Departments of Nutrition and Food Hygiene and.
Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China.
Pediatrics. 2020 May;145(5). doi: 10.1542/peds.2019-2209. Epub 2020 Apr 22.
Several studies have investigated the association of breastfeeding status with offspring mortality in Africa, but most studies were from one center only or had limited statistical power to draw robust conclusions.
Data came from 75 nationally representative cross-sectional Demographic and Health Surveys in 35 countries in sub-Saharan Africa conducted between 2000 and 2016. Our study relied on 217 112 individuals aged 4 days to 23 months for breastfeeding pattern analysis, 161 322 individuals aged 6 to 23 months for breastfeeding history analysis, and 104 427 individuals aged 12 to 23 months for breastfeeding duration analysis.
Compared with children aged 4 days to 23 months exclusively breastfed in the first 3 days of life, those not breastfed had a high risk of mortality at <2 years of age (odds ratio [OR] = 13.45; 95% confidence interval [CI] = 11.43-15.83). Young children who were predominantly breastfed or partially breastfed had moderately increased risk of mortality at <2 years of age (OR = 1.11, 95% CI = 1.03-1.21 for predominant pattern; OR = 1.12, 95% CI = 0.99-1.27 for partial pattern). Compared with children aged 6 to 23 months who were breastfed within the first 6 months of life, those not breastfed had a high risk of mortality (OR = 5.65; 95% CI = 4.27-7.47). Compared with children aged 12 to 23 months who were breastfed for ≥6 months, those who were breastfed for shorter periods had a higher risk of mortality (OR = 2.78, 95% CI = 1.45-5.32 for duration of <3 months; OR = 5.28, 95% CI = 3.24-8.61 for those who were not breastfed).
Our findings support exclusive breastfeeding during the first 6 months of life and continued breastfeeding up to 2 years of age recommended by the World Health Organization for reducing mortality of children <2 years old in sub-Saharan Africa.
有几项研究调查了母乳喂养状况与非洲儿童死亡率之间的关联，但大多数研究仅来自一个中心，或统计能力有限，无法得出可靠的结论。
数据来自 2000 年至 2016 年间在撒哈拉以南非洲 35 个国家进行的 75 项具有全国代表性的横断面人口与健康调查。我们的研究依赖于 217112 名 4 天至 23 个月大的个体进行母乳喂养模式分析，161322 名 6 至 23 个月大的个体进行母乳喂养史分析，以及 104427 名 12 至 23 个月大的个体进行母乳喂养持续时间分析。
与生命最初 3 天内仅纯母乳喂养的 4 天至 23 个月大的儿童相比，未母乳喂养的儿童在<2 岁时死亡的风险较高（比值比[OR] = 13.45；95%置信区间[CI] = 11.43-15.83）。主要母乳喂养或部分母乳喂养的幼儿在<2 岁时死亡的风险略有增加（主要模式的 OR = 1.11，95%CI = 1.03-1.21；部分模式的 OR = 1.12，95%CI = 0.99-1.27）。与生命最初 6 个月内母乳喂养的 6 至 23 个月大的儿童相比，未母乳喂养的儿童死亡风险较高（OR = 5.65；95%CI = 4.27-7.47）。与母乳喂养≥6 个月的 12 至 23 个月大的儿童相比，母乳喂养时间较短的儿童死亡风险更高（<3 个月的持续时间的 OR = 2.78，95%CI = 1.45-5.32；未母乳喂养的 OR = 5.28，95%CI = 3.24-8.61）。
我们的研究结果支持世界卫生组织建议的在生命最初 6 个月内进行纯母乳喂养，并持续母乳喂养至 2 岁，以降低撒哈拉以南非洲<2 岁儿童的死亡率。
