Arora Amit, Manohar Narendar, Hayen Andrew, Bhole Sameer, Eastwood John, Levy Steven, Scott Jane Anne
School of Science and Health, Western Sydney University, Campbelltown Campus, Penrith, NSW Australia.
Discipline of Paediatrics and Child Health, Sydney Medical School, Westmead, NSW Australia.
Int Breastfeed J. 2017 Sep 15;12:39. doi: 10.1186/s13006-017-0130-0. eCollection 2017.
Breastfeeding has short-term and long-term benefits for both the infant and the mother. The objective of this study was to identify the incidence of breastfeeding initiation among women in South Western Sydney, and the factors associated with the initiation of breastfeeding.
Child and Family Health Nurses recruited mother-infant dyads ( = 1035) to the birth study in South Western Sydney, an ethnically and socio-economically diverse area, at the first post-natal home visit. A sample of 935 women completed a structured, interviewer-administered questionnaire at 8 weeks. Multivariate logistic regression analysis was used to identify those factors independently associated with the initiation of breastfeeding.
In total, 92% of women ( = 860) commenced breastfeeding in hospital. Women who completed a university degree were more likely to initiate breastfeeding compared to those who did not complete high school (AOR = 7.16, 95% CI 2.73, 18.79). Vietnamese women had lower odds of breastfeeding initiation compared to Australian born women (AOR = 0.34. 95% CI 0.13, 0.87). Women who had more than one child were less likely to breastfeed than those who had one child (AOR = 0.38, 95% CI 0.19, 0.79). Women who gave birth via a caesarean section were less likely to breastfeed their baby compared to those who had a vaginal delivery (AOR = 0.27, 95% CI 0.14, 0.52). Women who drank alcohol during pregnancy had 72% lower odds to breastfeed compared to those who did not drink alcohol during pregnancy (AOR = 0.28, 95% CI 0.11, 0.71). Women who reported that their partner preferred breastfeeding were more likely to initiate breastfeeding (AOR = 11.77, 95% CI 5.73, 24.15) and women who had chosen to breastfeed before pregnancy had more than 2.5 times the odds of breastfeeding their baby compared to those women who made their decision either during pregnancy or after labour (AOR = 2.80, 95% CI 1.31, 5.97).
Women with lower levels of education, who consume alcohol during pregnancy, have more than one child, and make infant feeding decision after becoming pregnant, and those born in Vietnam should be targeted when implementing breastfeeding promotion programs. Further, women who deliver by caesarean section require additional breastfeeding support post-delivery and it is important to include fathers in breastfeeding related decisions and encourage them to participate in antenatal programs.
母乳喂养对婴儿和母亲都有短期和长期益处。本研究的目的是确定悉尼西南部女性开始母乳喂养的发生率，以及与开始母乳喂养相关的因素。
儿童与家庭健康护士在悉尼西南部这个种族和社会经济多元化的地区，于产后首次家访时招募母婴二元组（n = 1035）参与出生研究。935名女性样本在8周时完成了一份由访谈员管理的结构化问卷。采用多因素逻辑回归分析来确定那些与开始母乳喂养独立相关的因素。
总计92%的女性（n = 860）在医院开始母乳喂养。完成大学学位的女性比未完成高中学业的女性更有可能开始母乳喂养（比值比[AOR]=7.16，95%置信区间[CI]2.73，18.79）。与澳大利亚出生的女性相比，越南女性开始母乳喂养的几率较低（AOR = 0.34，95% CI 0.13，0.87）。有多个孩子的女性比只有一个孩子的女性母乳喂养的可能性更小（AOR = 0.38，95% CI 0.19，0.79）。与经阴道分娩的女性相比，剖宫产的女性母乳喂养婴儿的可能性更小（AOR = 0.27，95% CI 0.14，0.52）。孕期饮酒的女性与孕期不饮酒的女性相比，母乳喂养的几率低72%（AOR = 0.28，95% CI 0.11，0.71）。报告其伴侣倾向于母乳喂养的女性更有可能开始母乳喂养（AOR = 11.77，95% CI 5.73，24.15），并且与那些在孕期或分娩后才做出决定的女性相比，孕前就选择母乳喂养的女性母乳喂养其婴儿的几率是前者的2.5倍多（AOR = 2.80，95% CI 1.31，5.97）。
在实施母乳喂养促进项目时，应将教育程度较低、孕期饮酒、有多个孩子、怀孕后才做出婴儿喂养决定的女性以及越南出生的女性作为目标人群。此外，剖宫产的女性产后需要额外的母乳喂养支持，让父亲参与与母乳喂养相关的决策并鼓励他们参加产前项目很重要。
