[阿拉伯婴儿早期断奶和延长母乳喂养的决定因素有哪些？]

Muhsen Khitam, Masarwa Samaher, Guttman Einat, Cohen Dani

Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.

Harefuah. 2011 Apr;150(4):333-7, 420.

BACKGROUND

Data on the determinants of breastfeeding in the Israeli Arab population are scarce.

AIMS

To examine breastfeeding practices and determinants of early breastfeeding weaning (< or =3 months of age) and of prolonged breastfeeding (>1 year of age) among Arab infants.

METHODS

A total of 213 heaLthy fuLL term newborns from 2 villages in northern Israel were followed-up until they reached 18 months of age in 2007-2009. Socio-demographic data and prenatal and neonatal history were obtained by maternal interviews. Mothers were interviewed again regarding their breastfeeding practices when the infants were 2, 4, 6, 8, 12 and 18 months of age.

RESULTS

Breastfeeding (any) and exclusive breastfeeding rates at enrollment (age 1 week to 2 months) were 98% and 20%, respectively. The proportions of early breastfeeding weaning and prolonged breastfeeding were 33% and 17%, respectively. In the lower socioeconomic status village, the risk of early breastfeeding weaning increased in girls (OR 2.69, P = 0.03), babies having siblings (OR 0.62, P = 0.03], those who had received herbal tea early (OR 3.33, P = 0.01), and neonates who were treated in intensive care after delivery (OR 8.48, P = 0.01]. It decreased with higher paternal education (OR=0.84, P = 0.01). Higher paternal education was also associated with increased odds of prolonged breastfeeding while early introduction of formula negatively affected these odds. In the higher socioeconomic status village, the risk of early breastfeeding weaning increased in relation to early introduction of formula (OR 3.95, P = 0.01) and decreased in relation to maternal use of folic acid in pregnancy [OR=0.20, P = 0.05). Folic acid use in pregnancy and having additional children increased the odds of prolonged breastfeeding, while early formula introduction decreased the odds.

CONCLUSIONS

The rate of exclusive breastfeeding is low and early breastfeeding weaning is common in Arab infants. The predictors of early and prolonged breastfeeding are in part behavioral and modifiable. Breastfeeding practices among IsraeLi Arab infants can be improved by adequate health education. Such interventions should also be oriented to Arab fathers.

背景

关于以色列阿拉伯人群母乳喂养决定因素的数据很少。

目的

研究阿拉伯婴儿的母乳喂养情况以及早期断奶（≤3个月龄）和延长母乳喂养（＞1岁）的决定因素。

方法

2007年至2009年，对以色列北部两个村庄的213名足月健康新生儿进行随访，直至他们满18个月龄。通过对母亲的访谈获取社会人口统计学数据以及产前和新生儿病史。当婴儿2、4、6、8、12和18个月大时，再次对母亲进行关于其母乳喂养情况的访谈。

结果

入组时（1周龄至2个月龄）的母乳喂养（任何形式）率和纯母乳喂养率分别为98%和20%。早期断奶和延长母乳喂养的比例分别为33%和17%。在社会经济地位较低的村庄，女孩早期断奶的风险增加（比值比2.69，P = 0.03），有兄弟姐妹的婴儿（比值比0.62，P = 0.03），早期喝过草药茶的婴儿（比值比3.33，P = 0.01），以及出生后在重症监护室接受治疗的新生儿（比值比8.48，P = 0.01）。随着父亲受教育程度提高，风险降低（比值比 = 0.84，P = 0.01）。父亲受教育程度较高也与延长母乳喂养的几率增加有关，而早期引入配方奶则对这些几率有负面影响。在社会经济地位较高的村庄，早期断奶的风险与早期引入配方奶有关（比值比3.95，P = 0.01），与母亲孕期使用叶酸有关的风险降低（比值比 = 0.20，P = 0.05）。孕期使用叶酸和有更多孩子会增加延长母乳喂养的几率，而早期引入配方奶则会降低几率。