Maternal control of milk feeding: the role of attitudes, intentions and experiences

母亲对母乳喂养的控制：态度、意图和经验的作用

• 批准号: ES/J002836/1
• 负责人: Amy Brown
• 金额: $ 9.82万
• 依托单位: Swansea University
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2011
• 资助国家: 英国
• 起止时间: 2011 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FJ002836%2F1
• 关键词: Maternal; control; milk; feeding; role

Levels of childhood obesity are increasing in the UK placing children at risk of current and future health problems with a significant impact upon NHS resources. Children from lower socioeconomic backgrounds are at increased risk. Childhood nutrition is a major risk factor for overweight and therefore early interventions to reduce obesity risk are needed. Individuals who recognise when they are full and do not overeat are more likely to be a healthy weight. Differences in this ability can be recognised from childhood. One influence upon this ability is the amount of control a mother exerts over her child's eating. Children have an innate ability to regulate intake of food but behaviours such as restricting intake or pressurising the child to consume more may lead to issues with eating style and overweight. Mothers who breastfeed use lower levels of control over their child's later diet. It has been hypothesised (but not examined) that differences in the feeding style of breast and formula fed infants may explain this. Breastfeeding is more 'baby-led' than formula feeding. The amount of milk consumed cannot be easily measured and feeds are frequent and irregular to stimulate milk supply. Conversely formula feeding is more visible and usually performed to a schedule. It is much easier to track amount of milk consumed. Whilst mothers who breastfeed need to follow their baby's cues to feed, formula feeding mothers have greater control and opportunity to manipulate intake. These differences may follow through into later feeding style. Alternatively mothers who desire a high level of control over feeding in general may choose to formula feed due to greater opportunity to manipulate feeding and go on to exert higher levels of control over later diet. My PhD research explored this relationship examining whether differences in maternal control could be identified during milk feeding and why any relationship might occur. In a longitudinal study, mothers who breastfed were more likely to feed to infant demand whilst mothers who formula fed were more likely to feed to a schedule and manipulate intake. Importantly, maternal control was associated with attitudes towards breastfeeding. Mothers who believed breastfeeding was inconvenient or difficult were more likely to control feeding patterns and to formula feed. These attitudes were present prenatally and predicted breastfeeding duration. Notably, mothers who started breastfeeding but held high concerns about feeding frequency and milk intake were more likely to stop breastfeeding and increase control. Formula feeding allowed greater control and routine. Potentially this is having an adverse effect upon infant health, through a shorter breastfeeding duration and impact upon ability to self regulate intake of energy leading to overweight. The research has important consequences for understanding influences upon breastfeeding duration and child overweight which are key public health concerns. The aim of the fellowship is to disseminate findings, through publications, conference presentations and study days for both academics and health professionals. This will allow further research into the area to be conducted and ensure findings are given directly to those working to increase breastfeeding rates. Key messages could be used to directly develop interventions to support pregnant and new mothers, particularly working antenatally to increase knowledge and confidence of the normality and need for baby-led breastfeeding. Findings could be used to inform evidence based policy in supporting breastfeeding. Beneficiaries of the fellowship would therefore include not only Academics but Health Professionals, Mothers and Infants and the General Public through potential increases in breastfeeding rates which in turn have a positive impact upon Public Health and thus NHS costs and resources. Overall the research is highly relevant, potentially improving both infant and maternal health.

在英国，儿童肥胖症的水平正在上升，使儿童面临当前和未来健康问题的风险，这对NHS的资源产生了重大影响。来自较低社会经济背景的儿童面临更高的风险。儿童营养是超重的一个主要风险因素，因此需要及早干预以降低肥胖风险。那些能意识到自己什么时候吃饱、吃得不多的人更有可能是健康的体重。这种能力的差异可以从孩提时代就认识到。对这种能力的影响之一是母亲对孩子饮食的控制程度。儿童天生就有调节食物摄入量的能力，但限制摄入量或强迫儿童多吃东西等行为可能会导致饮食风格和超重的问题。母乳喂养的母亲对孩子以后的饮食控制水平较低。有人假设(但没有检验)，母乳喂养和配方奶喂养的婴儿的喂养方式的差异可能解释了这一点。与配方奶相比，母乳喂养更多地是由婴儿主导的。牛奶的消耗量很难测量，而且喂奶频繁且不规律，以刺激牛奶供应。相反，配方奶喂养更明显，通常会按计划进行。跟踪牛奶消耗量要容易得多。虽然母乳喂养的母亲需要遵循婴儿的暗示来喂养，但配方奶喂养的母亲有更大的控制权和机会来操纵摄入量。这些差异可能会延续到后来的喂养方式。或者，希望对一般喂养进行高水平控制的母亲可以选择配方奶喂养，因为有更多的机会操纵喂养，并继续对以后的饮食施加更高水平的控制。我的博士研究探索了这种关系，考察了母乳喂养过程中母体控制的差异是否可以被识别出来，以及为什么会出现这种关系。在一项纵向研究中，母乳喂养的母亲更有可能满足婴儿的需求，而配方奶喂养的母亲更有可能按计划喂养并控制摄入量。重要的是，母亲的控制与对母乳喂养的态度有关。认为母乳喂养不方便或困难的母亲更有可能控制喂养模式和配方奶喂养。这些态度在产前就存在，并可以预测母乳喂养的持续时间。值得注意的是，开始母乳喂养但对喂养频率和母乳摄入量高度担忧的母亲更有可能停止母乳喂养并加强控制。配方奶喂养允许更好的控制和例行公事。这可能会对婴儿健康产生不利影响，因为母乳喂养持续时间较短，并影响自我调节能量摄入的能力，从而导致超重。这项研究对于理解母乳喂养持续时间和儿童超重的影响具有重要的意义，这些都是关键的公共卫生问题。该奖学金的目的是通过出版物、会议报告和面向学者和卫生专业人员的研究日来传播研究结果。这将允许对该地区进行进一步的研究，并确保研究结果直接提供给那些致力于提高母乳喂养率的人。可以利用关键信息直接制定干预措施，支持孕妇和新母亲，特别是在临产前工作，以增加对正常哺乳和婴儿引导母乳喂养的需要的了解和信心。研究结果可以被用来为支持母乳喂养的循证政策提供依据。因此，该研究金的受益者不仅包括学者，而且还包括卫生专业人员、母亲和婴儿以及普通公众，因为母乳喂养率可能会增加，这反过来又会对公共卫生产生积极影响，从而对国民保健系统的费用和资源产生积极影响。总体而言，这项研究具有很高的相关性，有可能改善婴儿和产妇的健康。

项目成果

Maternal trait personality and breastfeeding duration: the importance of confidence and social support.

• DOI: 10.1111/jan.12219
• 发表时间: 2014-03
• 期刊: Journal of advanced nursing
• 影响因子: 3.8
• 作者: Brown A

Fathers' experiences of supporting breastfeeding: challenges for breastfeeding promotion and education.

• DOI: 10.1111/mcn.12129
• 发表时间: 2014-10
• 期刊: Maternal & child nutrition
• 影响因子: 3.4
• 作者: Brown A;Davies R
• 通讯作者: Davies R