Effects of infant feeding practice on weight gain from birth to 3 years
Effects of infant feeding practice on weight gain from birth to 3 years
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DOI：
10.1136/adc.2008.137554
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发表时间：
2009-08-01
影响因子：
5.2
通讯作者：
Dezateux, C.
中科院分区：
文献类型：
--
作者：
Griffiths, L. J.;Smeeth, L.;Dezateux, C.
目的：婴儿喂养习惯对儿童期体重增加的影响仍未得到解决，很少有研究对混杂因素进行适当调整。本研究探讨了母乳喂养的开始，母乳喂养的持续时间和引入固体食物的年龄对从出生到3岁体重增加的影响。设计：全国代表性前瞻性研究。设置：英格兰，威尔士，苏格兰和北方爱尔兰。参与者：来自英国千禧年队列研究的10533名3岁儿童。主要结果指标：从出生到3岁的条件性体重增加z评分（调整出生体重）;进行多元线性回归分析，以检查调整混杂因素后婴儿喂养方法对该措施的影响。母乳喂养开始和母乳喂养持续时间与出生至3岁的体重增加显著相关。未接受母乳喂养的婴儿比母亲开始母乳喂养的婴儿生长更快（校正回归系数（z评分差异）0.06，95% CI 0.02 - 0.09），母乳喂养少于4个月的婴儿（0.05，95% CI 0.01 - 0.09）比母乳喂养4个月或更长时间的婴儿生长更快。在3年时调整身高z评分后，早期引入固体与体重增加速度加快无关（20.01，95%CI 20.04至0.03）。结论：开始和延长母乳喂养可能会减少学龄前体重的过度增加。早期摄入固体食物与儿童早期体重快速增加之间的关系是通过儿童身高来介导的。虽然影响规模很小，但在人群水平上，它们具有公共卫生重要性，因为这些风险因素可能是可以改变的。需要制定战略，支持母亲遵循国际上推荐的婴儿喂养做法。
Objective: The influence of infant feeding practices on weight gain during childhood remains unresolved, with few studies adjusting appropriately for confounding factors. This study examined the effect of breastfeeding initiation, breastfeeding duration and age at introduction of solid foods on weight gain from birth to 3 years.Design: Nationally representative prospective study.Setting: England, Wales, Scotland and Northern Ireland.Participants: 10 533 3-year-old children from the UK Millennium Cohort Study.Main outcome measure: Conditional weight gain z-scores from birth to 3 years (adjusted for birthweight); multiple linear regression analyses were conducted to examine the impact of infant feeding practices on this measure after adjustment for confounding factors.Results: Breastfeeding initiation and breastfeeding duration were significantly associated with weight gain from birth to 3 years. Infants receiving no breast milk grew faster than those whose mothers initiated breastfeeding (adjusted regression coefficient (difference in z-scores) 0.06, 95% CI 0.02 to 0.09), as did those breastfed for less than 4 months (0.05, 95% CI 0.01 to 0.09) versus those breastfed 4 months or longer. Early introduction of solids was not associated with faster weight gain after adjustment for height z-score at 3 years (20.01, 95% CI 20.04 to 0.03).Conclusions: Initiating and prolonging breastfeeding may reduce excess weight gain by preschool age. Association of the early introduction of solids with rapid weight gain during early childhood is mediated through childhood stature. Although effects sizes are small, at a population level they are of public health importance as these risk factors are potentially modifiable. Strategies to support mothers to follow internationally recommended infant feeding practices are required.