Cousens S, Nacro B, Curtis V, Kanki B, Tall F, Traore E, Diallo I, Mertens T
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, England.
Bull World Health Organ. 1993;71(6):713-22.
Reported are our findings from a case-control study of the association between prolonged breast-feeding and clinical malnutrition in an urban setting in West Africa. The cases were children aged 12-36 months who had been hospitalized with a diagnosis of clinical malnutrition. Children of a similar age who lived in neighbouring courtyards were recruited as controls. For 152 case-control pairs in which both children were receiving solid foods, non-breast-feeding was associated with an increased risk of clinical malnutrition (crude odds ratio = 2.37; 95% confidence interval = 1.24, 4.55). This association remained statistically significant after controlling for various potentially confounding variables (P = 0.03). Our findings suggest that either prolonged breast-feeding may offer substantial protection against clinical malnutrition in the study population or malnutrition leads mothers to stop breast-feeding. These results are inconsistent with those of a number of workers who have reported that prolonged breast-feeding is associated with an increased risk of malnutrition. This inconsistency might have arisen because of differences in the definition of malnutrition used or because of variations in the quantity and quality of weaning foods available in different settings. We found no evidence to support the hypothesis that prolonged breast-feeding may be detrimental to children.
本文报告了我们在西非一个城市环境中进行的一项病例对照研究的结果,该研究旨在探讨延长母乳喂养与临床营养不良之间的关联。病例为年龄在12至36个月之间、因临床营养不良诊断而住院的儿童。居住在相邻庭院的同龄儿童被招募为对照。在152对病例对照中,两个孩子都在接受固体食物,非母乳喂养与临床营养不良风险增加相关(粗比值比 = 2.37;95%置信区间 = 1.24, 4.55)。在控制了各种潜在的混杂变量后,这种关联在统计学上仍然显著(P = 0.03)。我们的研究结果表明,要么延长母乳喂养可能为研究人群提供对临床营养不良的实质性保护,要么营养不良导致母亲停止母乳喂养。这些结果与一些研究人员的报告不一致,他们报告称延长母乳喂养与营养不良风险增加有关。这种不一致可能是由于所使用的营养不良定义不同,或者是由于不同环境中可获得的断奶食品的数量和质量存在差异。我们没有发现证据支持延长母乳喂养可能对儿童有害的假设。