0～4月龄不同喂养方式对婴儿体格生长速率及营养状况的影响

目的:探讨0~4月龄不同喂养方式对足月产单胎正常儿0~12月龄体格生长速率及营养状况的影响。方法:选取2007年7月1日~2008年7月31日在该院出生的211名足月产单胎正常儿为研究对象,按喂养方式分为两组,其中母乳喂养组115名、混合喂养组96名。将所有婴儿分为13个月龄组进行体重和身长测量,比较各项体格指标的增长值变化,评价每名婴儿在3、6、9、12月龄的营养状况(Kaup指数法)。结果:不同喂养方式婴儿体重增长值比较,差异无统计学意义(P>0.05),混合喂养组3月龄与12月龄身长增长值较母乳喂养组高,且差异有统计学意义(P<0.05),其他月龄两组婴儿的身长增长值比较,差异均无统计学意义(P>0.05);两种喂养方式婴儿各月龄营养状况比较,差异均无统计学意义(P>0.05)。结论:混合喂养可导致婴儿生长发育偏离健康母乳喂养婴儿,生后坚持母乳喂养对婴儿期达到最佳生长发育状态具有重要作用。     

不同喂养方式对4月龄婴儿体格发育的影响

目的:探讨不同喂养方式对婴儿体格发育的影响。方法:选择健康婴儿304例,根据出生后前4个月喂养方式分为母乳喂养组、混合喂养组和人工喂养组,测量4月龄时的体重、身长和血骨碱性磷酸酶(BALP)。结果:3组婴儿的体重和身长差异无统计学意义(P0.05);3组婴儿佝偻病发生率比较差异有统计学意义(P0.05),母乳喂养组与人工喂养组佝偻病发生率比较差异有统计学意义(P0.01)。结论:不同喂养方式对4月龄婴儿体重、身长影响差异不大;母乳喂养婴儿补充维生素D不合理,佝偻病发生率会增加,倡导母乳喂养的同时需要合理添加维生素D。     

婴儿早期喂养对1岁前疾病与生长发育的影响

目的 了解西安市第一医院所属地段婴幼儿喂养情况,探讨不同喂养方式及疾病对婴幼儿体格发育的影响.方法 将582例婴儿根据出生后前4～6个月的喂养方式分为完全母乳喂养组,部分母乳喂养组和人工喂养组.分别从1个月开始每月测量身长、体重到其1岁时,并记录婴儿1岁内"四病"的患病情况.结果 完全母乳喂养组,部分母乳喂养组和人工喂养组婴儿6月龄时的身长分别为68.41±2.31cm、68.25±2.39cm及68.06±2.41cm,体重分别为8.33±0.99kg、8.18±1.01kg及8.07±0.98kg,方差分析提示不同喂养方式婴儿6月龄时身长、体重的比较有统计学意义(身长F=36.71,体重F=34.54,均P＜0.05),身长及体重超均值率也有统计学意义(身长χ2=11.940,P=0.03;体重χ2=7.105,P=0.029),其中完全母乳喂养与部分母乳喂养儿高于人工喂养儿;1岁时,3种喂养方式婴儿身长分别为76.31±2.33cm、76.28±2.35cm及76.19±2.43cm,体重分别为10.32±1.36kg、10.41±1.38kg及10.43±1.36kg,经比较无统计学意义(身长F=19.31,体重F=18.89,P＞0.05);3种喂养方式的婴儿1岁内"四病"患病率比较有统计学差异(χ2=22.398,P<0.05).结论 母乳喂养是婴儿最理想的喂养方式,可降低"四病"患病率,在无母乳的情况下,配方奶粉不失为最佳的选择.     

