父母对婴儿喂养的控制。婴儿体重、食欲和喂养方式的影响。
Parental control over feeding in infancy. Influence of infant weight, appetite and feeding method.
作者信息
Fildes Alison, van Jaarsveld Cornelia H M, Llewellyn Clare, Wardle Jane, Fisher Abigail
机构信息
Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, Gower Street, London WC1E 6BT, UK; Department of Primary Care and Public Health Sciences, King's College London, Capital House, 42 Weston Street, London SE1 3QD, UK.
Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, Gower Street, London WC1E 6BT, UK.
出版信息
Appetite. 2015 Aug;91:101-6. doi: 10.1016/j.appet.2015.04.004. Epub 2015 Apr 8.
BACKGROUND AND OBJECTIVE
Parental control over feeding has been linked to child overweight. Parental control behaviours have been assumed to be exogenous to the child, but emerging evidence suggests they are also child-responsive. This study tests the hypothesis that parental control in early infancy is responsive to infant appetite and weight.
SUBJECTS AND METHODS
Participants were 1920 mothers from the Gemini twin cohort, using one randomly selected child per family. Data come from questionnaires completed when the children were approximately 8 months. Mothers completed measures of 'pressure' and 'restriction', reported feeding method (breast- and bottle feeding), rated their infant's appetite during the first 3 months, provided health professional recorded weight measurements, and reported their concerns about their infant's weight. Logistic regression examined predictors of 'pressure' and 'restriction', adjusting for maternal demographics and BMI. Interactions between feeding method and control were also tested.
RESULTS
'Pressure' was associated with lower birth weight (OR = 0.79, 95% CI: 0.65-0.97), greater concern about underweight (OR = 1.88, 1.29-2.75), and lower infant appetite (OR = 0.59, 0.47-0.75). 'Restriction' was associated with higher appetite (OR = 1.44, 1.09-1.89) and bottle feeding (OR = 2.86, 2.18-3.75). A significant interaction with feeding method indicated that infants with high appetites were more likely to be restricted only if they were bottle-fed (OR = 1.52, 1.13-2.04).
CONCLUSION
Mothers vary in their levels of control over milk-feeding and this is partly responsive to the infant's characteristics. They tend to pressure infants who are lighter and have a smaller appetite, and restrict infants with larger appetites if they are bottle-fed. Guidance on infant feeding may be better received if it acknowledges that parents respond to infant characteristics in order to achieve their feeding goals.
背景与目的
父母对喂养的控制与儿童超重有关。父母的控制行为一直被认为是儿童外部的因素，但新出现的证据表明，这些行为也会因儿童的情况而有所反应。本研究检验了一个假设，即婴儿早期父母的控制是对婴儿食欲和体重的反应。
对象与方法
研究对象为来自双子座双胞胎队列的1920名母亲，每个家庭随机选择一个孩子。数据来自孩子约8个月大时填写的问卷。母亲们完成了“压力”和“限制”的测量，报告了喂养方式（母乳喂养和奶瓶喂养），对婴儿前3个月的食欲进行了评分，提供了健康专业人员记录的体重测量数据，并报告了她们对婴儿体重的担忧。逻辑回归分析了“压力”和“限制”的预测因素，并对母亲的人口统计学特征和体重指数进行了调整。还测试了喂养方式与控制之间的相互作用。
结果
“压力”与较低的出生体重（OR = 0.79，95% CI：0.65 - 0.97）、对体重不足的更大担忧（OR = 1.88，1.29 - 2.75）以及较低的婴儿食欲（OR = 0.59，0.47 - 0.75）有关。“限制”与较高的食欲（OR = 1.44，1.09 - 1.89）和奶瓶喂养（OR = 2.86，2.18 - 3.75）有关。与喂养方式的显著相互作用表明，食欲高的婴儿只有在奶瓶喂养时才更有可能受到限制（OR = 1.52，1.13 - 2.04）。
结论
母亲对母乳喂养的控制程度各不相同，这部分是对婴儿特征的反应。她们倾向于对体重较轻、食欲较小的婴儿施加压力，而对奶瓶喂养且食欲较大的婴儿进行限制。如果婴儿喂养指导承认父母会根据婴儿特征来实现喂养目标，可能会更容易被接受。
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