Gregory Emily F, Butz Arlene M, Ghazarian Sharon R, Gross Susan M, Johnson Sara B
General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
J Hum Lact. 2015 Aug;31(3):444-51. doi: 10.1177/0890334415579655. Epub 2015 Apr 9.
Breastfeeding expectations predict breastfeeding duration. The extent to which expectations for duration are met remains unknown.
To evaluate prospective measures of expected breastfeeding duration, changes in expectations over time, and factors associated with meeting expectations.
The Infant Feeding Practices Study II followed women from late pregnancy to 1 year postpartum. Expected breastfeeding duration was assessed 5 times. Logistic regression identified factors associated with met prenatal expectations. Subgroup analysis compared met prenatal expectations to satisfaction with breastfeeding duration.
One-year postpartum, 34.7% of 1802 participants had met prenatal expected breastfeeding duration, and 23.9% were still breastfeeding. Fifty-eight percent of women met expectations stated at 7 months postpartum. Modifiable risk factors associated with meeting prenatal expectations included early regular breast pump use (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.18-2.07). Return to work was negatively associated with met expectations (return by 6 weeks postpartum: OR, 0.48; 95% CI, 0.33-0.71; later return: OR, 0.73; 95% CI, 0.56-0.95). Among those who reported on satisfaction with duration (n = 1226), 40.4% were satisfied. Satisfaction was associated with meeting expectations (OR, 10.56; 95% CI, 7.67-14.55), but expectation and satisfaction measures were not equivalent. Elevated body mass index and depressive symptoms at 2 months postpartum were negatively associated with both measures.
Most participants did not meet prenatal or postnatal expectations for breastfeeding duration and were unsatisfied with duration. However, at 12 months, more participants felt they had met their expectations and were satisfied with their breastfeeding duration than were actually breastfeeding. Therefore, women may perceive greater breastfeeding progress than suggested by Healthy People 2020 benchmarks.
母乳喂养期望可预测母乳喂养持续时间。期望的持续时间在多大程度上得以实现仍不清楚。
评估预期母乳喂养持续时间的前瞻性指标、期望随时间的变化以及与实现期望相关的因素。
《婴儿喂养实践研究II》对从妊娠晚期至产后1年的女性进行随访。预期母乳喂养持续时间评估了5次。逻辑回归确定了与实现产前期望相关的因素。亚组分析比较了产前期望的实现情况与对母乳喂养持续时间的满意度。
产后1年，1802名参与者中有34.7%实现了产前预期的母乳喂养持续时间，23.9%仍在进行母乳喂养。58%的女性实现了产后7个月时表达的期望。与实现产前期望相关的可改变风险因素包括早期定期使用吸奶器（优势比[OR]，1.55；95%置信区间[CI]，1.18 - 2.07）。重返工作与实现期望呈负相关（产后6周内返回：OR，0.48；95% CI，0.33 - 0.71；较晚返回：OR，0.73；95% CI，0.56 - 0.95）。在报告对持续时间满意度者中（n = 1226），40.4%感到满意。满意度与实现期望相关（OR，10.56；95% CI，7.67 - 14.55），但期望和满意度指标并不等同。产后2个月时体重指数升高和抑郁症状与这两个指标均呈负相关。
大多数参与者未达到产前或产后对母乳喂养持续时间的期望，且对持续时间不满意。然而，在12个月时，感觉自己实现了期望并对母乳喂养持续时间满意的参与者多于实际仍在进行母乳喂养的人数。因此，女性可能认为母乳喂养进展比《健康人民2020》基准所显示的更大。
