接受哺乳的小孩比較不會發生記憶問題、精神與健康疾病


  November 4, 2008 (加州聖地牙哥)-一項發表於美國公共健康醫學會第136屆年會的新研究結果顯示,就小孩智力與情緒發展而言,母乳比罐裝牛奶好。
  
  來自波士頓麻州綜合醫院(MGH)的作者Katherine Hobbs Knutosn醫師與Alexy Arauz Boudreau醫師在口頭報告時表示,接受餵乳的兒童比較少表現出對記憶能力的擔憂,且這些兒童比較不需要接受行為、品行或是精神健康問題的治療。
  
  MGH的精神科醫師Knutosn向Medscape公共衛生與疾病預防表示,設計良好的研究支持哺乳與認知及治療發育之間的關係,但是這個效應對於行為與精神發育的影響目前仍不清楚。這裡的新發現是,嬰兒時期哺乳與對於行為擔憂的下降有關,同時也比較不會被健康照護人員診斷行為或是品行異常,且在兒童時期時也比較不需要健康照護。
  
  作者們取用來自國家兒童健康普查的數據,包括超過100,000位父母以及負責兒童健康的監護人,這些兒童的年齡介於10個月到18歲。
  
  這項研究收納1~5歲兒童的數據,父母與監護人被問到他們是否有,還是完全不會擔心兒童們如何學習為他或是她做事;這些兒童在學前或是在學校學習的狀況。
  
  作者控制兒童的年齡、種族、性別與社會經濟地位,以及胎教及母體健康狀況。
  
  餵乳與父母及監護人報告關心兒童為他(她)們自己學習而感到擔憂的勝算比(OR)為0.77,兒童學習學前技能能力的勝算比為0.76。且這與對於兒童行為較不擔心(OR,0.85),較不容易被診斷有行為或是品行問題,或是較少接受精神健康照護(兩者的OR皆為0.63)有關。
  
  Knustan醫師表示,這些發現的原因未明。我們的研究無法解釋為什麼餵乳會影響行為,可能是母乳的營養物質影響了兒童神經機轉與精神發育。
  
  俄亥俄州辛辛那提兒童醫院醫療中心的哺乳醫學中心主任,同時也是副教授的Sheela R. Geraghty醫師提醒,雖然作者並未控制胎教與母體健康的因素,但哺乳與未哺乳的媽媽是不同的。哺乳的媽媽回答對她們的孩子在行為上的期待與未哺乳的媽媽不同。
  
  沒有參與這項研究的Geraghty醫師表示,當這些初期研究數據發表時,這個摘要凸顯了報告他們的孩子是接受母乳哺育的也會報告他們的孩子比較少有行為與品行上的問題。這些發現並沒有明顯的因果關係,但是他們凸顯了為寶寶所做出的決定,包括是否哺乳,在嬰兒時期初期都可能對之後兒童時期有持續的影響。
  
  Knutosn醫師與Geraghty醫師皆表示沒有相關資金上的往來。

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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