母乳喂养与4～5岁儿童气质特征发育的关系

背景:气质在儿童心理发展中发挥重要的作用。气质主要由遗传所决定,但也受一些其他因素的影响,研究其影响因素,进而从影响因素入手进行气质培育对于促进儿童心理发展和减少行为问题的发生具有重要意义。目的:分析母乳喂养与4～5岁儿童气质特征之间的关系。设计:整群抽样调查。单位:青岛大学医学院附属医院、淄博市中心医院、青岛大学医学院儿科研究所。对象:选择2005-03/06淄博市市内4区的8所幼儿园4～5岁儿童737名,其中男孩399名,女孩338名。调查对象及其家属对本实验目的均知情。方法:采用NYLS3～7岁儿童气质量表和自制的儿童气质影响因素问卷,采用分层整群抽样的方法,对737名儿童进行调查。对气质类型9个维度与生后4个月内喂养类型、母乳喂养持续时间的相关性进行分析;以气质各纬度为因变量,以生后4个月内喂养类型、母乳喂养持续时间等为自变量进行多元逐步回归分析。主要观察指标:气质纬度、生后4个月内喂养类型和母乳喂养持续时间。结果:纳入儿童737名,全部进入结果分析。相关分析发现气质维度适应度与生后4个月内主要喂奶粉正相关(r=0.084,P=0.030),规律性和注意分散与只喂奶粉负相关(r=-0.087,-0.075,P=0.022,0.047),活动水平与只喂母乳正相关,与母乳与奶粉量相等负相关(r=0.084,-0.077,P=0.030,0.045),趋避性与主要喂母乳负相关(r=-0.097,P=0.012)。气质维度规律性、情绪本质、活动水平与母乳喂养持续时间4～6个月负相关(r=-0.082,-0.102,-0.153,P=0.036,0.009,0.001),情绪本质、活动水平与母乳喂养持续时间≥9个月正相关(r=0.089,0.088,P=0.024,0.025)。校正家庭结构、父母亲受教育水平等因素后,适应度的影响因素是主要喂奶粉;反应强度的影响因素是母乳喂养持续时间4～6个月和主要喂母乳;规律性的影响因素是母乳喂养持续时间7～9个月和只喂奶粉;活动水平的影响因素是母乳与奶粉等量和母乳喂养持续时间7～9个月;情绪本质的影响因素是只喂奶粉和母乳喂养持续时间7～9个月;趋避性的影响因素是主要喂母乳和母乳与奶粉等量;注意分散的影响因素是主要喂奶粉。结论:婴儿生后4个月内喂养类型和母乳喂养持续时间与4～5岁儿童气质维度发展有关,在气质培养与干预中应充分考虑母乳喂养的作用。

Association between infant breastfeeding and temperamental characteristics development in children aged 4-5 years

BACKGROUND: Temperament plays an important role in psychological development of children. Generally speaking, temperament is genetically determined, but it is also influenced by some other factors. The influential factors studies of temperament are important to promote psychological development and reduce behavior problems of children.OBJECTIVE: To explore the correlation between breastfeeding and temperamental characteristics in children aged 4-5 years old.DESIGN: Random cluster sampling.SETTING: Affiliated Hospital of Medical College, Qingdao University, Zibo Central Hospital, and Research Institute of Pediatrics, Medical College of Qingdao University.PARTICIPANTS: 737 children (399 males, 338 females) aged 4-5 years old from 8 kindergartens of 4 districts in Zibo were selected from March to June 2005. All the subjects and their parents were informed about the experimental goal.METHODS: With stratified random cluster sampling, 737 children were investigated by NYLS 3-7 years old children temperament questionnaire and self-made inventory questionnaire. The association of 9 dimensions including adaptability, rhythmicity (regularity), activity level, persistence, quality of mood, approach and withdrawal, intension of reaction, distractibility and threshold of responsiveness with feeding type in the first 4 months after birth and duration of breastfeeding was analyzed; the multiple gradual regressive analysis was carried out with each dimension of temperament as the dependent variable and feeding type in the first 4 months after birth and duration of breastfeeding etc. as the independent variables.MAIN OUTCOME MEASURES: Temperamental dimension, feeding categories in the fist 4 months, and breastfeeding duration.RESULTS: All 737 children were involved in the result analysis. Correlation analysis indicated that temperamental adaptability was positively related with formula milk mainly in the first 4 months after birth (r =0.084, P =0.030);Rhythmicity and distractibility were negatively related with formula milk only (r =-0.087, -0.075, P =0.022, 0.047);Activity level were positively related with breast milk only and negatively with both breast milk and formula milk equally (r =0.084, -0.077, P =0.030, 0.045); Approach and withdrawal was negatively related with breast milk mainly (r =-0.097, P =0.012). Rhythmicity, quality of mood and activity level were negatively related with breastfeeding for 4-6 months (r =-0.082, -0.102, -0.153, P =0.036, 0.009, 0.001); Quality of mood and activity level were positively related with the duration of breastfeeding more than 9 months (r =0.089, 0.088, P =0.024,0.025). After rectifying the family structure, and educational level of parents, the influencing factor of adaptability was formula mainly; intensity of reaction was breastfeeding duration for 4-6 months and breast milk mainly;rhythmicity was breastfeeding duration for 7-9 months and formula only; activity level was both breast milk and formula milk equally and breastfeeding duration for 7-9 months; quality of mood was formula only and duration of breastfeeding for 7-9 months; approach-withdrawal was breast milk mainly and both breast milk and formula milk equally; distractibility was formula milk mainly.CONCLUSION: Temperamental development of children aged 4-5 years old is related to feeding type in the first 4 months after birth and duration of breastfeeding; therefore, it is essential to pay attention to breastfeeding during temperamental cultivation and intervention.