The effect of breast-feeding with and without formula use on the risk of obesity at 4 years of age
The effect of breast-feeding with and without formula use on the risk of obesity at 4 years of age
复制标题
DOI：
10.1038/oby.2004.190
复制
发表时间：
2004-09-01
期刊：
影响因子：
--
通讯作者：
Whitaker, RC
中科院分区：
文献类型：
--
作者：
Bogen, DL;Hanusa, BH;Whitaker, RC
目的：确定预防日后肥胖所需的最短母乳喂养时间，同时使用配方奶是否会削弱母乳喂养的任何保护作用，以及哪些母婴特征可能会改变母乳喂养与儿童肥胖之间的关系。研究方法和程序：这是一项回溯性队列研究。参与者是73,458名白人和黑人低收入儿童，从出生到4岁。4岁时的肥胖定义为测量的BMI大于或等于第95个百分位数。喂养暴露基于母乳喂养持续时间和配方奶粉开始年龄。结果：4岁时儿童肥胖率为11.5%。只有16%的儿童母乳喂养8周或更长时间。只有在母亲怀孕期间没有吸烟的白人儿童中，母乳喂养才与肥胖风险降低有关。在这一亚组中，与从未母乳喂养的儿童相比，肥胖风险(调整后的优势比，95%可信区间)的降低只发生在没有母乳喂养至少16周(0.71，0.56至0.92)或至少26周同时使用配方奶(0.70，0.61至0.81)的儿童。在母亲怀孕期间吸烟的白人和黑人中，母乳喂养与4岁时肥胖风险的降低没有相关性。讨论：在低收入儿童群体中，只有在母亲怀孕期间不吸烟的白人中，母乳喂养持续至少16周不含配方奶粉或至少26周使用配方奶粉时，母乳喂养才与4岁时肥胖风险降低相关。
Objective: To determine the minimal duration of breast-feeding required to protect against later obesity, whether the concurrent use of formula lessened any protective effect of breast-feeding, and what maternal or child characteristics might modify the association between breast-feeding and child obesity.Research Methods and Procedures: This was a retrospective cohort study. Participants were 73,458 white and black low-income children followed from birth through 4 years of age. Obesity at age 4 years was defined as measured BMI greater than or equal to 95th percentile. Feeding exposure was based on breast-feeding duration and the age of formula initiation. Covariates were obtained from the children's birth certificates.Results: At age 4 years, the prevalence of obesity was 11.5%. Only 16% of children were breast-fed 8 weeks or longer. Breast-feeding was associated with a reduced risk of obesity only in white children whose mothers had not smoked in pregnancy. In this subgroup, the reduction in obesity risk (adjusted odds ratio, 95% confidence interval), compared with those never breast-fed, occurred only for children who were breast-fed at least 16 weeks without formula (0.71, 0.56 to 0.92) or at least 26 weeks with concurrent formula (0.70, 0.61 to 0.81). Among whites whose mothers smoked in pregnancy and among blacks, breast-feeding was not associated with a reduced risk of obesity at age 4 years.Discussion: In a population of low-income children, breast-feeding was associated with a reduced risk of obesity at age 4 years only among whites whose mothers did not smoke in pregnancy and only when breast-feeding continued for at least 16 weeks without formula or at least 26 weeks with formula.