Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan.
Department of Pediatrics, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
J Pediatr. 2014 May;164(5):1019-1025.e3. doi: 10.1016/j.jpeds.2014.01.012. Epub 2014 Feb 13.
To prospectively examine the prolonged effect of breastfeeding on behavioral development.
We used a large, nationwide Japanese population-based longitudinal survey that began in 2001. We restricted participants to term singletons with birth weight >2500 g (n = 41 188). Infant feeding practice was queried at age 6-7 months. Responses to survey questions about age-appropriate behaviors at age 2.5 and 5.5 years were used as indicators of behavioral development. We conducted logistic regression analyses, controlling for potential child and parental confounding factors, with formula feeding as the reference group.
We observed a dose-response relationship between breastfeeding status and an inability to perform age-appropriate behaviors at both ages. With a single exception, all ORs for outcomes for exclusive breastfeeding were smaller than those for partial feeding of various durations. The protective associations did not change after adjustment for an extensive list of confounders or in the sensitivity analyses.
We observed prolonged protective effects of breastfeeding on developmental behavior skills surveyed at age 2.5 and 5.5 years. Beneficial effects were most likely in children who were breastfed exclusively, but whether a biological ingredient in breast milk or extensive interactions through breastfeeding, or both, is beneficial is unclear.
前瞻性研究母乳喂养对行为发育的长期影响。
我们使用了一项始于 2001 年的大型、全国性的日本基于人群的纵向调查。我们将参与者限制为出生体重>2500g 的足月单胎儿（n=41188）。在 6-7 个月龄时询问婴儿喂养方式。在 2.5 岁和 5.5 岁时，根据年龄适当行为的调查问题回答，作为行为发育的指标。我们进行了逻辑回归分析，控制了潜在的儿童和父母混杂因素，以配方奶喂养为参考组。
我们观察到母乳喂养状况与两个年龄组的行为不能适应年龄呈剂量反应关系。除了一个例外，所有纯母乳喂养的 OR 均小于各种持续时间的部分喂养的 OR。在调整了大量混杂因素或进行敏感性分析后，保护关联没有改变。
我们观察到母乳喂养对 2.5 岁和 5.5 岁时发育行为技能的长期保护作用。母乳喂养的益处最有可能发生在纯母乳喂养的儿童中，但母乳中的生物成分还是通过母乳喂养的广泛相互作用，或者两者都有益，目前尚不清楚。
