美国儿科学会：纯母乳喂养的持续时间

美国儿科学会（AAP）建议纯母乳喂养六个月，并且根据母亲和婴儿双方的意愿，将母乳喂养延续至一岁或更久。这一建议得到了世界卫生组织（WHO）和美国国家科学院医学研究院（the Institute of Medicine）的支持。 对比纯母乳喂养四个月和六个月的婴儿的健康状况（包括胃肠道疾病、中耳炎、呼吸系统疾病和过敏性疾病的情况），以及母亲月经推迟和产后瘦身的状况，两者的差异支持了纯母乳喂养六个月的建议。 纯母乳喂养四个月的婴儿罹患下呼吸道疾病、中耳炎或腹泻的发病率显著高于纯母乳喂养六个月或六个月以上的婴儿。和纯母乳喂养超过六个月的婴儿相比，纯母乳四到六个月的婴儿得肺炎的风险增加了四倍。不仅如此，纯母乳喂养六个月延长了哺乳闭经期，因此延长了生育间隔，从而降低了产下早产儿的风险。 AAP发现一些婴儿因为家庭和病史、个人的发育状况，以及/或者社会和文化的变更，在六个月之前就开始了包括含麸质谷物的辅食喂养。因为母乳喂养有免疫保护的功能，建议婴儿只有在纯母乳的情况下，才能开始这些辅食的添加。随着添加的辅食的数量和种类的增加，应鼓励母亲继续母乳喂养至婴儿一岁以上。 The AAP recommends exclusive breastfeeding for about 6 months, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant, a recommendation concurred to by the WHO and the Institute of Medicine. Support for this recommendation of exclusive breastfeeding is found in the differences in health outcomes of infants breastfed exclusively for 4 vs 6 months, for gastrointestinal disease, otitis media, respiratory illnesses, and atopic disease, as well as differences in maternal outcomes of delayed menses and postpartum weight loss. Compared with infants who never breastfed, infants who were exclusively breastfed for 4 months had significantly greater incidence of lower respiratory tract illnesses, otitis media, and diarrheal disease than infants exclusively breastfed for 6 months or longer.When compared with infants who exclusively breastfed for longer than 6 months, those exclusively breastfed for 4 to 6 months had a fourfold increase in the risk of pneumonia.Furthermore, exclusively breastfeeding for 6 months extends the period of lactational amenorrhea and thus improves child spacing, which reduces the risk of birth of a preterm infant. The AAP is cognizant that for some infants, because of family and medical history, individual developmental status, and/or social and cultural dynamics, complementary feeding, including gluten-containing grains, begins earlier than 6 months of age.Because breastfeeding is immunoprotective, when such complementary foods are introduced, it is advised that this be done while the infant is feeding only breastmilk.Mothers should be encouraged to continue breastfeeding through the first year and beyond as more and varied complementary foods are introduced. 来源：http://pediatrics.aappublications.org/content/129/3/e827.full 翻译：http://www.weibo.com/2514526082/zvv2Aev2H