Grimshaw Kate E C, Aksoy Burcu, Palmer Anna, Jenner Katharine, Oliver Erin M, Maskell Joe, Kemp Terri, Foote Keith D, Roberts Graham C, Ellahi Basma, Margetts Barrie M
Clinical Experimental Science Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
Department of Clinical Sciences, University of Chester, Chester, UK.
Matern Child Nutr. 2015 Oct;11(4):703-11. doi: 10.1111/mcn.12052. Epub 2013 Jun 18.
Breastfeeding duration and exclusive breastfeeding rates are universally below those recommended by World Health Organization. Due to limitations and challenges associated with researching breastfeeding characteristics, the times when exclusivity is likely to be lost and when women are most likely to discontinue breastfeeding have not yet been identified. Prospective food diaries allow reliable description of the dynamics of breastfeeding to be made to help identify these key time periods. Food diaries detailing intake from birth until the cessation of breastfeeding were analysed for 718 infants recruited into a national arm of an international multicentre birth cohort study (EuroPrevall). Analyses included linear regression analysis and Kaplan-Meier time course analysis. Breastfeeding and exclusive breastfeeding cessation rates for younger mothers (<25 years) are high in the first few weeks after delivery but slow markedly in the period 10-12 weeks after delivery. Cessation rates are consistent from 0 to 26 weeks in older mothers. This difference in feeding patterns led to significant differences between the two different age groups at 26 weeks for breastfeeding (P = 0.006) and exclusive breastfeeding at 8 weeks (P = 0.009). Forty-nine per cent of younger mothers (<25 years) stopped breastfeeding before their infant was 3 weeks old. To increase breastfeeding duration, further work is required to investigate the attitudes and perceptions associated with such high breastfeeding cessation rates in younger mothers during these very early post-natal weeks.
母乳喂养的持续时间和纯母乳喂养率普遍低于世界卫生组织的建议水平。由于研究母乳喂养特征存在局限性和挑战，目前尚未确定可能失去纯母乳喂养的时间以及女性最有可能停止母乳喂养的时间。前瞻性食物日记能够可靠地描述母乳喂养的动态变化，有助于确定这些关键时期。对国际多中心出生队列研究（欧洲Prevail）的一个国家分支中招募的718名婴儿，分析了从出生到停止母乳喂养期间详细记录摄入量的食物日记。分析包括线性回归分析和Kaplan-Meier时间进程分析。年轻母亲（<25岁）在分娩后的头几周内母乳喂养和纯母乳喂养的停止率较高，但在分娩后10 - 12周期间显著下降。年龄较大的母亲在0至26周期间停止率较为稳定。这种喂养模式的差异导致两个不同年龄组在26周时母乳喂养（P = 0.006）和8周时纯母乳喂养（P = 0.009）存在显著差异。49%的年轻母亲（<25岁）在其婴儿3周龄之前就停止了母乳喂养。为了延长母乳喂养时间，需要进一步开展工作，以调查年轻母亲在产后早期出现如此高的母乳喂养停止率背后的态度和观念。
