Rossiter Melissa D, Colapinto Cynthia K, Khan Mohammad K A, McIsaac Jessie-Lee D, Williams Patricia L, Kirk Sara F L, Veugelers Paul J
Department of Applied Human Sciences, University of Prince Edward Island, 550 University Avenue, Charlottetown, PE, C1A 4P3, Canada,
Matern Child Health J. 2015 Sep;19(9):2048-56. doi: 10.1007/s10995-015-1717-y.
Breastfeeding has been rigorously studied in relation to childhood obesity prevention. Few studies have examined whether combination feeding—breast milk and formula—may also be protective against obesity. This study aimed to investigate the relationship between breastfeeding duration, combination feeding and overweight and obesity among Canadian school children. We analyzed data from a 2011 cross-sectional, population based survey (n = 5,560), which included self-reported infant feeding behaviours, a food frequency questionnaire and measured height and weight. Multilevel regression methods were used to examine the association between breastfeeding duration and overweight and obesity adjusting for socioeconomic status, diet quality and physical activity. Thirty-four percent of children were breastfed for <1 week or never while 32% were breastfed for at least 6 months. In the fully adjusted model, children who were only formula fed or who were combination fed for <6 months were more likely to be overweight or obese relative to children who were only breastfed (OR 1.29, 95% CI 1.04-1.60 and OR 1.35, 95% CI 1.09-1.69, respectively). When examining overweight and obese children separately, those who were only formula fed were more likely obese (OR 1.57, 95% CI 1.10-2.25) relative to their peers who were only breastfed. And those who were combination fed for <6 months relative to those only breastfed were more likely to be overweight (OR 1.29, 95% CI 1.01-1.66). Breastfeeding, in the absence of formula feeding, appears to have a protective effect on childhood obesity. While combination feeding confers less benefit than only breastfeeding, it is more desirable than formula feeding alone. Strategies and social policies are needed to promote exclusive and longer breastfeeding duration and should be integrated with comprehensive efforts to prevent childhood obesity and to reduce the burden of chronic diseases in the long term.
关于母乳喂养与儿童肥胖预防的关系已经进行了大量研究。很少有研究探讨混合喂养（母乳和配方奶）是否也能预防肥胖。本研究旨在调查加拿大学龄儿童的母乳喂养时长、混合喂养与超重及肥胖之间的关系。我们分析了2011年一项基于人群的横断面调查（n = 5560）的数据，其中包括自我报告的婴儿喂养行为、食物频率问卷以及测量的身高和体重。采用多水平回归方法，在调整社会经济地位、饮食质量和身体活动等因素后，研究母乳喂养时长与超重及肥胖之间的关联。34%的儿童母乳喂养时间不足1周或从未进行母乳喂养，而32%的儿童母乳喂养至少6个月。在完全调整模型中，与仅母乳喂养的儿童相比，仅喂配方奶或混合喂养不足6个月的儿童超重或肥胖的可能性更大（分别为OR 1.29，95%CI 1.04 - 1.60和OR 1.35，95%CI 1.09 - 1.69）。分别考察超重和肥胖儿童时，与仅母乳喂养的同龄人相比，仅喂配方奶的儿童更易肥胖（OR 1.57，95%CI 1.10 - 2.25）。与仅母乳喂养的儿童相比，混合喂养不足6个月的儿童超重的可能性更大（OR 1.29，95%CI 1.01 - 1.66）。在不进行配方奶喂养的情况下，母乳喂养似乎对儿童肥胖具有保护作用。虽然混合喂养的益处不如纯母乳喂养，但比单纯配方奶喂养更可取。需要制定策略和社会政策来促进纯母乳喂养和延长母乳喂养时长，并应与预防儿童肥胖和长期减轻慢性病负担的综合努力相结合。
