University of Pennsylvania, Perelman School of Medicine, Center for Clinical Epidemiology and Biostatistics, Philadelphia, PA, USA.
Int J Behav Nutr Phys Act. 2011 Aug 17;8:89. doi: 10.1186/1479-5868-8-89.
Behavioral mechanisms that contribute to the association between breastfeeding and reduced obesity risk are poorly understood. The purpose of this study was to evaluate the hypothesis that feeding human milk from the breast (direct breastfeeding) has a more optimal association with subsequent child appetite regulation behaviors and growth, when compared to bottle-feeding.
Children (n = 109) aged 3- to 6- years were retrospectively classified as directly breastfed (fed exclusively at the breast), bottle-fed human milk, or bottle-fed formula in the first three months of life. Young children's appetite regulation was examined by measuring three constructs (satiety response, food responsiveness, enjoyment of food) associated with obesity risk, using the Child Eating Behavior Questionnaire. Multinomial logistic regression analyses were used to test whether children bottle-fed either human milk or formula had reduced odds of high satiety and increased odds of high food responsiveness and high enjoyment of food compared to children fed directly from the breast. Current child weight status and growth trends from 6-36 months were also examined for their relation to direct breastfeeding and appetite regulation behaviors in early childhood.
Children fed human milk in a bottle were 67% less likely to have high satiety responsiveness compared to directly breastfed children, after controlling for child age, child weight status, maternal race/ethnicity, and maternal education. There was no association of bottle-feeding (either human milk or formula) with young children's food responsiveness and enjoyment of food. There was neither an association of direct breastfeeding with current child weight status, nor was there a clear difference between directly breastfed and bottle-fed children in growth trajectories from 6- to 36-months. More rapid infant changes in weight-for-age score were associated with lower satiety responsiveness, higher food responsiveness and higher enjoyment of food in later childhood
While direct breastfeeding was not found to differentially affect growth trajectories from infancy to childhood compared to bottle-feeding, results suggest direct breastfeeding during early infancy is associated with greater appetite regulation later in childhood. A better understanding of such behavioral distinctions between direct breastfeeding and bottle-feeding may identify new pathways to reduce the pediatric obesity epidemic.
导致母乳喂养与肥胖风险降低之间关联的行为机制尚未得到充分理解。本研究的目的是评估以下假设：与奶瓶喂养相比，直接母乳喂养（仅通过乳房喂养）与后续儿童食欲调节行为和生长具有更理想的关联。
回顾性地将 3 至 6 岁的儿童（n=109）分为直接母乳喂养（仅通过乳房喂养）、奶瓶喂养人乳或奶瓶喂养配方奶三种类型。使用儿童饮食行为问卷（Child Eating Behavior Questionnaire）测量与肥胖风险相关的三个构念（饱腹感反应、食物反应性、对食物的享受）来评估幼儿的食欲调节情况。使用多项逻辑回归分析来检验与直接母乳喂养相比，奶瓶喂养人乳或配方奶的儿童是否具有较低的高饱腹感和较高的高食物反应性以及高食物享受的可能性。还检查了从 6 至 36 个月的当前儿童体重状况和生长趋势与儿童早期直接母乳喂养和食欲调节行为的关系。
在控制儿童年龄、儿童体重状况、母亲种族/民族和母亲教育程度后，与直接母乳喂养的儿童相比，奶瓶喂养人乳的儿童高饱腹感的可能性低 67%。奶瓶喂养（人乳或配方奶）与幼儿的食物反应性和对食物的享受没有关联。直接母乳喂养与当前儿童的体重状况没有关联，也没有直接母乳喂养和奶瓶喂养的儿童在从 6 至 36 个月的生长轨迹之间存在明显差异。婴儿体重-年龄评分的变化与较低的饱腹感反应、较高的食物反应性和较高的食物享受有关。
与奶瓶喂养相比，直接母乳喂养并未发现对婴儿期到儿童期的生长轨迹产生差异影响，但结果表明，婴儿期早期的直接母乳喂养与儿童后期的食欲调节更相关。更好地了解直接母乳喂养和奶瓶喂养之间的这些行为差异可能为减少小儿肥胖流行提供新途径。
