Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea.
Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
J Korean Med Sci. 2023 Apr 17;38(15):e116. doi: 10.3346/jkms.2023.38.e116.
Although the optimal duration of breastfeeding remains unclear, breastfeeding is generally recommended exclusively for the first 6 months of life, which continues into late infancy. However, the awareness regarding the effects of long-term breastfeeding is relatively low compared with that of breastfeeding in early infancy. We aimed to investigate the growth and nutritional characteristics of the children with prolonged breastfeeding (PBF) over 1 year.
This cross-sectional study was based on the data of children aged 12 to 23 months from the National Health and Nutrition Examination Survey (2010-2020) conducted by the Korean Center for Disease Control and Prevention. Data on anthropometric measurements, dietary behavior, and food and nutrient intake were extracted, and the association between PBF and growth, nutritional status, and dietary patterns were analyzed.
Of the 872 children with a birth weight of ≥ 2.5 kg in the final analysis, 34.2% continued breastfeeding over 12 months of age, and their median breastfeeding duration was 14.2 months. Children with PBF were more likely to have lower current body weight ( < 0.001) and weight gain ( < 0.001), lower daily protein ( = 0.012), calcium ( < 0.001), and iron ( < 0.001) intake per calorie compared with children weaned by 12 months of age or those who were never breastfed. Furthermore, they were started on complementary food at 6 months or later rather than 4-5 months ( < 0.001), consumed cow's milk earlier ( = 0.012), and consumed probiotics as dietary supplements ( < 0.001) significantly less commonly. When comparing the intake of food groups, children with PBF had a significantly higher intake of cereals and grains ( = 0.023) and fruits ( = 0.020) and a significantly lower intake of bean products ( = 0.020) and milk and dairy products ( = 0.003).
Korean children who continued breastfeeding over 12 months of age showed distinct characteristics in terms of growth, nutritional status, and dietary patterns in the second year of life compared to children who did not. Long-term additional research on their growth and nutritional status may be needed; however, these findings are significant as important fundamental data for nutritional counseling to establish healthy PBF.
尽管母乳喂养的最佳持续时间仍不清楚，但通常建议纯母乳喂养应持续到婴儿出生后 6 个月，之后再进入婴儿期晚期。然而，与婴儿早期母乳喂养相比，人们对长期母乳喂养的影响的认识相对较低。我们旨在研究延长母乳喂养（PBF）超过 1 年对儿童生长和营养特征的影响。
这是一项基于韩国疾病控制和预防中心（2010-2020 年）进行的全国健康和营养检查调查（NHANES）中 12 至 23 个月儿童数据的横断面研究。提取了人体测量学测量、饮食行为以及食物和营养素摄入量的数据，并分析了 PBF 与生长、营养状况和饮食模式之间的关系。
在最终分析的 872 名出生体重≥2.5kg 的儿童中，34.2%的儿童在 12 个月龄后继续母乳喂养，其母乳喂养中位数为 14.2 个月。与 12 个月龄断奶或从未母乳喂养的儿童相比，PBF 儿童的当前体重（<0.001）和体重增加（<0.001）较低，每日蛋白质（=0.012）、钙（<0.001）和铁（<0.001）摄入量也较低。此外，他们在 6 个月或更晚时才开始添加补充食品，而不是在 4-5 个月时（<0.001），更早地开始饮用牛奶（=0.012），且更不常食用益生菌作为膳食补充剂（<0.001）。在比较食物组的摄入量时，PBF 儿童的谷物和谷物（=0.023）以及水果（=0.020）摄入量较高，而豆制品（=0.020）和牛奶及奶制品（=0.003）的摄入量较低。
与未进行母乳喂养的儿童相比，12 个月龄后继续母乳喂养的韩国儿童在第二年的生长、营养状况和饮食模式方面具有明显的特征。可能需要对他们的生长和营养状况进行长期的额外研究，但这些发现很重要，因为它们为建立健康的 PBF 提供了营养咨询的重要基础数据。
