Breast feeding and cognitive development in childhood: a prospective birth cohort study

The aim of this study was to examine prospectively the relation between duration of breast feeding and cognitive outcomes. A cohort study of 2860 children enrolled before birth provided data from 2393 term infants of English-speaking mothers. Of these, complete infant feeding data in the first year of life and verbal cognitive IQ (Peabody Picture Vocabulary Test - PPVT-R) were available for 1450 children at 6 years, and a performance subtest (Perceptual organisation WISC - Block Design) for 1375 children at 8 years. Full breast feeding was categorised as none,> 0 to < 4 months, 4-6 months and> 6 months. Associations between breast-feeding duration and PPVT-R at 6 years and Block Design at 8 years were estimated before and after adjustment for gender, gestational age, maternal age, maternal education, parental smoking and the presence of older siblings. The early cessation of full breast feeding was associated with reduced verbal IQ and the performance subtest. In unadjusted analysis, mean standardised PPVT-R scores were 6.44 points greater (P < 0.0001) in children fully breast fed for> 6 months compared with those never breast fed. After adjustment, mean PPVT-R scores were 3.56 points higher in children fully breast fed for> 6 months compared with those children never breast fed (P = 0.003). Similarly, Block Design scores were higher in those fully breast fed for> 6 months compared with those never breast fed in unadjusted (P = 0.001) but not adjusted analyses (P = 0.223). Interactions between maternal education (four levels) and breast feeding demonstrated a positive association of maternal education on verbal IQ (F = 2.64; P = 0.005) in children breast fed for longer but not on performance (F = 0.74; P = 0.67). The early introduction of milk other than breast milk was associated with reduced verbal IQ after adjustment for social and perinatal confounders. Although these effects were interacting with maternal education, they may act through undefined mechanisms in human milk.     

Breast feeding and weaning practices of urban housewives in Srinagar

Researchers interviewed 125 mothers in Srinagar, India about breast feeding and weaning practices. Overall the mothers were generally illiterate (52%), housewives (67.2%), Muslim (76%), and from a nuclear family (56%). 39% were in the low income group. Most of the children (48%) ranged for 6-12 months old. 96% of the children had been breast fed. Some of the reasons for breast feeding included nutritional quality, economical, pleased the mother, and made the infant feel secure. 65.8% breast fed their infants on demand. 65.7% weaned their infants between 7-9 months yet 52% believed breast feeding should continue to 18 months. 96% breast fed their infants while ill with diarrhea. 57% believed colostrum to be unhygienic and did not feed it to their infants. 72% decided to breast feed before becoming pregnant while 36% decided to bottle feed before pregnancy. 89% of illiterate mothers breast fed while only 45% of literate mothers did. Further, only 11.8% of the mothers whose family income was 1500 rupees/month breast fed whereas 47% in the lower and 41.2% in the middle income groups did. At 7-9 months, 69.8% of illiterate and 69.5% of literate mothers had already introduced semi solid foods. 78.3% of literate mothers gave semi solid foods to their infants 2 times/day, but only 11.6% of the illiterate mothers did so. Moreover 81.4% of illiterate mothers only fed their infants semi solid foods once a day. Literate mothers were more likely than literate mothers to feed their infants solid foods (75% vs. 46.2%), introduce them at an earlier age (22.2% vs 10%, 7-9 months), and feed them more often (55.5% vs 16.6%; twice a day). In conclusion, the higher the educational status the more likely mothers were likely to breast feed.     

不同喂养方式对早产儿生长发育的影响

目的:探讨早产儿住院期间开奶时间及出院后喂养方式对其生长发育的影响。方法:选择张掖市人民医院102例早产儿,其中7天内禁食者45例,生后72 h经母乳喂养或早期微量喂养者67例,出院后纯母乳喂养者64例,早产配方奶喂养3月者13例,生后即足月配方奶喂养25例。所有早产儿出院后3月、1岁、3岁分别测量体重、身高、头围3项生长指标,按7日内开始喂养、7日后开始喂养和母乳喂养、早产配方奶喂养、足月配方奶喂养分类进行统计分析,观察不同开始喂养时间和不同喂养方式对早产儿体格发育的影响。结果:住院期间7日内开始喂养的早产儿出院后3月时的体重、身高和头围明显高于住院期间7日后开始喂养的早产儿(P<0.05);出院后采用早产儿配方奶、母乳喂养和足月配方奶喂养的早产儿,其3月及1岁时的体重、身高和头围依次降低,3组差异有统计学意义(P<0.01),q检验进一步显示,早产儿配方奶、母乳喂养和足月配方奶喂养者体重、身高、头围比较有统计学差异(P<0.01),3组3岁时体格生长指标比较无统计学差异(P>0.05)。结论:对住院的早产儿,开始喂养时间早,可以促进3月内的婴儿的体格生长,出院后的用早产儿配方奶能促进1岁内的体格生长,优于母乳喂养,而母乳喂养优于足月配方奶喂养,出院后首选早产儿配方奶或母乳喂养。     

