Following the World Health Organization's Recommendation of Exclusive Breastfeeding to 6 Months of Age Does Not Impact the Growth of Rural Gambian Infants.
Following the World Health Organization's Recommendation of Exclusive Breastfeeding to 6 Months of Age Does Not Impact the Growth of Rural Gambian Infants.
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遵循世界卫生组织对6个月大的母乳喂养的专有建议不会影响冈比亚农村婴儿的成长。
DOI：
10.3945/jn.116.241737
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发表时间：
2017-02
期刊：
影响因子：
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通讯作者：
Moore SE
中科院分区：
文献类型：
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作者：
Eriksen KG;Johnson W;Sonko B;Prentice AM;Darboe MK;Moore SE
背景：世界卫生组织建议婴儿出生前6个月纯母乳喂养(EBF)。目的：这项研究的目的是评估EBF对6个月龄冈比亚农村营养不良高危婴儿生长的益处。方法：EID(早期营养和免疫发育)试验中出生至2岁的婴儿(n=756)，如果只喂母乳，不喂其他液体或食物，则将其归类为纯母乳喂养。EBF状态进入混杂因素调整的多水平模型，通过使用11,000个年龄加权(WAZ)、年龄加权(LAZ)和长度加权(WLZ)z得分观察来测试与增长轨迹的关联。结果：32%的婴儿接受纯母乳喂养至6个月。停用EBF的平均年龄为5.2mo，∼为3.5mo时开始发育迟缓。在纯母乳喂养到6个月的婴儿(EBF-6)和没有纯母乳喂养的婴儿(NEBF-6)之间，在6和12个月大的婴儿之间发现了一些不同的WAZ和WHZ的证据，EBF-6儿童的平均z得分更高。两组Z评分差异不大(6个月龄时：0.147 WAZ；95%CI：−0.001，0.293 WAZ；0.189 WAZ；95%CI：0.038，0.341 WAZ)。在LAZ的任何时间点(6、12和24个月龄)都没有观察到EBF-6和NEBF-6婴儿之间存在差异的证据。此外，在3个月龄时较高的平均WLZ与随后停止EBF时较高的平均年龄相关，这意味着在这种情况下存在相反的因果关系(系数：0.060；95%CI：0.008，0.120)。结论：EBF对冈比亚农村婴幼儿生长发育的影响有限。这项试验在http://www.isrctn.com注册为ISRCTN49285450。
Background: The WHO recommends exclusive breastfeeding (EBF) for the first 6 mo of life. Objective: The objective of this study was to assess the benefit of EBF to age 6 mo on growth in a large sample of rural Gambian infants at high risk of undernutrition. Methods: Infants with growth monitoring from birth to 2 y of age (n = 756) from the ENID (Early Nutrition and Immune Development) trial were categorized as exclusively breastfed if only breast milk and no other liquids or foods were given. EBF status was entered into confounder-adjusted multilevel models to test associations with growth trajectories by using >11,000 weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) z score observations. Results: Thirty-two percent of infants were exclusively breastfed to age 6 mo. The mean age of discontinuation of EBF was 5.2 mo, and growth faltering started at ∼3.5 mo of age. Some evidence for a difference in WAZ and WHZ was found between infants who were exclusively breastfed to age 6 mo (EBF-6) and those who were not (nEBF-6), at 6 and 12 mo of age, with EBF-6 children having a higher mean z score. The differences in z scores between the 2 groups were small in magnitude (at 6 mo of age: 0.147 WAZ; 95% CI: −0.001, 0.293 WAZ; 0.189 WHZ; 95% CI: 0.038, 0.341 WHZ). No evidence for a difference between EBF-6 and nEBF-6 infants was observed for LAZ at any time point (6, 12, and 24 mo of age). Furthermore, a higher mean WLZ at 3 mo of age was associated with a subsequent higher mean age at discontinuation of EBF, which implied reverse causality in this setting (coefficient: 0.060; 95% CI: 0.008, 0.120). Conclusion: This study suggests that EBF to age 6 mo has limited benefit to the growth of rural Gambian infants. This trial was registered at http://www.isrctn.com as ISRCTN49285450.