Waite Whitney M, Taylor James A
Department of Pediatrics, University of Washington , Seattle, Washington.
Breastfeed Med. 2016 May;11:180-5. doi: 10.1089/bfm.2015.0170. Epub 2016 Apr 8.
Because neonatal jaundice remains one of the most commonly treated conditions of the newborn infant, it is important to assess the unintended consequences of treatment with phototherapy. The objective of this study was to evaluate whether treatment with phototherapy affects breastfeeding duration in newborns >35 weeks gestation.
We analyzed data from the Infant Feeding Practices Study II. The exposure of interest was treatment of neonatal jaundice with phototherapy. The outcomes of interest were any breastfeeding through 12 months and exclusive breastfeeding through 4 months. Logistic regression models were developed to evaluate the association between the exposure and outcomes of interest. All models were adjusted for maternal age, race, education, household income, and gestational age, as well as for several potential markers of suboptimal breastfeeding.
Our study included 4,441 infants, of which 220 (5%) received phototherapy. We found no difference in the likelihood of any breastfeeding through 9 months of age, however, by 12 months, infants exposed to phototherapy were less likely to still be breastfed than those who were not exposed (adjusted odds ratio [aOR] 0.58, 95% confidence interval [95% CI] 0.37-0.92). Infants exposed to phototherapy were less likely to be exclusively breastfed throughout the first 4 months of life.
Although phototherapy use did not substantially impact rates of any breastfeeding during the first year, it was associated with decreased rates of exclusive breastfeeding in the first 4 months of life. This suggests that we need to tailor messaging to mothers of infants receiving phototherapy to promote exclusive breastfeeding.
由于新生儿黄疸仍然是新生儿最常见的治疗病症之一,因此评估光疗治疗的意外后果很重要。本研究的目的是评估光疗治疗是否会影响孕周>35周的新生儿的母乳喂养持续时间。
我们分析了《婴儿喂养实践研究II》的数据。感兴趣的暴露因素是用光照疗法治疗新生儿黄疸。感兴趣的结局是12个月内的任何母乳喂养以及4个月内的纯母乳喂养。我们建立了逻辑回归模型来评估暴露因素与感兴趣的结局之间的关联。所有模型均针对母亲年龄、种族、教育程度、家庭收入、孕周以及母乳喂养不理想的几个潜在指标进行了调整。
我们的研究纳入了4441名婴儿,其中220名(5%)接受了光疗。我们发现9个月龄时任何母乳喂养的可能性没有差异,然而,到12个月时,接受光疗的婴儿仍进行母乳喂养的可能性低于未接受光疗的婴儿(调整后的优势比[aOR]为0.58,95%置信区间[95%CI]为0.37-0.92)。接受光疗的婴儿在生命的前4个月内纯母乳喂养的可能性较小。
尽管使用光疗在第一年对任何母乳喂养率没有实质性影响,但它与生命前4个月纯母乳喂养率的降低有关。这表明我们需要针对接受光疗的婴儿的母亲调整宣传信息,以促进纯母乳喂养。