Milk feeding and dietary patterns predict weight and fat gains in infancy

Current guidelines recommend that infants are exclusively breast fed for the first 6 months of life, with particular solid foods being gradually introduced from 6 months. Our objective was to compare the growth of infants whose feeding most closely followed current guidelines with the growth of infants with other feeding practices. Participants were 1740 infants in a prospective cohort study in Southampton, UK. At 6 and 12 months, infants’ milk feeding was recorded, diets assessed using food frequency questionnaires (FFQ), and anthropometry performed. Principal components analysis was used to identify patterns of foods in the diet using the food intakes assessed by the FFQs. Two patterns (‘infant guidelines’ and ‘adult foods’) explained most variance in infant diet at 6 and 12 months of age. The main outcomes were conditional growth in weight, length and skinfold thickness from 0–6 and 6–12 months. Infants who were breast fed from 0–6 months gained weight, length and adiposity more slowly than formula‐fed infants, independent of age at introduction of solids and maternal factors: compared with infants who were breast fed from 0–6 months, formula‐fed infants gained 0.21 standard deviation scores (SDS) in weight [95% confidence interval (CI) 0.00, 0.42]. Infants whose dietary pattern was most similar to current feeding guidelines, with high frequencies of fresh fruit and vegetables, home‐prepared foods and breast milk, gained weight and skinfold thickness more rapidly from 6 to 12 months than other infants, independent of milk feeding, age at introduction of solids and maternal factors. Compared with infants in the lowest quarter, infants in the highest ‘infant guidelines’ score quarter gained 0.24 SDS [95% CI 0.06, 0.43] in weight and 0.26 SDS [95% CI 0.07, 0.45] in skinfold thickness. Conversely, infants whose diets had the highest frequencies of breads and processed foods gained weight less rapidly from 6 to 12 months than other infants. The extent to which the patterns of diet and growth we have described will influence the current or later health of infants is unknown. We are following up the infants in this study to assess the impact of these patterns beyond the first year of life. These associations should also be examined in other settings and populations.     

丽水市0~6月婴儿母乳喂养现状分析

目的 了解丽水市区6月龄以下婴儿喂养情况及相关因素,为提高母乳喂养率提供参考。方法 自制调查问卷,对儿保科门诊6个月以下婴儿进行调查,就婴儿喂养、母亲情况及影响母乳喂养的相关因素进行分析。结果 调查675名婴儿,纯母乳喂养率为40.89%,部分母乳喂养率为39.11%,配方奶喂养占20.00%;不同月龄婴儿的喂养方式存在不同;单因素分析显示喂养方式与母亲文化程度、家庭月收入、母亲有无产科并发症、分娩方式、新生儿是否入住新生儿监护室、是否早开奶、母亲是否接受健康教育、出生胎龄等因素有关(P均<0.05);经Logistic回归分析显示,家庭月收入、分娩方式、新生儿是否入住新生儿监护室、是否早开奶、母亲是否接受健康教育5个因素有关。配方奶喂养比母乳喂养肥胖发生率更高。结论 加强健康教育、早开奶、降低剖宫产率、良好的环境及家庭氛围、在新生儿因疾病住院期间保持泌乳是提高母乳喂养率的有效措施。     

The Bedouin Infant Feeding Study: study design and factors influencing the duration of breast feeding

Summary. A longitudinal study of infant feeding practices, growth and morbidity among Bedouin Arab infants residing in the Negev, Israel, was conducted during a 3-year period (1981–1983). Follow-up samples were restricted to healthy newborns. The majority of newborns are breast fed at birth but, by 2 months, 50% are also introduced to a milk supplement. Based on the bivariate analysis using the logrank test to examine the factors associated with exclusive versus partial breast feeding during the first 6 months, those born during the wet cool months are exclusively breast fed longer than those born during the dry season. More traditional women, living in tents rather than houses or huts, exclusively breast feed for at least 6 months. In a multiple logistic regression model, parity, house type and birth season are independently associated with the odds of exclusively breast feeding for the first 6 months of life. Factors influencing the duration of any breast feeding for the first 18 months include: house type, place of residence, birthweight, and whether the infant was stunted at 6 months.     

