Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL USA.
Ruth M. Colket Endowed Chair in Pediatric Nursing, Children's Hospital of Philadelphia, University of Pennsylvania School of Nursing, Anesthesia and Critical Care Medicine - Perelman School of Medicine, Philadelphia, PA USA.
J Pediatr Nurs. 2020 Jan-Feb;50:5-13. doi: 10.1016/j.pedn.2019.09.020. Epub 2019 Oct 26.
Breastfed infants experience less severe infections while actively breastfeeding. However, little is known about whether a history of prior breastfeeding affects severity of illness. Therefore, the purpose of this integrative review was to examine the relationship between previous exposure to mother's own milk (MOM) feeding and severity of respiratory infectious illness in infants and children.
Studies meeting the following criteria were included: human subjects, term birth, ages 0-35 months at time of study, diagnosis of pneumonia, bronchiolitis or croup, MOM feeding, and statistical analyses reporting separate respiratory infectious illness outcomes when combined with other infections.
Twelve articles met eligibility criteria.
Major findings were inconsistent definitions of both dose and exposure period of breastfeeding and the severity of illness. In particular, the severity of illness measure was limited by the use of proxy variables such as emergency room visits or hospitalizations that lacked reliability and validity. However, given this limitation, the data suggested that exclusive breastfeeding for four to six months was associated with reduced severity of illness as measured by frequency of visits to the primary care provider office, emergency department or hospitalization.
Future research in this area should incorporate reliable and valid measures of MOM dose and exposure period and severity of illness outcomes in the critically ill child.
Among many positive outcomes associated with breastfeeding, an additional talking point for encouragement of exclusive breastfeeding for four to six months may be protective against severe respiratory infectious illness after cessation of breastfeeding.
母乳喂养的婴儿在进行母乳喂养时，感染的严重程度较低。然而，人们对母乳喂养史是否会影响疾病的严重程度知之甚少。因此，本综述的目的是研究婴儿和儿童期母亲自身奶（MOM）喂养史与呼吸道感染性疾病严重程度之间的关系。
符合以下标准的研究被纳入：人类研究对象、足月出生、研究时年龄为 0-35 个月、肺炎、细支气管炎或喘鸣的诊断、MOM 喂养以及报告了在与其他感染合并时单独的呼吸道感染性疾病结果的统计分析。
符合条件的文章有 12 篇。
主要发现是母乳喂养的剂量和暴露期以及疾病严重程度的定义不一致。特别是，疾病严重程度的衡量标准受到使用代理变量（如急诊就诊或住院）的限制，这些变量缺乏可靠性和有效性。然而，鉴于这一限制，数据表明，纯母乳喂养四到六个月与减少因看普通科医生、急诊室或住院而导致的疾病严重程度相关。
该领域的未来研究应在严重疾病儿童中纳入可靠和有效的 MOM 剂量和暴露期以及疾病严重程度结果的衡量标准。
在与母乳喂养相关的众多积极结果中，鼓励纯母乳喂养四到六个月的另一个重要观点可能是在停止母乳喂养后对严重呼吸道感染性疾病的保护作用。