不同喂养方式对出院后早产儿早期体格生长的影响分析

目的探讨上海市社区儿保门诊早产低出生体重儿不同喂养方式对其生后1~4个月阶段的体重、身长和头围等体格发育的影响。方法选取2012年1月—2017年1月期间在上海市浦东新区潍坊社区卫生服务中心儿保门诊系统体检的96例早产低出生体重儿(孕周37周且出生体重2 500 g)为研究对象。根据出院后喂养方式不同分为4组。试验组:强化母乳喂养组(20例);对照组:早产儿出院后配方奶(PDF)组(23例)、普通配方奶(TF)组(16例)和纯母乳喂养(BM)组(37例)。利用统计学方法分析比较各喂养组在出生后1月、2月和4月龄时体重、身长及头围增长值的差异。结果试验组在1月、2月和4个月时的体重、身长及头围增长值大于对照组中纯母乳喂养组和普通配方奶组(P0.05)。对照组中,PDF组在1月、2月和4月时的体重、身长及头围增长值大于普通配方奶组和纯母乳喂养组(P0.05),试验组和PDF组之间差异没有统计学意义(P0.05)。结论强化母乳喂养和早产儿奶粉喂养是早产低出生体重儿出生后比较理想的喂养方式,对早产儿早期体格生长有良好的促进作用,帮助其实现追赶性生长,减少宫外发育迟缓的发生。     

喂养方式与体格发育影响分析

目的:为提高母乳喂养率,了解喂养方式与民族、性别差异,探讨不同喂养方式对婴儿体格发育的影响。方法:对544例足月婴儿进行0~4个月时的喂养方式调查和生长监测,分别进行体重、身长、头围的比较。结果:0~4个月婴儿母乳喂养率为69.30%;其中,朝鲜族母乳喂养率为66.96%,汉族为69.93%。0~4个月母乳喂养方式的婴儿体重高于混合喂养及人工喂养,差异有显著性(P<0.05);2月龄母乳喂养与人工喂养组小儿身高有差异(P<0.05)。结论:母乳喂养对婴儿生长发育优于混合喂养及人工喂养。     

农村4月龄内婴儿体格生长的影响因素分析

目的 了解农村4月龄内婴儿体格生长的主要影响因素及母乳喂养对体格生长的作用。方法 应用科技部基础性工作专项课题“中国母乳喂养婴儿生长速率监测及标准值研究”中六省农村地区4月龄内婴儿体格发育纵向随访数据,构建年龄别体重、身长和体质指数的多水平模型。结果 婴儿年龄、性别、出生体重、出生身长、产次、母亲年龄、父母身高、季节、喂养方式以及年龄和喂养方式的交互效应与体格生长有关,差异均有统计学意义(P均<0.05)。结论 与婴儿一般情况、家庭人口学特征、父母生物学特征、母亲围生期因素这些不可变因素相比,选择母乳喂养是促进农村4月龄内婴儿体格生长的有效措施。     

正常足月儿婴儿期生长速率的研究

目的:了解婴儿期体格生长速率变化的规律,制定相应的婴儿期体格生长速率标准值,指导家长准确地评价婴儿生长发育状况。方法:对389名正常足月儿分别在初生、3月龄、6月龄、9月龄、12月龄测量其体重、身长,按性别、喂养方式、出生体重分组并进行分析。结果:婴儿期不同阶段的体重、身长增长速率存在非常显著性差异(P<0.001),头三个月最快,以后呈迅速递减趋势。男婴体重、身长增长速率在出生后头三个月明显快于女婴,此后三个月龄阶段无显著性差异;不同喂养方式婴儿各月龄阶段体重、身长增长速率差异无统计学意义;不同出生体重婴儿各月龄阶段体重、身长增长速率差异无统计学意义。结论:0～3个月婴儿体格增长最快,肥胖检出率迅速上升;喂养方式和出生体重对婴儿期生长速率无明显影响,且4～12个月期间生长速率的性别差异消失。     

