Sipsma Heather L, Jones Krista, Nickel Nathan C
Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, University of Chicago, Chicago, IL, USA.
Department of Public Health, Benedictine University, Lisle, IL, USA.
Birth. 2017 Sep;44(3):272-280. doi: 10.1111/birt.12284. Epub 2017 Mar 21.
Breastfeeding rates are disproportionately low among young mothers in the United States. Although the use of hospital practices to promote breastfeeding is widely supported, the extent to which these practices help explain breastfeeding disparities by maternal age is unclear. Accordingly, we aimed to explore how maternal age may affect (1) receipt of hospital practices and (2) associations between these practices and exclusive breastfeeding.
Data were derived from participants (n = 1598) of Listening to Mothers III, a national survey administered to mothers of singleton births in United States hospitals from July 2011 to June 2012. We used multivariable logistic regression models and interaction terms to examine maternal age as an effect modifier.
Compared with mothers aged 30 and older, mothers aged 18-19 had lower odds of reporting that nurses helped them initiate breastfeeding when ready (OR 0.59 [95% CI 0.35-0.99]), they roomed-in with their baby (OR 0.32 [95% CI 0.19-54]) and they did not receive a pacifier (OR 0.53 [95% CI 0.32-0.90]). Many associations with breastfeeding were stronger among mothers aged 18-19 and 20-24 than mothers aged 25-29 and 30 and older. Additionally, compared with receiving a pacifier, not receiving a pacifier was associated with greater odds of exclusive breastfeeding at 1 week among mothers aged 30 and older (OR 1.47 [95% CI 1.02-2.11]) but lower odds among mothers aged 18-19 (OR 0.26 [95% CI 0.10-0.70]).
Hospital practices to promote breastfeeding may be differentially implemented by maternal age. Encouraging teenage mothers to room-in with their babies may be particularly important for reducing breastfeeding disparities. Pacifier use among babies of teenage mothers requires further exploration.
美国年轻母亲的母乳喂养率低得不成比例。尽管利用医院措施来促进母乳喂养得到广泛支持，但这些措施在多大程度上有助于解释按母亲年龄划分的母乳喂养差异尚不清楚。因此，我们旨在探讨母亲年龄如何可能影响：（1）医院措施的接受情况；（2）这些措施与纯母乳喂养之间的关联。
数据来自“倾听母亲III”的参与者（n = 1598），这是一项2011年7月至2012年6月在美国医院对单胎分娩母亲进行的全国性调查。我们使用多变量逻辑回归模型和交互项来检验母亲年龄作为效应修饰因素的情况。
与30岁及以上的母亲相比，18 - 19岁的母亲报告护士在她们准备好时帮助她们开始母乳喂养的几率较低（比值比[OR]0.59[95%置信区间（CI）0.35 - 0.99]），她们与婴儿同室（OR 0.32[95% CI 0.19 - 0.54]），并且她们没有收到安抚奶嘴（OR 0.53[95% CI 0.32 - 0.90]）。与母乳喂养的许多关联在18 - 19岁和20 - 24岁的母亲中比在25 - 29岁和30岁及以上的母亲中更强。此外，与收到安抚奶嘴相比，未收到安抚奶嘴与30岁及以上母亲在1周时纯母乳喂养几率更高相关（OR 1.47[95% CI 1.02 - 2.11]），但与18 - 19岁母亲中较低的几率相关（OR 0.26[95% CI 0.10 - 0.70]）。
促进母乳喂养的医院措施可能因母亲年龄而有不同实施情况。鼓励青少年母亲与婴儿同室对于减少母乳喂养差异可能特别重要。青少年母亲所生婴儿使用安抚奶嘴的情况需要进一步探讨。
