University of California, Irvine, USA.
London School of Economics, UK.
Econ Hum Biol. 2021 Dec;43:101065. doi: 10.1016/j.ehb.2021.101065. Epub 2021 Oct 5.
Evidence on the post-weaning benefits of early-life breastfeeding is mixed, and highly context-dependent. Moreover, this evidence is drawn almost exclusively from modern settings, limiting our understanding of the relationship between breastfeeding and subsequent health in the past. We provide novel evidence on the nature and reach of these post-weaning benefits in a historical setting, drawing on a rich new longitudinal dataset covering nearly 1000 children from the Foundling Hospital, an orphanage in turn-of-the-century London. We find that even after the cessation of breastfeeding, ever-breastfed status reduced mortality risk and raised weight-for-age in infancy, that exclusive breastfeeding conferred additional benefits, and that breastfeeding duration had little impact. We also find a U-shaped pattern in weight-for-age by time since weaning, indicating a deterioration in health shortly after weaning, followed by a recovery. The early post-weaning advantages associated with breastfeeding, however, did not persist into mid-childhood. This indicates that any protective effects of earlier breastfeeding attenuated with age, and suggests a strong role for catch-up growth. This study contributes to the data and empirical settings available to explore the relationship between infant feeding and post-weaning health, and helps shed light on the contribution of changing breastfeeding norms to trends in health in twentieth-century Britain.
关于生命早期母乳喂养对断奶后益处的证据是混杂的，并且高度依赖于具体情况。此外，这些证据几乎完全来自现代背景，限制了我们对过去母乳喂养与后续健康之间关系的理解。我们在历史背景下提供了关于这些断奶后益处的性质和范围的新证据，利用了一个新的、丰富的纵向数据集，该数据集涵盖了伦敦世纪之交的一家孤儿院——济贫院的近 1000 名儿童。我们发现，即使在停止母乳喂养之后，曾经母乳喂养的状态也降低了死亡率并提高了婴儿期的体重与年龄比值，纯母乳喂养还带来了额外的益处，而母乳喂养时间长短的影响不大。我们还发现，体重与年龄的比值随着断奶时间的推移呈 U 形模式，这表明断奶后不久健康状况恶化，然后恢复。然而，与母乳喂养相关的早期断奶后优势并没有持续到儿童中期。这表明，早期母乳喂养的任何保护作用都会随着年龄的增长而减弱，并表明追赶生长的作用很强。这项研究为探索婴儿喂养与断奶后健康之间的关系提供了更多的数据和实证背景，并有助于揭示不断变化的母乳喂养规范对 20 世纪英国健康趋势的贡献。
