哮喘联盟

   摘要
   背景：有假说认为早年饮食改变可能促进儿童哮喘和特应性增加。婴儿喂养的时间和食物对儿童哮喘和特应性疾病发生率的长期影响尚不明确。
   目标：研究头6个月内，母乳喂养时长和添加辅食的时间节点与10岁内父母报告哮喘、喘息和特异性湿疹发生率的关系。
   方法：营养对湿疹和哮喘的影响研究（SEATON）纳入了1924名辛格尔顿婴儿，前瞻性收集了长达6个月的婴儿喂养行为（母乳喂养和添加辅食），1、2、5和10年时评估结局（喘息、特异性湿疹和哮喘）。采用广义估计方程式和离散危险度模型分析数据并校正混淆因素。
   结果：6个月时，59%和35%的妈妈分别停止了单纯和主要母乳喂养。尽管配方喂养与过去12个月内喘息发生负相关（无配方喂养的校正OR：070，95%可信区间0.50-0.97），5个月后添加饼干/面包与特异性湿疹负相关（校正OR 1.34，95%可信区间1.06-1.69），多重测试校正后这些结果就失去了统计学意义。根据6个月内湿疹发生和特应性疾病家族史分层后得到的结果与整个研究人群的结果没有实质区别。
   结论和临床意义：我们的结果提示头6个月婴儿喂养性质对儿童哮喘和特应性疾病的长期风险无实质影响，对特应性疾病家族史导致的特应性疾病高危儿童也无实质影响。
 

（刘国梁 审校）
Clin Exp Allergy. 2013 Nov;43(11):1263-73. doi: 10.1111/cea.12180.
 

Breastfeeding and introduction of complementary foods during infancy in relation
to the risk of asthma and atopic diseases up to 10 years.
 

Nwaru BI, Craig LC, Allan K, Prabhu N, Turner SW, McNeill G, Erkkola M, Seaton A,
Devereux G.
 

Abstract
BACKGROUND: It has been hypothesized that changes in diet during early life may have contributed to the increase in childhood asthma and atopy. The long-term effect of the timing and content of infant feeding on the incidence of asthma and atopic diseases in children is unclear.
OBJECTIVE: To investigate the associations between duration of breastfeeding and the timing of introduction of complementary foods during the first 6 months and parental-reported asthma, wheeze and atopic eczema up to 10 years of age.
METHODS: Infant feeding practices (breastfeeding and introduction of complementary foods) of 1924 singleton children participating in the Study of Eczema and Asthma To Observe the influence of Nutrition (SEATON) birth cohort were prospectively collected up to 6 months with outcomes (wheeze, atopic eczema and asthma) being assessed at 1, 2, 5 and 10 years. Data were analysed using generalized estimating equations and discrete hazards models with adjustment for confounders.
RESULTS: By 6 months, 59% and 35% of mothers had stopped exclusive and total breastfeeding, respectively. Although formula feeding was adversely associated with wheeze in the past 12 months (adjusted OR for no formula feeding: 070, 95% CI 0.50-0.97), and the introduction of biscuits/bread after 5 months of age adversely associated with atopic eczema (adjusted OR 1.34, 95% CI 1.06-1.69), these results lost their statistical significance after adjustment for multiple testing. Stratification of the results by the presence of eczema by 6 months of age and family atopic history did not substantially differ from the results of the whole study population.
CONCLUSION AND CLINICAL RELEVANCE: Our results suggest that the nature of infant feeding during the first 6 months seems not to substantially influence the long-term risk of asthma and atopic diseases in children, nor in children at high risk of atopic disease because of a family history of atopic disease.
 

Clin Exp Allergy. 2013 Nov;43(11):1263-73. doi: 10.1111/cea.12180.