Division of Paediatrics, Nursing Profession Centre, Oslo University Hospital, Rikshospitalet, Norway.
Acta Paediatr. 2010 Mar;99(3):373-8. doi: 10.1111/j.1651-2227.2009.01605.x. Epub 2009 Dec 24.
To explore the prevalence of breast milk feeding (BMF) of infants with congenital heart defects (CHD) during first 6 months of life, as compared with general population.
The study is based on a subsample of the Norwegian Mother and Child Cohort Study conducted by Norwegian Institute of Public Health. A total of 60,600 mothers completed a questionnaire about infant feeding at 6 months postpartum. Infants with moderate/severe CHD (n = 131) were identified using nationwide CHD registry. A group of infants with CHD with comorbidity was also defined (n = 65). BMF was classified as predominant, continued, or no BMF. Month to month feeding status was analysed by means of Cox regression analyses.
Between child age 2-6 months, mothers of infants with CHD had a hazard ratio (HR) of 1.69 of weaning their child compared with mothers of controls. Mothers of infants with CHD with comorbidity weaned at an even faster rate (HR 3.54). At age 6 months, 9.9% of infants with CHD were fed with breast milk predominately, 64.1% continued to receive breast milk, and only 26% were fed no breast milk. For infants with CHD with comorbidity, corresponding percentages were 7.7%, 43.1% and 49.2%, respectively.
Although CHD alone and particularly CHD with comorbidity increased risk that mothers wean earlier, a relatively high rate of continued breastfeeding was maintained. Future studies should investigate factors that support continued BMF even in the most severely affected children with CHD.
探讨先天性心脏病(CHD)婴儿在生命的头 6 个月中母乳喂养(BMF)的流行率,与一般人群相比。
本研究基于挪威公共卫生研究所进行的挪威母亲和儿童队列研究的一个子样本。共有 60600 名母亲在产后 6 个月时完成了一份关于婴儿喂养的问卷。使用全国性的 CHD 登记册确定了 131 名患有中度/重度 CHD 的婴儿。还定义了一组患有 CHD 合并症的婴儿(n=65)。将 BMF 分为主要、持续或无 BMF。通过 Cox 回归分析按月分析喂养状况。
在儿童 2-6 个月大时,与对照组的母亲相比,患有 CHD 的婴儿的母亲断奶的风险比(HR)为 1.69。患有 CHD 合并症的婴儿的母亲断奶速度更快(HR 3.54)。在 6 个月大时,9.9%的 CHD 婴儿主要以母乳喂养,64.1%的婴儿继续母乳喂养,只有 26%的婴儿没有母乳喂养。对于患有 CHD 合并症的婴儿,相应的百分比分别为 7.7%、43.1%和 49.2%。
尽管 CHD 本身,特别是 CHD 合并症增加了母亲更早断奶的风险,但持续母乳喂养的比例仍然相对较高。未来的研究应调查支持即使在最严重的 CHD 患儿中持续母乳喂养的因素。