Ma Xiaoguang, Liu Jihong, Smith Michael
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA,
Matern Child Health J. 2014 Jul;18(5):1271-9. doi: 10.1007/s10995-013-1362-2.
Few studies examined breastfeeding initiation and duration among mothers who were eligible for the Women Infants Children (WIC) program and did not participate. This study is sought to understand the role of WIC participation and poverty level in breastfeeding initiation and duration in South Carolina. The data came from the 2009-2010 South Carolina Pregnancy Risk Assessment Monitoring System (unweighted N = 1,796). All participants were classified as WIC participants, income-eligible non-WIC participants, and income-ineligible non-WIC participants. Logistic regression models were used to analyze the association between breastfeeding initiation and WIC participation. The Kaplan-Meier method and Cox proportional hazards models were used to determine whether the continuation of breastfeeding and hazards of discontinuing breastfeeding differed by WIC participation groups. In South Carolina, two out of three women (67.2%) initiated breastfeeding. The breastfeeding initiation rate was higher among income-ineligible (84.0%) and income-eligible (78.9%) non-WIC participants than among WIC participants (55.5%). Compared to WIC participants, both income-ineligible [odds ratio (OR) = 2.1, 95% confidence interval (CI) 1.2-4.0] and income-eligible (OR = 2.6, 95% CI 1.1-4.3) non-WIC participants were more likely to initiate breastfeeding. Among mothers who already initiated breastfeeding, after adjusting covariates, the hazard ratios for weaning within 34 weeks postpartum were not significantly different by WIC participation groups. This study confirmed WIC participants were less likely to initiate breastfeeding. Once initiated, WIC participation did not significantly impact breastfeeding duration in the early postpartum period. Poverty status may not play an important role in explaining disparities in breastfeeding initiation between WIC and non-WIC participants.
很少有研究调查符合妇女婴儿儿童（WIC）项目资格但未参与该项目的母亲的母乳喂养开始情况和持续时间。本研究旨在了解WIC项目参与情况和贫困水平在南卡罗来纳州母乳喂养开始情况和持续时间方面所起的作用。数据来自2009 - 2010年南卡罗来纳州妊娠风险评估监测系统（未加权N = 1796）。所有参与者被分为WIC项目参与者、符合收入条件的非WIC项目参与者和不符合收入条件的非WIC项目参与者。使用逻辑回归模型分析母乳喂养开始与WIC项目参与之间的关联。采用Kaplan - Meier方法和Cox比例风险模型来确定WIC项目参与组之间母乳喂养的持续情况和停止母乳喂养的风险是否存在差异。在南卡罗来纳州，三分之二的女性（67.2%）开始了母乳喂养。不符合收入条件（84.0%）和符合收入条件（78.9%）的非WIC项目参与者的母乳喂养开始率高于WIC项目参与者（55.5%）。与WIC项目参与者相比，不符合收入条件的非WIC项目参与者[优势比（OR）= 2.1，95%置信区间（CI）1.2 - 4.0]和符合收入条件的非WIC项目参与者（OR = 2.6，95% CI 1.1 - 4.3）开始母乳喂养的可能性更大。在已经开始母乳喂养的母亲中，调整协变量后，产后34周内断奶的风险比在WIC项目参与组之间没有显著差异。本研究证实WIC项目参与者开始母乳喂养的可能性较小。一旦开始，WIC项目参与在产后早期对母乳喂养持续时间没有显著影响。贫困状况在解释WIC项目参与者和非WIC项目参与者在母乳喂养开始方面的差异时可能不起重要作用。
