Breastfeeding, maternal asthma and wheezing in the first year of life: a longitudinal birth cohort study
Breastfeeding, maternal asthma and wheezing in the first year of life: a longitudinal birth cohort study
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DOI：
10.1183/13993003.02019-2016
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发表时间：
2017-05-01
影响因子：
24.3
通讯作者：
Sears, Malcolm R.
中科院分区：
文献类型：
--
作者：
Azad, Meghan B.;Vehling, Lorena;Sears, Malcolm R.
母乳喂养对呼吸系统健康的影响尚不确定，特别是当母亲患有哮喘时。我们研究了母乳喂养与婴儿出生后第一年喘息的关系。我们研究了2773名来自加拿大健康婴儿纵向发育（CHILD）出生队列的婴儿。护理人员报告了婴儿喂养和3、6和12个月时的喘息发作情况。母乳喂养分为纯母乳喂养、部分母乳喂养（辅以配方食品或辅食）和不母乳喂养。总体而言，21%的母亲患有哮喘，46%的母乳喂养至少12个月，21%的婴儿患有喘息。在患有哮喘的母亲中，母乳喂养与婴儿喘息呈负相关，与母亲吸烟、受教育程度等危险因素无关(调整后比率比（aRR） 0.52；母乳喂养12个月和< 6个月的95% CI 0.35-0.77)。与6个月时不母乳喂养相比，纯母乳喂养减少了62% (aRR 0.38; 95% CI 0.20-0.71)，部分母乳喂养补充辅食减少了37% (aRR 0.63; 95% CI 0.43-0.93)；然而，当母乳喂养补充配方奶时，没有显著的保护作用（aRR 0.89; 95% CI 0.61-1.30）。在没有母亲哮喘的情况下，相关性不显著（交互作用的p值< 0.01）。在哮喘母亲所生的婴儿中，母乳喂养似乎以剂量依赖的方式赋予对喘息的保护。
The impact of breastfeeding on respiratory health is uncertain, particularly when the mother has asthma. We examined the association of breastfeeding and wheezing in the first year of life.We studied 2773 infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Caregivers reported on infant feeding and wheezing episodes at 3, 6 and 12 months. Breastfeeding was classified as exclusive, partial (supplemented with formula or complementary foods) or none.Overall, 21% of mothers had asthma, 46% breastfed for at least 12 months and 21% of infants experienced wheezing. Among mothers with asthma, breastfeeding was inversely associated with infant wheezing, independent of maternal smoking, education and other risk factors (adjusted rate ratio (aRR) 0.52; 95% CI 0.35-0.77 for >= 12 versus < 6 months breastfeeding). Compared with no breastfeeding at 6 months, wheezing was reduced by 62% with exclusive breastfeeding (aRR 0.38; 95% CI 0.20-0.71) and by 37% with partial breastfeeding supplemented with complementary foods (aRR 0.63; 95% CI 0.43-0.93); however, breastfeeding was not significantly protective when supplemented with formula (aRR 0.89; 95% CI 0.61-1.30). Associations were not significant in the absence of maternal asthma (p-value for interaction < 0.01).Breastfeeding appears to confer protection against wheezing in a dose-dependent manner among infants born to mothers with asthma.