Kramer Michael S, Matush Lidia, Bogdanovich Natalia, Aboud Frances, Mazer Bruce, Fombonne Eric, Collet Jean-Paul, Hodnett Ellen, Mironova Elena, Igumnov Sergei, Chalmers Beverley, Dahhou Mourad, Platt Robert W
Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Canada.
Am J Clin Nutr. 2009 Oct;90(4):1070-4. doi: 10.3945/ajcn.2009.28021. Epub 2009 Aug 26.
Despite the current World Health Organization recommendation that infants be exclusively breastfed for 6 mo, this practice remains unusual in both developed and developing countries.
The objective was to compare health and development outcomes at age 6.5 y in children who were exclusively breastfed for 3 mo (EBF3) or for 6 mo (EBF6); in the EBF3 group, the children continued partial breastfeeding for > or =6 mo.
This was a prospective cohort study nested within a large, cluster-randomized trial of a breastfeeding promotion intervention in the Republic of Belarus. Outcomes compared at 6.5 y included anthropometric measurements, systolic and diastolic blood pressure, intelligence quotient, teachers' ratings of academic performance, parent- and teacher-rated behavior, atopic symptoms, allergen skin-prick tests, and dental caries. All statistical analyses were adjusted for cluster- and individual-level covariates and for clustering of outcomes within the clinics at which the children were examined.
The 2427 EBF3 and 524 EBF6 children who were followed up represented 84.7% and 89.4%, respectively, of those followed for the first year of life. The only significant differences observed between the 2 groups were in mean body mass index, triceps skinfold thickness, and hip circumference, all of which were higher in the EBF6 group.
We observed no demonstrable beneficial or adverse long-term effects on child health of exclusive breastfeeding for 6 mo. Higher adiposity measures in the EBF6 group probably reflect reverse causality rather than a causal effect of prolonged exclusive breastfeeding. Established benefits appear to be limited to the period of exclusive breastfeeding.
尽管世界卫生组织目前建议婴儿纯母乳喂养6个月，但在发达国家和发展中国家，这种做法仍然并不常见。
比较纯母乳喂养3个月（EBF3）或6个月（EBF6）的儿童在6.5岁时的健康和发育结果；在EBF3组中，儿童继续部分母乳喂养≥6个月。
这是一项前瞻性队列研究，嵌套于白俄罗斯共和国一项关于促进母乳喂养干预措施的大型整群随机试验中。在6.5岁时比较的结果包括人体测量、收缩压和舒张压、智商、教师对学业成绩的评分、家长和教师对行为的评分、特应性症状、变应原皮肤点刺试验和龋齿。所有统计分析均针对整群和个体水平的协变量以及儿童接受检查的诊所内结果的聚类情况进行了调整。
接受随访的2427名EBF3儿童和524名EBF6儿童分别占生命第一年随访儿童的84.7%和89.4%。两组之间观察到的唯一显著差异在于平均体重指数、肱三头肌皮褶厚度和臀围，所有这些在EBF6组中均较高。
我们未观察到纯母乳喂养6个月对儿童健康有明显的长期有益或有害影响。EBF6组中较高的肥胖指标可能反映的是反向因果关系，而非延长纯母乳喂养的因果效应。已确定的益处似乎仅限于纯母乳喂养期间。
