母乳喂养与4～5岁儿童气质及行为发育关系研究

Association of breastfeeding with behavioral problems and temperament development in children aged 4-5 years

摘要:

目的：儿童期行为问题的持续存在,可导致成年的精神障碍;气质发育对未来健康个性的形成有着不可忽视的作用。通过研究儿童气质和行为发育的影响因素,寻找促进心理健康发展的途径是近年来的研究热点。该研究通过探讨母乳喂养与4～5岁儿童气质各维度及行为问题发生之间的关系,为预防学龄前儿童行为问题的发生并促进儿童气质的健康发育和未来健康个性的形成提供理论依据。方法：采用分层整群抽样的方法,抽取淄博市城区8所幼儿园的737名4～5岁儿童,其中男399人,女338人。应用Achenbach儿童行为量表、3～7岁儿童气质量表和自制的儿童行为和气质影响因素问卷调查儿童的气质、行为发育状况及其影响因素。以行为问题的有无为因变量,以生后4个月内喂养情况、母乳喂养持续时间等为自变量分性别进行多因素非条件Logistic回归分析;分别以气质各维度为因变量,以生后4个月内喂养情况、母乳喂养持续时间、家庭结构等为自变量进行多元逐步回归分析。结果：考虑家庭结构、父母亲受教育水平、看电视时间及户外活动时间等因素后,“母乳喂养持续时间≥9个月”是男童行为问题发生影响因素(OR=0.184),“主要喂母乳”和“母乳喂养持续时间≥9个月”是女童行为问题发生的影响因素(OR=2.203,0.165);“主要喂奶粉”、“母乳喂养持续时间4～6个月”、“主要喂母乳”、“母乳喂养持续时间7～9个月”、“只喂奶粉”、“母乳与奶粉等量”和“母乳喂养持续时间7～9个月”等是气质各维度的影响因素。结论：母乳喂养量少和母乳喂养持续时间短是4～5岁儿童行为问题发生的危险因素;母乳喂养量和母乳喂养持续时间是儿童气质维度的影响因素。为预防和减少儿童行为问题的发生,对儿童气质发育给予积极促进,婴儿期应提倡母乳喂养,并尽可能延长母乳喂养的时间。

Abstract:

OBJECTIVE: Childhood behavioral problems can predict future psychiatric disorders. Temperament development is important for a healthy personality in adulthood. This study investigated whether breastfeeding is associated with the occurrence of behavioral problems and the temperament development in preschool children. METHODS: A total of 737 children (399 boys and 338 girls) aged 4-5 years in Zibo City were recruited by stratified random cluster sampling. They were born at term with a birth weight of ≥ 2.5 kg. The feeding patterns and the breastfeeding duration in infancy were collected. Behavioral and temperament developments were investigated by the Achenbach Child Behavior Checklist (CBCL), temperament questionnaire for 3-7-year-old children and a self-designed inventory questionnaire. The association of feeding patterns and the breastfeeding duration with behavioral problem occurrence and the temperament development in children were analyzed by a multivariate non-conditional logistic regression analysis and a multivariate stepwise regression analysis. RESULTS: After controlling for confounding variables, such as family income and parental education levels, it was found that a breastfeeding duration of ≥ 9 months was a protective factor against behavioral problem occurrence in boys (OR=0.184). In girls, a breastfeeding duration of ≥ 9 months was also a protective factor against behavioral problem occurrence (OR=0.165), while a mixed feeding with more breast milk and less formula milk was a risk factor (OR= 2.203). The factors influencing temperament development consisted of exclusive formula feeding and the duration of breastfeeding (lasting for 4-6 months or 7-9 months) as well as a mixed feeding (with more formula milk and less breast milk, more breast milk and less formula milk, or equal amount of both). CONCLUSIONS: The fewer amounts and the shorter duration of breastfeeding are risk factors for behavioral problems occurrence in children aged 4-5 years. Children's temperament development is correlated with the feeding patterns and the breastfeeding duration.