Departments of Health Services and Program in Nutritional Sciences.
Global Health, University of Washington, Seattle, WA.
Am J Clin Nutr. 2018 Mar 1;107(3):335-344. doi: 10.1093/ajcn/nqy001.
Women's employment improves household income, and can increase resources available for food expenditure. However, employed women face time constraints that may influence caregiving and infant and young child feeding (IYCF) practices. As economic and social trends shift to include more women in the labor force in low- and middle-income countries (LMICs), a current understanding of the association between maternal employment and IYCF is needed.
We investigated the association between maternal employment and IYCF.
Using cross-sectional samples from 50 Demographic and Health Surveys, we investigated the association between maternal employment and 3 indicators of IYCF: exclusive breastfeeding (EBF) among children aged <6 mo (n = 47,340) and minimum diet diversity (MDD) and minimum meal frequency (MMF) (n = 137,208) among children aged 6-23 mo. Mothers were categorized as formally employed, informally employed, or nonemployed. We used meta-analysis to pool associations across all countries and by region.
According to pooled estimates, neither formal [pooled odds ratio (POR) = 0.91; 95% CI: 0.81, 1.03] nor informal employment (POR = 1.05; 95% CI: 0.95, 1.16), compared to nonemployment, was associated with EBF. Children of both formally and informally employed women, compared to children of nonemployed women, had higher odds of meeting MDD (formal POR = 1.47; 95% CI: 1.35, 1.60; informal POR = 1.11; 95% CI: 1.03, 1.20) and MMF (formal POR = 1.18; 95% CI: 1.10, 1.26; informal POR = 1.15; 95% CI: 1.06, 1.24). Sensitivity analyses indicated that compared to nonemployed mothers, the odds of continued breastfeeding at 1 y were lower among formally employed mothers (POR = 0.82; 95% CI: 0.73, 0.98) and higher among informally employed mothers (POR = 1.19; 95% CI: 1.01, 1.40).
Efforts to promote formalized employment among mothers may be an effective method for improving diet diversity and feeding frequency in LMICs. Formally employed mothers may benefit from support for breastfeeding to enable continued breastfeeding through infancy. This trial was registered at clinicaltrials.gov as NCT03209999.
妇女就业可提高家庭收入，并增加用于食品支出的资源。然而，就业妇女面临时间限制，这可能会影响其照顾子女和婴幼儿喂养（IYCF）的实践。随着经济和社会趋势向包括更多低收入和中等收入国家（LMIC）的劳动力中的妇女转变，目前需要了解产妇就业与 IYCF 之间的关联。
我们调查了产妇就业与 IYCF 之间的关联。
我们使用来自 50 项人口与健康调查的横断面样本，调查了产妇就业与 3 项 IYCF 指标之间的关联：6 个月以下儿童的纯母乳喂养（EBF）（n=47340）和 6-23 个月儿童的最低饮食多样性（MDD）和最低膳食频率（MMF）（n=137208）。母亲分为正式就业、非正式就业或非就业。我们使用荟萃分析来汇总所有国家和地区的关联。
根据汇总估计，与非就业相比，正规就业（汇总优势比 [POR] = 0.91；95%CI：0.81，1.03）和非正规就业（POR = 1.05；95%CI：0.95，1.16）均与 EBF 无关。与非就业妇女的子女相比，正规和非正规就业妇女的子女更有可能满足 MDD（正规 POR = 1.47；95%CI：1.35，1.60；非正规 POR = 1.11；95%CI：1.03，1.20）和 MMF（正规 POR = 1.18；95%CI：1.10，1.26；非正规 POR = 1.15；95%CI：1.06，1.24）。敏感性分析表明，与非就业母亲相比，正式就业母亲持续母乳喂养 1 年的可能性较低（POR=0.82；95%CI：0.73，0.98），而非正式就业母亲的可能性较高（POR=1.19；95%CI：1.01，1.40）。
努力促进母亲的正规化就业可能是改善 LMIC 饮食多样性和喂养频率的有效方法。正式就业的母亲可能需要支持母乳喂养，以使其能够在婴儿期持续母乳喂养。这项试验在 clinicaltrials.gov 上注册为 NCT03209999。
