較真要點(趕時間?只看要點就夠了!)
1
最新的證據綜合發現:與混合餵養或者配方奶餵養比擬, 純母乳餵養(從出生第一口奶開始, 吃的就是母乳)至少3個月, 對濕疹的發生並沒有明顯的防護效果。
2
世界衛生組織最新的文獻綜述結果提示:沒有明確證據支持母乳餵養可以防護過敏性疾病(好比濕疹, 食品過敏, 哮喘)。
3
由於母乳餵養對孩子和母親有很多其他健康意義, 所以母乳餵養仍舊是寶寶最理想的餵養方式, 值得鼎力提倡並積極推行。
當前證據不支持純母乳餵養可以降低寶寶濕疹風險
關於母乳餵養與嬰幼兒濕疹的關係已經有很多相關研究。
大量的研究但結論各異, 難免讓人目眩繚亂, 到底該相信哪一個呢?關於母乳餵養和濕疹, 有科研團隊和權勢鉅子機構對現有證據和文獻進行了系統分析和綜述。
好比, 在2009年, 有一項關於母乳餵養與濕疹之間關係的系統綜述和薈萃分析(這是在循證醫學裡, 用來評估和綜合證據的國際同一方法)。 這項綜述共包含了21個符合要求的研究, 這些研究都發表於1977年到2007年期間。 綜合證據後得出:與混合餵養或者配方奶餵養比擬,
而UpToDate臨床參謀(這是一個基於循證醫學的臨床決議計畫支持資料庫系統)在2016年8月也發表了關於母乳餵養與過敏性疾病的臨床專題的文獻綜述,
除了母乳餵養與濕疹, 還有一個大家都不目生的說法是母乳餵養可以減少孩子過敏的風險。 那這個說法有證據嗎?
目前還沒有明確證據支持母乳餵養減少過敏的說法
在2016年1月, 世界衛生組織(WHO)在柳葉刀(世界醫學界最權勢鉅子的學術期刊之一)上發佈了最新一期的母乳餵養綜述。 關於母乳餵養是否減少過敏的題目, 這個綜述裡包含了各種形式的母乳餵養和其他餵養方式的對比,
在統一年, 澳大利亞臨床免疫學和過敏學會的最新指南也指出目前並沒有同一證據證實母乳餵養可以有效防止過敏性疾病(見下圖)。
這篇文章讀完了, 新手媽媽們該怎麼做?
1. 固然現有證據不支援 “純母乳餵養(也就是第一口奶就是吃母乳)可以減少孩子發生濕疹的概率”, 目前也沒有明確證據支持“母乳餵養可以防護過敏性疾病” , 但母乳餵養有很多其他被驗證的健康意義, 母乳餵養仍舊是最理想的餵養方式, 應提倡並積極推行。
2. 寶寶出生後第一時間與媽媽肌膚接觸並吮吸乳房, 不僅可以讓寶寶吃到貴重的初乳, 還可以匡助順利實現母乳餵養。 因此, 即使目前證據不支援第一口奶吃母乳可以降低濕疹風險, 也應積極推行產後第一時間的母嬰肌膚接觸和哺乳。
3. 多多貯備準確的知識, 才能在母乳餵養道路上應對自如, 不等閒被誤導或動搖, 還可以減少不必要的焦急和自責。
參考文獻:
1.Kull I, Bohme M, Wahlgren CF, et al. Breast-feeding reduces the risk for childhood eczema. J Allergy Clin Immunol 2005; 116:657.
2.Kramer MS, Chalmers B, Hodnett ED, et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA 2001; 285:413.
3.Schoetzau A, Filipiak-Pittroff B, Franke K, et al. Effect of exclusive breast-feeding and early solid food avoidance on the incidence of atopic dermatitis in high-risk infants at 1 year of age. Pediatr Allergy Immunol 2002; 13:234.
4.Laubereau B, Brockow I, Zirngibl A, et al. Effect of breast-feeding on the development of atopic dermatitis during the first 3 years of life--results from the GINI-birth cohort study. J Pediatr 2004; 144:602.
5.Ludvigsson JF, Mostrom M, Ludvigsson J, Duchen K. Exclusive breastfeeding and risk of atopic dermatitis in some 8300 infants. Pediatr Allergy Immunol 2005; 16:201.
6.Snijders BE, Thijs C, Kummeling I, et al. Breastfeeding and infant eczema in the first year of life in the KOALA birth cohort study: a risk period-specific analysis. Pediatrics 2007; 119:e137.
7.Jelding-Dannemand E, Malby Schoos AM, Bisgaard H. Breast-feeding does not protect against allergic sensitization in early childhood and allergy-associated disease at age 7 years. J Allergy Clin Immunol 2015; 136:1302.
