Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Guy's Hospital, King's College London, London, UK.
Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
Matern Child Nutr. 2021 Oct;17(4):e13222. doi: 10.1111/mcn.13222. Epub 2021 Jun 1.
The health benefits of breastfeeding are well recognised, but breastfeeding rates worldwide remain suboptimal. Breastfeeding outcomes have yet to be explored among women who give birth to macrosomic (birthweight ≥4000 g) infants, a cohort for whom the benefits of breastfeeding may be particularly valuable, offering protection against later-life morbidity associated with macrosomia. This longitudinal prospective cohort study aimed to identify whether women who give birth to macrosomic infants are at greater risk of breastfeeding non-initiation or exclusive breastfeeding (EBF) cessation. A total of 328 women in their third trimester were recruited from hospital and community settings and followed to 4 months post-partum. Women gave birth to 104 macrosomic and 224 non-macrosomic (<4000 g) infants between 2018 and 2020. Longitudinal logistic regression models calculated odds ratios (ORs) and 95% confidence intervals (CIs) to assess likelihood of EBF at four timepoints post-partum (birth, 2 weeks, 8 weeks, and 4 months) between women who gave birth to macrosomic and non-macrosomic infants, adjusted for maternal risk (obesity and/or diabetes), ethnicity and mode of birth. Macrosomic infants were more likely to be exclusively breastfed at birth and 2 weeks post-partum than non-macrosomic infants with adjusted OR = 1.94 (95% CI: 0.90, 4.18; p = 0.089) and 2.13 (95% CI: 1.11, 4.06; p = 0.022), respectively. There were no statistically significant associations between macrosomia and EBF at 8 weeks or 4 months post-partum. Macrosomia may act as a protective factor against early formula-milk supplementation, increasing the likelihood of EBF in the early post-partum period, but rates of exclusive breastfeeding continued to decline over the first 4 months post-partum.
母乳喂养对健康的益处已得到广泛认可，但全球范围内的母乳喂养率仍不理想。对于分娩出巨大儿（出生体重≥4000 克）的女性，其母乳喂养的结果尚未得到探索，而对于这一人群，母乳喂养的益处可能特别有价值，可以预防与巨大儿相关的后期生活发病率。本纵向前瞻性队列研究旨在确定分娩出巨大儿的女性是否更有可能出现母乳喂养起始失败或纯母乳喂养（EBF）中断。2018 年至 2020 年期间，共招募了 328 名处于妊娠晚期的医院和社区女性，并随访至产后 4 个月。这些女性分娩了 104 名巨大儿和 224 名非巨大儿（<4000 克）。采用纵向逻辑回归模型计算产后四个时间点（出生时、2 周、8 周和 4 个月）的 EBF 可能性的比值比（OR）和 95%置信区间（CI），以评估分娩出巨大儿和非巨大儿的女性之间的 EBF 可能性，调整了产妇风险（肥胖和/或糖尿病）、种族和分娩方式。巨大儿在出生时和产后 2 周时更有可能进行纯母乳喂养，调整后的 OR 分别为 1.94（95%CI：0.90，4.18；p=0.089）和 2.13（95%CI：1.11，4.06；p=0.022）。巨大儿与产后 8 周和 4 个月时的 EBF 之间没有统计学显著关联。巨大儿可能是早期配方奶补充的保护因素，增加了产后早期 EBF 的可能性，但在产后 4 个月内，纯母乳喂养的比例继续下降。
