Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, Faculty of Health Sciences and.
Pediatrics. 2020 Nov;146(5). doi: 10.1542/peds.2019-1892.
Studies on the association between breastfeeding and infections in children beyond the first year of life reveal conflicting results. In a population-based birth cohort, we investigated whether the duration of breastfeeding was associated with the number of hospitalizations due to infection and symptoms of infection at home.
In the Odense Child Cohort, text message questionnaires were used to register information on breastfeeding (weekly until end of weaning) and symptoms of infection (biweekly; 12-36 months of age). Hospitalization data were obtained from the Danish National Patient Registry.
Of the 1087 invited, 815 mother-infant pairs were included. The median duration of any breastfeeding was 7.6 (interquartile range: 3.5-10.4) months and of exclusive breastfeeding was 2.1 (interquartile range: 0.7-4.4) months. Hospitalization due to infection was seen in 207 (25.4%) infants during the first 3 years of life. The adjusted incidence rate ratio (IRR) for hospitalization due to any infection decreased with a longer duration of any breastfeeding (adjusted IRR: 0.96; 95% confidence interval 0.93-0.99; < .001). The strongest associations between the duration of any breastfeeding and hospitalizations due to infection were found within the first year of life, for lower respiratory tract infections, and other infections ( ≤ .05). For infants exclusively breastfed, the adjusted IRR for hospitalization was 0.88 (95% confidence interval: 0.80-0.96; = .006). No protective associations were present between breastfeeding and infection symptoms registered at home from ages 12 to 36 months.
The results suggest that increased duration of breastfeeding, especially exclusive breastfeeding, protects against infections requiring hospitalization in the first year of life but not hospitalizations or symptoms of infection at home beyond the first year.
针对婴儿一岁后母乳喂养与感染之间关系的研究结果存在差异。本研究通过基于人群的出生队列，调查母乳喂养时长是否与因感染而住院的次数以及在家中出现感染症状的次数相关。
在奥登塞儿童队列中，我们使用短信问卷来登记母乳喂养信息（直至断奶结束，每周登记一次）和感染症状信息（12-36 个月龄时，每两周登记一次）。住院数据来自丹麦国家患者登记处。
在 1087 名受邀者中，815 对母婴被纳入研究。母乳喂养的中位时长为 7.6 个月（四分位间距 3.5-10.4），纯母乳喂养的中位时长为 2.1 个月（四分位间距 0.7-4.4）。在婴儿 3 岁前，共有 207 名（25.4%）婴儿因感染而住院。任何感染导致的住院的校正发病率比（IRR）随母乳喂养时长的增加而降低（校正 IRR：0.96；95%置信区间 0.93-0.99； ＜0.001）。母乳喂养时长与感染导致的住院之间的最强关联存在于婴儿一岁内，尤其是下呼吸道感染和其他感染（ ＜0.05）。对于纯母乳喂养的婴儿，住院的校正 IRR 为 0.88（95%置信区间：0.80-0.96； ＝0.006）。母乳喂养时长与 12-36 个月龄在家中出现的感染症状之间没有保护关联。
研究结果表明，母乳喂养时长增加，特别是纯母乳喂养时长增加，可预防婴儿一岁内因感染而住院，但对一岁后在家中出现感染症状或因感染而住院无预防作用。
