Mølbak K, Gottschau A, Aaby P, Højlyng N, Ingholt L, da Silva A P
Epidemiology Research Unit, Danish Epidemiology Science Centre, Statens Seruminstitut, Copenhagen.
BMJ. 1994 May 28;308(6941):1403-6. doi: 10.1136/bmj.308.6941.1403.
To analyse the impact of breast feeding on diarrhoeal disease and survival in children above 1 year of age in Guinea-Bissau, west Africa.
A community study of an open cohort followed up weekly by interviews over 15 months. Data on feeding practices, anthropometry, and survival were recorded for three years.
301 randomly selected houses in a semiurban area in the capital, Bissau.
849 children aged less than 3 years.
Incidence and duration of diarrhoea, weight for age, and death of a child.
The incidence of diarrhoea was higher in weaned children than in partially breast fed children, both in 1 year olds (relative risk 1.41; 95% confidence interval 1.23 to 1.62) and in 2 year olds (1.67; 1.29 to 2.15). The mean duration of an episode of diarrhoea was 5.3 days in breast fed children compared with 6.3 days in weaned children (P = 0.001). Independent of the age of weaning, a similar increase was found in an analysis comparing, for each child, the rate and duration of diarrhoea one month before and one month after weaning. Children with low weight for age were breast fed longer than the better nourished children (P = 0.02). Children aged 12-35 months who were not breast fed had a 3.5 times higher mortality (1.4 to 8.3) than breast fed children.
The beneficial effects of breast feeding are not restricted to infancy. Though children who are partially breast fed after infancy may have a lower state of nutrition than the weaned ones, the benefit in terms of lower morbidity may be more important for child survival in places with a high morbidity from diarrhoea and with high mortality.
分析母乳喂养对西非几内亚比绍1岁以上儿童腹泻病及生存情况的影响。
一项对开放队列进行的社区研究，通过为期15个月的每周访谈进行随访。记录三年的喂养方式、人体测量学和生存数据。
首都比绍一个半城市地区随机选取的301所房屋。
849名3岁以下儿童。
腹泻的发病率和持续时间、年龄别体重以及儿童死亡情况。
在1岁儿童（相对危险度1.41；95%置信区间1.23至1.62）和2岁儿童（1.67；1.29至2.15）中，断奶儿童的腹泻发病率均高于部分母乳喂养儿童。母乳喂养儿童腹泻发作的平均持续时间为5.3天，而断奶儿童为6.3天（P = 0.001）。在一项分析中，比较每个儿童断奶前一个月和断奶后一个月的腹泻发生率和持续时间，发现无论断奶年龄如何，都有类似的增加。年龄别体重低的儿童母乳喂养时间比营养状况较好的儿童更长（P = 0.02）。12至35个月未母乳喂养的儿童死亡率比母乳喂养儿童高3.5倍（1.4至8.3）。
母乳喂养的有益作用并不局限于婴儿期。尽管婴儿期后部分母乳喂养的儿童营养状况可能低于断奶儿童，但在腹泻发病率高和死亡率高的地区，较低发病率对儿童生存的益处可能更为重要。