喂养方式对8月龄婴儿身长、体重发育的影响

目的探讨喂养方式对婴幼儿身长、体重发育的影响,为提高中关村地区的婴幼儿保健水平提供依据。方法将中关村社区儿保门诊系统管理的724名8月龄婴儿按喂养方式分为纯母乳喂养组和人工喂养组,以χ2检验方法分析两组的婴儿体重、身长增长率的差异;将纯母乳喂养组和人工喂养组的婴儿分别按性别分组,以χ2检验方法分析每组男女婴儿间体重、身长增长率的差异。结果纯母乳喂养组和人工喂养组婴儿体重、身长增长率比较,差异均无统计学意义(P0.05)。人工喂养组男婴身长增长率小于人工喂养组女婴身长增长率,经χ2检验差异有统计学意义(χ2=8.559,P=0.003)。纯母乳喂养组男婴和女婴身长、体重增长率,人工喂养组男婴和女婴体重增长率比较,差异均无统计学意义(P0.05)。结论纯母乳喂养和人工喂养的婴儿身长、体重发育无明显差异,但母乳喂养在提高婴儿免疫力,增加母婴交流等方面是人工喂养无法比拟的,仍应大力提倡和促进母乳喂养。若母亲患有不能喂养的疾病或无母乳时,才可考虑人工喂养。     

2011年北京市顺义区1岁以内婴儿体格发育调查

目的了解北京市顺义区1岁以内婴儿体格发育状况,为制定促进婴儿生长发育的干预措施提供科学依据。方法整群抽样顺义区城区、乡村婴儿341名,进行体格发育、喂养状况、健康状况调查。结果北京市顺义区平均婴儿出生体重为3403 g,出生身长均为49.90 cm;4月龄内完全母乳喂养率为51.35%,6月龄内纯母乳喂养率为49.12%,6月龄内首次添加辅食构成比为99%;婴儿生长迟缓率、低体重率、消瘦率分别为0%、0.29%、2.93%;腹泻、呼吸道感染、贫血患病率分别为6.74%、4.69%、18.39%。结论北京市顺义区1岁内婴幼儿生长发育状况较好。     

中国六城市母乳喂养婴儿0～12月生长发育纵向研究

【目的】 获取我国城市母乳喂养婴儿纵向生长发育监测数据,全面了解我国营养良好人群婴儿生长发育现状和特点,为进行生长发育监测和营养指导提供参考依据。 【方法】 参考世界卫生组织2006年生长发育标准监测方案,在我国六省会城市营养良好人群进行抽样,共1 343名纯母乳喂养婴儿进行0～12月龄生长发育监测,包括体重、身长、头围测量和喂养情况调查,共完成16次随访。 【结果】 六省会城市母乳喂养婴儿生后3月龄体重达出生时2倍,12月龄体重达出生时3倍,12月龄身长为出生时1.5倍;各月龄点男婴体格发育指标均高于女婴,差异有统计学意义。男、女婴儿各月龄体格发育值均高于1987年纵向监测资料,婴儿生长发育潜力得到进一步发展。除生后7 d和14 d外,其他各月龄体格发育值均高于世界卫生组织2006年标准。 【结论】 我国母乳喂养婴儿生长发育水平良好,仍处于生长长期趋势中,生长发育水平已经超过世界卫生组织公布的2006年母乳喂养婴儿生长发育标准。     

