School of Psychology, Cardiff University, UK.
Eur Child Adolesc Psychiatry. 2011 Dec;20(11-12):571-9. doi: 10.1007/s00787-011-0224-y. Epub 2011 Oct 26.
A number of public health interventions aimed at increasing the uptake of breastfeeding are in place in the United States and other Western countries. While the physical health and nutritional benefits of breastfeeding for the mother and child are relatively well established, the evidence for psychological effects is less clear. This study aimed to examine whether there is an association between breastfeeding and later conduct problems in children. It also considered the extent to which any relationship is attributable to maternally-provided inherited characteristics that influence both likelihood of breastfeeding and child conduct problems. A prenatal cross-fostering design with a sample of 870 families with a child aged 4-11 years was used. Mothers were genetically related or unrelated to their child as a result of assisted reproductive technologies. The relationship between breastfeeding and conduct problems was assessed while controlling for theorised measured confounders by multivariate regression (e.g. maternal smoking, education, and antisocial behaviour), and for unmeasured inherited factors by testing associations separately for related and unrelated mother-child pairs. Breastfeeding was associated with lower levels of conduct disorder symptoms in offspring in middle childhood. Breastfeeding was associated with lower levels of conduct problems even after controlling for observed confounders in the genetically related group, but not in the genetically unrelated group. In contrast, maternal antisocial behaviour showed robust associations with child conduct problems after controlling for measured and inherited confounders. These findings highlight the importance of using genetically sensitive designs in order to test causal environmental influences.
美国和其他西方国家已经采取了多项公共卫生干预措施，旨在提高母乳喂养率。虽然母乳喂养对母婴的身体健康和营养益处已经得到了相对充分的证实，但关于其心理影响的证据还不是很明确。本研究旨在探讨母乳喂养与儿童后期行为问题之间是否存在关联。研究还考虑了母乳喂养与儿童行为问题之间的关系在多大程度上归因于母亲提供的遗传特征，这些特征既影响母乳喂养的可能性，也影响儿童行为问题的可能性。研究采用了产前交叉寄养设计，样本包括 870 个有 4-11 岁儿童的家庭。母亲与孩子通过辅助生殖技术存在遗传关系或无遗传关系。在控制了理论上的混杂因素（如母亲吸烟、教育程度和反社会行为）后，通过多元回归评估母乳喂养与行为问题之间的关系，并通过分别测试相关和不相关的母婴对子之间的关联，控制未测量的遗传因素。在中度儿童期，母乳喂养与子女的行为障碍症状水平较低有关。即使在控制了遗传相关组中观察到的混杂因素后，母乳喂养与行为问题的关联仍然存在，但在遗传不相关组中则不存在。相比之下，母亲的反社会行为在控制了测量和遗传混杂因素后，与儿童行为问题之间存在稳健的关联。这些发现强调了使用遗传敏感设计来测试环境因素的因果影响的重要性。
