Minami Yuko, Miyashita Minoru, Ishida Takanori, Fujita Megumi, Hamada Hirotaka, Saito Masatoshi, Arima Takahiro, Yaegashi Nobuo
Department of Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Center for Preventive Medicine, Osaki Citizen Hospital, 2-3-15 Senjuji-machi, Furukawa, Osaki, Miyagi 989-6174, Japan.
Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
Prev Med. 2023 Mar;168:107446. doi: 10.1016/j.ypmed.2023.107446. Epub 2023 Feb 10.
Breastfeeding has many benefits for infant growth and maternal health, such as reducing breast cancer risk. However, data on maternal factors influencing breastfeeding are insufficient. To clarify the associations between maternal lifestyle and diet during pregnancy and exclusive breastfeeding (EBF), we conducted a prospective study of pregnant women within the framework of the Japan Environment and Children's Study (a nationwide birth cohort study). Of 97,413 pregnant women recruited between January 2011 and March 2014, 27,775 with a singleton first live birth whose dietary data during pregnancy and lactation data were complete were eligible. Using logistic regression, we evaluated the associations between lifestyle factors including smoking and prepregnancy body mass index and intake of nutrients (macronutrients, isoflavones, and dietary fiber), some of which are known risk factors of breast cancer, and EBF for one month postpartum (initiation of EBF). To investigate the associations of these factors with EBF for 6 months (continuation of EBF), 9582 women who had successfully completed one-month EBF were further followed up. Smoking and prepregnancy obesity were inversely associated with the initiation and continuation of EBF. Intakes of protein, fat, isoflavone, and dietary fiber were positively associated (p = 0.0001 for dietary fiber), and carbohydrate intake was inversely associated with the initiation of EBF. Dietary fiber intake was also associated with the continuation of EBF (p = 0.048). These findings indicate that maternal lifestyles during pregnancy affect lactation performance. Lifestyle adjustments during pregnancy may have favorable effects on maternal and children's health through successful breastfeeding.
母乳喂养对婴儿生长和母亲健康有诸多益处，比如降低患乳腺癌风险。然而，关于影响母乳喂养的母亲因素的数据并不充分。为了阐明孕期母亲生活方式和饮食与纯母乳喂养（EBF）之间的关联，我们在日本环境与儿童研究（一项全国性出生队列研究）的框架内对孕妇进行了一项前瞻性研究。在2011年1月至2014年3月招募的97413名孕妇中，27775名单胎首次活产且孕期饮食数据和哺乳期数据完整的孕妇符合条件。我们使用逻辑回归评估了包括吸烟和孕前体重指数等生活方式因素以及营养素（宏量营养素、异黄酮和膳食纤维）的摄入量与产后一个月纯母乳喂养（纯母乳喂养的开始）之间的关联，其中一些营养素是已知的乳腺癌风险因素。为了研究这些因素与纯母乳喂养6个月（纯母乳喂养的持续）之间的关联，对9582名成功完成一个月纯母乳喂养的女性进行了进一步随访。吸烟和孕前肥胖与纯母乳喂养的开始和持续呈负相关。蛋白质、脂肪、异黄酮和膳食纤维的摄入量呈正相关（膳食纤维的p值 = 0.0001），碳水化合物摄入量与纯母乳喂养的开始呈负相关。膳食纤维摄入量也与纯母乳喂养的持续有关（p值 = 0.048）。这些发现表明孕期母亲的生活方式会影响泌乳表现。孕期进行生活方式调整可能通过成功母乳喂养对母亲和儿童的健康产生有利影响。
