Evidence suggests that a range of f

Evidence suggests that a range of factors are associated with both the decision to breastfeed and the duration of breastfeeding. Specifically, women who choose not to breastfeed and who breastfeed for a shorter length of time tend to be younger, less well educated, sole parents, poorer, and to report lower levels of parental nurturance.4-6 In addition, women who do not breastfeed are more likely to have smoked during their pregnancy, to have infants of lower birth weight, and to be primiparous (i.e. having their first child).4 Finally, several studies also show that mothers who are employed or anticipate returning to full-time employment are less likely to breastfeed, and when they do, will tend to feed their babies for a shorter length of time.7,8

These findings clearly indicate that infant breastfeeding is a selective process, whereby those infants who have been exposed to greater perinatal risk and who come from more disadvantaged social and family backgrounds are less likely to be breastfed. It is, therefore, important that these pre-existing differences be considered by researchers when examining associations between breastfeeding and child psychosocial outcomes. Although most studies reviewed have attempted to control statistically for some of these differences, very few have controlled extensively for a range of these confounding factors.4

Findings from short-term outcome studies suggest that breastfeeding may have some benefits for both mother and infant, as well as for their developing relationship. Specifically, mothers who breastfeed have been found to report lower levels of perceived stress and negative mood, higher levels of maternal attachment, and tend to perceive their infants as more reinforcing than mothers who formula-feed.5,9 There is evidence to suggest that breastfeeding mothers may hold their babies for longer and feel more confident as parents.10 After breastfeeding, mothers also report reductions in negative mood compared to mood levels prior to breastfeeding.5

In terms of infant behaviour, there is some suggestion that in the first few weeks of life breastfed babies may be characterized by improved alertness11,12 and other aspects of neurobehavioural functioning.13 For example, Hart et al.13 found that one-week-old breastfed infants obtained significantly higher scores on the orientation and motor scales on the Brazelton Neonatal Behavioural Assessment Scale.14 In addition, they also tended have better self-regulation, fewer abnormal reflexes and fewer signs of withdrawal than formula-fed infants. Additional support for the possible self-regulatory benefits associated with breastfeeding is also provided by a short-term follow-up study of 158 infants.10 This study found that between the ages of 13 and 52 weeks, breastfed babies consistently cried for shorter periods of time than formula-fed babies

Only a small number of studies have examined the effects of breastfeeding on the development of the mother-infant relationship.9,10 One study has shown that although breast- and formula-feeding mothers spend similar amounts of time involved in care-taking activities with their infant, breastfeeding mother-infant dyads spent more time engaged in playful and positive interactions than formula-feeding dyads, with this time difference increasing from 3.2 hours per month at six weeks to 19.4 hours per month at 13 weeks. Importantly, this difference persisted after statistical control for the effects of maternal employment and socioeconomic status. A similar, but less well controlled study by Else-Quest et al.9 also suggests some linkages between breastfeeding and improved mother and infant psychosocial functioning. They compared two groups of mothers and infants at ages four and 12 months: those who breastfed their infants during the first week and those who did not. At four months, mothers in the breastfeeding group reported higher levels of attachment to their infant and increased infant reinforcement. However, these differences were no longer evident at 12 months. At the 12-month assessment, breastfeeding mothers reported lower levels of negative mood, behaved less intrusively with their infants, and their infants obtained lower scores on a measure of dysregulation (anxiety, self-regulation, frequency of mood changes and organization). The authors concluded that although breastfeeding was associated with some relationship and infant advantages, formula-fed dyads did not have poor quality relationships. The findings from this study are limited by a lack of control for confounding factors and also by the fact that by four months, 50% of the breastfeeding mothers had weaned their babies. Finally, a study of 915 infants found that both exclusively and non-exclusively breastfed infants obtained higher scores on the social personal subscale of the Griffith Scales of Mental Development at 18 months.15

There are even fewer studies examining the longer-term psychosocial effects of breastfeeding. At present, findings are mixed, with some studies suggesting some limited psychosocial benefits4,16 and others not.17 No clear evidence has emerged to suggest that breastfed babies are at lower risk of developing behaviour or mental health problems in later life.4,17,18 However, one study has shown a small but significant association between breastfeeding duration and adolescents' perceptions of maternal care, with a longer duration of breastfeeding being associated with increased adolescent perceptions of maternal nurturance. This association persisted after statistical control for a wide range of the selection factors noted above.

