Griffiths L J, Smeeth L, Hawkins S Sherburne, Cole T J, Dezateux C
MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London WC1N 1EH, UK.
Arch Dis Child. 2009 Aug;94(8):577-82. doi: 10.1136/adc.2008.137554. Epub 2008 Nov 19.
The influence of infant feeding practices on weight gain during childhood remains unresolved, with few studies adjusting appropriately for confounding factors. This study examined the effect of breastfeeding initiation, breastfeeding duration and age at introduction of solid foods on weight gain from birth to 3 years.
Nationally representative prospective study.
England, Wales, Scotland and Northern Ireland.
10,533 3-year-old children from the UK Millennium Cohort Study.
Conditional weight gain z-scores from birth to 3 years (adjusted for birthweight); multiple linear regression analyses were conducted to examine the impact of infant feeding practices on this measure after adjustment for confounding factors.
Breastfeeding initiation and breastfeeding duration were significantly associated with weight gain from birth to 3 years. Infants receiving no breast milk grew faster than those whose mothers initiated breastfeeding (adjusted regression coefficient (difference in z-scores) 0.06, 95% CI 0.02 to 0.09), as did those breastfed for less than 4 months (0.05, 95% CI 0.01 to 0.09) versus those breastfed 4 months or longer. Early introduction of solids was not associated with faster weight gain after adjustment for height z-score at 3 years (-0.01, 95% CI -0.04 to 0.03).
Initiating and prolonging breastfeeding may reduce excess weight gain by preschool age. Association of the early introduction of solids with rapid weight gain during early childhood is mediated through childhood stature. Although effects sizes are small, at a population level they are of public health importance as these risk factors are potentially modifiable. Strategies to support mothers to follow internationally recommended infant feeding practices are required.
婴儿喂养方式对儿童期体重增加的影响尚无定论，很少有研究对混杂因素进行适当调整。本研究探讨了母乳喂养开始时间、母乳喂养持续时间和引入固体食物的年龄对出生至3岁体重增加的影响。
具有全国代表性的前瞻性研究。
英格兰、威尔士、苏格兰和北爱尔兰。
来自英国千禧队列研究的10533名3岁儿童。
出生至3岁的条件性体重增加z评分（根据出生体重进行调整）；进行多元线性回归分析，以检验在调整混杂因素后婴儿喂养方式对该指标的影响。
母乳喂养开始时间和母乳喂养持续时间与出生至3岁的体重增加显著相关。未接受母乳喂养的婴儿比母亲开始母乳喂养的婴儿生长更快（调整后的回归系数（z评分差异）为0.06，95%可信区间为0.02至0.09），母乳喂养少于4个月的婴儿（0.05，95%可信区间为0.01至0.09）比母乳喂养4个月或更长时间的婴儿生长更快。在调整3岁时的身高z评分后，过早引入固体食物与体重增加更快无关（-0.01，95%可信区间为-0.04至0.03）。
开始并延长母乳喂养可能会减少学龄前儿童体重过度增加。幼儿期过早引入固体食物与体重快速增加之间的关联是通过儿童身高介导的。尽管效应大小较小，但在人群层面上它们具有公共卫生重要性，因为这些风险因素具有潜在的可改变性。需要采取策略支持母亲遵循国际推荐的婴儿喂养方式。
