Dewey K G, Cohen R J, Brown K H, Rivera L L
Department of Nutrition and the Program in International Nutrition, University of California, Davis 95616-8669, USA.
Am J Clin Nutr. 1999 Apr;69(4):679-86. doi: 10.1093/ajcn/69.4.679.
The optimal age at which to introduce complementary foods is a topic of considerable debate.
This study was designed to evaluate this issue in a nutritionally vulnerable population in Honduras.
Mothers of low-birth-weight (1500-2500 g) term (ie, small-for-gestational-age) infants were recruited in the hospital and assisted with exclusive breast-feeding during the first 4 mo. At 4 mo, mothers were randomly assigned to either continue exclusive breast-feeding to 6 mo (EBF; n = 59) or to feed complementary solid foods (jarred rice cereal, chicken, and fruit and vegetables) twice daily from 4 to 6 mo while continuing to breast-feed at their initial frequency (SF; n = 60). At 4 and 6 mo, breast milk and total energy intake were measured for a nonrandom subsample (those who could stay overnight in a central unit: 32 EBF and 31 SF).
At 4 mo, breast milk intake in the subsample was not significantly different between groups (EBF: 729 +/- 135 g/d; SF: 683 +/- 151 g/d: P >0.2); from 4 to 6 mo it increased (by 28 g/d) in the EBF group but decreased (by 39 g/d) in the SF group (P < 0.005). Nonetheless, total energy intake (including solid foods) increased more from 4 to 6 mo in the SF than in the EBF group. However, there were no significant differences between groups in weight or length gain during the intervention or subsequently (6-12 mo).
There was no growth advantage of complementary feeding of small-for-gestational-age, breast-fed infants between 4 and 6 mo of age.
引入辅食的最佳年龄是一个备受争议的话题。
本研究旨在评估洪都拉斯营养脆弱人群中的这一问题。
招募低出生体重（1500 - 2500克）足月儿（即小于胎龄儿）的母亲，在医院协助她们在前4个月进行纯母乳喂养。4个月时，母亲们被随机分为两组，一组继续纯母乳喂养至6个月（纯母乳喂养组；n = 59），另一组从4个月至6个月每天两次喂辅食（罐装米粉、鸡肉、水果和蔬菜），同时继续按初始频率母乳喂养（辅食组；n = 60）。在4个月和6个月时，对一个非随机子样本（那些能在中心单元过夜的：32名纯母乳喂养组和31名辅食组）测量母乳和总能量摄入量。
在4个月时，子样本中两组的母乳摄入量无显著差异（纯母乳喂养组：729 ± 135克/天；辅食组：683 ± 151克/天：P > 0.2）；从4个月至6个月，纯母乳喂养组的母乳摄入量增加（增加28克/天），而辅食组则减少（减少39克/天）（P < 0.005）。尽管如此，从4个月至6个月，辅食组的总能量摄入量（包括固体食物）比纯母乳喂养组增加得更多。然而，在干预期间或之后（6 - 12个月），两组在体重或身长增加方面无显著差异。
对于小于胎龄的母乳喂养婴儿，在4至6个月龄时进行辅食喂养没有生长优势。
