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婴儿在出生后第一年的喂养方式与 6 岁内哮喘和过敏性疾病的风险。

Infant Feeding Practices During the First Postnatal Year and Risk of Asthma and Allergic Disease During the First 6 Years of Life.

机构信息

Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.

College of Medicine, The Ohio State University, Columbus, Ohio, USA.

出版信息

Breastfeed Med. 2021 Jul;16(7):539-546. doi: 10.1089/bfm.2020.0275. Epub 2021 Mar 17.

DOI:10.1089/bfm.2020.0275
PMID:33733866
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8290294/
Abstract

Breastfeeding may protect against childhood asthma and allergic diseases. Studies have not focused on the mode of feeding human milk and followed children to school age although feeding human milk from a bottle rather than the breast may alter the risk of disease. At 12 months' postpartum, women in the Moms2Moms study (Columbus, OH) completed a survey assessing sociodemographic and infant feeding behaviors. At 6 years' postpartum, they completed a survey and pediatric medical records were abstracted to assess asthma and allergic disease diagnoses. Logistic regression models were used to estimate associations between infant feeding behaviors and asthma or allergic disease. Of 285 children, 16% had asthma and 44% ever had ≥1 allergy diagnosis. Longer durations of each infant feeding behavior were not clearly associated with increased odds of asthma or allergic disease by age 6. Results suggested that longer durations of breast milk feeding (regardless of the mode of feeding) may be related to a lower risk of food allergy (e.g., odds ratio [OR] = 0.96, 95% confidence interval [CI] = 0.87-1.05; OR = 0.57, 95% CI = 0.19-1.74), but that the mode of feeding (regardless of the substance fed) may be more meaningful for environmental allergies (e.g., exclusive direct breast milk feeding OR = 0.32, 95% CI = 0.06-1.81). However, effect estimates were imprecise and CIs included the null. Although no clear associations between mode of breast milk feeding (breast versus expressed) and asthma and allergy outcomes were observed, future research with larger samples should further evaluate these associations.

摘要

母乳喂养可能预防儿童哮喘和过敏性疾病。尽管用奶瓶喂养母乳而不是直接母乳喂养可能会改变疾病的风险,但研究并未关注母乳喂养方式,并对儿童进行随访至学龄期。在产后 12 个月,Moms2Moms 研究(俄亥俄州哥伦布市)中的女性完成了一项评估社会人口统计学和婴儿喂养行为的调查。在产后 6 年,她们完成了一项调查,儿科病历被摘录以评估哮喘和过敏性疾病的诊断。使用逻辑回归模型来估计婴儿喂养行为与哮喘或过敏性疾病之间的关联。在 285 名儿童中,16%患有哮喘,44%曾有≥1 次过敏诊断。每种婴儿喂养行为的持续时间较长与 6 岁时哮喘或过敏疾病的发生几率增加没有明显关联。结果表明,较长时间的母乳喂养(无论喂养方式如何)可能与较低的食物过敏风险相关(例如,比值比[OR] = 0.96,95%置信区间[CI] = 0.87-1.05;OR = 0.57,95% CI = 0.19-1.74),但喂养方式(无论喂养的物质如何)可能对环境过敏更有意义(例如,纯直接母乳喂养 OR = 0.32,95% CI = 0.06-1.81)。然而,效应估计值不够精确,置信区间包含零。尽管未观察到母乳喂养方式(母乳喂养与挤出后喂养)与哮喘和过敏结果之间存在明显关联,但未来应进一步评估具有更大样本量的研究中的这些关联。

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本文引用的文献

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The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods.早期营养干预对婴幼儿特应性疾病发展的影响:母亲饮食限制、母乳喂养、水解配方和引入变应原性补充食品时间的作用。
Pediatrics. 2019 Apr;143(4). doi: 10.1542/peds.2019-0281. Epub 2019 Mar 18.
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Vital Signs: Asthma in Children - United States, 2001-2016.生命体征:美国2001 - 2016年儿童哮喘情况
MMWR Morb Mortal Wkly Rep. 2018 Feb 9;67(5):149-155. doi: 10.15585/mmwr.mm6705e1.
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Modes of Infant Feeding and the Risk of Childhood Asthma: A Prospective Birth Cohort Study.婴儿喂养方式与儿童哮喘风险:一项前瞻性出生队列研究
J Pediatr. 2017 Nov;190:192-199.e2. doi: 10.1016/j.jpeds.2017.07.012.
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Human Milk and Allergic Diseases: An Unsolved Puzzle.人乳与过敏性疾病:未解之谜。
Nutrients. 2017 Aug 17;9(8):894. doi: 10.3390/nu9080894.
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Infant feeding patterns and eczema in children in the first 6 years of life.婴儿喂养模式与儿童在生命的头 6 年中湿疹的关系。
Clin Exp Allergy. 2017 Oct;47(10):1285-1298. doi: 10.1111/cea.12998. Epub 2017 Sep 4.
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Breastfeeding, maternal asthma and wheezing in the first year of life: a longitudinal birth cohort study.母乳喂养、产妇哮喘与婴儿 1 岁内喘息:一项纵向出生队列研究。
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Feeding at the Breast and Expressed Milk Feeding: Associations with Otitis Media and Diarrhea in Infants.母乳喂养与挤奶喂养:与婴儿中耳炎和腹泻的关联
J Pediatr. 2016 Jul;174:118-25. doi: 10.1016/j.jpeds.2016.04.006. Epub 2016 May 9.
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Acta Paediatr. 2015 Dec;104(467):38-53. doi: 10.1111/apa.13132.
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Randomized trial of peanut consumption in infants at risk for peanut allergy.对有花生过敏风险婴儿食用花生的随机试验。
N Engl J Med. 2015 Feb 26;372(9):803-13. doi: 10.1056/NEJMoa1414850. Epub 2015 Feb 23.
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Allergy and asthma prevention 2014.2014年变应性疾病和哮喘预防
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