8.Langan SM, Fewtrell M. Does breastfeeding protect against the development of eczema.Br J Dermatol. 2011;165(6):1157–1158
9.Flohr C, Nagel G, Weinmayr G, et al. Lack of evidence for a protective effect of prolonged breastfeeding on childhood eczema: lessons from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two. Br J Dermatol 2011; 165:1280.
10.Bergmann RL, Diepgen TL, Kuss O, et al. Breastfeeding duration is a risk factor for atopic eczema. Clin Exp Allergy 2002; 32:205.
11.Pesonen M, Kallio MJ, Ranki A, Siimes MA. Prolonged exclusive breastfeeding is associated with increased atopic dermatitis: a prospective follow-up study of unselected healthy newborns from birth to age 20 years. Clin Exp Allergy 2006; 36:1011.
12.Giwercman C, Halkjaer LB, Jensen SM, et al. Increased risk of eczema but reduced risk of early wheezy disorder from exclusive breast-feeding in high-risk infants. J Allergy Clin Immunol 2010; 125:866.
13.Sandini U, Kukkonen AK, Poussa T, Sandini L, Savilahti E, Kuitunen M. Protective and risk factors for allergic diseases in high-risk children at the ages of two and five years. Int Archives Allergy Immunology. 2011;156(3):339–348
14.Rollins NC, Bhandari N, Hajeebhoy N, et al., Lancet Breastfeeding Series Group. Why invest, and what it will take to improve breastfeeding practices? Lancet 2016; 387:491–504.
15.Victora CG, Bahl R, Barros AJ, et al., Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016; 387:475–490.
還可以減少不必要的焦急和自責。參考文獻:
1.Kull I, Bohme M, Wahlgren CF, et al. Breast-feeding reduces the risk for childhood eczema. J Allergy Clin Immunol 2005; 116:657.
2.Kramer MS, Chalmers B, Hodnett ED, et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA 2001; 285:413.
3.Schoetzau A, Filipiak-Pittroff B, Franke K, et al. Effect of exclusive breast-feeding and early solid food avoidance on the incidence of atopic dermatitis in high-risk infants at 1 year of age. Pediatr Allergy Immunol 2002; 13:234.
4.Laubereau B, Brockow I, Zirngibl A, et al. Effect of breast-feeding on the development of atopic dermatitis during the first 3 years of life--results from the GINI-birth cohort study. J Pediatr 2004; 144:602.
5.Ludvigsson JF, Mostrom M, Ludvigsson J, Duchen K. Exclusive breastfeeding and risk of atopic dermatitis in some 8300 infants. Pediatr Allergy Immunol 2005; 16:201.
6.Snijders BE, Thijs C, Kummeling I, et al. Breastfeeding and infant eczema in the first year of life in the KOALA birth cohort study: a risk period-specific analysis. Pediatrics 2007; 119:e137.
7.Jelding-Dannemand E, Malby Schoos AM, Bisgaard H. Breast-feeding does not protect against allergic sensitization in early childhood and allergy-associated disease at age 7 years. J Allergy Clin Immunol 2015; 136:1302.
8.Langan SM, Fewtrell M. Does breastfeeding protect against the development of eczema.Br J Dermatol. 2011;165(6):1157–1158
9.Flohr C, Nagel G, Weinmayr G, et al. Lack of evidence for a protective effect of prolonged breastfeeding on childhood eczema: lessons from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two. Br J Dermatol 2011; 165:1280.
10.Bergmann RL, Diepgen TL, Kuss O, et al. Breastfeeding duration is a risk factor for atopic eczema. Clin Exp Allergy 2002; 32:205.
11.Pesonen M, Kallio MJ, Ranki A, Siimes MA. Prolonged exclusive breastfeeding is associated with increased atopic dermatitis: a prospective follow-up study of unselected healthy newborns from birth to age 20 years. Clin Exp Allergy 2006; 36:1011.
12.Giwercman C, Halkjaer LB, Jensen SM, et al. Increased risk of eczema but reduced risk of early wheezy disorder from exclusive breast-feeding in high-risk infants. J Allergy Clin Immunol 2010; 125:866.
13.Sandini U, Kukkonen AK, Poussa T, Sandini L, Savilahti E, Kuitunen M. Protective and risk factors for allergic diseases in high-risk children at the ages of two and five years. Int Archives Allergy Immunology. 2011;156(3):339–348
14.Rollins NC, Bhandari N, Hajeebhoy N, et al., Lancet Breastfeeding Series Group. Why invest, and what it will take to improve breastfeeding practices? Lancet 2016; 387:491–504.
15.Victora CG, Bahl R, Barros AJ, et al., Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016; 387:475–490.