Marquis G S, Habicht J P, Lanata C F, Black R E, Rasmussen K M
Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
Am J Clin Nutr. 1997 Nov;66(5):1102-9. doi: 10.1093/ajcn/66.5.1102.
Although breast-feeding is widely accepted as important for infant health, its benefits during the second year of life have been questioned. We analyzed data from 107 breast-fed and weaned Peruvian children living in a periurban community to determine whether breast milk contributed to improved linear growth between 12 and 15 mo of age. Breast-feeding frequency was self-reported; intakes of complementary foods and animal products were estimated from a food-frequency survey. Multivariate-linear-regression analysis was used to predict the length of the children at 15 mo of age. Determinants of length included length and weight-for-length at 12 mo of age (US National Center for Health Statistics standards), interval between 12- and 15-mo measurements, breast-feeding frequency, incidence of diarrhea, and intakes of complementary and animal-product foods. Complementary foods, animal-product foods, and breast milk all promoted toddlers' linear growth. In subjects with low intakes of animal-product foods, breast-feeding was positively associated (P < 0.05) with linear growth. There was a 0.5-cm/3 mo difference in linear growth between weaned toddlers and children who consumed the average number of feedings of breast milk. Linear growth was also positively associated with intake of animal-product foods in children with low intakes of complementary foods. The negative association between diarrhea and linear growth did not occur in subjects with high complementary-food intakes. When the family's diet is low in quality, breast milk is an especially important source of energy, protein, and accompanying micronutrients in young children. Thus, continued breast-feeding after 1 y of age, in conjunction with feeding of complementary foods, should be encouraged in toddlers living in poor circumstances.
尽管母乳喂养对婴儿健康的重要性已被广泛认可,但其在生命第二年的益处却受到了质疑。我们分析了来自生活在城郊社区的107名秘鲁母乳喂养和已断奶儿童的数据,以确定母乳是否有助于改善12至15月龄儿童的线性生长。母乳喂养频率由家长自我报告;通过食物频率调查估算辅食和动物产品的摄入量。采用多元线性回归分析预测儿童15月龄时的身长。身长的决定因素包括12月龄时的身长和身长别体重(美国国家卫生统计中心标准)、12至15月龄测量期间隔、母乳喂养频率、腹泻发生率以及辅食和动物产品食物的摄入量。辅食、动物产品食物和母乳均促进幼儿的线性生长。在动物产品食物摄入量低的儿童中,母乳喂养与线性生长呈正相关(P<0.05)。断奶幼儿与平均母乳喂养次数的儿童之间的线性生长差异为0.5厘米/3个月。在辅食摄入量低的儿童中,线性生长也与动物产品食物的摄入量呈正相关。腹泻与线性生长之间的负相关在辅食摄入量高的儿童中未出现。当家庭饮食质量较低时,母乳是幼儿能量、蛋白质及相关微量营养素的重要来源。因此,对于生活条件较差的幼儿,应鼓励在1岁后继续母乳喂养并添加辅食。