Kistin N, Benton D, Rao S, Sullivan M
Cook County Hospital, Chicago, Illinois.
Pediatrics. 1990 Nov;86(5):741-6.
Many factors are associated with low breast-feeding rates among black low-income women. This study examines whether, despite such factors, health professionals' prenatal education of black poor women is associated with increased breast-feeding rates. Black women born in the United States who attended a midwives prenatal clinic (N = 159) were randomly assigned to two types of prenatal education or were followed up in a control group. All women were interviewed on entry into the study and after delivery of their infants. Women assigned to group classes attended at least one session discussing myths, problems, and benefits of breast-feeding. Women assigned to individual prenatal counseling spoke with a pediatrician or nurse practitioner, who discussed breast-feeding topics similar to those covered in the classes. Women in the control group received no additional prenatal education. The three study groups had significantly different percentages of women who breast-fed (controls 22%, classes 46%, individual sessions 53%). Higher percentages of women in the study groups carried out their prenatal plans to breast-feed (controls 50%, classes 86%, individual sessions 62%) or breast-fed despite prenatal plans to bottle-feed (controls 10%, classes 26%, individual sessions 48%). After multivariable analysis controlling for age, prenatal plans to breast-feed, prior breast-feeding experience, perceived support for breast-feeding, education, gravidity, and employment plans, women in intervention groups had a higher likelihood of breast-feeding than control subjects. These findings suggest that an increase in relatively simple, not-too-time-consuming educational efforts in institutions and offices serving black low-income women might yield significant narrowing of the gap in breast-feeding rates between white affluent women and black low-income women.
许多因素与黑人低收入女性的低母乳喂养率相关。本研究探讨了尽管存在这些因素，但健康专业人员对黑人贫困女性的产前教育是否与母乳喂养率的提高相关。在美国出生的参加助产士产前诊所的黑人女性（N = 159）被随机分配到两种产前教育类型中，或在对照组中接受随访。所有女性在进入研究时和分娩后都接受了访谈。被分配到小组课程的女性参加了至少一次讨论母乳喂养的误区、问题和益处的课程。被分配到个体产前咨询的女性与儿科医生或执业护士交谈，他们讨论了与课程中涵盖的类似的母乳喂养话题。对照组的女性没有接受额外的产前教育。三个研究组中进行母乳喂养的女性百分比有显著差异（对照组22%，课程组46%，个体咨询组53%）。研究组中更高比例的女性按照她们的产前计划进行母乳喂养（对照组50%，课程组86%，个体咨询组62%），或者尽管产前计划是瓶喂但仍然进行了母乳喂养（对照组10%，课程组26%，个体咨询组48%）。在对年龄、产前母乳喂养计划、既往母乳喂养经历、感知到的母乳喂养支持、教育程度、妊娠次数和就业计划进行多变量分析后，干预组的女性比对照组更有可能进行母乳喂养。这些发现表明，在为黑人低收入女性服务的机构和办公室中增加相对简单、不太耗时的教育努力，可能会显著缩小白人富裕女性和黑人低收入女性在母乳喂养率上的差距。