母乳喂养时间及辅食添加时机与婴幼儿过敏性疾病相关性研究

目的:探讨母乳喂养时间及辅食添加时机与婴幼儿过敏性疾病发生的相关性。方法:收集接受过敏性疾病诊断的婴幼儿160例,通过调查问卷方式调查每位婴幼儿母乳喂养时间及蛋黄和蛋白、鱼虾、坚果添加时机。结果:母乳喂养时间>3个月的婴幼儿过敏性疾病发生率显著低于母乳喂养时间≤3个月婴幼儿,6个月前和6个月后添加蛋黄和蛋白、8个月前和8个月后添加鱼虾的婴幼儿过敏性疾病发生率差异无统计学意义(P>0.05)。>1岁添加坚果的婴幼儿过敏性疾病发生率低于1岁前添加的婴幼儿。结论:婴幼儿母乳喂养时间应>3个月,蛋黄和蛋白可在6个月前添加,鱼虾可在8个月前添加,坚果应在1岁后添加。     

西宁、西安地区回族婴儿母乳喂养状况调查研究

目的 了解西宁、西安两地回族婴儿母乳喂养状况, 为制定针对性的改善措施提供依据。方法 随机整群抽取西宁回族168例、汉族119例及西安回族114例、汉族101例6～24月健康婴幼儿及其主要喂养人作为研究对象, 调查其母乳喂养状况。结果 1)西宁4月内纯母乳喂养率(58.54%)高于西安(43.72%)(P＜0.05), 而6月内纯母乳喂养率(19.51%)低于西安(32.09%)(P＜0.05);2)西宁回族4月内纯母乳喂养率(58.33%)高于西安回族(39.47%)(P＜0.05);3)不能进行母乳喂养的主要原因为母亲自认母乳量分泌不足(76.25%);4)西宁辅食添加时间(4.48±1.60)月早于西安地区(5.67±1.59)月(P＜0.05);5)母乳喂养率与主要喂养人的文化程度呈正相关(P＜0.05)。结论 加强对喂养人科学喂养知识的宣传是提高西部地区婴儿母乳喂养率的关键。     

The Bedouin Infant Feeding Study: study design and factors influencing the duration of breast feeding.

A longitudinal study of infant feeding practices, growth and morbidity among Bedouin Arab infants residing in the Negev, Israel, was conducted during a 3-year period (1981-1983). Follow-up samples were restricted to healthy newborns. The majority of newborns are breast fed at birth but, by 2 months, 50% are also introduced to a milk supplement. Based on the bivariate analysis using the logrank test to examine the factors associated with exclusive versus partial breast feeding during the first 6 months, those born during the wet cool months are exclusively breast fed longer than those born during the dry season. More traditional women, living in tents rather than houses or huts, exclusively breast feed for at least 6 months. In a multiple logistic regression model, parity, house type and birth season are independently associated with the odds of exclusively breast feeding for the first 6 months of life. Factors influencing the duration of any breast feeding for the first 18 months include: house type, place of residence, birthweight, and whether the infant was stunted at 6 months.     

