在尼日利亚和孟加拉国，皮肤接触对尽早开始母乳喂养的重要性。
The importance of skin-to-skin contact for early initiation of breastfeeding in Nigeria and Bangladesh.
作者信息
Singh Kavita, Khan Shane M, Carvajal-Aguirre Liliana, Brodish Paul, Amouzou Agbessi, Moran Allisyn
机构信息
MEASURE Evaluation/Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
出版信息
J Glob Health. 2017 Dec;7(2):020505. doi: 10.7189/jogh.07.020505.
BACKGROUND
Skin-to-skin contact (SSC) between mother and newborn offers numerous protective effects, however it is an intervention that has been under-utilized. Our objectives are to understand which newborns in Bangladesh and Nigeria receive SSC and whether SSC is associated with the early initiation of breastfeeding.
METHODS
Demographic and Health Survey (DHS) data were used to study the characteristics of newborns receiving SSC for non-facility births in Nigeria (DHS 2013) and for both facility and non-facility births in Bangladesh (DHS 2014). Multivariable logistic regression was used to study the association between SSC and early initiation of breastfeeding after controlling for key socio-demographic, maternal and newborn-related factors.
RESULTS
Only 10% of newborns in Nigeria and 26% of newborns in Bangladesh received SSC. In the regression models, SSC was significantly associated with the early initiation of breastfeeding in both countries (OR = 1.42, 95% CI 1.15-1.76 for Nigeria; OR = 1.27, 95% CI 1.04-1.55, for Bangladesh). Findings from the regression analysis for Bangladesh revealed that newborns born by Cesarean section had a 67% lower odds of early initiation of breastfeeding than those born by normal delivery (OR = 0.33, 95% CI 0.26-0.43). Also in Bangladesh newborns born in a health facility had a 30% lower odds of early initiation of breastfeeding than those born in non-facility environments (OR = 0.70, 95% CI 0.53-0.92). Early initiation of breastfeeding was significantly associated with parity, urban residence and wealth in Nigeria. Geographic area was significant in the regression analyses for both Bangladesh and Nigeria.
CONCLUSIONS
Coverage of SSC is very low in the two countries, despite its benefits for newborns without complications. SSC has the potential to save newborn lives. There is a need to prioritize training of health providers on the implementation of essential newborn care including SSC. Community engagement is also needed to ensure that all women and their families regardless of residence, socio-economic status, place or type of delivery, understand the benefits of SSC and early initiation of breastfeeding.
背景
母婴皮肤接触（SSC）对新生儿有诸多保护作用，但这一干预措施的利用率一直不高。我们的目标是了解孟加拉国和尼日利亚哪些新生儿接受了母婴皮肤接触，以及母婴皮肤接触是否与早期母乳喂养有关。
方法
利用人口与健康调查（DHS）数据，研究尼日利亚2013年非医疗机构分娩的新生儿以及孟加拉国2014年医疗机构和非医疗机构分娩的新生儿接受母婴皮肤接触的特征。在控制关键的社会人口统计学、孕产妇和新生儿相关因素后，采用多变量逻辑回归研究母婴皮肤接触与早期母乳喂养之间的关联。
结果
尼日利亚只有10%的新生儿、孟加拉国只有26%的新生儿接受了母婴皮肤接触。在回归模型中，两国母婴皮肤接触均与早期母乳喂养显著相关（尼日利亚：比值比[OR]=1.42，95%置信区间[CI]为1.15-1.76；孟加拉国：OR=1.27，95%CI为1.04-1.55）。孟加拉国回归分析的结果显示，剖宫产出生的新生儿早期开始母乳喂养的几率比顺产出生的新生儿低67%（OR=0.33，95%CI为0.26-0.43）。同样在孟加拉国，在医疗机构出生的新生儿早期开始母乳喂养的几率比在非医疗机构出生的新生儿低30%（OR=0.70，95%CI为0.53-0.92）。在尼日利亚，早期母乳喂养与产次、城市居住情况和财富显著相关。在孟加拉国和尼日利亚的回归分析中，地理区域均具有显著性。
结论
尽管母婴皮肤接触对无并发症的新生儿有益，但这两个国家的母婴皮肤接触覆盖率非常低。母婴皮肤接触有可能挽救新生儿生命。有必要优先培训卫生保健人员实施包括母婴皮肤接触在内的基本新生儿护理。还需要社区参与，以确保所有妇女及其家庭，无论居住地点、社会经济地位、分娩地点或分娩类型如何，都了解母婴皮肤接触和早期母乳喂养的益处。
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