Vail Brennan, Prentice Philippa, Dunger David B, Hughes Ieuan A, Acerini Carlo L, Ong Ken K
Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; School of Medicine, University of California San Francisco, San Francisco, CA.
Department of Pediatrics, University of Cambridge, Cambridge, United Kingdom.
J Pediatr. 2015 Aug;167(2):317-24.e1. doi: 10.1016/j.jpeds.2015.05.003. Epub 2015 Jun 12.
To test whether earlier age at weaning (age 3-6 months) may promote faster growth during infancy.
Weaning at age 3.0-7.0 months was reported by 571 mothers of term singletons in a prospective birth cohort study conducted in Cambridge, UK. Infant weight and length were measured at birth and at age 3 months and 12 months. Anthropometric values were transformed into age- and sex-adjusted z-scores. Three linear regression models were performed, including adjustment for confounders in a stepwise manner. Measurements at age 3 months, before weaning, were used to consider reverse causality.
Almost three-quarters (72.9%) of infants were weaned before age 6 months. Age at weaning of 3.0-7.0 months was inversely associated with weight and length (but not with body mass index) at 12 months (both P ≤ .01, adjusted for maternal and demographic factors). These associations were attenuated after adjustment for type of milk feeding and weight or length at age 3 months (before weaning). Rapid weight gain between 0 and 3 months predicted subsequent earlier age at weaning (P = .01). Our systematic review identified 2 trials, both reporting null effects of age at weaning on growth, and 15 observational studies, with 10 reporting an inverse association between age at weaning and infant growth and 4 reporting evidence of reverse causality.
In high-income countries, weaning between 3 and 6 months appears to have a neutral effect on infant growth. Inverse associations are likely related to reverse causality.
测试更早断奶(3 - 6个月龄)是否可促进婴儿期更快生长。
在英国剑桥进行的一项前瞻性出生队列研究中,571名单胎足月儿的母亲报告了孩子3.0 - 7.0个月龄时的断奶情况。在出生时、3个月龄和12个月龄时测量婴儿体重和身长。人体测量值转换为年龄和性别校正的z评分。进行了三个线性回归模型,包括逐步调整混杂因素。使用3个月龄(断奶前)的测量值来考虑反向因果关系。
近四分之三(72.9%)的婴儿在6个月龄前断奶。3.0 - 7.0个月龄时的断奶与12个月龄时的体重和身长呈负相关(但与体重指数无关)(P均≤0.01,经母亲和人口统计学因素校正)。在调整了喂奶类型以及3个月龄(断奶前)时的体重或身长后,这些关联减弱。0至3个月龄间体重快速增加预示着随后断奶年龄更早(P = 0.01)。我们的系统评价确定了2项试验,均报告断奶年龄对生长无影响,以及15项观察性研究,其中10项报告断奶年龄与婴儿生长呈负相关,4项报告有反向因果关系的证据。
在高收入国家,3至6个月龄断奶似乎对婴儿生长有中性影响。负相关可能与反向因果关系有关。