Amir Lisa Helen, Donath Susan M
Centre for the Study of Mothers' and Children's Health, La Trobe University, Australia.
Breastfeed Rev. 2003 Jul;11(2):19-29.
Women who smoke are less likely to breastfeed their children than nonsmokers. It is thought that nicotine has a negative effect on breastmilk supply by suppressing prolactin levels. The aim of this review was to assess the epidemiological evidence that maternal smoking has a negative physiological effect on breastfeeding. The following data sources were searched: The Cochrane Library, Medline, CINAHL, Current Contents, Psychinfo, Sociological Abstracts and the Lactation Resource Centre (Australian Breastfeeding Association) using the key words 'smoking' and 'breastfeeding' or 'infant feeding'. The Journal of Human Lactation and Birth were hand searched. Women who smoke are less likely to intend to breastfeed, less likely to initiate breastfeeding, and likely to breastfeed for a shorter duration than nonsmokers. Several studies have found a dose-response relationship between the number of cigarettes smoked each day and breastfeeding intention, initiation, and duration that persists after adjusting for confounding factors. In some population groups a high proportion of smokers breastfeed successfully. The association between maternal smoking and lack of breastfeeding is consistent across different study designs in a range of countries. Given that women who smoke are less likely to intend to breastfeed, however, it cannot be assumed that the relationship between smoking and duration of breastfeeding is a physiological one. If smoking had a consistent negative physiological effect on lactation, one would not expect to see such wide variations in breastfeeding rates among women who smoke. Therefore, it is likely that psychosocial factors are largely responsible for the lower rates of breastfeeding found in women who smoke compared with those who do not.
吸烟的女性比不吸烟的女性进行母乳喂养的可能性更低。人们认为尼古丁会通过抑制催乳素水平对母乳供应产生负面影响。本综述的目的是评估有关母亲吸烟对母乳喂养产生负面生理影响的流行病学证据。检索了以下数据来源：考克兰图书馆、医学索引数据库、护理学与健康领域数据库、现刊目次、心理学文摘数据库、社会学文摘以及哺乳资源中心（澳大利亚母乳喂养协会），使用关键词“吸烟”和“母乳喂养”或“婴儿喂养”。对《人类泌乳杂志》和《分娩》进行了手工检索。吸烟的女性进行母乳喂养的意愿更低，开始母乳喂养的可能性更小，且母乳喂养的持续时间可能比不吸烟的女性短。多项研究发现，每天吸烟的数量与母乳喂养意愿、开始母乳喂养以及母乳喂养持续时间之间存在剂量反应关系，在对混杂因素进行调整后这种关系依然存在。在一些人群中，很大比例的吸烟者成功进行了母乳喂养。在一系列国家中，不同的研究设计都显示母亲吸烟与缺乏母乳喂养之间存在关联。然而，鉴于吸烟的女性进行母乳喂养的意愿更低，不能假定吸烟与母乳喂养持续时间之间的关系是生理性的。如果吸烟对泌乳有持续的负面生理影响，那么在吸烟女性中就不会看到母乳喂养率有如此大的差异。因此，与不吸烟的女性相比，吸烟女性母乳喂养率较低很可能主要是由社会心理因素导致的。
