Division of Health Policy and Administration, Yale University School of Epidemiology and Public Health, 47 College Street, Room 104, New Haven, CT 06520-8088, USA.
Matern Child Health J. 2012 Oct;16(7):1421-30. doi: 10.1007/s10995-011-0908-4.
To examine the association between breastfeeding duration and sources of education about breastfeeding and breast pumps. We analyzed data from the Infant Feeding Practices Survey II (n = 2,586), a national longitudinal consumer-based study. We used χ(2) and ANOVA to contrast categorical and continuous variables, respectively, and logistic regression to model the association between breastfeeding duration and sources of education about breastfeeding and breast pump use. In unadjusted results, multiple sources of breastfeeding and breast pump education were significantly associated with breastfeeding duration. However, in multivariable logistic regression models, there was a negative association between longer breastfeeding duration and receiving breast pump education from a physician/physician assistant (OR 0.58, 95% CI 0.36-0.93); and a positive association between longer breastfeeding duration and receiving breastfeeding education from classes/support group (OR: 1.85, 95% CI: 1.24-2.76) and receiving breast pump education from friends/relatives (OR: 1.70, 95% CI: 1.13-2.55). Although healthcare providers such as physicians and nurses have regular contact with women, the only statistically significant association between breastfeeding and breast pump education from healthcare providers and longer breastfeeding duration was a negative one. This likely reflects time and resource limitations of clinical practice, but may also indicate a need for more consistent training for healthcare providers who provide breastfeeding and breast pump education. Social supports, such as education from classes/support groups and friends/relatives demonstrated positive associations with longer breastfeeding duration. This emphasizes the importance of fostering a positive sphere of influence around breastfeeding women. Future work should also investigate alternative levers of action, such as policies affecting insurance coverage of breast pumps.
为了研究母乳喂养时长与母乳喂养和吸奶器教育来源之间的关系，我们分析了婴儿喂养实践调查 II （n=2586）的数据，这是一项全国性的纵向消费者为基础的研究。我们分别使用 χ(2)和 ANOVA 来对比分类和连续变量，并使用逻辑回归来建立母乳喂养时长与母乳喂养和吸奶器使用教育来源之间的关系。在未调整的结果中，多种母乳喂养和吸奶器教育来源与母乳喂养时长显著相关。然而，在多变量逻辑回归模型中，较长的母乳喂养时长与从医生/医生助理那里获得吸奶器教育呈负相关（OR 0.58，95%CI 0.36-0.93）；与从课程/支持小组获得母乳喂养教育呈正相关（OR：1.85，95%CI：1.24-2.76），与从朋友/亲戚那里获得吸奶器教育呈正相关（OR：1.70，95%CI：1.13-2.55）。尽管医生和护士等医疗保健提供者与女性有定期接触，但医疗保健提供者提供的母乳喂养和吸奶器教育与较长的母乳喂养时长之间唯一具有统计学意义的关联是负相关。这可能反映了临床实践的时间和资源限制，但也可能表明需要为提供母乳喂养和吸奶器教育的医疗保健提供者提供更一致的培训。社会支持，如来自课程/支持小组和朋友/亲戚的教育，与较长的母乳喂养时长呈正相关。这强调了在母乳喂养女性周围营造积极影响圈的重要性。未来的工作还应研究替代的行动杠杆，例如影响吸奶器保险覆盖范围的政策。