Growth and feeding practices of Vietnamese infants in Australia

OBJECTIVE: To investigate the growth and feeding practices in first-generation Vietnamese infants living in Australia. DESIGN: Cohort study. SETTING: The study was conducted between 1999 and 2002 in Sydney. SUBJECTS: A total of 239 Vietnamese women were recruited randomly from antenatal clinics, and of these 210 were initially seen. During the first year, 20 cases (9.5%) were lost to follow-up. Data were collected at 0.5, 2, 4, 6, 9 and 12 months. RESULTS: Vietnamese infants were significantly longer and heavier than reference data (both P<0.0001). The Vietnamese infants had a significant decline in weight growth with age compared with reference data (P<0.001). The Vietnamese infants had marginally higher s.d. score for ideal weight for length than reference data (P=0.044). There was a significant decline in ideal weight for length with age compared with reference data (P=0.0065). Both parents were significantly shorter (mean s.d. height scores: -1.5+/-0.8 (mother) and -1.8+/-0.8 (father)) than reference data (P<0.001). The incidence of breast feeding was 79%, but half of the breast feeding women had stopped breast feeding by 3 months. A total of 162 (79.8%) infants were given infant formula within the first week, of whom 131 (80.1%) were fed infant formula within the first 24 h after birth. CONCLUSIONS: Vietnamese infants in this study had growth comparable with reference data despite their parents being shorter than reference data. Breast feeding duration was short with infant formula being introduced early.     

Prolonged breast feeding related to later solid food acceptance

Summary 132 full-term healthy infants were studied for the first 18 months of life and parents were interviewed regarding their child's acceptance of solid foods. Results indicate that infants breast fed for less than 3 months showed a better acceptance of solid foods at 18 months than those breast fed for 6 months or more. It would appear that prolonged breast feeding increases resistance to weaning, and that later feeding problems can be reduced if chewable foods are introduced at an appropriate age.     

婴儿不同喂养方式与钙营养状况分析

目的:了解不同喂养方式下婴儿钙及维生素D的营养状况。方法:对在中国人民解放军空军总医院儿保门诊就诊的286例6～12月龄婴儿1日的喂养情况进行调查,计算出钙及维生素D的摄入量,并与膳食营养素参考摄入量(recom-mended nutrients intakes,RNI)进行比较,对不同喂养方式下婴儿骨碱性磷酸酶水平进行测定分析。结果:人工喂养及混合喂养婴儿中钙及维生素D摄入过多比例较母乳喂养婴儿多见。母乳喂养组中维生素D摄入过少的情况较其他两组多见。与人工喂养组及混合喂养组比较,骨碱性磷酸酶升高在母乳喂养组多见。结论:钙及维生素D的补充应根据喂养情况合理摄入。     

A longitudinal study of vietnamese children born in Australia: Infant feeding,growth in infancy and after five years

Feeding practices and growth were studied longitudinally from birth to 12 months in a group of Vietnamese infants (25 boys, 23 girls) born in Perth, Western Australia. Weight and height data were recorded for 38 of these children at five years of age. Eighty one per cent of the infants were breast fed on leaving hospital; this rate decreased throughout infancy to 23% at 12 months. The incidence of breast feeding, its duration, and the age at which solids were introduced by immigrant mothers reflected local practices. However, the kinds of solids introduced, and the practice of giving infants extra fluids at a very early age (water, 42% of infants at one week; orange juice, 25% at one month) appear to reflect practices in their country of origin. Median (50th centile) weights of the Vietnamese at birth approximated 10th centile values and median length, between 10th and 25th centile values for Australian (Perth) infants of the same sex. Growth rates in the first three months of life exceeded the rates of Australian infants but subsequently a fall-off in rate of weight gain resulted in the 50th centile weights of the Vietnamese again approximating 10th centile Australian values at 12 months. The data at five years suggest that some small enhancement of growth may have occurred in these children: their 50th centile values for weight at that age fell between the 10th and 25th Australian values, and for height approximated the 25th Australian centiles     

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。     

Breast feeding practices--impressions from an urban community.

Information regarding breast feeding practices of 600 children below 3 years of age attending hospital OPDs and private clinics during 1984-85 were collected. 51.3% received breast milk within 24 hrs. of birth, mean duration of breast feeding being 6 months. 68% of Infants had been given prelacteal feeds. 34% children were exclusively breast fed till 1 month. Insufficient milk was an important reason for discontinuation before 6 months.     

