Kogan Michael D, Singh Gopal K, Dee Deborah L, Belanoff Candice, Grummer-Strawn Laurence M
Health Resources and Services Administration, Maternal and Child Health Bureau, 5600 Fishers Lane, Room 18-41, Rockville, MD 20857, USA.
Am J Public Health. 2008 Oct;98(10):1872-80. doi: 10.2105/AJPH.2007.127118. Epub 2008 Aug 13.
We sought to determine the impact of sociodemographic and behavioral factors and state legislation on breastfeeding initiation (child ever fed breastmilk) and duration.
We used data from a nationally representative study of children aged 6 to 71 months (N = 33 121); we calculated unadjusted and adjusted state estimates for breastfeeding initiation and duration. We used logistic regression models to examine factors associated with never breastfeeding or breastfeeding less than 6 months. We conducted a multilevel analysis of state legislation's role.
There were wide state variations in breastfeeding initiation and duration. The western and northwestern states had the highest rates. Covariate adjustment accounted for 25% to 30% of the disparity. Multivariate analysis showed that the adjusted odds of not being breastfed were 2.5- to 5.15-times greater in southern states compared with Oregon (reference). Children in states without breastfeeding legislation had higher odds of not being breastfed.
Sociodemographic and maternal factors do not account for most breastfeeding rate variation. The association with breastfeeding legislation should be explored and may reflect cultural norms.
我们试图确定社会人口统计学和行为因素以及州立法对母乳喂养开始情况（孩子是否曾接受母乳喂养）和持续时间的影响。
我们使用了一项针对6至71个月儿童的全国代表性研究的数据（N = 33121）；我们计算了母乳喂养开始情况和持续时间的未调整和调整后的州估计值。我们使用逻辑回归模型来研究与从未母乳喂养或母乳喂养少于6个月相关的因素。我们对州立法的作用进行了多层次分析。
母乳喂养开始情况和持续时间在各州之间存在很大差异。西部和西北部各州的比率最高。协变量调整解释了25%至30%的差异。多变量分析表明，与俄勒冈州（参照州）相比，南部各州未进行母乳喂养的调整后几率高出2.5至5.15倍。没有母乳喂养立法的州的儿童未进行母乳喂养的几率更高。
社会人口统计学和母亲因素并不能解释大多数母乳喂养率的差异。应探讨与母乳喂养立法的关联，这可能反映了文化规范。