不同喂养方式对婴儿早期生长发育影响的研究

目的 探讨纯母乳喂养和纯人工喂养对足月儿及早产儿在6个月体格发育、智力、运动发育、气质类型及气质各维度得分的影响。从而进一步论证母乳喂养对婴幼儿生长发育的重要性,为推进0~6个月纯母乳喂养提供理论依据和支持。方法 本课题选取足月儿97例和早产儿67例。即共分为四组A组为足月母乳喂养组(54例)、B组为足月人工喂养组(43例)、C组为早产母乳喂养组(38例)、D组为早产人工喂养组(29例)。测量A、B、C、D四组在出生、42 d、2、3、6个月时的体重、身长和头围,并计算其净增值。测试6个月时(早产儿纠正月龄6个月时)的智力发育指数、运动发育指数、气质类型及气质各维度得分,进行比较。结果 生长发育方面,母乳喂养的婴儿在出生~42 d、42 d～2个月、2～3个月三个时间段体重净增值大于人工喂养,差异有统计学意义(P<0.05);对于足月儿来说,母乳喂养分别在2～3个月、3～6个月两个时间段和出生～42 d、2～3个月两个时间段,对应的身长和头围净增值较人工喂养多,对于早产儿来说,母乳喂养分别在出生~42 d、42 d～2个月、2～3个月、3～4个月四个时间段和42 d～2个月、2～3个月两个时间段,对应的身长和头围净增值较人工喂养多。母乳喂养的婴儿在生后6个月测量的智力、运动发育指数较人工喂养的高。母乳喂养与人工喂养在小儿气质形成上无差异。结论 纯母乳喂养不论对足月儿还是早产儿6个月时的智力发育指数和运动发育指数均较纯人工喂养高,而体格发育优势主要集中在出生后前3个月,而足月及早产婴儿在6个月时的气质类型与是否母乳喂养无明显的关联。     

Determinants of infant growth in the slums of Dhaka: size and maturity at birth, breastfeeding and morbidity

OBJECTIVE: To investigate the influences of size at birth, breastfeeding and morbidity on growth during infancy in poor areas of urban Bangladesh. DESIGN: This was a prospective observational study of a cohort of newborn infants followed until 12 months of age. SETTING: Slum areas of Dhaka City in Bangladesh. SUBJECTS: A total of 1654 newborn infants were enrolled at birth, and follow-up was completed for 1207 infants. Repeated anthropometric measurements and interviews of caretakers on infant feeding and morbidity were conducted. A mixed effects regression method was used for modeling infant growth. RESULTS: After adjusting for other variables, mean differences in body weight by birth weight and length, small-for-gestational age and prematurity categories remained relatively constant throughout infancy. A positive impact of exclusive breastfeeding in the first 3 5 months on infant growth was detectable at 12 months of age. Although the bigger babies in the sample tended to grow relatively even bigger; exclusive breastfeeding appeared to counteract this pattern. Reported diarrhoea was associated with lower body weights and lengths even after adjusting for feeding patterns. CONCLUSIONS: Size at birth has an important role in determining growth during infancy. Effective strategies for improving birth weight, poorly addressed till now in Bangladesh, are needed. The sustained effect on growth and the even more beneficial effect in lighter infants are compelling reasons for promotion of exclusive breastfeeding in early infancy.     

Breastfeeding and infant size: evidence of reverse causality

Infants who receive prolonged and exclusive breastfeeding grow more slowly during the first year of life than those who do not. However, infant feeding and growth are dynamic processes in which feeding may affect growth, and prior growth and size may also influence subsequent feeding decisions. The authors carried out an observational analysis of 17,046 Belarusian infants who were recruited between June 1996 and December 1997 and who participated in a cluster-randomized trial of a breastfeeding promotion intervention. To assess the effects of infant size on subsequent feeding, the authors restricted the analysis to infants breastfed (or exclusively breastfed) at the beginning of each follow-up interval and examined associations between weight or length at the beginning of the interval and weaning or discontinuation of exclusive breastfeeding by the end of the interval. Smaller size (especially weight for age) was strongly and statistically significantly associated with increased risks of subsequent weaning and of discontinuing exclusive breastfeeding (adjusted odds ratios = 1.2-1.6), especially between 2 and 6 months, even after adjusment for potential confounding factors and clustered measurement. The authors speculate that similar dynamic processes involving infant crying, other signs of hunger, and supplementation/weaning undermine causal inferences about the "effect" of prolonged and exclusive breastfeeding on slower infant growth.     

