Poton Wanêssa Lacerda, Soares Ana Luiza Gonçalves, Menezes Ana Maria Baptista, Wehrmeister Fernando César, Gonçalves Helen
Universidade Vila Velha, Faculdade de Medicina, Vila Velha (ES), Brasil. Correspondência:
University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, Reino Unido.
Rev Panam Salud Publica. 2018 Feb 19;41:e142. doi: 10.26633/RPSP.2017.142.
To assess the association between breastfeeding duration and externalizing behaviors in childhood and adolescence.
Data from the 1993 Pelotas Birth Cohort was used. Information on breastfeeding was assessed at 12 months of age. Behavior was assessed at 4 years of age using the Child Behavior Checklist (CBCL), and at ages 11 and 15 years using the Strengths and Difficulties Questionnaire (SDQ), both administered to the mother or caretaker. Of 5 249 cohort participants, those with complete data on breastfeeding and externalizing behaviors were included: 630 children at 4 years of age, 1 277 adolescents at 11 years, and 1 199 at 15 years. Poisson regression with robust variance was used to assess the association between breastfeeding duration and externalizing behaviors.
After adjustment for confounders, children who were breastfed for least 6 months had lower risk of hyperactivity (RR = 0.54; 95%CI: 0.32-0.91) at age 11 compared to those breastfed for less than 1 month. However, no association was observed between breastfeeding duration and externalizing behaviors at ages 4 and 15.
Although breastfeeding for at least 6 months was inversely associated with hyperactivity at 11 years of age no association was observed at 4 and 15 years of age. Further longitudinal studies should focus on other aspects influencing externalizing behaviors, such as presence of the father in the family, domestic violence and abuse, and the quality of mother-child relationship.
评估母乳喂养持续时间与儿童及青少年外化行为之间的关联。
使用了1993年佩洛塔斯出生队列的数据。在12月龄时评估母乳喂养信息。在4岁时使用儿童行为检查表（CBCL）评估行为，在11岁和15岁时使用长处与困难问卷（SDQ）评估行为，均由母亲或照料者填写。在5249名队列参与者中，纳入了母乳喂养和外化行为数据完整的参与者：4岁儿童630名，11岁青少年1277名，15岁青少年1199名。采用稳健方差的泊松回归评估母乳喂养持续时间与外化行为之间的关联。
在对混杂因素进行调整后，与母乳喂养不足1个月的儿童相比，母乳喂养至少6个月的儿童在11岁时多动风险较低（相对风险 = 0.54；95%置信区间：0.32 - 0.91）。然而，在4岁和15岁时未观察到母乳喂养持续时间与外化行为之间存在关联。
尽管母乳喂养至少6个月与11岁时的多动呈负相关，但在4岁和15岁时未观察到这种关联。进一步的纵向研究应关注影响外化行为的其他方面，如家庭中父亲的存在、家庭暴力和虐待以及母子关系质量。