北京市朝阳区母乳喂养情况及相关影响因素研究

目的:了解北京市朝阳区母乳喂养情况及相关影响因素,为进一步探索有效的干预措施以提高母乳喂养率而提供科学依据。方法:采用整群抽样法抽取朝阳区103名婴儿母亲,对其进行统一问卷调查,并对结果录入分析。结果:产后婴儿0～4个月中纯母乳喂养48名,占47.5%;非纯母乳喂养53名,占52.5%。母乳喂养情况受学历、工作、年龄及分娩方式等多种因素影响。结论:朝阳区的纯母乳喂养率偏低,社会各界应更多关注哺乳期妇女,继续加强母乳喂养的宣传力度,巩固、强化母乳喂养知识与技能,树立正确的态度和坚定的信心,关注高龄产妇等重点人群,以提高母乳喂养率,保护母婴健康。     

攀枝花市东区纯母乳喂养现状调查及分析

目的 了解攀枝花市东区纯母乳喂养现状及相关影响因素,为临床提供参考依据。方法 对攀枝花市东区315名2岁以内婴幼儿母亲进行面对面问卷调查,将293份合格问卷运用SPSS 22.0软件对数据进行描述统计和Logistic回归分析。结果 母乳喂养坚持到18个月以上仅占1.4%,纯母乳喂养到4~6个月只有34.5%。结论 开奶时间越早、纯母乳喂养的方式、自觉母乳量可以满足婴儿使母亲更倾向于纯母乳喂养。     

Breast feeding is related to C reactive protein concentration in adult women

OBJECTIVE: To assess the influence of infant breast feeding on C reactive protein (CRP), a marker of low grade inflammation associated with cardiovascular mortality independent of serum cholesterol concentrations. DESIGN: Serum CRP, total cholesterol, anthropometric, and blood pressure measurements were performed along with assessment of infant breast feeding duration, birth weight, smoking status, adult socioeconomic status, number of health problems, and hormonal contraceptive use. SETTING: A New Zealand predominantly European descent community birth cohort. PARTICIPANTS: 822 men and women aged 26 years. MAIN RESULTS: There was a significant linear relation (p<0.001) between duration of breast feeding and adult CRP level in women. The geometric means (IQR) for CRP were 2.22 (1, 4) mg/l for women breast fed for six months or more and 3.95 (2, 8) mg/l for women not breast fed (ratio, 95% confidence interval (CI): 0.69 (0.55 to 0.87). The linear association between cholesterol and breast feeding was also significant (p = 0.01), the geometric mean (IQR) total cholesterol levels being 4.62 (4.10, 5.10) for those breast fed for six months or more and 5.04 (4.5, 5.80) for those not breast fed (ratio, 95% CI: 0.92 (0.87, 0.98). There was no relation between CRP or total cholesterol and duration of breast feeding in men. CONCLUSIONS: The findings of lower CRP with an increased duration of breast feeding in women suggest early postnatal nutrition may influence long term cardiovascular risk.     

婴幼儿喂养问题情况调查

目的了解婴幼儿哺乳及乳类以外食物添加情况。方法选取2004年3月-2008年2月首都儿科研究所附属儿童医院儿童保健门诊收治的主诉有喂养困难或睡眠不实、哭闹、排便紊乱等症状与喂养相关的婴幼儿为调查对象,将中华医学会儿科学分会儿童保健学组婴幼儿喂养建议及美国儿科学会儿科护理教材作为喂养适宜的判定标准,采用医生与家长一对一访谈及统一调查问卷形式,详细询问家长就诊时哺乳和乳类以外食物添加情况。结果基本符合婴幼儿适宜推荐哺乳次数者仅占10．9％（97／886）;多于推荐次数占82．6％（732／886）,有6．4％（57／886）哺乳少于推荐次数。〈4月龄、4～6月龄和〉6月龄超过适宜推荐次数分别占各自月龄组的40．4％（19／47）、53．0％（87／164）、92．7％（626／675）,随月龄增加超过适宜推荐频次者增多（Х2=104．137,P〈O．001）。〉4月龄婴幼儿有夜间哺乳行为者达86．5％（726／839）,其中2次者占39．9％（355／839）,〉3次者占25．6％（214／839）,夜间哺乳频次并没有随月龄增加而减少（Х2=28．869,P=O．017）。在〈4月龄婴儿中,有12．8％（6／47）已经开始添加乳类以外食物;4-,6月龄时添加者占67．7％（111／164）;但6-9月龄、9～12月龄、12-36月龄尚未添加者分别占43．6％（144／330）、17．4％（32／184）、11．2％（18／161）。结论喂养问题婴幼儿哺乳频次和夜间哺乳偏多,乳类以外食物添加出现偏晚与偏早现象。