric obesity epidemic.