Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK.
Arch Dis Child. 2012 Jan;97(1):39-42. doi: 10.1136/adc.2009.177337. Epub 2010 Jun 23.
UK breastfeeding rates are low and socially distributed. Childcare provides a potential setting for breastfeeding promotion. However, little is known about the association between childcare and breastfeeding in different socio-economic groups.
Using data from a contemporary UK cohort of infants (n=18,050) the authors calculated RR for breastfeeding for at least 4 months according to informal childcare (care by friends, grandparents, other relatives, etc) and formal childcare (eg, nurseries, crèches), both lasting at least 10 h a week and commencing before the age of 4 months, compared to being cared for 'only by a parent' (this includes childcare for less than 10 h a week), overall and by socio-economic group.
Compared to being looked after only by a parent, informal (RR 0.51 (95% CI 0.43 to 0.59)) and formal (0.84 (0.72 to 0.99)) childcare was associated with a reduced likelihood of breastfeeding. For informal childcare, both part-time and full-time care was associated with a reduced risk of breastfeeding, whereas for formal care, only full-time formal childcare was associated with a reduced likelihood of breastfeeding. The reduced likelihood of breastfeeding in informal childcare was similar across all socio-economic groups, whereas for formal childcare the reduced likelihood was only seen for mothers from managerial and professional backgrounds (0.76 (0.62 to 0.94)), those who had a degree (0.71 (0.58 to 0.86)) and couple families (0.79 (0.66 to 0.94)). In contrast, lone mothers were more likely to breastfeed if their infant was cared for in formal childcare (1.65 (1.04 to 2.63)).
Informal childcare was associated with a reduced likelihood of breastfeeding for all groups of mothers. Formal childcare arrangements were only associated with a reduced likelihood of breastfeeding if used full-time by more advantaged families.
英国的母乳喂养率较低，且呈社会分布不均的态势。儿童保育为母乳喂养的推广提供了一个潜在的场所。然而，对于儿童保育与不同社会经济群体母乳喂养之间的关系，人们知之甚少。
本研究使用来自当代英国婴儿队列（n=18050）的数据，根据非正规儿童保育（由朋友、祖父母、其他亲属等照顾）和正规儿童保育（如托儿所、托儿所等）计算至少 4 个月母乳喂养的 RR，每周至少 10 小时，且开始于 4 个月之前，与仅由父母照顾（包括每周少于 10 小时的儿童保育）相比，总体和按社会经济群体进行比较。
与仅由父母照顾相比，非正规（RR0.51（95%CI0.43-0.59））和正规（0.84（0.72-0.99））儿童保育与母乳喂养可能性降低相关。对于非正规儿童保育，无论是兼职还是全日制保育都与母乳喂养风险降低相关，而对于正规儿童保育，只有全日制正规儿童保育与母乳喂养可能性降低相关。非正规儿童保育中母乳喂养可能性降低在所有社会经济群体中相似，而对于正规儿童保育，仅在管理和专业背景的母亲（0.76（0.62-0.94））、有学位的母亲（0.71（0.58-0.86））和夫妻家庭（0.79（0.66-0.94））中观察到母乳喂养可能性降低。相比之下，如果婴儿在正规儿童保育中接受护理，单身母亲更有可能进行母乳喂养（1.65（1.04-2.63））。
非正规儿童保育与所有群体母亲母乳喂养的可能性降低相关。只有当正规儿童保育被更有优势的家庭全日制使用时，才与母乳喂养可能性降低相关。
