母乳喂养持续时间对腺样体肥大、打鼾及急性中耳炎的影响：一项学龄前儿童病例对照研究
Impact of Breastfeeding Duration on Adenoid Hypertrophy, Snoring and Acute Otitis Media: A Case-Control Study in Preschool Children.
作者信息
Zwierz Aleksander, Domagalski Krzysztof, Masna Krystyna, Walentowicz Paweł, Burduk Paweł
机构信息
Department of Otolaryngology, Phoniatrics and Audiology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 75 Ujejskiego Street, 85-168 Bydgoszcz, Poland.
Department of Immunology, Faculty of Biological and Veterinary Sciences, Nicolaus Copenicus University, 87-100 Toruń, Poland.
出版信息
J Clin Med. 2023 Dec 14;12(24):7683. doi: 10.3390/jcm12247683.
BACKGROUND
The aim of this study was to analyze the relationship between breastfeeding duration and adenoid size, snoring and acute otitis media (AOM).
METHODS
We analyzed the medical history of children admitted to the ENT outpatient clinic in 2022 and 2023, reported symptoms, ear, nose and throat (ENT) examination, and flexible nasopharyngoscopy examination of 145 children aged 3-5 years.
RESULTS
Breastfeeding duration of 3 and 6 months or more had a significant effect on the reduction of snoring ( = 0.021; = 0.039). However, it had no effect on the adenoid size, mucus coverage and sleeping with an open mouth. Snoring was correlated with open mouth sleeping ( < 0.001), adenoid size with a 75% A/C ratio or more ( < 0.001), and adenoid mucus coverage in the Mucus of Adenoid Scale by Nasopharyngoscopy Assessment-MASNA scale ( = 0.009). Children who were breastfed for less than 3 months had more than a four-fold greater risk of snoring. There was a statistically significant correlation between AOM and gender ( = 0.033), breastfeeding duration in groups fed 1, 3 or 6 months or more ( = 0.018; = 0.004; = 0.004) and those fed with mother's breast milk 3 or 6 months or more ( = 0.009; = 0.010). Moreover, a correlation was found between adenoid size and mucus coverage, tympanogram, and open-mouth sleeping ( < 0.001). Independent factors of snoring in 3- to 5-year-old children were breastfeeding duration of less than 3 months ( = 0.032), adenoid size with an A/C ratio of 75% or more ( = 0.023) and open mouth sleeping ( = 0.001).
CONCLUSIONS
Children breastfed for 3 and 6 months or more exhibited reduced rates of snoring. There was no effect of breastfeeding duration on adenoid size in children aged 3 to 5 years, suggesting that the link between breastfeeding duration and snoring is primarily associated with craniofacial development and muscle tone stimulation. A breastfeeding duration of 1 month or more plays a key role in reducing the rate of AOM. The mother's milk plays a protective role against AOM. The presence of mucus might be responsible for snoring in preschool children. A medical history of breastfeeding should be taken into consideration when snoring children are suspected of adenoid hypertrophy.
背景
本研究旨在分析母乳喂养持续时间与腺样体大小、打鼾及急性中耳炎（AOM）之间的关系。
方法
我们分析了2022年和2023年耳鼻喉科门诊收治的儿童的病史、报告的症状、耳鼻喉（ENT）检查以及145名3至5岁儿童的纤维鼻咽喉镜检查结果。
结果
母乳喂养3个月及6个月或更长时间对减少打鼾有显著影响（P = 0.021；P = 0.039）。然而，它对腺样体大小、黏液覆盖情况及张口睡眠没有影响。打鼾与张口睡眠相关（P < 0.001），腺样体大小与A/C比值达到75%或更高相关（P < 0.001），并且通过鼻咽喉镜评估-腺样体黏液量表（MASNA量表）评估的腺样体黏液覆盖情况相关（P = 0.009）。母乳喂养少于3个月的儿童打鼾风险高出四倍多。AOM与性别（P = 0.033）、母乳喂养1个月、3个月或6个月及更长时间的组（P = 0.018；P = 0.004；P = 0.004）以及母乳喂养3个月或6个月及更长时间的组（P = 0.009；P = 0.010）之间存在统计学显著相关性。此外，发现腺样体大小与黏液覆盖情况、鼓室图及张口睡眠之间存在相关性（P < 0.001）。3至5岁儿童打鼾的独立因素为母乳喂养少于3个月（P = 0.032）以及A/C比值达到75%或更高的腺样体大小（P = 0.023）和张口睡眠（P = 0.001）。
结论
母乳喂养3个月及6个月或更长时间的儿童打鼾率降低。母乳喂养持续时间对3至5岁儿童的腺样体大小没有影响，这表明母乳喂养持续时间与打鼾之间的联系主要与颅面发育和肌张力刺激有关。母乳喂养1个月或更长时间在降低AOM发生率方面起关键作用。母乳对预防AOM有保护作用。黏液的存在可能是学龄前儿童打鼾的原因。当怀疑打鼾儿童患有腺样体肥大时，应考虑母乳喂养史。
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