Lauer Jeremy A, Betrán Ana Pilar, Barros Aluísio J D, de Onís Mercedes
Department of Making Pregnancy Safer, World Health Organization, Geneva, Switzerland.
Public Health Nutr. 2006 Sep;9(6):673-85. doi: 10.1079/phn2005891.
We estimate attributable fractions, deaths and years of life lost among infants and children < or = 2 years of age due to suboptimal breast-feeding in developing countries.
We compare actual practices to a minimum exposure pattern consisting of exclusive breast-feeding for infants < or = 6 months of age and continued breast-feeding for older infants and children < or = 2 years of age. For infants, we consider deaths due to diarrhoeal disease and lower respiratory tract infections, and deaths due to all causes are considered in the second year of life. Outcome measures are attributable fractions, deaths, years of life lost and offsetting deaths potentially caused by mother-to-child transmission of HIV through breast-feeding.
Developing countries.
Infants and children < or = 2 years of age.
Attributable fractions for deaths due to diarrhoeal disease and lower respiratory tract infections are 55% and 53%, respectively, for the first six months of infancy, 20% and 18% for the second six months, and are 20% for all-cause deaths in the second year of life. Globally, as many as 1.45 million lives (117 million years of life) are lost due to suboptimal breast-feeding in developing countries. Offsetting deaths caused by mother-to-child transmission of HIV through breast-feeding could be as high as 242,000 (18.8 million years of life lost) if relevant World Health Organization recommendations are not followed.
The size of the gap between current practice and recommendations is striking when one considers breast-feeding involves no out-of-pocket costs, that there exists universal consensus on best practices, and that implementing current international recommendations could potentially save 1.45 million children's lives each year.
我们估算了发展中国家2岁及以下婴幼儿因母乳喂养不充分而导致的归因分数、死亡数和寿命损失年数。
我们将实际做法与一种最低暴露模式进行比较，该模式包括对6个月及以下婴儿进行纯母乳喂养，以及对2岁及以下较大婴儿和儿童持续母乳喂养。对于婴儿，我们考虑腹泻病和下呼吸道感染导致的死亡，以及生命第二年所有原因导致的死亡。结局指标为归因分数、死亡数、寿命损失年数以及因母乳喂养导致母婴传播艾滋病毒可能造成的抵消死亡数。
发展中国家。
2岁及以下婴幼儿。
婴儿期前六个月因腹泻病和下呼吸道感染导致的死亡归因分数分别为55%和53%，后六个月分别为20%和18%，生命第二年所有原因导致的死亡归因分数为20%。在全球范围内，发展中国家因母乳喂养不充分导致多达145万例死亡（1.17亿寿命损失年）。如果不遵循世界卫生组织的相关建议，因母乳喂养导致母婴传播艾滋病毒造成的抵消死亡数可能高达24.2万例（1880万寿命损失年）。
当考虑到母乳喂养无需自掏腰包费用、对于最佳做法存在普遍共识且实施当前国际建议每年有可能挽救145万儿童生命时，当前做法与建议之间的差距之大令人震惊。
