Department of Medicine McMaster University Hamilton Canada.
Department of Pediatrics and Child Health University of Manitoba Winnipeg Canada.
J Am Heart Assoc. 2021 Aug 3;10(15):e019067. doi: 10.1161/JAHA.120.019067. Epub 2021 Jul 21.
Background Breastfeeding in infancy is associated with lower cardiovascular disease risk in adulthood; however, the amount of breastfeeding required to achieve this benefit is unknown. Methods and Results In the CHILD (Canadian Healthy Infant Longitudinal Development) Cohort Study, we analyzed 2382 children with complete data on early life feeding and blood pressure. Infant feeding was documented from hospital records in the first few days of life and reported by mothers throughout infancy. Blood pressure was measured at 3 years of age. Analyses controlled for birth weight, gestational age, socioeconomic status, maternal body mass index, and other potential confounders. We found that nearly all children (2333/2382; 97.9%) were ever breastfed, of whom 98 (4.2%) only briefly received breast milk during their birth hospitalization ("early limited breastfeeding"). At 3 years of age, blood pressure was higher in children who were never breastfed (mean systolic/diastolic 103/60 mm Hg) compared with those who were ever breastfed (99/58 mm Hg), including those who received only early limited breastfeeding (99/57 mm Hg). These differences in systolic blood pressure persisted in adjusted models (ever breastfed: -3.47 mm Hg, 95% CI, -6.14 to -0.80; early limited breastfeeding: -4.24 mm Hg, 95% CI, -7.45 to -1.04). Among breastfed children, there was no significant dose-response association according to the duration or exclusivity of breastfeeding. Associations were not mediated by child body mass index. Conclusions Although the benefits of sustained and exclusive breastfeeding are indisputable, this study indicates any breastfeeding, regardless of duration or exclusivity, is associated with lower blood pressure at 3 years of age. Further research examining the bioactive components of early breast milk, underlying mechanisms, and long-term associations is warranted.
婴儿期母乳喂养与成年后患心血管疾病的风险较低有关;然而,达到这一益处所需的母乳喂养量尚不清楚。
在 CHILD(加拿大健康婴儿纵向发展)队列研究中,我们分析了 2382 名有完整生命早期喂养和血压数据的儿童。婴儿喂养情况从生命最初几天的医院记录中记录,并由母亲在整个婴儿期报告。血压在 3 岁时测量。分析控制了出生体重、胎龄、社会经济地位、母亲的体重指数和其他潜在的混杂因素。我们发现,几乎所有的儿童(2333/2382;97.9%)都接受过母乳喂养,其中 98 名(4.2%)仅在住院分娩期间短暂接受过母乳(“早期有限母乳喂养”)。在 3 岁时,从未接受过母乳喂养的儿童的血压较高(平均收缩压/舒张压 103/60mmHg),与接受过母乳喂养的儿童(99/58mmHg)相比,包括仅接受过早期有限母乳喂养的儿童(99/57mmHg)。这些收缩压的差异在调整后的模型中仍然存在(母乳喂养:-3.47mmHg,95%CI,-6.14 至-0.80;早期有限母乳喂养:-4.24mmHg,95%CI,-7.45 至-1.04)。在母乳喂养的儿童中,母乳喂养的持续时间或排他性与血压没有显著的剂量反应关系。这些关联不受儿童体重指数的影响。
尽管持续和完全母乳喂养的益处是无可争议的,但本研究表明,无论母乳喂养的持续时间或排他性如何,与 3 岁时的血压较低有关。进一步研究早期母乳中的生物活性成分、潜在机制和长期关联是必要的。