Department of Kinesiology, California Polytechnic State University, San Luis Obispo, CA
Adv Nutr. 2017 May 15;8(3):495-510. doi: 10.3945/an.116.014753. Print 2017 May.
Recent recommendations and prevention programs have focused on the promotion of responsive feeding during infancy, but more research is needed to understand best practices for fostering responsive feeding during early life. The objective of this systematic review was to synthesize the accumulating bodies of evidence aimed at understanding associations between mothers' feeding experiences and responsive feeding in an attempt to clarify the nature of associations between feeding mode and responsive feeding. A literature search was conducted between January and October 2016; articles were collected from PsychINFO, Medline, and CINAHL, as well as from references in published research and reviews. Article inclusion criteria were as follows: ) empirical research, ) included a measure of infant feeding, ) included a measure of maternal responsiveness, ) study conducted in human participants, ) available in English, and ) study conducted in a developed and/or high-income country. Forty-three studies were identified. Cross-sectional observational studies consistently reported greater responsiveness among breastfeeding mothers than among formula-/bottle-feeding mothers. In addition, longitudinal studies showed that longer breastfeeding durations predicted lower use of nonresponsive feeding practices during later childhood, and some, but not all, found that breastfeeding mothers showed greater increases in responsiveness across infancy than did formula-/bottle-feeding mothers. However, a limited number of longitudinal studies also reported that greater responsiveness during early infancy predicted longer breastfeeding durations. A common limitation among these studies is the correlational nature of their designs and lack of prenatal measures of maternal responsiveness, which hinders our understanding of causal mechanisms. Although 2 randomized clinical trials aimed at promoting maternal responsiveness did not find effects of the intervention on breastfeeding outcomes, these findings were limited by the way in which breastfeeding outcomes were assessed. In sum, although there is consistent evidence for an association between breastfeeding and responsive feeding, more research is needed to better understand the mechanisms underlying this association.
近期的建议和预防方案侧重于在婴儿期促进响应式喂养，但需要更多的研究来了解在生命早期促进响应式喂养的最佳实践。本系统评价的目的是综合现有的证据，旨在了解母亲的喂养经验与响应式喂养之间的关联，试图阐明喂养方式与响应式喂养之间关联的本质。2016 年 1 月至 10 月期间进行了文献检索；文章来自 PsychINFO、Medline 和 CINAHL，以及已发表的研究和综述中的参考文献。纳入标准如下：) 实证研究，) 包括婴儿喂养措施，) 包括母亲响应性措施，) 在人类参与者中进行的研究，) 英文可用，) 在发达国家/高收入国家进行的研究。共确定了 43 项研究。横断面观察性研究一致报告母乳喂养母亲比配方奶/奶瓶喂养母亲更具响应性。此外，纵向研究表明，母乳喂养持续时间较长与后期儿童期非响应性喂养行为的使用减少有关，有些（但不是全部）研究发现，与配方奶/奶瓶喂养母亲相比，母乳喂养母亲在婴儿期的响应性增加更大。然而，少数纵向研究还报告说，婴儿早期的响应性越大，母乳喂养持续时间越长。这些研究的一个共同局限性是其设计的相关性和缺乏对母亲响应性的产前测量，这阻碍了我们对因果机制的理解。尽管有 2 项旨在促进母亲响应性的随机临床试验没有发现干预对母乳喂养结果的影响，但这些发现受到评估母乳喂养结果的方式的限制。总之，尽管有一致的证据表明母乳喂养与响应式喂养之间存在关联，但需要更多的研究来更好地理解这种关联的机制。
