Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mail-stop K-22, Atlanta, GA 30341-3724, USA.
Matern Child Health J. 2012 Nov;16(8):1672-8. doi: 10.1007/s10995-011-0871-0.
Research shows that maternity care practices are important to promoting breastfeeding in the early post partum period; however, little is known about the association between maternity care practices and breastfeeding among different racial and ethnic groups. We examined the association between maternity care practices and breastfeeding duration to ≥10 weeks overall and among various racial and ethnic groups using data from the Pregnancy Risk Assessment and Monitoring System (PRAMS). PRAMS is a state, population-based surveillance system that collects information on maternal behaviors. We used maternity care practices data from 11 states and New York City with response rates ≥70% from 2004 to 2006. Multiple maternity care practices were examined and the analysis adjusted for demographic characteristics, participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), lifestyle, and infant variables. The outcome variable for multivariable analysis was breastfeeding duration to <10 weeks or ≥10 weeks. PRAMS data show that 22.1% of women did not breastfeed, about 27.7% breastfed for <10 weeks and 50.2% breastfed for ≥10 weeks. Breastfeeding patterns varied with white and Hispanic women reporting highest breastfeeding initiation and duration prevalence. Overall, practices positively associated with ≥10 duration were: breastfeeding initiated within the first hour after birth (adjusted OR [AOR] = 1.29; 95% CI: 1.16-1.45); fed breast milk only (AOR = 2.40; 95% CI: 2.15-2.68); breastfed on demand (AOR = 1.23; 95% CI 1.08-1.40) and receiving telephone support (AOR = 1.20; 95% CI: 1.03-1.39). Maternity care practices associated with breastfeeding to ≥10 weeks varied across three racial/ethnic groups. One practice, that of giving newborns breast milk only, was positively associated with breastfeeding duration of ≥10 weeks across all three groups. Maternity care practices associated with breastfeeding continuation to ≥10 weeks varied by race/ethnicity. For example: breastfeeding within the first hour, baby given a pacifier, and assistance from hospital staff, were significantly associated with breastfeeding duration among black and white women and not Hispanics. The practice of breastfeeding on demand was significantly associated with breastfeeding to ≥10 weeks for black and Hispanic women and not for whites. Hospitals may want to examine the implementation of specific practices in relation to the cultural backgrounds of women to promote breastfeeding.
研究表明，产妇护理实践对促进产后早期母乳喂养很重要；然而，对于不同种族和族裔群体的产妇护理实践与母乳喂养之间的关联知之甚少。我们使用来自妊娠风险评估和监测系统（PRAMS）的数据，检查了产妇护理实践与母乳喂养持续时间的关系，以了解整体和不同种族和族裔群体中持续时间≥ 10 周的情况。PRAMS 是一个州、基于人群的监测系统，收集产妇行为信息。我们使用了来自 2004 年至 2006 年 11 个州和纽约市的数据，这些州和市的回复率≥ 70%。研究了多种产妇护理实践，分析调整了人口统计学特征、参与妇女、婴儿和儿童特别补充营养计划（WIC）、生活方式和婴儿变量。多变量分析的结果变量是母乳喂养持续时间<10 周或≥10 周。PRAMS 数据显示，22.1%的女性不进行母乳喂养，约 27.7%的女性母乳喂养持续时间<10 周，50.2%的女性母乳喂养持续时间≥10 周。母乳喂养模式因白人和西班牙裔妇女报告的母乳喂养起始和持续时间最高而有所不同。总体而言，与≥10 周持续时间呈正相关的做法包括：在出生后第一小时内开始母乳喂养（调整后的比值比 [AOR] = 1.29；95%CI：1.16-1.45）；仅喂母乳（AOR = 2.40；95%CI：2.15-2.68）；按需母乳喂养（AOR = 1.23；95%CI 1.08-1.40）和接受电话支持（AOR = 1.20；95%CI：1.03-1.39）。与母乳喂养至≥10 周相关的产妇护理实践因三个种族/族裔群体而异。有一种做法，即仅给新生儿喂母乳，与所有三组的母乳喂养持续时间≥10 周呈正相关。与母乳喂养持续时间≥10 周相关的产妇护理实践因种族/族裔而异。例如：在第一小时内母乳喂养、给婴儿奶嘴和医院工作人员的帮助，与黑人和白人妇女的母乳喂养持续时间显著相关，而与西班牙裔妇女无关。按需母乳喂养与黑人妇女和西班牙裔妇女的母乳喂养至≥10 周显著相关，而与白人妇女无关。医院可能希望检查与妇女文化背景相关的具体实践的实施情况，以促进母乳喂养。