母乳喂养与神经行为发育的相关研究

【目的】 通过调查儿保门诊婴儿喂养情况,探讨母乳喂养与婴儿神经行为发育相关性。 【方法】 对长沙市妇幼保健院2010年7-12月进行健康体检的274例6~12月龄婴儿进行现况调查,通过问卷调查收集婴儿喂养情况,采用Gesell发育量表对婴儿的神经行为发育进行评估。用ANOVA单因素方差分析及多元逐步回归分析等方法进行统计分析。 【结果】 出生后纯母乳喂养占67.9%,纯母乳喂养6个月以上占13.1%。婴儿发育商比较,女婴发育商高于男婴(P<0.05);纯母乳喂养组高于人工喂养组和部分母乳喂养组,在适应性、大运动能区,差异有统计学意义(P<0.05);多元逐步回归分析显示:纯母乳喂养时间为婴儿发育商的主要影响因素。 【结论】 纯母乳喂养时间的延长有利于婴儿的神经行为发育。     

我国中西部4省(自治区)农村婴幼儿喂养情况及其影响因素研究

目的了解我国中西部地区农村婴幼儿母乳喂养和辅食添加的现状及其影响因素,为今后有针对性地开展干预提供科学依据。方法采用多阶段分层随机抽样方法,对我国中西部4省(自治区)农村地区1272名婴幼儿进行母乳喂养和辅食添加情况调查。应用SPSS 19.0软件进行分析。结果婴幼儿6个月龄内纯母乳喂养率为70.0%,33.0%的婴幼儿在6个月龄内添加了强化铁米粉。多因素分析,接受过母乳喂养宣传(OR=2.191,95%CI:1.695～2.833)、民族(OR=1.173,95%CI:1.080～1.275)和出生低体重(OR=0.579,95%CI:0.376～0.892)与6个月龄内是否纯母乳喂养有关联;民族(OR=1.141,95%CI:1.047～1.242)和婴幼儿贫血(OR=1.406,95%CI:1.054～1.877)与添加强化铁米粉有关联。结论我国中西部农村地区纯母乳喂养率有待提高,辅食添加不合理,应通过电视、广播、热线电话等方式宣传通俗易懂的科学喂养知识,提高母乳喂养率,促进合理喂养。     

Breastfeeding in HIV Exposed Infants Significantly Improves Child Health: A Prospective Study

Breastfeeding has been shown to benefit both maternal and child immune status. The impact of exclusive breastfeeding in the presence of HIV infection on maternal and child health is still unclear. Socio-economic factors make breast-feeding an important source of nutrition for an infant 6 months and under in the developing world. A prospective study was conducted to examine the impact of feeding mode on various maternal indices including anthropometry; body composition indicators (using FTIR); haematology and biochemical markers; as well as incidence rates of opportunistic infections and clinical disease progression. In infants we examined the impact on growth, development and morbidity. AFASS criteria (affordable, feasible, accessible, sustainable and safe) were fulfilled by 38.7% of the formula feeding mothers. No significant differences between the formula feeding and breastfeeding groups in terms of haematological, immunological and body composition changes were seen. Breastfeeding mothers had significantly lower events with high depression scores (P = 0.043). Breastfeeding infants had a significantly lower risk of diarrhoea and hospitalisation at 3 months (P = 0.006 and 0.014 respectively). Breastfeeding was significantly associated with better development scores and growth parameters. Breastfeeding is not harmful to the mother in the presence of HIV infection. Mothers are still choosing formula feeding inappropriately despite counselling about the AFASS criteria. Breastfeeding is beneficial to the infants especially in the first 3 months of life.     

Position of the American Dietetic Association: Promoting and Supporting Breastfeeding

