Haile Zelalem T, Elmasry Mohamed, Chavan Bhakti, Azulay Chertok Ilana R
J Midwifery Womens Health. 2017 Sep;62(5):562-571. doi: 10.1111/jmwh.12657. Epub 2017 Sep 20.
Although benefits of breastfeeding for infants, women, and society are well established, breastfeeding rates in the United States remain below the Healthy People 2020 goals. Various factors are known to influence breastfeeding practices. Limited research has been conducted to examine the influence of type of birth attendant on exclusive breastfeeding.
A cross-sectional analysis was conducted using data from the Infant Feeding Practices Study II collected between May 2005 and June 2007.
The study sample included 2026 women, aged 18 years or older. At discharge, 74.6% of women exclusively breastfed, and 27.6% exclusively breastfed at 3 months postpartum. Bivariate analysis showed a statistically significant association between type of health professional at birth and exclusive breastfeeding at discharge (P = .001) and 3 months postpartum (P < .001). After adjusting for potential confounders, the association between type of health professional at birth and exclusive breastfeeding at discharge was no longer significant. However, the odds of exclusive breastfeeding at 3 months postpartum were higher among women whose birth was attended by a midwife or nurse-midwife compared to those whose birth was attended by an obstetrician (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.34-2.61; P < .001).
Exclusive breastfeeding continuation may be influenced by the type of health professional attending the birth. In addition to having a skilled workforce, health care professionals involved in perinatal care need to be educated and trained to promote and support exclusive breastfeeding as recommended. The complex and multifactorial nature of the maternal decision to exclusively breastfeed requires broader understanding of contextual factors.
尽管母乳喂养对婴儿、女性和社会的益处已得到充分证实，但美国的母乳喂养率仍低于《健康人民2020》的目标。已知多种因素会影响母乳喂养行为。关于分娩护理人员类型对纯母乳喂养影响的研究有限。
使用2005年5月至2007年6月期间收集的《婴儿喂养实践研究II》的数据进行横断面分析。
研究样本包括2026名18岁及以上的女性。出院时，74.6%的女性进行纯母乳喂养，产后3个月时这一比例为27.6%。双变量分析显示，出生时的健康专业人员类型与出院时（P = .001）和产后3个月（P < .001）的纯母乳喂养之间存在统计学上的显著关联。在对潜在混杂因素进行调整后，出生时的健康专业人员类型与出院时纯母乳喂养之间的关联不再显著。然而，与由产科医生接生的女性相比，由助产士或注册护士助产士接生的女性在产后3个月进行纯母乳喂养的几率更高（优势比[OR]，1.87；95%置信区间[CI]，1.34 - 2.61；P < .001）。
纯母乳喂养的持续情况可能会受到接生健康专业人员类型的影响。除了拥有技术熟练的劳动力外，参与围产期护理的医疗保健专业人员还需要接受教育和培训，以按照建议促进和支持纯母乳喂养。母亲决定纯母乳喂养这一复杂且多因素的性质需要对背景因素有更广泛的理解。
