Khan Shane M, Speizer Ilene S, Singh Kavita, Angeles Gustavo, Twum-Danso Nana Ay, Barker Pierre
Data and Analytics, Division of Data, Research and Policy, United Nations Children's Fund (UNICEF), New York, New York, 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.
J Glob Health. 2017 Dec;7(2):020506. doi: 10.7189/jogh.07.020506.
Breastfeeding is known as a key intervention to improve newborn health and survival while prelacteal feeds (liquids other than breastmilk within 3 days of birth) represents a departure from optimal feeding practices. Recent programmatic guidelines from the WHO and UNICEF outline the need to improve newborn feeding and points to postnatal care (PNC) as a potential mechanism to do so. This study examines if PNC and type of PNC provider are associated with key newborn feeding practices: breastfeeding within 1 day and prelacteal feeds.
We use data from the Demographic and Health Surveys for 15 sub-Saharan African countries to estimate 4 separate pooled, multilevel, logistic regression models to predict the newborn feeding outcomes.
PNC is significantly associated with increased breastfeeding within 1day (OR = 1.35, < 0.001) but is not associated with PLFs (OR = 1.04, = 0.195). PNC provided by nurses, midwives and untrained health workers is also associated with higher odds of breastfeeding within 1 day of birth (OR = 1.39, < 0.001, (OR = 1.95, < 0.001) while PNC provided by untrained health workers is associated with increased odds of PLFs (OR = 1.20, = 0.017).
PNC delivered through customary care may be an effective strategy to improve the breastfeeding within 1 day but not to discourage PLFs. Further analysis should be done to examine how these variables operate at the country level to produce finer programmatic insight.
母乳喂养是改善新生儿健康和生存状况的关键干预措施，而初乳前喂养（出生后3天内除母乳外的其他液体）则偏离了最佳喂养方式。世界卫生组织和联合国儿童基金会最近的项目指南概述了改善新生儿喂养的必要性，并指出产后护理（PNC）是实现这一目标的潜在机制。本研究探讨产后护理及产后护理提供者类型是否与关键的新生儿喂养方式相关：出生后1天内进行母乳喂养和初乳前喂养。
我们使用来自撒哈拉以南非洲15个国家的人口与健康调查数据，估计4个单独的汇总、多层次逻辑回归模型，以预测新生儿喂养结果。
产后护理与出生后1天内母乳喂养增加显著相关（OR = 1.35，P < 0.001），但与初乳前喂养无关（OR = 1.04，P = 0.195）。护士、助产士和未经培训的卫生工作者提供的产后护理也与出生后1天内母乳喂养的较高几率相关（OR = 1.39，P < 0.001，OR = 1.95，P < 0.001），而未经培训的卫生工作者提供的产后护理与初乳前喂养几率增加相关（OR = 1.20，P = 0.017）。
通过常规护理提供的产后护理可能是提高出生后1天内母乳喂养率的有效策略，但不能抑制初乳前喂养。应进一步分析，以研究这些变量在国家层面如何运作，从而获得更精细的项目见解。
