Cameron Sonya L, Heath Anne-Louise M, Gray Andrew R, Churcher Barbara, Davies Rhondda S, Newlands Alana, Galland Barbara C, Sayers Rachel M, Lawrence Julie A, Taylor Barry J, Taylor Rachael W
Departments of Human Nutrition, Women's and Children's Health, and.
Departments of Human Nutrition.
J Nutr. 2015 Jul;145(7):1481-90. doi: 10.3945/jn.114.202689. Epub 2015 May 20.
Although the WHO recommends that complementary feeding in infants should begin at 6 mo of age, it often begins before this in developed countries.
Our objective was to determine whether lactation consultant (LC) support, with educational resources given at 4-mo postpartum, can delay the introduction of complementary foods until around 6 mo of age.
A total of 802 mother-infant pairs were recruited from the single maternity hospital serving Dunedin, New Zealand (59% response rate) and randomly assigned to the following: 1) usual care (control group); 2) infant sleep education intervention (Sleep); 3) food, activity, and breastfeeding intervention (FAB); or 4) combination (both) intervention (Combo). Certified LCs delivered 3 intervention sessions (late pregnancy and 1-wk and 4-mo postpartum). The 4-mo contact used educational resources focused on developmental readiness for complementary foods. Age when complementary foods were introduced was obtained from repeated interviews (monthly from 3- to 27-wk postpartum).
A total of 49.5% and 87.2% of infants received complementary foods before 5 and 6 mo of age, respectively. There was evidence of group differences in the number of infants introduced to complementary foods before 5 mo (P = 0.006), with those receiving support and resources (FAB and Combo groups combined; 55.6%) more likely to wait until at least 5 mo compared with controls (control and Sleep groups combined; 43.3%) (OR: 1.52; 95% CI: 1.08, 2.16). However, there was no evidence they were more likely to wait until 6 mo of age (P = 0.52). Higher maternal age, higher parity, and a less positive attitude toward breastfeeding were positively associated, and drinking alcohol during pregnancy was negatively associated, with later age of introduction of complementary foods.
Providing an LC and educational resources at 4-mo postpartum to predominantly well-educated, mainly European, women can delay the introduction of complementary foods until 5 mo of age, but not until the WHO recommendation of 6 mo. This trial was registered at clinicaltrials.gov as NCT00892983.
尽管世界卫生组织建议婴儿应在6月龄开始添加辅食，但在发达国家，辅食添加往往早于这个时间。
我们的目的是确定在产后4个月提供教育资源并给予泌乳顾问（LC）支持，是否能将辅食添加推迟至约6月龄。
从新西兰达尼丁唯一的妇产医院招募了802对母婴（应答率为59%），并随机分为以下几组：1）常规护理（对照组）；2）婴儿睡眠教育干预（睡眠组）；3）食物、活动及母乳喂养干预（FAB组）；或4）联合（两者）干预（组合组）。经认证的泌乳顾问进行3次干预课程（孕晚期、产后1周和产后4个月）。产后4个月的接触使用了侧重于辅食添加发育准备情况的教育资源。辅食添加的年龄通过多次访谈获得（产后3至27周每月进行一次）。
分别有49.5%和87.2%的婴儿在5月龄和6月龄前添加了辅食。有证据表明，在5月龄前添加辅食的婴儿数量存在组间差异（P = 0.006），与对照组（对照组和睡眠组合并；43.3%）相比，接受支持和资源的婴儿（FAB组和组合组合并；55.6%）更有可能等到至少5月龄（比值比：1.52；95%置信区间：1.08，2.16）。然而，没有证据表明他们更有可能等到6月龄（P = 0.52）。产妇年龄较大、胎次较多以及对母乳喂养的态度不太积极与辅食添加较晚呈正相关，孕期饮酒与辅食添加较晚呈负相关。
在产后4个月为主要是受过良好教育的欧洲女性提供泌乳顾问和教育资源，可以将辅食添加推迟至5月龄，但不能推迟到世界卫生组织建议的6月龄。该试验已在clinicaltrials.gov上注册，注册号为NCT00892983。
