University of Health Sciences, Faculty of Postgraduate Studies, Vientiane, Laos.
BMC Pregnancy Childbirth. 2013 Dec 5;13:223. doi: 10.1186/1471-2393-13-223.
The benefits of breastfeeding are well-recognised. The majority of first-time mothers in the Lao People's Democratic Republic however do not follow WHO guidelines of exclusively breastfeeding for the first six months, and less than half breastfeed for two years. UNICEF identified lack of exclusive breastfeeding as the second highest risk factor for under 5 mortality in Lao PDR, closely following lack of skilled delivery care. This study explored the reasons and influences behind first-time mothers' breastfeeding practices, as well as the role of attitudes, beliefs and experiences in influencing those practices.
A qualitative research design was chosen for this exploratory study. Two districts in Vientiane were selected, and in each district four focus group discussions, two with six first-time mothers and two with health staff were undertaken. In addition, sixteen in-depth interviews with first-time mothers and seven individual key informants were conducted.
Participants demonstrated positive attitudes towards breastfeeding and recognised its importance. Despite this, breastfeeding practices were suboptimal. Few exclusively breastfed for the first six months of the baby's life and most of the first-time mothers included in the sample had stopped or planned to stop breastfeeding by the time the infant was 18 months of age. Work was named as one of the main reasons for less than ideal breastfeeding practices. Traditional beliefs and advice from health staff and the first-time mothers' own mothers, were important influences on breastfeeding practices. First-time mothers also cited experiencing tension when there were differences in advice they received from different people.
Overall, the mothers were well-informed on the benefits of breastfeeding, and displayed positive attitudes towards it. Nevertheless, few maintained optimal breastfeeding practices in the first two years of the infant's life. Further effort needs to be directed at addressing knowledge and non-knowledge barriers to optimal breastfeeding practices. Of particular importance is working with employers, developing supportive employment policies, providing postnatal support and working with lay people and health professionals. Research is also needed to identify the optimal combination of interventions to promote good breastfeeding practices.
母乳喂养的益处是众所周知的。然而，老挝人民民主共和国的大多数初产妇并没有遵循世界卫生组织的指导方针，即纯母乳喂养至 6 个月，而且不到一半的产妇母乳喂养至 2 年。联合国儿童基金会确定，缺乏纯母乳喂养是老挝人民民主共和国 5 岁以下儿童死亡的第二大高风险因素，仅次于缺乏熟练的分娩护理。本研究探讨了初产妇母乳喂养行为的背后原因和影响因素，以及态度、信念和经验在影响这些行为方面的作用。
本探索性研究采用定性研究设计。在万象选择了两个区，每个区进行了两次焦点小组讨论，每次讨论有 6 名初产妇和 2 名卫生工作者参加。此外，还对 16 名初产妇进行了 16 次深入访谈，并对 7 名关键知情人进行了个人访谈。
参与者对母乳喂养表现出积极的态度，并认识到其重要性。尽管如此，母乳喂养的做法仍不尽如人意。很少有人在婴儿生命的前 6 个月完全母乳喂养，而且大多数参与研究的初产妇在婴儿 18 个月时已经停止或计划停止母乳喂养。工作被认为是导致母乳喂养不理想的主要原因之一。传统观念以及卫生工作者和初产妇自己母亲的建议，对母乳喂养的做法有重要影响。初产妇还提到，当她们从不同的人那里收到不同的建议时，她们会感到紧张。
总的来说，母亲们对母乳喂养的益处有很好的了解，并对此持积极态度。然而，很少有人在婴儿生命的头两年保持最佳的母乳喂养行为。需要进一步努力解决知识和非知识障碍，以实现最佳母乳喂养行为。特别重要的是与雇主合作，制定支持性的就业政策，提供产后支持，并与非专业人员和卫生专业人员合作。还需要研究确定促进良好母乳喂养行为的最佳干预措施组合。
