Do infants fed from bottles lack self-regulation of milk intake compared with directly breastfed infants?
Do infants fed from bottles lack self-regulation of milk intake compared with directly breastfed infants?
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DOI：
10.1542/peds.2009-2549
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发表时间：
2010-06-01
期刊：
影响因子：
8
通讯作者：
Grummer-Strawn, Laurence M
中科院分区：
文献类型：
--
作者：
Li, Ruowei;Fein, Sara B;Grummer-Strawn, Laurence M
目的：母乳喂养如何降低儿童肥胖风险尚不清楚，其中一个假设与母乳喂养婴儿的自我调节能力有关。我们研究了婴儿对牛奶摄入量的自我调节是否受到喂养方式（奶瓶还是母乳）和奶瓶中的牛奶类型（配方奶还是母乳）的影响。患者和方法：2005-2007年婴儿喂养实践研究II的参与者在其婴儿一岁期间每月接受问卷调查，并可获得1250名婴儿的竞争数据。我们测试了婴儿早期喂养方式和牛奶类型对婴儿后期自我调节的影响。结果：虽然只有27%的婴儿在婴儿期早期完全母乳喂养的婴儿在婴儿期后期清空奶瓶或杯子，54%的婴儿在母乳喂养和奶瓶喂养的婴儿这样做，68%的婴儿只用奶瓶喂养的婴儿这样做。多变量回归分析表明，在生命早期更密集的奶瓶喂养的婴儿，在生命后期清空奶瓶或杯子的可能性大约是那些较少密集的奶瓶喂养的婴儿的71%或2倍(奶瓶喂养的(1/3)-（2/3)或（2/3）与奶瓶喂养的<(1/3)）。当分别考虑配方奶和乳汁时，观察到类似的剂量-反应关系。结论：婴儿期早期用奶瓶喂养的婴儿在婴儿期后期比直接用乳房喂养的婴儿更容易清空奶瓶或杯子。无论是哪种奶，奶瓶喂养与母乳喂养在影响婴儿对奶摄入量的自我调节方面是不同的。
OBJECTIVE: How breastfeeding reduces the risk of childhood obesity is unclear, and 1 hypothesis pertains to the ability of breastfed infants to self-regulate. We studied whether infants' self-regulation of milk intake is affected by feeding mode (bottle versus breast) and the type of milk in the bottle (formula versus expressed breast milk).PATIENTS AND METHODS: Participants in the 2005-2007 Infant Feeding Practices Study II received monthly questionnaires during their infant's first year, and compete data were available for 1250 infants. We tested the impact of feeding mode and type of milk during early infancy on self-regulation during late infancy.RESULTS: Although only 27% of infants fed exclusively at the breast in early infancy emptied the bottle or cup in late infancy, 54% of infants who were fed both at the breast and by bottle did so, and 68% of those who were fed only by bottle did so. Multivariate regression analysis indicated that infants who were bottle-fed more intensively early in life were approximately 71% or 2 times more likely to empty the bottle or cup later in life than those who were bottle-fed less intensively ((1/3)-(2/3) or (2/3) of milk feeds given by bottle versus < (1/3) of milk feeds). When feeding formula and expressed milk were considered separately, similar dose-response relationships were observed.CONCLUSIONS: Infants who are bottle-fed in early infancy are more likely to empty the bottle or cup in late infancy than those who are fed directly at the breast. Bottle-feeding, regardless of the type of milk, is distinct from feeding at the breast in its effect on infants' self-regulation of milk intake.