Felice Julia P, Cassano Patricia A, Rasmussen Kathleen M
Division of Nutritional Sciences, Cornell University, Ithaca, NY
Division of Nutritional Sciences, Cornell University, Ithaca, NY.
Am J Clin Nutr. 2016 May;103(5):1267-77. doi: 10.3945/ajcn.115.115733. Epub 2016 Mar 23.
Most American mothers who feed human milk (HM) now use pumps to produce some of the HM they feed. Pumping is nationally recommended, but associations between pumping and HM-feeding durations are unknown.
We examined whether and how the pumping frequency and types of reasons for pumping between 1.5 and 4.5 mo postpartum are associated with HM-feeding durations. We classified pumping reasons as nonelective [e.g., because of a difficulty feeding at the breast (FAB)] or elective (e.g., to produce HM to mix with solids). We hypothesized that women who pumped more frequently or nonelectively would have shorter HM-feeding durations.
We used data from 1116 mothers in a longitudinal cohort who fed and pumped HM 1.5-4.5 mo postpartum. We used χ(2) and Cox proportional hazards regression models to examine the survival of any HM feeding, exclusive HM feeding, and FAB.
Compared with mothers who pumped for elective reasons, mothers who reported one nonelective reason had greater hazards of stopping feeding any HM (HR: 1.12; 95% CI: 1.05, 1.21) or exclusive HM (HR: 1.14; 95% CI: 1.09, 1.20) and of stopping FAB (HR: 2.07; 95% CI: 1.77, 2.42). Mothers who pumped most frequently had the highest mean hazards of stopping feeding any HM (HR: 1.82; 95% CI: 1.68, 1.93) and feeding exclusive HM (HR: 1.21; 95% CI: 1.14, 1.26). Hazards of stopping FAB varied across the year. Compared with the least-frequent pumpers, the most-frequent pumpers had a 2.6-fold higher hazard of stopping FAB at 3 mo postpartum and a 1.7-fold higher hazard at 6 mo postpartum.
Nonelective pumping reasons and higher pumping frequency were associated with shorter HM-feeding durations. Mothers who report that they use a breast pump for reasons related to either employment or FAB difficulty and their infants may be more vulnerable to risks associated with a shorter HM-feeding duration.
现在，大多数进行母乳喂养的美国母亲会使用吸奶器来挤出部分她们用于喂养的母乳。全国范围内都推荐使用吸奶器，但吸奶器使用情况与母乳喂养时长之间的关联尚不清楚。
我们研究了产后1.5至4.5个月期间的吸奶频率和吸奶原因类型是否以及如何与母乳喂养时长相关。我们将吸奶原因分为非选择性的（例如，由于亲喂困难）或选择性的（例如，为了挤出母乳以便与固体食物混合）。我们假设更频繁吸奶或非选择性吸奶的女性母乳喂养时长会更短。
我们使用了来自一个纵向队列中1116名母亲的数据，这些母亲在产后1.5至4.5个月进行母乳喂养并使用吸奶器。我们使用卡方检验和Cox比例风险回归模型来研究纯母乳喂养、完全母乳喂养以及亲喂困难情况的持续时间。
与因选择性原因吸奶的母亲相比，报告一项非选择性吸奶原因的母亲停止纯母乳喂养（风险比：1.12；95%置信区间：1.05，1.21）、停止完全母乳喂养（风险比：1.14；95%置信区间：1.09，1.20）以及停止亲喂困难情况（风险比：2.07；95%置信区间：1.77，2.42）的风险更高。吸奶最频繁的母亲停止纯母乳喂养（风险比：1.82；95%置信区间：1.68，1.93）和停止完全母乳喂养（风险比：1.21；95%置信区间：1.14，1.26）的平均风险最高。停止亲喂困难情况的风险在一年中有所不同。与吸奶频率最低的母亲相比，吸奶频率最高的母亲在产后3个月停止亲喂困难情况的风险高2.6倍，在产后6个月高1.7倍。
非选择性吸奶原因和更高的吸奶频率与更短的母乳喂养时长相关。报告因工作或亲喂困难而使用吸奶器的母亲及其婴儿可能更容易面临母乳喂养时长较短所带来的风险。
