Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, 119228, Singapore.
Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore.
Appetite. 2020 Jul 1;150:104653. doi: 10.1016/j.appet.2020.104653. Epub 2020 Mar 7.
Individual differences in children's eating behaviours emerge early. We examined the relationship between breastfeeding exposure and subsequent eating behaviours among children from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Children (n = 970) were grouped according to their breastfeeding exposure: high (full breastfeeding ≥ 4 months with continued breastfeeding ≥ 6 months), low (any breastfeeding < 3 months or no breastfeeding) and intermediate (between low and high breastfeeding categories). Aspects of eating behaviour from ages 15 months to 6 years were captured using a combination of maternal reports (Child Eating Behaviour Questionnaire; Infant Feeding Questionnaire; Preschooler Feeding Questionnaire) and laboratory-based measures of meal size, oral processing behaviours (e.g. average eating speed and bite size) and tendency to eat in the absence of hunger. Most children had low (44%) or intermediate (44%) breastfeeding exposure; only 12% had high exposure. After adjusting for confounders, multivariable linear regression analyses indicated the high (but not intermediate) breastfeeding group was associated with significantly lower reported food fussiness at 3 years compared to low breastfeeding group (-0.38 [-0.70, -0.06]), with similar but non-significant trends observed at 6 years (-0.27 [-0.66, 0.11]). At 3 years, mothers in the high breastfeeding group also reported the least difficulty in child feeding compared to low breastfeeding group (-0.22 [-0.43, -0.01]). However, high breastfeeding was not associated with any other maternal-reports of child feeding or eating behaviours, and no significant associations were observed between breastfeeding exposure and any of the laboratory measures of eating behaviour at any of the time points. These results do not strongly support the view that increased breastfeeding exposure alone has lasting and consistent associations with eating behaviours in early childhood.
儿童的饮食行为存在个体差异，且这些差异很早就会显现。我们检验了新加坡儿童成长队列研究（GUSTO）中母乳喂养与儿童后续饮食行为之间的关系。根据母乳喂养暴露情况，将儿童（n=970）分为三组：高（完全母乳喂养≥4 个月，持续母乳喂养≥6 个月）、低（母乳喂养<3 个月或无母乳喂养）和中（低和高母乳喂养类别之间）。采用母亲报告（儿童饮食行为问卷、婴儿喂养问卷、学前儿童喂养问卷）和实验室测量相结合的方法，从 15 个月到 6 岁期间，评估了儿童饮食行为的各个方面，包括每餐食量、口腔处理行为（如平均进食速度和咬块大小）以及有无饥饿感时的进食倾向。大多数儿童的母乳喂养暴露水平较低（44%）或中等（44%），只有 12%的儿童母乳喂养暴露水平较高。调整混杂因素后，多元线性回归分析表明，与低母乳喂养组相比，高母乳喂养组（但不是中母乳喂养组）3 岁时报告的食物挑剔程度明显较低（-0.38[-0.70，-0.06]），6 岁时也有类似但无统计学意义的趋势（-0.27[-0.66，0.11]）。3 岁时，与低母乳喂养组相比，高母乳喂养组的母亲还报告说，在喂养孩子方面最不困难（-0.22[-0.43，-0.01]）。然而，高母乳喂养与任何其他儿童喂养或饮食行为的母亲报告均无关联，且在任何时间点，母乳喂养暴露与任何实验室饮食行为测量均无显著关联。这些结果并不强烈支持这样一种观点，即单纯增加母乳喂养暴露与儿童早期的饮食行为具有持久和一致的关联。