Conclusion

Evidence to support a link between breastfeeding and positive psychosocial outcomes for children is at best modest, and in many cases has been limited by inadequate control for pre-existing differences between breast- and formula-fed infants and their families. Nonetheless, there is some suggestion that breastfed infants may be more alert, cry less, and be better able to engage in interactions with their parents than formula-fed infants. Breastfeeding may also have some stress-reducing properties for mothers and assist parenting confidence. Finally, one well-controlled long-term follow-up study has shown small to modest increases in perceived maternal care among adolescents who were breastfed for longer durations. The mechanisms by which these associations arise have not been empirically established. Attachment fostered through breastfeeding is one possible and frequently cited mechanism. Another explanation could be that associations between breastfeeding and improved mother-child relations may, at least in part, reflect improvements in child cognitive functioning associated with breastfeeding.

Kết quả (Việt) 1:

Bằng chứng cho thấy rằng một loạt các yếu tố có liên quan đến quyết định cho con bú và thời gian cho con bú. Cụ thể, các phụ nữ người chọn không để cho con bú và những người cho con bú trong một khoảng thời gian ngắn hơn thời gian có xu hướng trẻ hơn, ít hơn cha mẹ cũng đào tạo, duy nhất, nghèo, và để báo cáo cấp dưới của nurturance.4-6 của cha mẹ trong ngoài ra, phụ nữ làm không cho con bú có nhiều khả năng có hút thuốc trong khi mang thai của họ, để có trẻ sơ sinh của trọng lượng sinh thấp, và phải được primiparous (tức là có đứa con đầu tiên).4 cuối cùng , một số nghiên cứu cũng cho thấy rằng bà mẹ được tuyển dụng hoặc đoán trước quay trở lại việc làm toàn thời gian ít có khả năng cho con bú, và khi họ làm, sẽ có xu hướng để nuôi trẻ sơ sinh của họ trong một khoảng thời gian ngắn hơn của time.7,8Những phát hiện này chỉ rõ rằng nuôi con bằng sữa trẻ sơ sinh là một quá trình chọn lọc, theo đó những trẻ sơ sinh người đã tiếp xúc với nguy cơ lớn hơn chu sinh và những người đến từ các nền tảng xã hội và gia đình hơn hoàn cảnh khó khăn có ít có khả năng là breastfed. Đó là, do đó, quan trọng rằng những khác biệt tồn tại trước được xem xét bởi các nhà nghiên cứu khi kiểm tra các Hiệp hội giữa con bằng sữa mẹ và trẻ em kết quả tâm lý. Mặc dù hầu hết các nghiên cứu được nhận xét đã cố gắng để kiểm soát ý nghĩa thống kê cho một số những khác biệt này, rất ít có kiểm soát rộng rãi cho một loạt các confounding factors.4Những phát hiện từ ngắn hạn kết quả nghiên cứu đề nghị đó cho con bú có thể có một số lợi ích cho cả mẹ và trẻ sơ sinh, cũng như của mối quan hệ đang phát triển. Đặc biệt, bà mẹ cho con bú có thể tìm thấy để báo cáo cấp thấp hơn của căng thẳng nhận thức và tâm trạng tiêu cực, các cấp độ cao hơn của bà mẹ tập tin đính kèm, và có xu hướng nhận thức của trẻ sơ sinh là tăng cường hơn bà mẹ công thức-feed.5,9 đó là bằng chứng cho thấy rằng bà mẹ cho con bú có thể giữ đứa con của mình cho lâu hơn và cảm thấy tự tin hơn là parents.10 sau khi cho con bú, bà mẹ cũng báo cáo giảm trong tâm trạng tiêu cực so với tâm trạng cấp trước khi breastfeeding.5Trong điều khoản của hành vi cho trẻ sơ sinh, đó là một số ý kiến cho rằng trong vài tuần đầu tiên của cuộc sống breastfed em bé có thể được định nghĩa bởi cải tiến alertness11, 12 và các khía cạnh của neurobehavioural functioning.13 ví dụ, Hart et al.13 tìm thấy rằng một tuần tuổi breastfed trẻ sơ sinh thu được các điểm số cao hơn đáng kể vào định hướng và động cơ quy mô trên Brazelton trẻ sơ sinh hành vi đánh giá Scale.14 trong bổ sung , họ cũng có xu hướng có quy định tự tốt hơn, phản xạ bất thường ít hơn và ít dấu hiệu của thu hồi hơn trẻ sơ sinh bú. Hỗ trợ bổ sung cho những lợi ích tự điều chỉnh có thể liên quan đến con bú sữa mẹ cũng cung cấp bởi một nghiên cứu ngắn hạn theo dõi của 158 infants.10 nghiên cứu này cho thấy rằng trong tuổi từ 