Universidade Federal da Bahia (UFBA), Departamento de Pediatria, Salvador, BA, Brazil.
Universidade Federal da Bahia (UFBA), Departamento de Nutrição, Salvador, BA, Brazil.
J Pediatr (Rio J). 2019 May-Jun;95(3):264-274. doi: 10.1016/j.jped.2018.06.013. Epub 2018 Aug 21.
To systematically review evidence related to nutritional and cardiometabolic outcomes in children born at term and small for gestational age and the association with breastfeeding.
Two independent reviewers searched the MEDLINE, LILACS, SciELO, and Embase databases without time or language restrictions. The PRISMA tool was used, and studies that evaluated infants born at term and small for gestational age, breastfed, and with an evaluation of cardiometabolic outcomes were included. Studies with preterm infants, those that did not have information on breastfeeding, and those with lack of evaluation of the outcome variables were excluded. Also excluded were review articles, editorials, and series of cases.
Only seven articles were found that met the abovementioned criteria. There was a great variability in the type of evaluation, as well as in the age of these children. It was demonstrated that breastfeeding promoted growth without body composition alteration and without increased insulin resistance in children with exclusive breastfeeding, when compared to children receiving a higher calorie formula, except for one article that observed an increase in fat mass in exclusively breastfed children.
Breastfeeding seems to be a safe feeding practice for infants born at term and small for gestational age, showing no association with deleterious short-term outcomes. Breastfeeding stimulation in these populations seems to be a way of preventing the health problems associated with the high risk of chronic noncommunicable diseases and obesity.
系统评价足月和小于胎龄儿的营养和心血管代谢结局的证据，以及与母乳喂养的关系。
两位独立评审员在无时间和语言限制的情况下搜索了 MEDLINE、LILACS、SciELO 和 Embase 数据库。使用了 PRISMA 工具，纳入了评估足月和小于胎龄儿、母乳喂养以及评估心血管代谢结局的研究。排除了早产儿研究、未提供母乳喂养信息的研究以及缺乏结局变量评估的研究。还排除了综述文章、社论和病例系列。
仅发现符合上述标准的 7 篇文章。评估的类型以及这些儿童的年龄存在很大的差异。与接受高卡路里配方的儿童相比，纯母乳喂养的儿童没有改变身体成分或增加胰岛素抵抗，促进了生长，除了一篇文章观察到纯母乳喂养的儿童脂肪量增加。
母乳喂养对于足月和小于胎龄儿来说似乎是一种安全的喂养方式，与短期不良结局没有关联。在这些人群中，刺激母乳喂养似乎是预防与慢性非传染性疾病和肥胖高风险相关的健康问题的一种方法。
