母乳喂养与6岁时的感染风险。

Breastfeeding and risk of infections at 6 years.

作者信息

Li Ruowei, Dee Deborah, Li Chuan-Ming, Hoffman Howard J, Grummer-Strawn Laurence M

机构信息

Divisions of Nutrition, Physical Activity and Obesity, and

Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia; and.

出版信息

Pediatrics. 2014 Sep;134 Suppl 1(Suppl 1):S13-20. doi: 10.1542/peds.2014-0646D.

Abstract

BACKGROUND

Previous studies have shown that breastfeeding is associated with reductions in the risk of common infections among infants; however, whether breastfeeding confers longer term protection is inconclusive.

METHODS

We linked data from the 2005-2007 IFPS II (Infant Feeding Practices Study II) and follow-up data collected when the children were 6 years old. Multivariable logistic regression was used, controlling for sociodemographic variables, to examine associations of initiation, duration, exclusivity of breastfeeding, timing of supplementing breastfeeding with formula, and breast milk intensity (proportion of milk feedings that were breast milk from age 0-6 months) with maternal reports of infection (cold/upper respiratory tract, ear, throat, sinus, pneumonia/lung, and urinary) and sick visits in the past year among 6-year-olds (N = 1281).

RESULTS

The most common past-year infections were colds/upper respiratory tract (66%), ear (25%), and throat (24%) infections. No associations were found between breastfeeding and colds/upper respiratory tract, lung, or urinary tract infections. Prevalence of ear, throat, and sinus infections and number of sick visits differed according to breastfeeding duration, exclusivity, and timing of supplementing breastfeeding with formula (P < .05). Among children ever breastfed, children breastfed for ≥9 months had lower odds of past-year ear (adjusted odds ratio [aOR]: 0.69 [95% confidence interval (95% CI): 0.48-0.98]), throat (aOR: 0.68 [95% CI: 0.47-0.98]), and sinus (aOR: 0.47 [95% CI: 0.30-0.72]) infections compared with those breastfed >0 to <3 months. High breast milk intensity (>66.6%) during the first 6 months was associated with lower odds of sinus infection compared with low breast milk intensity (<33.3%) (aOR: 0.53 [95% CI: 0.35-0.79]).

CONCLUSIONS

This prospective longitudinal study suggests that breastfeeding may protect against ear, throat, and sinus infections well beyond infancy.

摘要

背景

既往研究表明,母乳喂养与降低婴儿常见感染风险相关;然而,母乳喂养是否能提供长期保护尚无定论。

方法

我们将2005 - 2007年IFPS II(婴儿喂养实践研究II)的数据与儿童6岁时收集的随访数据相链接。使用多变量逻辑回归,控制社会人口学变量,以研究母乳喂养的开始、持续时间、排他性、用配方奶补充母乳喂养的时间以及母乳强度(0至6个月龄时母乳喂养在总喂养次数中所占比例)与母亲报告的6岁儿童(N = 1281)过去一年的感染情况(感冒/上呼吸道、耳部、咽喉、鼻窦、肺炎/肺部和泌尿系统感染)以及因病就诊情况之间的关联。

结果

过去一年最常见的感染是感冒/上呼吸道感染(66%)、耳部感染(25%)和咽喉感染(24%)。未发现母乳喂养与感冒/上呼吸道感染、肺部感染或泌尿系统感染之间存在关联。耳部、咽喉和鼻窦感染的患病率以及因病就诊次数因母乳喂养持续时间、排他性和用配方奶补充母乳喂养的时间而异(P < 0.05)。在曾经母乳喂养的儿童中,母乳喂养≥9个月的儿童过去一年发生耳部感染(调整后的优势比[aOR]:0.69 [95%置信区间(95%CI):0.48 - 0.98])、咽喉感染(aOR:0.68 [95%CI:0.47 - 0.98])和鼻窦感染(aOR:0.47 [95%CI:0.30 - 0.72])的几率低于母乳喂养0至<3个月的儿童。与低母乳强度(<33.3%)相比,前6个月高母乳强度(>66.6%)与鼻窦感染几率较低相关(aOR:0.53 [95%CI:0.35 - 0.79])。

结论

这项前瞻性纵向研究表明,母乳喂养可能在婴儿期之后很长时间内预防耳部、咽喉和鼻窦感染。

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