Scott J A, Binns C W
Institute for Medical Research, PFK Edinburgh Ltd, Edinburgh, Scotland.
Breastfeed Rev. 1999 Mar;7(1):5-16.
Breastfeeding is promoted internationally as the preferred method of feeding for infants up to the age of four to six months. As a consequence there is much research interest in factors which may be predictors of breastfeeding. This paper presents a review of the recent literature identifying factors associated with the initiation and duration of breastfeeding among Western women. Attention was focused on studies which employed multivariate analysis of the data and breastfeeding initiation and duration were considered as two uniquely separate events. This review reveals that the associations between breastfeeding and many of the factors commonly investigated were not consistent. Many of the strong associations previously reported in univariate studies were not evident in more recent studies which employed multivariate analysis to control for covariates and potential confounders. While there was a strong and consistent association with demographic factors such as maternal age and level of education, there was a less consistent association with factors such as marital and socioeconomic status. Similarly, the previously reported univariate associations between breastfeeding and biomedical factors such as parity, method of delivery and infant health were less consistent in multivariate studies. However, a consistent negative association has been reported between maternal smoking habits and breastfeeding duration. More recent studies have investigated the association between breastfeeding and psychosocial factors. There is evidence to suggest that fathers play an important role in the breastfeeding decision and that intended duration is a strong predictor of actual duration. Despite the inconsistency of the reported associations, this review highlights the fact that breastfeeding is multifactorial in nature and future programs aimed at promoting breastfeeding must take this into consideration.
母乳喂养在国际上被提倡为四个月至六个月大婴儿的首选喂养方式。因此，对于可能成为母乳喂养预测因素的因素有很多研究兴趣。本文对近期文献进行了综述，确定了西方女性中与母乳喂养开始和持续时间相关的因素。重点关注了对数据进行多变量分析的研究，并且将母乳喂养开始和持续时间视为两个独特的独立事件。该综述表明，母乳喂养与许多常见研究因素之间的关联并不一致。先前在单变量研究中报道的许多强关联在最近采用多变量分析来控制协变量和潜在混杂因素的研究中并不明显。虽然与诸如产妇年龄和教育水平等人口统计学因素存在强烈且一致的关联，但与诸如婚姻和社会经济地位等因素的关联则不太一致。同样，先前报道的母乳喂养与诸如产次、分娩方式和婴儿健康等生物医学因素之间的单变量关联在多变量研究中也不太一致。然而，据报道产妇吸烟习惯与母乳喂养持续时间之间存在一致的负相关。最近的研究调查了母乳喂养与心理社会因素之间的关联。有证据表明父亲在母乳喂养决策中起着重要作用，并且预期持续时间是实际持续时间的有力预测因素。尽管所报道的关联不一致，但该综述强调了母乳喂养本质上是多因素的这一事实，未来旨在促进母乳喂养的项目必须考虑到这一点。
