接受哺乳的小孩比较不会发生记忆问题、精神与健康疾病


  November 4, 2008 (加州圣地牙哥)-一项发表于美国公共健康医学会第136届年会的新研究结果显示,就小孩智力与情绪发展而言,母乳比罐装牛奶好。
  
  来自波士顿麻州综合医院(MGH)的作者Katherine Hobbs Knutosn医师与Alexy Arauz Boudreau医师在口头报告时表示,接受餵乳的儿童比较少表现出对记忆能力的担忧,且这些儿童比较不需要接受行为、品行或是精神健康问题的治疗。
  
  MGH的精神科医师Knutosn向Medscape公共卫生与疾病预防表示,设计良好的研究支持哺乳与认知及治疗发育之间的关系,但是这个效应对于行为与精神发育的影响目前仍不清楚。这里的新发现是,婴儿时期哺乳与对于行为担忧的下降有关,同时也比较不会被健康照护人员诊断行为或是品行异常,且在儿童时期时也比较不需要健康照护。
  
  作者们取用来自国家儿童健康普查的数据,包括超过100,000位父母以及负责儿童健康的监护人,这些儿童的年龄介于10个月到18岁。
  
  这项研究收纳1~5岁儿童的数据,父母与监护人被问到他们是否有,还是完全不会担心儿童们如何学习为他或是她做事;这些儿童在学前或是在学校学习的状况。
  
  作者控制儿童的年龄、种族、性别与社会经济地位,以及胎教及母体健康状况。
  
  餵乳与父母及监护人报告关心儿童为他(她)们自己学习而感到担忧的胜算比(OR)为0.77,儿童学习学前技能能力的胜算比为0.76。且这与对于儿童行为较不担心(OR,0.85),较不容易被诊断有行为或是品行问题,或是较少接受精神健康照护(两者的OR皆为0.63)有关。
  
  Knustan医师表示,这些发现的原因未明。我们的研究无法解释为什么餵乳会影响行为,可能是母乳的营养物质影响了儿童神经机转与精神发育。
  
  俄亥俄州辛辛那提儿童医院医疗中心的哺乳医学中心主任,同时也是副教授的Sheela R. Geraghty医师提醒,虽然作者并未控制胎教与母体健康的因素,但哺乳与未哺乳的妈妈是不同的。哺乳的妈妈回答对她们的孩子在行为上的期待与未哺乳的妈妈不同。
  
  没有参与这项研究的Geraghty医师表示,当这些初期研究数据发表时,这个摘要凸显了报告他们的孩子是接受母乳哺育的也会报告他们的孩子比较少有行为与品行上的问题。这些发现并没有明显的因果关系,但是他们凸显了为宝宝所做出的决定,包括是否哺乳,在婴儿时期初期都可能对之后儿童时期有持续的影响。
  
  Knutosn医师与Geraghty医师皆表示没有相关资金上的往来。

Breast-Fed Children Have Fewer Learning Problems, Mental Health Diagnoses

By Norra MacReady
Medscape Medical News

November 4, 2008 (San Diego, California) — Breast-feeding is associated with better intellectual and emotional development than bottle feeding, according to findings presented here at the American Public Health Association 136th Annual Meeting.

Parents or guardians of breast-fed children were less likely to express concern about learning capacities, and the children were less likely to have required treatment for behavioral, conduct, or mental-health problems, authors Katherine Hobbs Knutson, MD, and Alexy Arauz Boudreau, MD, MPH, from the Massachusetts General Hospital (MGH) in Boston, reported in an oral presentation.

Good research supports the association between breast-feeding and cognitive and intellectual development, but its effect on behavior and psychologic development are not as well understood, Dr. Knutson, a psychiatrist at MGH, told Medscape Public Health & Prevention. "What's new here is that breast-feeding during infancy is associated with decreased parental concern about behavior, fewer diagnoses of behavioral or conduct disorder by healthcare professionals, and [less need for] mental healthcare during childhood."

The authors drew on data from the National Survey of Children's Health, which included interviews with more than 100,000 parents and guardians on the health of their children, who ranged in age from 10 months to 18 years. This study included data on children from 1 to 5 years of age. The parents or guardians were asked if they were concerned a lot, a little, or not at all about how well the child was learning to do things for him- or herself; how well the child was learning preschool or school skills, and how he or she was behaving in general. Answers indicating any degree of concern were combined for the analysis. The parents and guardians were also asked whether the child had ever been diagnosed with conduct or behavioral problems, and whether the child had ever received any mental-health care or counseling.

The authors controlled for the child's age, race, sex, and socioeconomic status, as well as parental education and maternal mental health.

Breast-feeding was associated with an odds ratio (OR) of 0.77 that parents or guardians would report concern about the child's ability to learn for him- or herself, and an OR of 0.76 for the child's ability to learn preschool skills. It was also associated with less concern about the child's behavior (OR, 0.85), and a lower likelihood of medically diagnosed behavior or conduct problems, or receipt of mental-health care (OR, 0.63 for both).

The reasons for these findings are still unclear, Dr. Knutson said. "Our study is unable to explain why breast-feeding may affect behavior, but it is possible that nutrients in human milk may influence the neurologic mechanisms or psychological development in children."

Although the authors did control for parental education and maternal mental health, "mothers who breast-feed are different than those who do or did not," warned Sheela R. Geraghty, MD, MS, assistant professor of pediatrics, and medical director of the Center for Breast-feeding Medicine at Cincinnati Children's Hospital Medical Center in Ohio. "Mothers who breast-feed answer behavioral expectations about their children differently than those who do not."

Still, she said, "while the data presented are preliminary, this abstract highlights [the fact] that parents who reported that their children were breast-fed also reported that their children had less behavioral and conduct problems," said Dr. Geraghty, who was not involved in the study. "These findings cannot be causally linked, but they highlight the point that choices made for the infant — including the feeding choices — in the early infancy period can have a lasting impact throughout childhood."

Neither Dr. Knutson nor Dr. Geraghty has disclosed any relevant financial disclosures.

American Public Health Association (APHA) 136th Annual Meeting: Abstract 173228. Presented October 29, 2008.

    
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