Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy.
Danone Nutricia Research, Utrecht, The Netherlands.
Nutr Rev. 2020 Nov 1;78(11):914-927. doi: 10.1093/nutrit/nuaa016.
Extensive literature is available on exclusive breastfeeding and formula-feeding practices and health effects. In contrast, limited and unstructured literature exists on mixed milk feeding (MMF), here defined as the combination of breastfeeding and formula feeding during the same period in term infants > 72 hours old (inclusion criterion).
A systematic review and meta-analysis were performed, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, on the global prevalence of MMF (primary outcome) and related drivers and practices (secondary outcomes).
The search of MMF in generally healthy populations was conducted across 6 databases, restricted to publications from January 2000 to August 2018 in English, Spanish, French, and Mandarin.
Two reviewers independently performed screenings and data extraction according to a priori inclusion and exclusion criteria.
Of the 2931 abstracts identified, 151 full-text publications were included for data extraction and 96 of those were included for data synthesis (the majority of those were cross-sectional and cohort studies). The authors summarized data across 5 different categories (feeding intention prenatally, and 4 age intervals between > 72 hours and > 6-23 months) and 5 regional subgroups. The overall prevalence of MMF across different age intervals and regions varied between 23% and 32%; the highest rate was found for the age group 4-6 months (32%; 95% confidence interval, 27%-38%); regional comparisons indicated highest MMF rates in Asia (34%), North and South America (33%), and Middle East and Africa together (36%), using a random effects meta-analysis model for proportions. Some drivers and practices for MMF were identified.
MMF is a widespread feeding reality. A shared and aligned definition of MMF will help shed light on this feeding practice and evaluate its influence on the duration of total breastfeeding, as well as on infants' nutrition status, growth, development, and health status in the short and long terms. PROSPERO registration number CRD42018105337.
关于纯母乳喂养和配方奶喂养的实践和健康影响，已有大量文献。相比之下，关于混合喂养（MMF）的文献有限且不系统，这里将 MMF 定义为在>72 小时龄的足月婴儿中同时进行母乳喂养和配方奶喂养（纳入标准）。
根据系统评价和荟萃分析的首选报告项目，对全球 MMF 的流行情况（主要结果）以及相关驱动因素和实践（次要结果）进行了系统回顾和荟萃分析。
在 6 个数据库中对一般健康人群中的 MMF 进行了检索，检索范围限于 2000 年 1 月至 2018 年 8 月间以英文、西班牙语、法语和简体中文发表的文献。
两名审查员根据预先设定的纳入和排除标准，独立进行筛选和数据提取。
在 2931 篇摘要中，有 151 篇全文出版物被纳入数据提取，其中 96 篇被纳入数据综合分析（其中大多数为横断面和队列研究）。作者总结了来自 5 个不同类别（产前喂养意向和 4 个>72 小时至>6-23 个月的年龄间隔）和 5 个区域亚组的数据。不同年龄间隔和地区的 MMF 总流行率在 23%至 32%之间有所不同；最高的发生率出现在 4-6 个月龄组（32%；95%置信区间，27%-38%）；区域比较表明，亚洲（34%）、北美和南美（33%）以及中东和非洲（36%）的 MMF 发生率最高，采用随机效应荟萃分析模型计算比例。确定了 MMF 的一些驱动因素和实践。
MMF 是一种广泛存在的喂养现实。对 MMF 的共同和一致定义将有助于阐明这种喂养实践，并评估其对总母乳喂养持续时间的影响，以及对婴儿短期和长期营养状况、生长、发育和健康状况的影响。PROSPERO 注册号 CRD42018105337。
