Bandusena A S L, Warnasuriya N D
Postgraduate Institute of Medicine, Colombo, Sri Lanka.
Ceylon Med J. 2009 Dec;54(4):124-7. doi: 10.4038/cmj.v54i4.1453.
To ascertain determinants and impact of the duration of exclusive breastfeeding (EBF) for four to six months on growth and incidence of respiratory tract and diarrhoeal infections
A descriptive cross-sectional study of infants aged 4-6 months, visiting selected well baby clinics in Colombo.
An interviewer administered questionnaire to determine duration and determinants of EBF and incidence of infections was used. Growth faltering was ascertained by perusing the growth chart.
The EBF rate for 4 months and beyond was 52.1% with only 3.6% being exclusively breastfed for 5 months and none for 6 months. 61% attending hospital clinics had EBF for 4 or more months as compared to 42% at community clinics. Higher level of maternal education, EBF of earlier child for longer duration, greater number of antenatal clinic visits, hearing the optimal duration of EBF via media, being well instructed on expressed breast milk and Caesarean section delivery were positively associated with EBF of 4 months and beyond. Being underweight for age (< 3rd centile) was significantly associated with longer periods of EBF, although growth faltering was not. There was no significant association between the duration of EBF and incidence of respiratory or diarrhoeal infections.
The EBF rate for 4 months and beyond was poor, with field clinics faring worse than hospital clinics.
确定4至6个月纯母乳喂养（EBF）的持续时间对生长以及呼吸道和腹泻感染发生率的决定因素和影响
对4至6个月大婴儿进行的描述性横断面研究，这些婴儿前往科伦坡选定的健康婴儿诊所就诊。
使用由访员管理的问卷来确定纯母乳喂养的持续时间和决定因素以及感染发生率。通过查看生长图表来确定生长发育迟缓情况。
4个月及以上的纯母乳喂养率为52.1%，仅3.6%的婴儿纯母乳喂养5个月，无婴儿纯母乳喂养6个月。在医院诊所就诊的婴儿中有61%纯母乳喂养4个月或更长时间，而在社区诊所这一比例为42%。母亲受教育程度较高、较早出生的孩子纯母乳喂养时间较长、产前检查次数较多、通过媒体了解到纯母乳喂养的最佳持续时间、得到关于挤出母乳的良好指导以及剖宫产分娩与4个月及以上的纯母乳喂养呈正相关。年龄别体重过低（<第3百分位数）与纯母乳喂养时间较长显著相关，尽管生长发育迟缓并非如此。纯母乳喂养持续时间与呼吸道或腹泻感染发生率之间无显著关联。
4个月及以上的纯母乳喂养率较低，基层诊所的情况比医院诊所更差。
