[母乳喂养（第一部分）：频率、益处与弊端、最佳持续时间以及影响其开始和持续时间的因素。临床实践指南]

[Breastfeeding (part one): Frequency, benefits and drawbacks, optimal duration and factors influencing its initiation and prolongation. Clinical guidelines for practice].

作者信息

Chantry A A, Monier I, Marcellin L

机构信息

Inserm UMR 1153, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre de recherche épidémiologie et statistique Sorbonne Paris Cité, DHU risques et grossesse, université Paris Descartes, maternité Port-Royal 6(e) étage, 53, avenue de l'Observatoire, 75014 Paris, France; École de sages-femmes Baudelocque, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 75014 Paris, France.

Inserm UMR 1153, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre de recherche épidémiologie et statistique Sorbonne Paris Cité, DHU risques et grossesse, université Paris Descartes, maternité Port-Royal 6(e) étage, 53, avenue de l'Observatoire, 75014 Paris, France; Maternité Antoine-Béclère, Assistance publique-Hôpitaux de Paris, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2015 Dec;44(10):1071-9. doi: 10.1016/j.jgyn.2015.09.026. Epub 2015 Nov 3.

DOI:10.1016/j.jgyn.2015.09.026

PMID:26545855

Abstract

OBJECTIVES

The objectives were to on assess the frequency and the duration of breastfeeding in France. On the other hand, the objectives were to identify its benefits and drawbacks, and to study the factors influencing its initiation and its extension.

MATERIAL AND METHODS

Bibliographic research in Medline, Google Scholar and in the Cochrane Library.

RESULTS

Breastfeeding concerns in France about 70% of children at birth (EL2). Its median duration is about 15 weeks and 3 weeks ½ for exclusive breastfeeding. At three months, only one third of children breastfed at birth are still being breastfed (EL2). Whether this is due to the composition of breast milk or the behavior of mothers with their children or their socio-cultural level, or even by all these components at once, breastfeeding is associated with better cognitive development children (EL2). This effect is even more reinforced that mothers breastfeed exclusively and prolonged (EL2). As part of the prevention of many diseases (ear infections, gastrointestinal infections, atopic diseases, obesity and cardiovascular diseases…), exclusive and prolonged breastfeeding (grade B) between 4 to 6 months is recommended (professional consensus). Breastfeeding is not a means of preventing postpartum depression (professional consensus). To reduce the incidence of breast cancer, prolonged breastfeeding is recommended (grade B). In order to increase the rate of initiation of breastfeeding as well as its duration, it is recommended that health professionals work closely with mothers in their project (grade A), the breastfeeding promotion messages include message to husbands (grade B), and to promote breastfeeding on demand without fixed interval between feedings (grade B). However, there is not enough data to recommend the use of a specific position during breastfeeding, or the use of one or two breast or to early start breastfeeding or not (professional consensus).

CONCLUSION

Exclusive and extended breastfeeding is recommended (grade B) between 4 to 6 months (professional consensus).

摘要

目的

目的是评估法国母乳喂养的频率和持续时间。另一方面，目的是确定其益处和缺点，并研究影响其开始和持续时间的因素。

材料与方法

在医学数据库（Medline）、谷歌学术和考科蓝图书馆进行文献研究。

结果

在法国，约70%的儿童出生时接受母乳喂养（证据水平2）。其平均持续时间约为15周，纯母乳喂养为3.5周。三个月时，出生时接受母乳喂养的儿童中只有三分之一仍在接受母乳喂养（证据水平2）。无论这是由于母乳的成分、母亲与孩子的行为、她们的社会文化水平，还是所有这些因素共同作用，母乳喂养与儿童更好的认知发展相关（证据水平2）。如果母亲进行纯母乳喂养且时间延长，这种效果会更明显（证据水平2）。作为预防多种疾病（耳部感染、胃肠道感染、过敏性疾病、肥胖症和心血管疾病等）的一部分，建议在4至6个月之间进行纯母乳喂养并延长时间（B级，专业共识）。母乳喂养不是预防产后抑郁症的方法（专业共识）。为降低乳腺癌的发病率，建议延长母乳喂养时间（B级）。为提高母乳喂养的开始率及其持续时间，建议卫生专业人员在其项目中与母亲密切合作（A级），母乳喂养促进信息应包括给丈夫的信息（B级），并提倡按需母乳喂养，喂奶间隔不固定（B级）。然而，没有足够的数据推荐在母乳喂养期间使用特定姿势，或使用一侧或两侧乳房，或是否尽早开始母乳喂养（专业共识）。