Training and Assistance for Health & Nutrition (TAHN) Foundation, Bangladesh.
Int Breastfeed J. 2010 Nov 30;5:21. doi: 10.1186/1746-4358-5-21.
In Bangladesh, many programs and projects have been promoting breastfeeding since the late 1980 s. Breastfeeding practices, however, have not improved accordingly.
For identifying program-relevant issues to improve breastfeeding in infancy, quantitative data were collected through visits to households (n = 356) in rural Chittagong and urban slums in Dhaka, and qualitative data from sub-samples by applying semi-structured in-depth interviews (n = 42), focus group discussions (n = 28), and opportunistic observations (n = 21). Trials of Improved Practices (TIPs) (n = 26) were conducted in the above sites and rural Sylhet to determine how best to design further interventions. Our analysis focused on five breastfeeding practices recommended by the World Health Organization: putting baby to the breast within the first hour of birth, feeding colostrum and not giving fluids, food or other substances in the first days of life, breastfeeding on demand, not feeding anything by bottle, and exclusive breastfeeding for the first six months.
The biggest gaps were found to be in putting baby to the breast within the first hour of birth (76% gap), feeding colostrum and not giving other fluids, foods or substances within the first three days (54% gap), and exclusive breastfeeding from birth through 180 days (90% gap). Lack of knowledge about dangers of delaying initiation beyond the first hour and giving other fluids, foods or substances, and the common perception of "insufficient milk" were main reasons given by mothers for these practices. Health workers had talked to only 8% of mothers about infant feeding during antenatal and immunization visits, and to 34% of mothers during sick child visits. The major providers of infant feeding information were grandmothers (28%).
The findings showed that huge gaps continue to exist in breastfeeding behaviors, mostly due to lack of awareness as to why the recommended breastfeeding practices are beneficial, the risks of not practicing them, as well as how to practice them. Health workers' interactions for promoting and supporting optimal breastfeeding are extremely low. Counseling techniques should be used to reinforce specific, priority messages by health facility staff and community-based workers at all contact points with mothers of young infants.
自 20 世纪 80 年代末以来，孟加拉国许多项目和计划一直在推广母乳喂养。然而，母乳喂养的做法并没有相应改善。
为了确定改善婴儿期母乳喂养的相关方案问题，通过对农村吉大港和达卡贫民窟的家庭（n=356）进行家访，收集了定量数据，并通过半结构化深入访谈（n=42）、焦点小组讨论（n=28）和机会观察（n=21）对亚样本进行了定性数据收集。在上述地点和农村锡尔赫特开展了改进实践试验（TIPs）（n=26），以确定如何最好地设计进一步的干预措施。我们的分析重点是世界卫生组织推荐的五种母乳喂养做法：在出生后第一个小时内让婴儿吃奶、在头三天内喂养初乳而不给其他液体、食物或其他物质、按需哺乳、不使用奶瓶喂养、在头六个月内进行纯母乳喂养。
发现在出生后第一个小时内让婴儿吃奶（76%的差距）、在头三天内喂养初乳而不给其他液体、食物或其他物质（54%的差距）和从出生到 180 天内进行纯母乳喂养（90%的差距）方面存在最大差距。母亲们给出的这些做法的主要原因是，她们对在第一个小时后延迟开始和给予其他液体、食物或物质的危险以及“奶水不足”的普遍看法缺乏认识。在产前和免疫接种访问期间，卫生工作者仅与 8%的母亲谈论过婴儿喂养问题，在儿童患病期间与 34%的母亲谈论过。提供婴儿喂养信息的主要提供者是祖母（28%）。
调查结果表明，母乳喂养行为方面仍然存在巨大差距，主要原因是缺乏对推荐的母乳喂养做法有益的原因、不实践这些做法的风险以及如何实践这些做法的认识。卫生工作者促进和支持最佳母乳喂养的互动非常低。应使用咨询技巧，通过卫生机构工作人员和社区工作者在与婴幼儿母亲的所有接触点，强化具体的、优先的信息。
