Merewood Anne, Mehta Supriya D, Chamberlain Laura Beth, Philipp Barbara L, Bauchner Howard
Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA.
Pediatrics. 2005 Sep;116(3):628-34. doi: 10.1542/peds.2004-1636.
The objectives of this study were to analyze all available breastfeeding data from US Baby-Friendly hospitals in 2001 to determine whether breastfeeding rates at Baby-Friendly designated hospitals differed from average US national, regional, and state rates in the same year and to determine prime barriers to implementation of the Baby-Friendly Hospital Initiative.
In 2001, 32 US hospitals had Baby-Friendly designation. Using a cross-sectional design with focused interviews, this study surveyed all 29 hospitals that retained that designation in 2003. Demographic data, breastfeeding rates, and information on barriers to becoming Baby-Friendly were also collected. Simple linear regression was used to assess factors associated with breastfeeding initiation.
Twenty-eight of 29 hospitals provided breastfeeding initiation rates: 2 from birth certificate data and 26 from the medical record. Sixteen provided in-hospital, exclusive breastfeeding rates. The mean breastfeeding initiation rate for the 28 Baby-Friendly hospitals in 2001 was 83.8%, compared with a US breastfeeding initiation rate of 69.5% in 2001. The mean rate of exclusive breastfeeding during the hospital stay (16 of 29 hospitals) was 78.4%, compared with a national mean of 46.3%. In simple linear regression analysis, breastfeeding rates were not associated with number of births per institution or with the proportion of black or low-income patients. Of the Ten Steps to Successful Breastfeeding the 3 described as most difficult to meet were Steps 6, 2, and 7. The reason cited for the problem with meeting Step 6 was the requirement that the hospital pay for infant formula.
Baby-Friendly designated hospitals in the United States have elevated rates of breastfeeding initiation and exclusivity. Elevated rates persist regardless of demographic factors that are traditionally linked with low breastfeeding rates.
本研究的目的是分析2001年美国爱婴医院所有可得的母乳喂养数据，以确定爱婴医院指定医院的母乳喂养率与同年美国全国、地区和州的平均母乳喂养率是否存在差异，并确定实施爱婴医院倡议的主要障碍。
2001年，美国有32家医院获得爱婴医院指定。本研究采用横断面设计并进行重点访谈，对2003年仍保留该指定的所有29家医院进行了调查。还收集了人口统计学数据、母乳喂养率以及成为爱婴医院的障碍信息。使用简单线性回归评估与母乳喂养开始相关的因素。
29家医院中的28家提供了母乳喂养开始率：2家来自出生证明数据，26家来自病历。16家提供了院内纯母乳喂养率。2001年28所爱婴医院的平均母乳喂养开始率为83.8%，而2001年美国的母乳喂养开始率为69.5%。住院期间的平均纯母乳喂养率（29家医院中的16家）为78.4%，而全国平均水平为46.3%。在简单线性回归分析中，母乳喂养率与每个机构的出生人数或黑人或低收入患者的比例无关。在成功母乳喂养的十项措施中，被描述为最难实现的三项措施是第6项、第2项和第7项。提到难以实现第6项措施的原因是医院需要为婴儿配方奶粉付费。
美国的爱婴医院指定医院的母乳喂养开始率和纯母乳喂养率有所提高。无论传统上与低母乳喂养率相关联的人口统计学因素如何，提高的比率都持续存在。
