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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Increasing breastfeeding rates to reduce infant illness at the community level.
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Increasing breastfeeding rates to reduce infant illness at the community level.

机译：提高母乳喂养率以减少社区一级的婴儿疾病。

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OBJECTIVE: Although breastfeeding is associated with lower rates of a variety of infant illnesses, skeptics have suggested that much of the association is attributable to confounding, even after appropriate statistical adjustment. This article utilizes a novel design to investigate changes in infant illness at the community level after a successful breastfeeding promotion program. METHODS: In this population-based cohort study, the medical records of all infants born in one Navajo community the year before a breastfeeding promotion program (n = 977) and the year during the intervention (n = 858) were reviewed. Outcomes assessed include changes after the intervention in: proportion breastfeeding and/or breastfeeding exclusively; incidence of common infant illnesses in the first year of life; and feeding-group specific incidence of illness. RESULTS: The proportion of women breastfeeding exclusively for any period of time increased from 16.4% to 54.6% after the intervention. The percent of children having pneumonia and gastroenteritis declined 32. 2% and 14.6%, respectively, after the intervention. Feeding-group specific rates of these illnesses were unchanged, indicating that the decline observed was attributable to the increased proportion of infants breastfeeding. In contrast, rates of croup and bronchiolitis increased after the intervention among those fed formula from birth, suggesting a viral epidemic which was limited to those never exclusively breastfed. Finally, sepsis declined in both formula-fed and breastfed infants after the intervention, suggesting that other factors affected this illness outcome after the intervention. CONCLUSIONS: Increasing the proportion of exclusively breastfed infants seems to be an effective means of reducing infant illness at the community level. The experimental design suggests that the increased incidence of illness among minimally breastfed infants is causally related to lack of breast milk, rather than being attributable to confounding.
机译：目的：尽管母乳喂养与各种婴儿疾病的发生率降低相关，但怀疑者认为，即使经过适当的统计调整，大部分这种关联也可归因于混淆。本文采用了新颖的设计，在一项成功的母乳喂养促进计划成功后，在社区一级调查了婴儿疾病的变化。方法：在这项基于人群的队列研究中，回顾了一个母乳喂养社区出生前一年（n = 977）和干预期间（n = 858）在一个纳瓦霍社区出生的所有婴儿的病历。评估的结果包括干预后的变化：母乳喂养比例和/或仅母乳喂养;出生后第一年常见婴儿疾病的发生率;和喂养组的特定疾病发病率。结果：干预后仅在任何时间进行母乳喂养的妇女比例从16.4％增加到54.6％。干预后患肺炎和肠胃炎的儿童百分比分别下降了32. 2％和14.6％。这些疾病的喂养组特定比率没有变化，表明观察到的下降是由于婴儿母乳喂养比例的增加。相比之下，从出生时开始喂食配方奶粉的婴儿干预后，臀部和细支气管炎的发生率增加，表明病毒流行仅限于从未完全母乳喂养的婴儿。最后，干预后的配方奶粉喂养和母乳喂养的婴儿败血症均下降，表明干预后其他因素影响了这种疾病的发生。结论：增加纯母乳喂养婴儿的比例似乎是减少社区一级婴儿疾病的有效手段。实验设计表明，最低限度母乳喂养的婴儿患病率的升高与缺乏母乳有因果关系，而不是由于混淆。

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