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HIV 暴露婴儿母乳喂养显著改善儿童健康:一项前瞻性研究。

Breastfeeding in HIV exposed infants significantly improves child health: a prospective study.

机构信息

Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Room 257, DDMRI Building, Congella, Durban 4013, South Africa.

出版信息

Matern Child Health J. 2012 Apr;16(3):632-40. doi: 10.1007/s10995-011-0795-8.

Abstract

Breastfeeding has been shown to benefit both maternal and child immune status. The impact of exclusive breastfeeding in the presence of HIV infection on maternal and child health is still unclear. Socio-economic factors make breast-feeding an important source of nutrition for an infant 6 months and under in the developing world. A prospective study was conducted to examine the impact of feeding mode on various maternal indices including anthropometry; body composition indicators (using FTIR); haematology and biochemical markers; as well as incidence rates of opportunistic infections and clinical disease progression. In infants we examined the impact on growth, development and morbidity. AFASS criteria (affordable, feasible, accessible, sustainable and safe) were fulfilled by 38.7% of the formula feeding mothers. No significant differences between the formula feeding and breastfeeding groups in terms of haematological, immunological and body composition changes were seen. Breastfeeding mothers had significantly lower events with high depression scores (P = 0.043). Breastfeeding infants had a significantly lower risk of diarrhoea and hospitalisation at 3 months (P = 0.006 and 0.014 respectively). Breastfeeding was significantly associated with better development scores and growth parameters. Breastfeeding is not harmful to the mother in the presence of HIV infection. Mothers are still choosing formula feeding inappropriately despite counselling about the AFASS criteria. Breastfeeding is beneficial to the infants especially in the first 3 months of life.

摘要

母乳喂养已被证明有益于母婴的免疫状态。在存在 HIV 感染的情况下,纯母乳喂养对母婴健康的影响仍不清楚。社会经济因素使得母乳喂养成为发展中国家 6 个月及以下婴儿的重要营养来源。进行了一项前瞻性研究,以检查喂养方式对各种母婴指标的影响,包括人体测量学;身体成分指标(使用 FTIR);血液学和生化标志物;以及机会性感染和临床疾病进展的发生率。在婴儿方面,我们研究了其对生长、发育和发病率的影响。满足可负担、可行、可及、可持续和安全(AFASS)标准的配方奶喂养母亲比例为 38.7%。在血液学、免疫学和身体成分变化方面,配方奶喂养组和母乳喂养组之间没有显著差异。母乳喂养的母亲出现高抑郁评分的事件明显较少(P=0.043)。母乳喂养的婴儿在 3 个月时腹泻和住院的风险明显较低(分别为 P=0.006 和 0.014)。母乳喂养与更好的发育评分和生长参数显著相关。在 HIV 感染的情况下,母乳喂养对母亲没有危害。尽管对 AFASS 标准进行了咨询,但母亲仍选择不恰当地进行配方奶喂养。母乳喂养对婴儿特别有益,尤其是在生命的头 3 个月。

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