13 và 52 tuần, em bé breastfed luôn khóc trong thời gian ngắn hơn thời gian so với trẻ sơ sinh búOnly a small number of studies have examined the effects of breastfeeding on the development of the mother-infant relationship.9,10 One study has shown that although breast- and formula-feeding mothers spend similar amounts of time involved in care-taking activities with their infant, breastfeeding mother-infant dyads spent more time engaged in playful and positive interactions than formula-feeding dyads, with this time difference increasing from 3.2 hours per month at six weeks to 19.4 hours per month at 13 weeks. Importantly, this difference persisted after statistical control for the effects of maternal employment and socioeconomic status. A similar, but less well controlled study by Else-Quest et al.9 also suggests some linkages between breastfeeding and improved mother and infant psychosocial functioning. They compared two groups of mothers and infants at ages four and 12 months: those who breastfed their infants during the first week and those who did not. At four months, mothers in the breastfeeding group reported higher levels of attachment to their infant and increased infant reinforcement. However, these differences were no longer evident at 12 months. At the 12-month assessment, breastfeeding mothers reported lower levels of negative mood, behaved less intrusively with their infants, and their infants obtained lower scores on a measure of dysregulation (anxiety, self-regulation, frequency of mood changes and organization). The authors concluded that although breastfeeding was associated with some relationship and infant advantages, formula-fed dyads did not have poor quality relationships. The findings from this study are limited by a lack of control for confounding factors and also by the fact that by four months, 50% of the breastfeeding mothers had weaned their babies. Finally, a study of 915 infants found that both exclusively and non-exclusively breastfed infants obtained higher scores on the social personal subscale of the Griffith Scales of Mental Development at 18 months.15There are even fewer studies examining the longer-term psychosocial effects of breastfeeding. At present, findings are mixed, with some studies suggesting some limited psychosocial benefits4,16 and others not.17 No clear evidence has emerged to suggest that breastfed babies are at lower risk of developing behaviour or mental health problems in later life.4,17,18 However, one study has shown a small but significant association between breastfeeding duration and adolescents' perceptions of maternal care, with a longer duration of breastfeeding being associated with increased adolescent perceptions of maternal nurturance. This association persisted after statistical control for a wide range of the selection factors noted above. ConclusionEvidence to support a link between breastfeeding and positive psychosocial outcomes for children is at best modest, and in many cases has been limited by inadequate control for pre-existing differences between breast- and formula-fed infants and their families. Nonetheless, there is some suggestion that breastfed infants may be more alert, cry less, and be better able to engage in interactions with their parents than formula-fed infants. Breastfeeding may also have some stress-reducing properties for mothers and assist parenting confidence. Finally, one well-controlled long-term follow-up study has shown small to modest increases in perceived maternal care among adolescents who were breastfed for longer durations. The mechanisms by which these associations arise have not been empirically established. Attachment fostered through breastfeeding is one possible and frequently cited mechanism. Another explanation could be that associations between breastfeeding and improved mother-child relations may, at least in part, reflect improvements in child cognitive functioning associated with breastfeeding.