DOES BREAST-FEEDING REALLY SAVE LIVES, OR ARE APPARENT BENEFITS DUE TO BIASES
DOES BREAST-FEEDING REALLY SAVE LIVES, OR ARE APPARENT BENEFITS DUE TO BIASES
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DOI：
10.1093/oxfordjournals.aje.a114236
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发表时间：
1986-02-01
影响因子：
5
通讯作者：
BUTZ, WP
中科院分区：
文献类型：
--
作者：
HABICHT, JP;DAVANZO, J;BUTZ, WP
对马来西亚半岛一项概率调查于 1976 年至 1977 年收集的母亲回忆数据进行的分析显示，六个月以下的母乳喂养与婴儿出生后第一年的存活率提高之间存在关联。样本选择不当和混杂控制不充分可能会在这些分析中引入很大的偏差。给出了这些偏差的大小和方向。即使这些偏见得到解决，不补充母乳喂养似乎也比补充母乳喂养更有益。婴儿越小、母乳喂养时间越长，在避免死亡方面的估计效益就越大。使用婴儿配方奶粉似乎并没有抵消早期断奶和补充的有害影响。这些分析发现母乳喂养与生存之间的正相关关系并不是由于死亡阻碍或终止母乳喂养。它们也不太可能是由于最近生病而放弃母乳喂养造成的，分析中也控制了这种情况。它们也不太可能是由于其他既增加死亡风险又缩短母乳喂养时间的因素造成的；当考虑到这些因素时，母乳喂养的有益效果会变得更强，这意味着，如果该样本中没有母乳喂养，出生第一周后死亡的婴儿数量将是两倍。
Analysis of mother''s recall data collected in 1976-1977 by a probability survey in Peninsular Malaysia shows an association between breastfeeding up to six months of age and improved survival of infants throughout the first year of life. Inappropriate sample selection and inadequate control of confounding can introduce large biases in these analyses. The magnitude and direction of these biases are presented. Even when these biases are dealt with, unsupplemented breastfeeding appears more beneficial than supplemented breastfeeding. The younger the infant and the longer the breastfeeding, the greater the estimated benefits in terms of deaths averted. The use of powdered infant formula did not appear to offset the detrimental effects of early weaning and supplementation. The positive relationships found in these analyses between breastfeeding and survival are not due to death precluding or terminating breastfeeding. Nor are they likely to be due to a shift away from breastfeeding because of recent illness, which was also controlled in the analyses. Nor are they likely to be due to other factors that both increase mortality risk and shorten breastfeeding; when such factors are taken into account, the beneficial effects of breastfeeding become stronger and imply that, if there had been no breastfeeding in this sample, twice as many babies would have died after the first week of life.