Jakobsen Marianne S, Sodemann Morten, Biai Sidu, Nielsen Jens, Aaby Peter
Bandim Health Project, Indepth Network, Danish Epidemiology Science Centre, Apartado 861, Bissau, Guinea-Bissau.
Acta Paediatr. 2008 Jan;97(1):68-75. doi: 10.1111/j.1651-2227.2007.00532.x. Epub 2007 Dec 3.
To evaluate the impact of promotion of exclusive breastfeeding on infant health in Guinea-Bissau, West Africa, where mortality rates are high, breastfeeding is widely practiced but exclusive breastfeeding is rare.
At the Bandim Health Project in Guinea Bissau, West Africa, a birth cohort of 1721 infants were randomized to receive health education: promotion of exclusive breastfeeding for the first 4-6 months of life according to WHO recommendations at the time of the study. All children were followed from birth to 6 months of age.
Introduction of both water and weaning food was significantly delayed in the intervention group. However we found no beneficial health effects of the intervention; there was no reduction in mortality in the intervention group compared with the control group (mortality rate ratio: 1.86 (0.79-4.39)), weight at 4-6 months of age was significantly lower in the intervention group (7.10 kg vs. 7.25 kg; Wilcoxon two-sample test: p=0.03). There was no difference in diarrhoea morbidity and hospitalization rates.
Although mothers were sensitive to follow new breastfeeding recommendations, it had no beneficial impact on infant health in this society with traditional, intensive breastfeeding. There seems to be little reason to discourage local practices as long as there are no strong data justifying such a change.
在西非几内亚比绍评估推广纯母乳喂养对婴儿健康的影响。该国死亡率高，母乳喂养普遍但纯母乳喂养很少见。
在西非几内亚比绍的班迪姆健康项目中，1721名婴儿的出生队列被随机分组以接受健康教育：按照研究时世界卫生组织的建议，在婴儿出生后头4至6个月推广纯母乳喂养。所有儿童从出生起随访至6个月大。
干预组引入水和断奶食品的时间显著延迟。然而，我们发现干预措施对健康没有有益影响；与对照组相比，干预组的死亡率没有降低（死亡率比：1.86（0.79 - 4.39）），干预组4至6个月大时的体重显著更低（7.10千克对7.25千克；威尔科克森两样本检验：p = 0.03）。腹泻发病率和住院率没有差异。
尽管母亲们对遵循新的母乳喂养建议很敏感，但在这个传统且密集进行母乳喂养的社会中，这对婴儿健康没有有益影响。只要没有有力数据支持这种改变，似乎没有什么理由劝阻当地的做法。
