Effect of breastfeeding on lung function in childhood and modulation by maternal asthma and atopy
Effect of breastfeeding on lung function in childhood and modulation by maternal asthma and atopy
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DOI：
10.1164/rccm.200610-1507oc
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发表时间：
2007-11-01
影响因子：
24.7
通讯作者：
Wright, Anne L.
中科院分区：
文献类型：
--
作者：
Guilbert, Theresa W.;Stern, Debra A.;Wright, Anne L.
基本原理：母乳喂养对早期呼吸道感染的保护作用是公认的，但其与随后哮喘发展的关系仍存在争议。Objectives：为了澄清这些复杂的问题，我们研究了肺功能和婴儿喂养practices.Methods：在图森儿童呼吸系统研究中，根据在入学和健康儿童访视时完成的问卷调查，前瞻性地评估了喂养方法。配方奶的引入分为2个月前（n = 143，“早期配方奶引入”），2个月至4个月前（n = 336），或4个月及以上（n = 200，“长期母乳喂养”）。在11岁和16岁时测量肺功能。采用随机效应模型评估婴儿喂养方法与肺功能指标之间的关系。指标和主要结果：16岁时FVC增加103 40.0 ml（P = 0.01），与早期配方奶粉喂养的儿童相比，母乳喂养时间较长的儿童FEV 1/FVC比值较低（-1.9 +/-0.6%，P = 0.004）。这种效应在母亲哮喘分层后有所改变。与早期引入配方奶粉的儿童相比，母亲患有哮喘的母乳喂养时间较长的儿童的FVC没有增加（P = 0.7），而FEV 1/FVC比值（-5.7 +/-2.4%，P = 0.02）在16岁时显著下降。与早期配方奶粉introduction.Conclusions：母乳喂养时间较长的儿童，非过敏性，非哮喘的母亲表现出增加的FVC（142 +/- 71.1 ml，P = 0.047），并没有减少FEV 1/FVC（P = 0.7）。然而，在存在母亲哮喘的情况下，母乳喂养时间越长，气流越少。
Rationale: The protective effect of breastfeeding on early respiratory infections is well established, but its relationship to the development of subsequent asthma remains controversial.Objectives: To clarify these complex issues, we examined the association between lung function and infant-feeding practices.Methods: In the Tucson Children's Respiratory Study, feeding practices were assessed prospectively based on questionnaires completed at enrollment and well-child visits. Formula introduction was categorized as having occurred before 2 months (n = 143, "earlyformula introduction"), from 2 and before 4 months (n = 336), or at 4 months and older (n = 200, "longer breastfed"). Lung function was measured at age 11 and 16 years. A random-effects model was used to assess the relationship of infant-feeding practices to measures of lung function.Measurements and Main Results: FVC by age 16 was increased by 103 40.0 ml (P = 0.01), and the FEV1/FVC ratio was lower (-1.9 +/- 0.6%, P = 0.004) in the longer breastfed children compared with children with early formula introduction. This effect was modified after stratifying by maternal asthma. Compared with children with early formula introduction, longer breastfed children with asthmatic mothers had an FVC that was not increased (P = 0.7) and an FEV1/FVC ratio (-5.7 +/- 2.4%, P = 0.02) that was significantly decreased by age 16. Longer breastfed children with nonatopic, nonasthmatic mothers demonstrated an increased FVC (142 +/- 71.1 ml, P = 0.047) and no decrease in FEV1/FVC (P = 0.7) compared with children with early formula introduction.Conclusions: Longer duration of breastfeeding favorably influences lung growth in children. However, in the presence of maternal asthma, longer breastfeeding is associated with decreased airflows.