การได้รับนมแม่อย่างเดียวเพิ่มความเสี่ยงต่อภาวะโลหิตจางในช่วงอายุ 6 เดือนแรกของชีวิตหรือไม่

Pornsuda Krittigamas; Wirada Sakamornchai; Chidchanok Ruengorn

Authors

Pornsuda Krittigamas Department of Pediatrics, Nakornping Hospital, Chiang Mai
Wirada Sakamornchai Department of Pediatrics, Nakornping Hospital, Chiang Mai
Chidchanok Ruengorn Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University

Keywords:

anemia, exclusive breastfeeding, infants

Abstract

Background: The World Health Organization recommends exclusively breastfeeding (EBF) for the first 6 months of life. However, infants undergo WHO EBF for 6 months may have an increased risk of anemia. Evidences regarding anemia associated with EBF are limited in the Northern part of Thailand. Objective: To investigate the incidence of anemia at 6 months of age among EBF infants and non-EBF infants, and risk factors of anemia at 6 months of age. Materials and Methods: The retrospective cohort study was conducted in term-healthy infants at a well-baby clinic, Nakornping Hospital in 2019. Mothers answered a questionnaire regarding history of breastfeeding. Hematocrit (Hct) level of infants was retrospectively recorded at birth and 6 months of age. Infants with Hct less than 40% at birth were excluded. Anemia was defined as Hct less than 33%. Data were analyzed comparing Hct between 2 groups of infants: the EBF in the first 6 months of age and the non-EBF. Multivariable linear regression and exponential risk regression were performed to investigate an effect of EBF. Results: Of 259 infants, 137 cases (52.9%) were male, the overall incidence of anemia was 61 cases (23.6%). Prevalence of 6-month EBF infants was 45.9%. Incidence of anemia in the EBF and non-EBF infants was 24.4 and 22.9%, respectively. When compared to the non-EBF group, no statistically significant differences were revealed, adjusted RR 0.98(0.61-1.58), p = 0.934. The mean of Hct in EBF and non-EBF infants were 34.18±3.23 and 34.57±3.38, respectively. There was no statistically significant between mean of Hct of the two groups with adjusted beta coefficient equals to -0.21(-1.09, 0.66), p = 0.631. Factors predicted anemia in infants at 6 months of age included maternal age <20 years (adj. OR 3.88, 95%CI 2.68-5.60), >35 years (adj. OR 2.26, 95%CI 1.44-3.53), mothers with HbE positive (adj. OR 3.01, 95%CI 1.62-5.60). Conclusion: Overall incidence of anemia in infants at 6 months of age was 23.6% classified as a moderate public health problem that urgent investigation is needed. There was no statistical significance between incidence of anemia in the EBF and non-EBF infants. EBF for the first 6 months of life does not increase the risk of anemia in healthy infants compared with non-EBF.

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