母乳喂养的保护作用与使用安抚奶嘴的加重作用在儿童支气管炎发病中的相互作用。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie Pub Date : 2024-10-01 DOI:10.1016/j.arcped.2024.05.004

Laureen Martin , Amaïa Bainier , Estelle Darviot , Aude Forgeron , Laurent Sarthou , Anne-Claire Wagner , Thomas Blanchais , Thomas Brigly , Françoise Troussier , Bernard Branger

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引用次数: 0

摘要

背景介绍在法国，每年冬季约有 30% 的婴儿患有急性支气管炎。在发展中国家，母乳喂养（BF）对急性下呼吸道感染有保护作用，但在工业化国家却很难证明这种作用。此外，使用安抚奶嘴对支气管炎发生的影响尚未得到明确证实。有鉴于此，本研究旨在调查在法国卢瓦尔河地区五家儿科急救中心就诊的 1 岁以下儿童支气管炎的发生与婴儿肥胖和使用安抚奶嘴之间的关系：2018年至2020年期间，法国卢瓦尔河地区五家医院的儿科急救中心在收治儿童时发放了一份调查问卷，收集了有关饮食、社会人口特征和发病原因的数据。支气管炎患儿被纳入第一组，因其他原因就诊的患儿（胃肠道感染或中耳炎除外）被纳入第二组。母乳喂养分为纯母乳喂养（EBF）和部分母乳喂养（PBF）。安抚奶嘴的使用分为经常使用、睡眠中使用和不使用：研究包括 671 名 1 岁以下儿童，其中 174 名（25.8%）因支气管炎入院。在单变量分析中，入院时母乳喂养（EBF 和 PBF）的第 1 组儿童明显少于第 2 组儿童：分别为 21.8% 对 32.8%（OR=0.57，95% CI：0.38-0.86，p = 0.006）；此外，第 1 组儿童使用安抚奶嘴的频率高于第 2 组儿童：分别为 84.5% 对 75.8%（OR=1.74，95% CI：1.10-2.76，p = 0.017）。在多变量分析中，对年龄进行调整后，9 个月和 12 个月以上的持续婴儿喂养或 EBF 仍是一个保护因素；但是，婴儿喂养的保护作用在使用安抚奶嘴后消失，而使用安抚奶嘴与支气管炎显著相关：结论：婴儿喂养对支气管炎的保护作用不受使用奶嘴的影响。然而，由于使用安抚奶嘴与支气管炎之间存在密切联系，婴儿喂养的效果有所减弱。本文讨论了在婴儿喂养和使用安抚奶嘴方面应向父母提出的建议。

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Interaction of the protective effect of breastfeeding and the aggravating effect of pacifier use in the occurrence of bronchiolitis in children

Background

Acute bronchiolitis affects around 30 % of infants each winter in France. Breastfeeding (BF) is described as being protective against acute lower respiratory infections in developing countries, but this effect is more difficult to demonstrate in industrialized countries. Moreover, the effect of using a pacifier in the occurrence of bronchiolitis is not clearly established. In this context, the aim of the study was to investigate the link between BF and the use of a pacifier in the occurrence of bronchiolitis in children under 1 year of age who presented to five pediatric emergency centers in Pays de la Loire, France.

Method

A questionnaire collecting data on diet, sociodemographic characteristics, and the reason for presentation was provided at the admission to pediatric emergency centers in five hospitals in Pays de Loire, France, between 2018 and 2020. Children with bronchiolitis were included in group 1, and children consulting for other reasons (except gastrointestinal infections or otitis) were included in group 2. Breastfeeding was classified as exclusive breastfeeding (EBF) and partial breastfeeding (PBF). Pacifier use was classified as frequent and during sleep or not used.

Results

The study included 671 children under 1 year of age, including 174 (25.8 %) who were admitted with bronchiolitis. In univariate analysis, a significantly smaller number of children in group 1 s were breastfed (EBF and PBF) at admission compared with children in group 2:21.8 % versus 32.8 %, respectively, (OR=0.57, 95 % CI: 0.38–0.86, p = 0.006); furthermore, children in group 1 used a pacifier more often than those in group 2: 84.5 % versus 75.8 % (OR=1.74, 95 % CI: 1.10–2.76, p = 0.017). In multivariate analysis, after adjusting for age, ongoing BF or EBF beyond 9 and 12 months of age remained a protective factor; however, the protective effect of BF disappeared with the introduction of a pacifier, and pacifier use was significantly associated with bronchiolitis.

Conclusion

The protective effect of BF against bronchiolitis was demonstrated independently of pacifier use. However, due to the strong association between pacifier use and bronchiolitis, the effect of BF weakened. The advice to be given to parents for BF and pacifier use is discussed.

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来源期刊

Archives De Pediatrie 医学-小儿科

CiteScore

2.80

自引率

5.60%

发文量

106

审稿时长

24.1 weeks

期刊介绍： Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics. Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. Archives de Pédiatrie is the official publication of the French Society of Pediatrics.