It is the position of the American Dietetic Association that exclusive breastfeeding provides optimal nutrition and health protection for the first 6 months of life and breastfeeding with complementary foods from 6 months until at least 12 months of age is the ideal feeding pattern for infants. Breastfeeding is an important public health strategy for improving infant and child morbidity and mortality, improving maternal morbidity, and helping to control health care costs. Breastfeeding is associated with a reduced risk of otitis media, gastroenteritis, respiratory illness, sudden infant death syndrome, necrotizing enterocolitis, obesity, and hypertension. Breastfeeding is also associated with improved maternal outcomes, including a reduced risk of breast and ovarian cancer, type 2 diabetes, and postpartum depression. These reductions in acute and chronic illness help to decrease health care-related expenses and productive time lost from work. Overall breastfeeding rates are increasing, yet disparities persist based on socioeconomic status, maternal age, country of origin, and geographic location. Factors such as hospital practices, knowledge, beliefs, and attitudes of mothers and their families, and access to breastfeeding support can influence initiation, duration, and exclusivity of breastfeeding. As experts in food and nutrition throughout the life cycle, it is the responsibility of registered dietitians and dietetic technicians, registered, to promote and support breastfeeding for its short-term and long-term health benefits for both mothers and infants.     

Effectiveness of a Breastfeeding Self-efficacy Intervention: Do Hospital Practices Make a Difference?

Breastfeeding self-efficacy interventions are important for improving breastfeeding outcomes. However, the circumstances that may influence the effectiveness of the interventions are unclear, especially in the context of hospitals with suboptimal infant feeding practices. Thus, we aimed to evaluate the effect of a self-efficacy intervention on breastfeeding self-efficacy and exclusive breastfeeding, and further assessed the difference in its effect by hospital-routine type. In this intervention study with a control group, 781 pregnant women were recruited from 2 “Baby-Friendly”-certified hospitals (BFH) and 2 non-Baby-Friendly Hospitals (nBFH) in Japan, and were allocated to an intervention or control group. Participants in the intervention group were provided with a breastfeeding self-efficacy workbook in their third trimester. The primary outcome was breastfeeding self-efficacy and the secondary outcome was infant feeding status. All analyses were stratified by the type of hospital, BFH or nBFH. In BFHs, the intervention improved both breastfeeding self-efficacy through 4 weeks postpartum (p = 0.037) and the exclusive breastfeeding rate at 4 weeks postpartum (AOR 2.32, 95 % CI 1.01–5.33). In nBFHs, however, no positive effect was observed on breastfeeding self-efficacy (p =? 0.982) or on the exclusive breastfeeding rate at 4 weeks postpartum (AOR 0.97, 95 % CI 0.52–1.81); in nBFHs, supplementation was provided for breastfed infants and the mother and infant were separated in the vast majority of cases. Infant feeding status at 12 weeks was not improved in either hospital type. The intervention improved breastfeeding self-efficacy and exclusive breastfeeding at 4 weeks postpartum only in BFHs. When breastfeeding self-efficacy interventions are implemented, hospital infant feeding practices may need to be optimized beforehand.     

The Australian Feeding Infants and Toddler Study (OzFITS 2021): Breastfeeding and Early Feeding Practices

The Australian Feeding Infants and Toddler Study 2021 (OzFITS 2021) is a nationwide survey of Australian caregivers’ infant and toddler feeding practices. Here, we describe breastfeeding rates and duration, use of breastmilk substitutes, and introduction of complementary (solid) foods, including common food allergens. Caregivers (n = 1140) were recruited by a digital marketing company and were interviewed using a structured telephone questionnaire to obtain information. Breastfeeding was initiated in 98% of infants, but the duration of exclusive breastfeeding to six months was less than 1%. Nearly 40% of children continued to receive breastmilk beyond one year, with 10% of toddlers receiving breastmilk at two years. One-quarter of infants were introduced to solid foods between 4 to 5 months, and nearly all infants had received solid foods by 7 months. New guidelines encourage the early introduction of potential food allergens to reduce the risk of allergy, and by 12 months, over 90% of children had been given eggs and peanuts. One-third of children received no breastmilk substitutes during their first year. One-third of infants first received breastmilk substitutes following birth and before discharge from the hospital. Of these infants, 30% ceased breastmilk substitute use after discharge. Our findings suggest a high rate of continued breastfeeding with 44% receiving breastmilk beyond 1 year. One approach to increase the duration of exclusive breastfeeding is to reduce breastmilk substitute use while in hospital.