母乳喂养总时长与健康城市儿童家庭食物不安全的关系。
Total Breastfeeding Duration and Household Food Insecurity in Healthy Urban Children.
机构信息
Department of Paediatrics, Faculty of Medicine (PD Wong, PC Parkin, RG Moodie, JL Maguire, and CS Birken); Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PD Wong, PC Parkin, JL Maguire, CS Birken, and CM Borkhoff); Sick Kids Research Institute (PD Wong, PC Parkin, CS Birken, and CM Borkhoff), Hospital for Sick Children.
Department of Paediatrics, Faculty of Medicine (PD Wong, PC Parkin, RG Moodie, JL Maguire, and CS Birken); Joannah & Brian Lawson Centre for Child Nutrition (PC Parkin, JL Maguire, and CS Birken); Institute of Health Policy, Management and Evaluation (PC Parkin, JL Maguire, CS Birken, and CM Borkhoff), University of Toronto; Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PD Wong, PC Parkin, JL Maguire, CS Birken, and CM Borkhoff); Sick Kids Research Institute (PD Wong, PC Parkin, CS Birken, and CM Borkhoff), Hospital for Sick Children.
出版信息
Acad Pediatr. 2019 Nov-Dec;19(8):884-890. doi: 10.1016/j.acap.2019.02.009. Epub 2019 Mar 1.
OBJECTIVE
Health care policy positions breastfeeding as an important part of the solution to household food insecurity; however, there are critical gaps in our knowledge of the relationship between breastfeeding duration (exposure variable) and household food insecurity (outcome variable). Our objective was to examine this relationship.
METHODS
A cross-sectional study was conducted from 2008 to 2016 of healthy urban children (N = 3838) who were 0 to 3 years old and recruited from The Applied Research Group for Kids (TARGet Kids!), a practice-based research network in Toronto, Canada. Total breastfeeding duration was collected from parent-reported questionnaires. Household food insecurity was measured using 1-item and 2-item food insecurity screens. Multivariable regression analysis was performed adjusting for prespecified covariates.
RESULTS
The median total breastfeeding duration was 10.5 months (interquartile range, 6.0-14.0), and 14.7% of households were food insecure. After adjusting for child characteristics (age, sex), maternal characteristics (age, ethnicity, education, employment), and family characteristics (number of children, single parent family, neighborhood equity score), there was no significant association between total breastfeeding duration and household food insecurity (odds ratio, 0.99; 95% confidence interval, 0.98-1.01). Although low-income families had an increased odds of being household food insecure (P ≤ .001), we found no significant association between total breastfeeding duration and household food insecurity at varying income levels.
CONCLUSIONS
We found no association between breastfeeding duration and household food insecurity, regardless of family income. Although breastfeeding is associated with improved child health outcomes and considered to be part of the solution to household food insecurity, interventions focused on social determinants may provide more promising targets for the prevention of household food insecurity.
目的
卫生保健政策将母乳喂养定位为解决家庭食物不安全问题的重要组成部分；然而，我们对母乳喂养持续时间（暴露变量）与家庭食物不安全（结果变量）之间的关系知之甚少。我们的目的是检验这种关系。
方法
2008 年至 2016 年，对来自加拿大多伦多基于实践的研究网络应用儿童研究组（TARGet Kids!）的 3838 名 0 至 3 岁健康城市儿童进行了一项横断面研究。总母乳喂养持续时间由家长报告的问卷收集。家庭食物不安全情况使用 1 项和 2 项食物不安全筛查工具进行测量。在调整了预先指定的协变量后，进行多变量回归分析。
结果
总母乳喂养持续时间中位数为 10.5 个月（四分位间距，6.0-14.0），14.7%的家庭食物不安全。在调整了儿童特征（年龄、性别）、产妇特征（年龄、种族、教育、就业）和家庭特征（儿童人数、单亲家庭、邻里公平评分）后，总母乳喂养持续时间与家庭食物不安全之间没有显著关联（比值比，0.99；95%置信区间，0.98-1.01）。尽管低收入家庭家庭食物不安全的可能性增加（P ≤.001），但我们发现，在不同收入水平下，总母乳喂养持续时间与家庭食物不安全之间没有显著关联。
结论
无论家庭收入如何，我们都没有发现母乳喂养持续时间与家庭食物不安全之间存在关联。尽管母乳喂养与改善儿童健康结果相关，并且被认为是解决家庭食物不安全问题的一部分，但针对社会决定因素的干预措施可能为预防家庭食物不安全提供更有希望的目标。
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