Mulder-Sibanda M, Sibanda-Mulder F S
Helen Keller International, Dhaka, Bangladesh.
Public Health. 1999 Mar;113(2):65-8. doi: 10.1016/s0033-3506(99)00120-1.
The association between breastfeeding and diarrhoeal morbidity was examined in a prevalence study of 5502 children aged 6-71 months from rural and urban Bangladesh. Breastfeeding was found to be associated with reduced prevalence of diarrhoea. This association was most pronounced at the age of six months and declined linearly to zero at approximately 30 months of age; thereafter, breastfeeding was increasingly associated with diarrhoeal illness. The linear association was found only among those children who have no access to modern health services and information, when controlling for urban and rural differences. The literature provides two opposing explanations for the positive association of prolonged breastfeeding with diarrhoeal illness. The first explanation suggests that breastfeeding can be seen as mothers' response to children's poor health. The second explanation incriminates sub-optimal child feeding practices, characterised by prolonged breastfeeding and inadequate quality and quantity of complementary foods, as the cause of malnutrition and diarrhoea. Further studies are needed to identify which explanation is correct, given the public health implications in terms of children's survival, growth and development.
在一项针对孟加拉国城乡5502名6至71个月大儿童的患病率研究中，对母乳喂养与腹泻发病率之间的关联进行了调查。研究发现，母乳喂养与腹泻患病率降低有关。这种关联在6个月大时最为明显，到大约30个月大时线性下降至零；此后，母乳喂养与腹泻疾病的关联越来越大。在控制城乡差异时，仅在那些无法获得现代卫生服务和信息的儿童中发现了这种线性关联。文献对延长母乳喂养与腹泻疾病的正相关关系提供了两种相反的解释。第一种解释认为，母乳喂养可被视为母亲对儿童健康状况不佳的反应。第二种解释将以延长母乳喂养以及补充食物质量和数量不足为特征的次优儿童喂养方式归咎为营养不良和腹泻的原因。鉴于对儿童生存、生长和发育的公共卫生影响，需要进一步研究以确定哪种解释是正确的。
