减少夜间喂养次数对婴儿 BMI 的影响。
The impact of reducing the frequency of night feeding on infant BMI.
机构信息
Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA.
Child Development and Behavior, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
出版信息
Pediatr Res. 2022 Jan;91(1):254-260. doi: 10.1038/s41390-021-01397-7. Epub 2021 Mar 4.
BACKGROUND
Teaching caregivers to respond to normal infant night awakenings in ways other than feeding is a common obesity prevention effort. Models can simulate caregiver feeding behavior while controlling for variables that are difficult to manipulate or measure in real life.
METHODS
We developed a virtual infant model representing an infant with an embedded metabolism and his/her daily sleep, awakenings, and feeds from their caregiver each day as the infant aged from 6 to 12 months (recommended age to introduce solids). We then simulated different night feeding interventions and their impact on infant body mass index (BMI).
RESULTS
Reducing the likelihood of feeding during normal night wakings from 79% to 50% to 10% lowered infant BMI from the 84th to the 75th to the 62nd percentile by 12 months, respectively, among caregivers who did not adaptively feed (e.g., adjust portion sizes of solid foods with infant growth). Among caregivers who adaptively feed, all scenarios resulted in relatively stable BMI percentiles, and progressively reducing feeding probability by 10% each month showed the least fluctuations.
CONCLUSIONS
Reducing night feeding has the potential to impact infant BMI, (e.g., 10% lower probability can reduce BMI by 20 percentile points) especially among caregivers who do not adaptively feed.
IMPACT
Teaching caregivers to respond to infant night waking with other soothing behaviors besides feeding has the potential to reduce infant BMI. When reducing the likelihood of feeding during night wakings from 79% to 50% to 10%, infants dropped from the 84th BMI percentile to the 75th to the 62nd by 12 months, respectively, among caregivers who do not adaptively feed. Night-feeding interventions have a greater impact when caregivers do not adaptively feed their infant based on their growth compared to caregivers who do adaptively feed. Night-feeding interventions should be one of the several tools in a multi-component intervention for childhood obesity prevention.
背景
教导照顾者以喂养以外的方式回应正常婴儿夜间觉醒，是预防肥胖的常见措施。模型可以模拟照顾者的喂养行为，同时控制现实生活中难以操作或测量的变量。
方法
我们开发了一个虚拟婴儿模型，代表一个婴儿，他/她的代谢和每天的睡眠、觉醒和喂养都由照顾者提供，从婴儿 6 个月到 12 个月（推荐引入固体食物的年龄）。然后，我们模拟了不同的夜间喂养干预措施及其对婴儿体重指数（BMI）的影响。
结果
在不适应性喂养（例如，根据婴儿的生长调整固体食物的份量）的照顾者中，将正常夜间觉醒时喂养的可能性从 79%降低到 50%再降低到 10%，分别使婴儿的 BMI 从第 84 百分位降低到第 75 百分位再降低到第 62 百分位，到 12 个月时。在适应性喂养的照顾者中，所有情景都导致相对稳定的 BMI 百分位，并且每月逐渐减少 10%的喂养概率显示出最小的波动。
结论
减少夜间喂养有可能影响婴儿的 BMI（例如，降低 10%的喂养概率可以降低 20 个 BMI 百分位），尤其是在不适应性喂养的照顾者中。
影响
教导照顾者以除喂养以外的其他安抚行为来回应婴儿夜间觉醒，有可能降低婴儿的 BMI。当夜间觉醒时的喂养可能性从 79%降低到 50%再降低到 10%时，在不适应性喂养的照顾者中，婴儿的 BMI 分别从第 84 百分位下降到第 75 百分位再下降到第 62 百分位，到 12 个月时。与适应性喂养的照顾者相比，当照顾者不根据婴儿的生长情况适应性喂养时，夜间喂养干预措施的影响更大。夜间喂养干预措施应该是儿童肥胖预防的多组分干预措施之一。
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