Cox Kylee, Giglia Roslyn, Binns Colin W
WA Country Health Service, Perth, Western Australia, Australia.
School of Public Health, Curtin University, Perth, Western Australia, Australia.
Aust J Rural Health. 2017 Dec;25(6):369-375. doi: 10.1111/ajr.12362. Epub 2017 Aug 23.
Despite strong and growing evidence for the benefits of exclusive breastfeeding to 6 months of age, few infants in developed countries reach this milestone. Although breastfeeding practice and its determinants are well described for women in metropolitan areas, there is limited evidence for rural and regional areas of Australia. This paper describes the influence of advice and support on breastfeeding duration for women in rural areas of Western Australia in the first 6 months of their infants' lives.
A cohort of 427 women and their infants were recruited from hospitals in regional Western Australia and followed up for a period of 12 months. Information about feeding methods was gathered in hospital and at a further seven follow-up contacts.
Women who had attended antenatal classes were less likely to have ceased exclusively breastfeeding before 6 months than those who had not attended classes (aHR: 0.61, 95% CI: 0.41-0.91). No significant associations were found between provision of information alone and duration of breastfeeding. Breastfeeding advice and support in the first 6 months was most commonly sought from Child Health Nurses, General Practitioners and friends.
Antenatal group education is effective in supporting breastfeeding duration for rural women and should be a key priority for rural health service providers. Health professionals are common sources of breastfeeding support postnatally, however creating and maintaining positive and supportive social networks for mothers might also contribute to increasing the proportion of rural infants who meet the World Health Organization guidelines for exclusive breastfeeding.
尽管有越来越多有力证据表明纯母乳喂养至6个月大有益处，但发达国家中很少有婴儿能达到这一里程碑。虽然大都市地区女性的母乳喂养情况及其决定因素已有详尽描述，但澳大利亚农村和偏远地区的相关证据有限。本文描述了建议和支持对西澳大利亚农村地区女性在其婴儿出生后前6个月母乳喂养持续时间的影响。
从西澳大利亚地区的医院招募了427名女性及其婴儿，并对其进行了为期12个月的随访。在医院以及另外7次随访中收集了有关喂养方式的信息。
参加过产前课程的女性在6个月前停止纯母乳喂养的可能性低于未参加课程的女性（调整后风险比：0.61，95%置信区间：0.41 - 0.91）。仅提供信息与母乳喂养持续时间之间未发现显著关联。在婴儿出生后的前6个月，母乳喂养建议和支持最常来自儿童健康护士、全科医生和朋友。
产前小组教育对支持农村女性的母乳喂养持续时间有效，应成为农村卫生服务提供者的关键优先事项。卫生专业人员是产后母乳喂养支持的常见来源，然而为母亲建立并维持积极且支持性的社交网络也可能有助于提高达到世界卫生组织纯母乳喂养指南的农村婴儿比例。
