Flower Kori B, Willoughby Michael, Cadigan R Jean, Perrin Eliana M, Randolph Greg
Charles Drew Community Health Center, Piedmont Health Services, 221 North Graham-Hopedale Road, Burlington, NC, USA.
Matern Child Health J. 2008 May;12(3):402-14. doi: 10.1007/s10995-007-0248-6. Epub 2007 Jul 18.
To determine factors associated with breastfeeding in rural communities.
We combined qualitative and quantitative data from the Family Life Project, consisting of: (1) a longitudinal cohort study (N=1292) of infants born September 2003-2004 and (2) a parallel ethnographic study (N=30 families). Demographic characteristics, maternal and infant health factors, and health services were used to predict breastfeeding initiation and discontinuation using logistic and Cox regression models, respectively. Ethnographic interviews identified additional reasons for not initiating or continuing breastfeeding.
Fifty-five percent of women initiated breastfeeding and 18% continued for at least 6 months. Maternal employment at 2 months and receiving WIC were associated with decreased breastfeeding initiation and continuation. Ethnographic data suggested that many women had never even considered breastfeeding and often discontinued breastfeeding due to discomfort, embarrassment, and lack of assistance.
Breastfeeding rates in these rural communities lag behind national averages. Opportunities for increasing breastfeeding in rural communities include enhancing workplace support, maximizing the role of WIC, increasing hospital breastfeeding assistance, and creating a social environment in which breastfeeding is normative.
确定农村社区中与母乳喂养相关的因素。
我们整合了来自家庭生活项目的定性和定量数据，该项目包括：（1）一项对2003年9月至2004年出生婴儿的纵向队列研究（N = 1292），以及（2）一项平行的人种学研究（N = 30个家庭）。分别使用逻辑回归和Cox回归模型，利用人口统计学特征、母婴健康因素和卫生服务来预测母乳喂养的开始和停止情况。人种学访谈确定了不开始或持续母乳喂养的其他原因。
55%的女性开始母乳喂养，18%的女性持续母乳喂养至少6个月。产后2个月母亲就业以及接受妇女、婴儿和儿童营养补充计划（WIC）与母乳喂养开始和持续情况的减少有关。人种学数据表明，许多女性甚至从未考虑过母乳喂养，并且常常由于不适、尴尬和缺乏帮助而停止母乳喂养。
这些农村社区的母乳喂养率落后于全国平均水平。在农村社区增加母乳喂养的机会包括加强工作场所支持、最大化WIC的作用、增加医院的母乳喂养援助，以及营造一个母乳喂养成为常态的社会环境。
