婴儿喂养方式与食物过敏、过敏性鼻炎、特应性皮炎和哮喘的终生相关性：系统综述。
Infant milk-feeding practices and food allergies, allergic rhinitis, atopic dermatitis, and asthma throughout the life span: a systematic review.
机构信息
Panum Group, Bethesda, MD.
USDA, Food and Nutrition Service, Alexandria, VA.
出版信息
Am J Clin Nutr. 2019 Mar 1;109(Suppl_7):772S-799S. doi: 10.1093/ajcn/nqy283.
BACKGROUND
During the Pregnancy and Birth to 24 Months Project, the USDA and Department of Health and Human Services initiated a review of evidence on diet and health in these populations.
OBJECTIVES
The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding prior to infant formula introduction, 4) feeding a lower versus higher intensity of human milk to mixed-fed infants, and 5) feeding a higher intensity of human milk by bottle versus breast with food allergies, allergic rhinitis, atopic dermatitis, and asthma.
METHODS
The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published between January 1980 and March 2016, dual-screened the results according to predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence.
RESULTS
The systematic reviews numbered 1-5 above included 44, 35, 1, 0, and 0 articles, respectively. Moderate, mostly observational, evidence suggests that 1) never versus ever being fed human milk is associated with higher risk of childhood asthma, and 2) among children and adolescents who were fed human milk as infants, shorter versus longer durations of any human milk feeding are associated with higher risk of asthma. Limited evidence does not suggest associations between 1) never versus ever being fed human milk and atopic dermatitis in childhood or 2) the duration of any human milk feeding and allergic rhinitis and atopic dermatitis in childhood.
CONCLUSIONS
Moderate evidence suggests that feeding human milk for short durations or not at all is associated with higher childhood asthma risk. Evidence on food allergies, allergic rhinitis, and atopic dermatitis is limited.
背景
在美国农业部和卫生与公众服务部的“怀孕和生育至 24 个月项目”中，他们对这些人群的饮食和健康相关证据进行了审查。
目的
这些系统评价的目的是检验以下关系：1）从未母乳喂养与曾母乳喂养；2）任何母乳喂养时间长短；3）婴儿配方奶引入前纯母乳喂养时间长短；4）混合喂养时母乳摄入强度高低；5）奶瓶喂养与亲喂时母乳摄入强度高低。与食物过敏、过敏性鼻炎、特应性皮炎和哮喘的关系。
方法
营养证据系统评价团队与外部专家合作开展了系统评价。我们在 CINAHL、Cochrane、Embase 和 PubMed 中检索了 1980 年 1 月至 2016 年 3 月间发表的文章，根据预定标准对结果进行双屏幕筛选，从每篇纳入研究中提取数据并评估其偏倚风险，对证据进行定性综合，形成结论陈述，并对证据强度进行分级。
结果
上述系统评价 1-5 分别纳入 44、35、1、0 和 0 篇文章。有中等质量、主要为观察性证据表明：1）从未母乳喂养与儿童哮喘风险增加相关；2）在婴儿期接受母乳喂养的儿童和青少年中，任何母乳喂养时间较短与哮喘风险增加相关。有限证据表明：1）从未母乳喂养与儿童期特应性皮炎无关；2）任何母乳喂养时间长短与儿童期过敏性鼻炎和特应性皮炎无关。
结论
中等质量证据表明，短期或完全不母乳喂养与儿童哮喘风险增加相关。关于食物过敏、过敏性鼻炎和特应性皮炎的证据有限。
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