School of Health Sciences, University of Tampere, Tampere, Finland.
Clin Exp Allergy. 2013 Nov;43(11):1263-73. doi: 10.1111/cea.12180.
It has been hypothesized that changes in diet during early life may have contributed to the increase in childhood asthma and atopy. The long-term effect of the timing and content of infant feeding on the incidence of asthma and atopic diseases in children is unclear.
To investigate the associations between duration of breastfeeding and the timing of introduction of complementary foods during the first 6 months and parental-reported asthma, wheeze and atopic eczema up to 10 years of age.
Infant feeding practices (breastfeeding and introduction of complementary foods) of 1924 singleton children participating in the Study of Eczema and Asthma To Observe the influence of Nutrition (SEATON) birth cohort were prospectively collected up to 6 months with outcomes (wheeze, atopic eczema and asthma) being assessed at 1, 2, 5 and 10 years. Data were analysed using generalized estimating equations and discrete hazards models with adjustment for confounders.
By 6 months, 59% and 35% of mothers had stopped exclusive and total breastfeeding, respectively. Although formula feeding was adversely associated with wheeze in the past 12 months (adjusted OR for no formula feeding: 070, 95% CI 0.50-0.97), and the introduction of biscuits/bread after 5 months of age adversely associated with atopic eczema (adjusted OR 1.34, 95% CI 1.06-1.69), these results lost their statistical significance after adjustment for multiple testing. Stratification of the results by the presence of eczema by 6 months of age and family atopic history did not substantially differ from the results of the whole study population.
Our results suggest that the nature of infant feeding during the first 6 months seems not to substantially influence the long-term risk of asthma and atopic diseases in children, nor in children at high risk of atopic disease because of a family history of atopic disease.
据推测,儿童时期饮食的变化可能导致哮喘和过敏的增加。婴儿喂养的时间和内容对儿童哮喘和过敏性疾病发病率的长期影响尚不清楚。
研究母乳喂养持续时间以及婴儿在 6 个月内开始添加补充食物的时间与父母报告的 10 岁以下儿童哮喘、喘息和特应性皮炎之间的关系。
前瞻性收集了 1924 名参与湿疹和哮喘观察营养影响研究(SEATON)出生队列的单胎儿童的婴儿喂养方式(母乳喂养和补充食物的引入),并在 6 个月时进行了评估,结果(喘息、特应性皮炎和哮喘)在 1、2、5 和 10 岁时进行了评估。使用广义估计方程和离散风险模型分析数据,并进行了混杂因素调整。
在 6 个月时,分别有 59%和 35%的母亲停止了纯母乳喂养和完全母乳喂养。虽然配方奶喂养与过去 12 个月的喘息(未使用配方奶喂养的调整 OR:0.70,95%CI 0.50-0.97)呈负相关,而且在 5 个月龄后引入饼干/面包与特应性皮炎呈负相关(调整 OR 1.34,95%CI 1.06-1.69),但这些结果在进行多次检验调整后失去了统计学意义。根据 6 个月时湿疹的存在和家族过敏史对结果进行分层,与整个研究人群的结果没有显著差异。
我们的结果表明,在头 6 个月内婴儿喂养的性质似乎不会显著影响儿童哮喘和过敏性疾病的长期风险,也不会影响因家族过敏史而处于高过敏风险的儿童。