Delgado Carlos Alberto, Munhoz Tiago N, Santos Iná S, Barros Fernando C, Matijasevich Alicia
Centro de Pesquisas Epidemiológicas - Universidade Federal de Pelotas, Rua Marechal Deodoro, CEP: 96020-220, Caixa Postal 464, 1160 Pelotas, RS, Brazil.
Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.
Child Adolesc Ment Health. 2017 Nov;22(4):209-215. doi: 10.1111/camh.12224. Epub 2017 Apr 17.
There is scarce and conflicting evidence on medium- to long-term effects of prolonged breastfeeding on child behavior.
A population-based birth cohort study started in 2004 in the city of Pelotas, Southern Brazil. Children were followed up at 3, 12, 24, and 48 months and 6 years of age. Breastfeeding duration was determined based on information collected around the time of weaning. Psychiatric disorders were assessed using the Development and Well-Being Assessment (DAWBA). Children who were never breastfed were excluded from the analysis. Crude and adjusted analyses were performed using Poisson regression with robust variance.
Data on breastfeeding and mental health at the age of 6 years were available for 3377 children. Prevalence of breastfeeding for 24-35 months and ≥36 months was 16.1% (95% CI: 14.8-17.3) and 8.1% (95% CI: 7.2-9.1), respectively. Prevalence of psychiatric disorders among those who were breastfed for <24 months, 24-35 months and ≥36 months was 12.4% (95% CI: 11.1-13.7), 13.1% (95% CI: 10.4-16.2) and 12.3% (95% CI: 8.7-16.8), respectively. No association was found between breastfeeding for 24 months or more and psychiatric disorders among children aged 6 years both in the crude and adjusted analyses.
In this cohort there was no association between breastfeeding for 24 months or more and an increased prevalence of psychiatric disorders at the age of 6 years. Studies analyzing the medium- and long-term effects of prolonged breastfeeding for 2 years or more are scarce and further research is needed regarding this practice.
关于延长母乳喂养对儿童行为的中长期影响，现有证据稀少且相互矛盾。
一项基于人群的出生队列研究于2004年在巴西南部的佩洛塔斯市启动。对儿童在3个月、12个月、24个月、48个月和6岁时进行随访。母乳喂养持续时间根据断奶前后收集的信息确定。使用发育与幸福评估（DAWBA）对精神障碍进行评估。从未接受母乳喂养的儿童被排除在分析之外。采用稳健方差的泊松回归进行粗分析和校正分析。
3377名儿童有6岁时母乳喂养和心理健康的数据。母乳喂养24至35个月和≥36个月的患病率分别为16.1%（95%CI：14.8 - 17.3）和8.1%（95%CI：7.2 - 9.1）。母乳喂养<24个月、24至35个月和≥36个月的儿童中精神障碍的患病率分别为12.4%（95%CI：11.1 - 13.7）、13.1%（95%CI：10.4 - 16.2）和12.3%（95%CI：8.7 - 16.8）。在粗分析和校正分析中，均未发现6岁儿童母乳喂养24个月及以上与精神障碍之间存在关联。
在该队列中，母乳喂养24个月及以上与6岁时精神障碍患病率增加之间无关联。分析延长母乳喂养2年及以上的中长期影响的研究较少，对此做法需要进一步研究。
