School of Nursing, George Mason University, Fairfax, VA 22030, USA.
Worldviews Evid Based Nurs. 2012 Dec;9(4):234-42. doi: 10.1111/j.1741-6787.2011.00236.x. Epub 2012 Jan 10.
The World Health Organization has identified childhood obesity as a major threat to global health. Accumulating evidence indicates that excess weight early in life is predictive of later childhood and adolescent obesity. Clinical practice guidelines for infant feeding behaviors have been developed by national and international health organizations. The relationship between these guidelines and infant weight status has not been established.
To examine the relationship between weight-for-age at 1 year and adherence to four clinical practice guidelines for feeding behaviors: no bottle-to-bed, minimal juice consumption, breastfeeding throughout the first year of life, and introduction to solid food no earlier than age 4-6 months.
Data were obtained from the Infant Feeding Practices Study II, a longitudinal, national survey administered by the U.S. Food and Drug Administration and Centers for Disease Control and Prevention that followed mother-infant dyads from pregnancy through 1 year postpartum. The sample was comprised of 691 infants for whom 12-month survey data were available.
Significant associations with weight-for-age were found for juice consumption (p= 0.003), breastfeeding during the second half of infancy (p < 0.001), and introduction to solid foods prior to age 4 months (p < 0.001). A regression model that controlled for infant and maternal characteristics demonstrated that these feeding behaviors remained significant predictors of weight-for-age at 12 months.
Modifiable infant feeding behaviors contributed to weight-for-age at 1 year. Replication studies with economically and culturally diverse samples are needed. Further, testing longitudinal interventions that address infant feeding practices is likely to yield the evidence needed for shaping future clinical practice guidelines that reduce the risk for childhood obesity and related pediatric comorbidities.
世界卫生组织已将儿童肥胖认定为对全球健康的主要威胁。越来越多的证据表明，生命早期的超重会预测后期儿童和青少年肥胖。各国和国际卫生组织已经制定了婴儿喂养行为的临床实践指南。但这些指南与婴儿体重状况之间的关系尚未确定。
研究一岁时体重与以下四种婴儿喂养行为临床实践指南的依从性之间的关系：奶瓶不入睡、果汁摄入最少、整个婴儿期进行母乳喂养以及固体食物引入时间不早于 4-6 个月。
数据来自婴儿喂养实践研究 II，这是一项由美国食品药品监督管理局和疾病控制与预防中心进行的纵向全国性调查，该研究从怀孕开始一直随访母婴对子到产后 1 年。样本包括 691 名婴儿，其中有 12 个月的调查数据。
与体重有关的显著关联与果汁摄入量（p=0.003）、婴儿期后半段母乳喂养（p<0.001）和 4 个月前引入固体食物（p<0.001）有关。在控制婴儿和母亲特征的回归模型中，这些喂养行为仍然是 12 个月时体重的重要预测因素。
可改变的婴儿喂养行为对一岁时的体重有影响。需要对具有经济和文化多样性的样本进行复制研究。此外，测试针对婴儿喂养行为的纵向干预措施可能会产生为制定未来降低儿童肥胖和相关儿科并发症风险的临床实践指南所需的证据。
