Habicht J P, DaVanzo J, Butz W P
Am J Epidemiol. 1986 Feb;123(2):279-90. doi: 10.1093/oxfordjournals.aje.a114236.
Analysis of mothers' recall data collected in 1976-1977 by a probability survey in Peninsular Malaysia shows an association between breastfeeding up to six months of age and improved survival of infants throughout the first year of life. Inappropriate sample selection and inadequate control of confounding can introduce large biases in these analyses. The magnitude and direction of these biases are presented. Even when these biases are dealt with, unsupplemented breastfeeding appears more beneficial than supplemented breastfeeding. The younger the infant and the longer the breastfeeding, the greater the estimated benefits in terms of deaths averted. The use of powdered infant formula did not appear to offset the detrimental effects of early weaning and supplementation. The positive relationships found in these analyses between breastfeeding and survival are not due to death precluding or terminating breastfeeding. Nor are they likely to be due to a shift away from breastfeeding because of recent illness, which was also controlled in the analyses. Nor are they likely to be due to other factors that both increase mortality risk and shorten breastfeeding; when such factors are taken into account, the beneficial effects of breastfeeding become stronger and imply that, if there had been no breastfeeding in this sample, twice as many babies would have died after the first week of life.
对1976 - 1977年在马来西亚半岛进行的概率调查所收集的母亲回忆数据的分析表明，6个月龄前的母乳喂养与婴儿在生命第一年的存活率提高之间存在关联。不恰当的样本选择和对混杂因素控制不足会在这些分析中引入很大偏差。文中呈现了这些偏差的大小和方向。即便处理了这些偏差，纯母乳喂养似乎比添加辅食的母乳喂养更有益。婴儿越小且母乳喂养时间越长，在避免死亡方面估计的益处就越大。使用婴儿配方奶粉似乎并未抵消早期断奶和添加辅食的有害影响。这些分析中发现的母乳喂养与存活率之间的正相关关系并非由于死亡导致母乳喂养停止或中断。它们也不太可能是由于近期患病而导致从母乳喂养转变，这一点在分析中也已得到控制。它们也不太可能是由于其他既增加死亡风险又缩短母乳喂养时间的因素；当考虑到这些因素时，母乳喂养的有益效果会更强，这意味着，如果这个样本中没有母乳喂养，那么在出生第一周后死亡的婴儿数量将会是原来的两倍。
