Callen Jennifer, Pinelli Janet
McMaster Children's Hospital, Hamilton, Ontario, Canada.
Birth. 2004 Dec;31(4):285-92. doi: 10.1111/j.0730-7659.2004.00321.x.
Analysis of differences in the incidence and duration of breastfeeding across countries may provide information about practices that encourage breastfeeding. This comparative review examines variation in the incidence and duration of breastfeeding for term infants that has been reported in studies from Canada, the United States, Europe, and Australia.
Searches were conducted in PubMed, MEDLINE (from 1966), CINHAL (from 1982), and the Cochrane Database of Systematic Reviews. Studies were limited to nonexperimental and observational research that addressed term infants (>37 weeks gestational age), performed in developed countries, written in the English language, and published since 1990. Additional studies were located from reference lists of meta-analyses, systematic reviews, and previous articles. All studies that met study criteria were included in the review, regardless of the quality of methodology.
Although studies had methodological limitations that precluded conducting a formal systematic review or meta-analysis, this comparative review revealed consistent differences among countries. For example, Europe and Australia reported a higher initiation and duration of breastfeeding term infants compared with Canada and the United States.
Studies that examined reasons for a higher incidence and duration of breastfeeding term infants consistently document that women who initiate and continue to breastfeed are older, married, better educated, and have higher family incomes than women who do not breastfeed.
分析各国母乳喂养的发生率和持续时间差异,可能会提供有关鼓励母乳喂养做法的信息。本比较性综述考察了加拿大、美国、欧洲和澳大利亚的研究报告中足月儿母乳喂养发生率和持续时间的差异。
在PubMed、MEDLINE(自1966年起)、CINHAL(自1982年起)和Cochrane系统评价数据库中进行检索。研究限于针对足月儿(胎龄>37周)的非实验性和观察性研究,研究在发达国家开展,以英文撰写,且自1990年以来发表。通过荟萃分析、系统评价和以往文章的参考文献列表找到其他研究。所有符合研究标准的研究均纳入本综述,无论其方法学质量如何。
尽管研究存在方法学局限性,无法进行正式的系统评价或荟萃分析,但本比较性综述揭示了各国之间存在一致的差异。例如,与加拿大和美国相比,欧洲和澳大利亚报告的足月儿母乳喂养开始率和持续时间更高。
研究足月儿母乳喂养发生率和持续时间较高的原因时,一致记录到,开始并持续母乳喂养的女性比不进行母乳喂养的女性年龄更大、已婚、受教育程度更高且家庭收入更高。