Fewtrell M S, Lucas A, Morgan J B
MRC Childhood Nutrition Research Centre, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
Arch Dis Child Fetal Neonatal Ed. 2003 Jul;88(4):F296-301. doi: 10.1136/fn.88.4.f296.
The optimal age for the introduction of solid foods (weaning) in infants is poorly researched yet may have implications for both short and longer term health. Many parents do not comply with current guidelines.
To determine and compare the age at weaning in term appropriate size for gestational age (AGA), small for gestational age (SGA), and preterm infants, and factors associated with weaning age in these groups.
Data from > 2000 infants from seven prospective randomised trails conducted between 1990 and 1997 were used to address the objectives.
Most infants, term AGA, SGA, or preterm, received solids before 4 months of age. Only 2% of term infants were exclusively breast fed to 6 months of age. Formula fed infants received solids on average two weeks earlier than breast fed infants. Preterm infants were significantly more likely, and term SGA infants less likely, to receive solids at both 6 and 12 weeks after term than term AGA infants. Weight at 6 weeks of age was a stronger predictor of earlier weaning than either birth weight or weight gain from birth to 6 weeks in term infants. In preterm infants, formula feeding and maternal smoking were associated with earlier weaning.
Infants born in the mid 1990s were weaned on average earlier than the 4 months recommended by the Department of Health. Earlier weaning was associated with less positive health behaviours. Further research is required to provide evidence based weaning guidelines, including specific advice for SGA and preterm infants, and to investigate longer term consequences of weaning practices.
婴儿引入固体食物（断奶）的最佳年龄研究较少，但可能对短期和长期健康都有影响。许多家长未遵循现行指南。
确定并比较足月儿、小于胎龄儿（SGA）和早产儿的断奶年龄，以及这些组中与断奶年龄相关的因素。
使用1990年至1997年间进行的7项前瞻性随机试验中2000多名婴儿的数据来实现这些目标。
大多数婴儿，无论是足月儿、SGA还是早产儿，在4个月龄前就开始食用固体食物。只有2%的足月儿纯母乳喂养至6个月龄。配方奶喂养的婴儿开始食用固体食物的时间平均比母乳喂养的婴儿早两周。与足月儿相比，早产儿在足月后6周和12周时更有可能开始食用固体食物，而足月SGA婴儿则不太可能。对于足月儿，6周龄时的体重比出生体重或从出生到6周龄的体重增加更能预测更早断奶。在早产儿中，配方奶喂养和母亲吸烟与更早断奶有关。
20世纪90年代中期出生的婴儿平均断奶时间早于卫生部建议的4个月。更早断奶与不太积极的健康行为有关。需要进一步研究以提供基于证据的断奶指南，包括针对SGA和早产儿的具体建议，并调查断奶做法的长期后果。
