College of Medicine, The Ohio State University, Columbus, Ohio, USA.
Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
Breastfeed Med. 2021 Sep;16(9):750-758. doi: 10.1089/bfm.2020.0261. Epub 2021 Apr 27.
To examine the associations between human milk feeding method (at the breast versus bottle) and measures of child adiposity during the first 6 years of life. Women 12 months' postpartum who delivered a singleton, liveborn infant at >24 weeks gestation completed a survey assessing infant feeding methods and sociodemographics. Mothers were recontacted when the child was 6 years old for a follow-up study assessing growth ( = 269). Children were categorized as ever or never having excess weight using weight-for-age z-scores (WAZ), weight-for-height z-scores (WHZ), and body mass index-for-age z-scores (BMIZ) from birth to 6 years. Modified Poisson regression estimated associations between the duration of each feeding method (exclusive and combined) with excess weight status. Mixed-effect models estimated associations between feeding methods and trajectories of the outcomes. For all feeding practices, increasing duration (in months) was unassociated with the risk of ever having excess weight by age 6 years. Based on mixed models, longer duration of feeding human milk by any method was associated with lower BMIZ (adj β for 6-12 months versus 0-3 months = -0.50, 95% CI: -0.99 to -0.01) and also with the shape of the BMIZ trajectory curve. No other associations between feeding methods and excess weight outcomes were observed. Longer duration of feeding human milk was associated with lower average BMIZ in early childhood but feeding at the breast and feeding expressed milk were not clearly associated with the outcomes when considered separately. Larger studies would help clarify the associations between these specific feeding methods and outcomes. IRB17-00876.
检查人乳喂养方式(母乳喂养与奶瓶喂养)与婴儿 6 岁前肥胖相关指标之间的关系。产后 12 个月、分娩孕周大于 24 周的单胎活产儿母亲完成了一项评估婴儿喂养方式和社会人口统计学特征的调查。当孩子 6 岁时,母亲会被重新联系以进行一项随访研究,评估其生长情况(=269)。从出生到 6 岁,使用体重年龄 z 评分(WAZ)、身高体重 z 评分(WHZ)和体重指数年龄 z 评分(BMIZ)将儿童分为超重或从不超重。改良泊松回归估计每种喂养方式(纯母乳喂养和混合喂养)持续时间与超重状态之间的关联。混合效应模型估计了喂养方式与结局轨迹之间的关联。对于所有喂养方式,持续时间(月)的增加与 6 岁时超重风险无关。基于混合模型,任何方法的人乳喂养时间较长与 BMIZ 较低相关(6-12 个月与 0-3 个月相比,调整β= -0.50,95%CI:-0.99 至-0.01),且与 BMIZ 轨迹曲线的形状相关。未观察到其他喂养方式与超重结局之间的关联。人乳喂养时间较长与儿童早期平均 BMIZ 较低有关,但当单独考虑时,母乳喂养和挤出奶喂养与这些结局之间没有明显的关联。更大的研究将有助于阐明这些特定喂养方式与结局之间的关系。IRB17-00876。