Gibson Maria V, Diaz Vanessa A, Mainous Arch G, Geesey Mark E
Medical University of South Carolina, Department of Family Medicine in Charleston, SC 29406, USA.
Birth. 2005 Jun;32(2):93-8. doi: 10.1111/j.0730-7659.2005.00351.x.
A more current estimate to evaluate ethnic and acculturation differences in breastfeeding is warranted, given the rapid growth of the Hispanic population in the United States and the proliferation of breastfeeding promotion programs. The study objective was to describe current national estimates of the prevalence of breastfeeding and evaluate differences in reasons not to breastfeed by acculturation status.
Secondary data analysis of the National Health and Nutrition Examination Survey (NHANES) 1999-2000 was performed on a nationally representative sample of non-Hispanic white women born in the U.S. and Hispanic women with at least one live birth. Acculturation status among Hispanics was assessed using a validated language scale, and prevalence of breastfeeding was based on maternal self-report.
Prevalence of breastfeeding was higher in less acculturated Hispanic women (59.2%) than high acculturated Hispanic women (33.1%) and white women (45.1%). Less acculturated Hispanic women were more likely to cite their child's physical/medical condition as a reason not to breastfeed (53.1%), whereas whites and more acculturated Hispanics were more likely to cite their child preferred the bottle (57.5% and 49.8%, respectively). A logistic regression analysis revealed no significant differences in likelihood to breastfeed between non-Hispanic whites and Hispanics after controlling for education, age, and income. Higher acculturated women were less likely to breastfeed their children than low acculturated women (95% CI: 0.14-0.40) even after education, age, and income were taken into account.
Acculturation differences in prevalence of breastfeeding and reasons not to breastfeed may be the result of attitudinal changes that occur due to acculturation. Further research into the acculturation process and its impact on breastfeeding may help to prevent the decline in breastfeeding that occurs as mothers become more acculturated. Meanwhile, patient education that addresses women's perceptions of the child's health condition and benefits of breastfeeding would be helpful.
鉴于美国西班牙裔人口的快速增长以及母乳喂养促进项目的激增，有必要对母乳喂养中的种族和文化适应差异进行更近期的评估。研究目的是描述当前全国母乳喂养患病率的估计情况，并评估因文化适应状况导致的不进行母乳喂养原因的差异。
对1999 - 2000年国家健康和营养检查调查（NHANES）的数据进行二次分析，样本为出生在美国的非西班牙裔白人女性以及至少生育过一个活产婴儿的西班牙裔女性，具有全国代表性。使用经过验证的语言量表评估西班牙裔女性的文化适应状况，母乳喂养患病率基于母亲的自我报告。
文化适应程度较低的西班牙裔女性母乳喂养患病率（59.2%）高于文化适应程度较高的西班牙裔女性（33.1%）和白人女性（45.1%）。文化适应程度较低的西班牙裔女性更有可能将孩子的身体/健康状况作为不进行母乳喂养的原因（53.1%），而白人和文化适应程度较高的西班牙裔女性更有可能提到孩子更喜欢奶瓶（分别为57.5%和49.8%）。逻辑回归分析显示，在控制教育程度、年龄和收入后，非西班牙裔白人和西班牙裔女性进行母乳喂养的可能性没有显著差异。即使考虑了教育程度、年龄和收入，文化适应程度较高的女性母乳喂养孩子的可能性低于文化适应程度较低的女性（95%置信区间：0.14 - 0.40）。
母乳喂养患病率和不进行母乳喂养原因的文化适应差异可能是由于文化适应导致的态度变化所致。对文化适应过程及其对母乳喂养影响的进一步研究可能有助于防止随着母亲文化适应程度提高而出现的母乳喂养率下降。同时，针对女性对孩子健康状况的认知以及母乳喂养益处的患者教育会有所帮助。
