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婴儿喂养方式与儿童睡眠呼吸障碍

Infant-feeding methods and childhood sleep-disordered breathing.

作者信息

Montgomery-Downs Hawley Evelyn, Crabtree Valerie McLaughlin, Sans Capdevila Oscar, Gozal David

机构信息

West Virginia University, Department of Psychology, 1124 Life Sciences Building, PO Box 6040, Morgantown, WV 26506-6040, USA.

出版信息

Pediatrics. 2007 Nov;120(5):1030-5. doi: 10.1542/peds.2007-0722.

Abstract

OBJECTIVE

Childhood sleep-disordered breathing has an adverse impact on cognitive development, behavior, quality of life, and use of health care resources. Early viral infections and other immune-mediated responses may contribute to development of the chronic inflammation of the upper airway and hypertrophic upper airway lymphadenoid tissues underlying childhood sleep-disordered breathing. Breastfeeding provides immunologic protection against such early exposures. Therefore, we sought to explore whether sleep-disordered breathing severity would differ for children who were breastfed as infants.

METHODS

The parents or guardians of 196 habitually snoring children (mean +/- SD: 6.7 +/- 2.9 years old) who were undergoing overnight polysomnography at Kosair Children's Hospital Sleep Medicine and Apnea Center completed a retrospective survey on the method(s) used to feed the child as an infant.

RESULTS

Among habitually snoring children, those who were fed breast milk for at least 2 months had significantly reduced sleep-disordered breathing severity on every measure assessed, including apnea-hypopnea index, oxyhemoglobin desaturation nadir, and respiratory arousal index. Breastfeeding for longer than 5 months did not contribute additional benefits.

CONCLUSIONS

Our findings support the notion that breastfeeding may provide long-term protection against the severity of childhood sleep-disordered breathing. Future research should explore mechanism(s) whereby infant-feeding methods may affect the pathophysiology of development of childhood sleep-disordered breathing.

摘要

目的

儿童睡眠呼吸障碍对认知发育、行为、生活质量及医疗资源利用均有不利影响。早期病毒感染及其他免疫介导反应可能促使儿童睡眠呼吸障碍所潜在的上气道慢性炎症及上气道淋巴样组织肥厚的发展。母乳喂养可提供针对此类早期暴露的免疫保护。因此,我们试图探究婴儿期接受母乳喂养的儿童睡眠呼吸障碍严重程度是否会有所不同。

方法

在 Kosair 儿童医院睡眠医学与呼吸暂停中心接受夜间多导睡眠图检查的 196 名习惯性打鼾儿童(平均±标准差:6.7±2.9 岁)的父母或监护人完成了一项关于婴儿期喂养孩子所用方法的回顾性调查。

结果

在习惯性打鼾儿童中,那些接受母乳喂养至少 2 个月的儿童,在包括呼吸暂停低通气指数、氧合血红蛋白饱和度最低点及呼吸觉醒指数在内的各项评估指标上,睡眠呼吸障碍严重程度均显著降低。母乳喂养超过 5 个月并未带来额外益处。

结论

我们的研究结果支持母乳喂养可能为儿童睡眠呼吸障碍严重程度提供长期保护这一观点。未来研究应探索婴儿喂养方式可能影响儿童睡眠呼吸障碍发生发展病理生理过程的机制。

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