Rius J M, Ortuño J, Rivas C, Maravall M, Calzado M A, López A, Aguar M, Vento M
Servicio de Pediatría, Hospital Virgen de la Luz, Cuenca, España.
Servicio de Pediatría, Hospital Virgen de la Vega, Murcia, España.
An Pediatr (Barc). 2014 Jan;80(1):6-15. doi: 10.1016/j.anpedi.2013.05.011. Epub 2013 Oct 3.
Breastfeeding has undoubtedly great benefits. Previous studies have foundan early dropout. Only a few studies have investigated related factors. Our aim was to find out on-going breastfeeding rates along the first 12 months after birth and analyse factors associated with early weaning.
This is a prospective study including consecutive pairs (mother and newborn) till completion of the required sample. Variables were collected performing a structured program of surveys to the mothers. Bivariate and multivariate analysis of the data was performed.
A total of 452 pairs were recruited. It was found that 81% of them started breastfeeding, with a prevalence of breastfeeding of 39% and 21% at 3 and 6 months after birth, respectively. Factors associated with early discontinuation of breastfeeding were: pregnancy induced by assisted reproduction methods (OR=5.58; 95% CI: 2.62-11.91), maternal smoking (OR=1.56; 95% CI: 1.10-2.22), poor maternal expectations about the duration of breastfeeding (OR=2.19; 95% CI: 1.49-3.23), use of nipple shields for breastfeeding (OR=2.57; 95% CI: 1.69-3.90), pacifier use on a regular basis during the first month after delivery (OR=1.39; 95% CI: 1.02-1.91), maternal university educational level (OR=0,59; 95% CI: 0,40-0,88), attending birth preparation programs during pregnancy (OR=0,68; 95% CI: 0,49-0,94), and believing having enough milk output at the time of discharge (OR=0,66; 95% CI: 0,47-0,92).
International recommendations about duration of breastfeeding are not achieved in our country because of high rates of early weaning. We describe the known factors involved and other novel factors. The implementation of interventions to increase breastfeeding rates and to prevent early weaning are strongly recommended.
母乳喂养无疑有诸多益处。以往研究发现早期断奶现象。仅有少数研究调查了相关因素。我们的目的是查明出生后前12个月的持续母乳喂养率,并分析与早期断奶相关的因素。
这是一项前瞻性研究,纳入连续的母婴对直至完成所需样本。通过对母亲进行结构化调查程序来收集变量。对数据进行双变量和多变量分析。
共招募了452对母婴。发现其中81%开始母乳喂养,出生后3个月和6个月时的母乳喂养率分别为39%和21%。与早期断奶相关的因素有:辅助生殖方法导致的妊娠(OR = 5.58;95%可信区间:2.62 - 11.91)、母亲吸烟(OR = 1.56;95%可信区间:1.10 - 2.22)、母亲对母乳喂养持续时间期望低(OR = 2.19;95%可信区间:1.49 - 3.23)、母乳喂养时使用乳头罩(OR = 2.57;95%可信区间:1.69 - 3.90)、产后第一个月定期使用安抚奶嘴(OR = 1.39;95%可信区间:1.02 - 1.91)、母亲大学学历(OR = 0.59;95%可信区间:0.40 - 0.88)、孕期参加分娩准备课程(OR = 0.68;95%可信区间:0.49 - 0.94)以及出院时认为有足够的乳汁分泌量(OR = 0.66;95%可信区间:0.47 - 0.92)。
由于早期断奶率高,我国未达到关于母乳喂养持续时间的国际建议。我们描述了已知的相关因素以及其他新因素。强烈建议实施干预措施以提高母乳喂养率并预防早期断奶。