Kearns Annie D, Castro Marcia C, Lourenço Bárbara H, Augusto Rosângela A, Cardoso Marly A
Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, 01246-904, Brazil.
Matern Child Health J. 2016 Jul;20(7):1539-48. doi: 10.1007/s10995-016-1953-9.
Introduction Breastfeeding is an important determinant of child survival and normal growth and development, but breastfeeding prevalence is generally low in Brazil. Factors associated with infant feeding practices there are not well understood. This paper examines factors associated with breastfeeding cessation in a township in the western Brazilian Amazon. Methods A cross-sectional, population-based study was conducted among children younger than 25 months and collected information on maternal and child characteristics. Survival analysis based on a proximal-distal framework examined the association between breastfeeding duration and socioeconomic and maternal/child biological factors. Results The median breastfeeding duration among 101 children who were no longer breastfeeding was 120 days. Almost two-thirds (63 %) of these children stopped breastfeeding before 6 months of age. In the larger sample of 209 children, 74.6 % had previously been bottle-fed. Considering the full proximal-distal model, a child who had ever been bottle-fed was expected to cease breastfeeding about 88 % sooner than one who was never bottle-fed (p < 0.001). Children in the second-poorest wealth quartile stopped breastfeeding sooner than children in the poorest quartile (p < 0.05). Discussion Breastfeeding cessation in the study area occurred much earlier than the recommended 2 years of age. Factors associated with ending breastfeeding early included ever-use of a bottle, having a single mother, and belonging to the second-poorest wealth quartile. Further research is needed to better understand these factors and other barriers women face to continuing breastfeeding.
引言
母乳喂养是儿童生存及正常生长发育的重要决定因素，但在巴西，母乳喂养的普及率普遍较低。该国与婴儿喂养方式相关的因素尚未得到充分了解。本文研究了巴西亚马孙地区西部一个城镇中与母乳喂养停止相关的因素。
方法
对25个月以下儿童开展了一项基于人群的横断面研究，收集了母婴特征信息。基于近端-远端框架的生存分析考察了母乳喂养持续时间与社会经济因素以及母婴生物学因素之间的关联。
结果
在101名已停止母乳喂养的儿童中，母乳喂养持续时间的中位数为120天。其中近三分之二（63%）的儿童在6个月龄前停止母乳喂养。在209名儿童的更大样本中，74.6%的儿童曾使用奶瓶喂养。考虑完整的近端-远端模型，曾使用奶瓶喂养的儿童预计比从未使用奶瓶喂养的儿童提前约88%停止母乳喂养（p<0.001）。第二贫困财富四分位数组的儿童比最贫困四分位数组的儿童更早停止母乳喂养（p<0.05）。
讨论
研究地区母乳喂养停止的时间比建议的2岁要早得多。与早期停止母乳喂养相关的因素包括曾使用奶瓶、母亲为单身以及属于第二贫困财富四分位数组。需要进一步开展研究，以更好地了解这些因素以及女性在持续母乳喂养方面面临的其他障碍。
