Singhal Atul, Morley Ruth, Cole Tim J, Kennedy Kathy, Sonksen Patricia, Isaacs Elizabeth, Fewtrell Mary, Elias-Jones Alun, Stephenson Terence, Lucas Alan
Medical Research Council Childhood Nutrition Research Center, Institute of Child Health, London, United Kingdom.
Am J Clin Nutr. 2007 Jan;85(1):152-9. doi: 10.1093/ajcn/85.1.152.
Breastfeeding has been reported to benefit visual development in children. A higher concentration of docosahexaneoic acid (DHA) in breast milk than in formula has been proposed as one explanation for this association and as a rationale for adding DHA to infant formula, but few long-term data support this possibility.
The objectives of the study were, first, to test the hypothesis that breastfeeding benefits stereoscopic visual maturation and, second, if that benefit is shown, to ascertain whether it is mediated by the dietary intake of DHA.
Stereoacuity was measured by using the random dot E test (primary outcome), and visual acuity was measured by using the Sonksen-Silver acuity system (secondary outcome) in previously breastfed (n = 78) or formula-fed (n = 184) children aged 4-6 y who had been followed prospectively from birth. In the formula-fed group, children were randomly assigned to receive formula with either DHA or arachidonic acid (n = 94) or a control formula (n = 90) for the first 6 mo.
Breastfed children had a significantly (P = 0.001) greater likelihood of foveal stereoacuity (high-grade or < 100 s/arc) than did formula-fed children (odds ratio: 2.5; 95% CI: 1.4, 4.5) independent of potential confounding (P = 0.005). Stereoacuity did not differ significantly between children randomly assigned to DHA-supplemented or control formula. None of the groups differed in Sonksen-Silver visual acuity.
These findings support the hypothesis that breastfeeding benefits long-term stereoscopic development. An effect of DHA cannot be excluded, but the lack of difference in stereoacuity between infants randomly assigned to DHA-containing and those assigned to control formula raises the hypothesis that factors in breast milk other than DHA account for the observed benefits.
据报道，母乳喂养对儿童视觉发育有益。母乳中二十二碳六烯酸（DHA）的浓度高于配方奶粉，这被认为是这种关联的一种解释，也是在婴儿配方奶粉中添加DHA的一个理由，但很少有长期数据支持这种可能性。
本研究的目的，首先是检验母乳喂养有利于立体视觉成熟这一假设，其次，如果显示出这种益处，确定其是否由DHA的饮食摄入介导。
通过随机点E测试测量立体视敏度（主要结果），并使用Sonksen-Silver视力系统测量视力（次要结果），对4至6岁的78名曾母乳喂养儿童和184名曾配方奶粉喂养儿童进行测量，这些儿童从出生起就进行了前瞻性跟踪。在配方奶粉喂养组中，儿童在出生后的前6个月被随机分配接受添加DHA或花生四烯酸的配方奶粉（n = 94）或对照配方奶粉（n = 90）。
与配方奶粉喂养的儿童相比，母乳喂养的儿童具有中央凹立体视敏度（高级或<100秒/弧度）的可能性显著更高（P = 0.001）（优势比：2.5；95%置信区间：1.4，4.5），且与潜在混杂因素无关（P = 0.005）。随机分配到添加DHA配方奶粉或对照配方奶粉的儿童之间立体视敏度无显著差异。所有组在Sonksen-Silver视力方面均无差异。
这些发现支持母乳喂养有利于长期立体视觉发育这一假设。不能排除DHA的作用，但随机分配到含DHA配方奶粉组和对照配方奶粉组的婴儿之间立体视敏度没有差异，这提出了一个假设，即除DHA外母乳中的其他因素导致了观察到的益处。
