Cordero L, Oza-Frank R, Moore-Clingenpeel M, Landon M B, Nankervis C A
Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA.
Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.
J Neonatal Perinatal Med. 2016;9(4):401-409. doi: 10.3233/NPM-161610.
In the US, at the time of discharge from the hospital, 79% of women had initiated breastfeeding. Intention to breastfeed is a strong predictor of breastfeeding initiation; however, we reported initiation failure in 45% of women with pregestational diabetes who intended to breastfeed. Information regarding intention and initiation among women with other high risk obstetrical conditions (HROB) remains scarce.
To ascertain demographic and clinical factors associated with breastfeeding initiation failure among women with HROB conditions who intended to breastfeed.
The study population is comprised of 89 women with diabetes (DM), 57 who were receiving treatment for substance abuse (SA), 51 women diagnosed with miscellaneous (MISC) conditions and 32 with history of preterm labor/delivery (PTL/D). Intention to exclusively breastfeed or in combination with formula (breastfed/FF) was ascertained prenatally. Breastfeeding was considered initiated if at discharge ≥50% of their infant feedings were maternal milk. Statistics include chi-square, Wilcoxon's and logistic regression (p < 0.05).
Of all women, 59% initiated any breastfeeding. Intention to breastfeed/FF, lack of mother-infant contact during the first hour following birth and limited lactation consultation were predictive of initiation failure. The odds of initiation failure were 2.3 times higher among women who wished to breastfeed/FF as compared to those who wished to exclusively breastfeed. Women from the SA group had lower rates of initiation failure than the other three HROB groups.
Intention to breastfeed among women with diverse HROB conditions is similar to that of the general population; however, initiation rates are disappointingly low. Intention to exclusively breastfeed results in fewer initiation failures. Prenatal intention to combine breast and formula feeding characterize women who may benefit from specific educational programs.
在美国，出院时79%的女性已开始母乳喂养。母乳喂养意愿是开始母乳喂养的有力预测指标；然而，我们报告称，45%打算母乳喂养的孕前糖尿病女性开始母乳喂养失败。关于其他高危产科情况（HROB）女性的母乳喂养意愿和开始情况的信息仍然很少。
确定打算母乳喂养的HROB情况女性中与母乳喂养开始失败相关的人口统计学和临床因素。
研究人群包括89名糖尿病（DM）女性、57名接受药物滥用治疗（SA）的女性、51名被诊断为其他疾病（MISC）的女性和32名有早产/分娩史（PTL/D）的女性。在产前确定纯母乳喂养或混合喂养（母乳喂养/配方奶喂养）的意愿。如果出院时≥50%的婴儿喂养是母乳，则认为开始母乳喂养。统计方法包括卡方检验、威尔科克森检验和逻辑回归（p<0.05）。
所有女性中，59%开始了任何形式的母乳喂养。母乳喂养/配方奶喂养的意愿、出生后第一小时母婴接触不足以及泌乳咨询有限是开始母乳喂养失败的预测因素。与希望纯母乳喂养的女性相比，希望母乳喂养/配方奶喂养的女性开始母乳喂养失败的几率高2.3倍。SA组女性的开始母乳喂养失败率低于其他三个HROB组。
患有不同HROB情况的女性母乳喂养意愿与普通人群相似；然而，开始母乳喂养的比例低得令人失望。纯母乳喂养的意愿导致开始母乳喂养失败的情况较少。产前有混合母乳喂养和配方奶喂养意愿的女性可能会从特定的教育项目中受益。
