1 Department of Obstetrics and Gynecology, São Paulo University Medical School, São Paulo, Brazil.
2 Department of Statistics, Institute of Mathematics and Statistics, São Paulo University, São Paulo, Brazil.
J Hum Lact. 2018 Nov;34(4):749-759. doi: 10.1177/0890334418767382. Epub 2018 Apr 16.
Many factors may influence a woman's decision to start and maintain breastfeeding. Research aim: This study aimed to investigate the factors associated with breastfeeding cessation in twin infants during the first 6 months after birth and to describe the main reasons for weaning cited by mothers of twins.
This is a secondary data analysis of a prospective randomized trial conducted in Brazil. Data were obtained through longitudinal quantitative and qualitative self-reported interviews. One hundred twenty-eight women pregnant with twins and their 256 infants were followed for up to approximately 6 months, during which time breastfeeding data were obtained through face-to-face interviews at three different points after birth: 30 to 40 days (Time 1), 90 days (Time 2), and 180 days (Time 3). The association between weaning and the investigated factors was examined using survival analysis methodologies.
Nonexclusive breastfeeding ( p = .004, Cox proportional hazards regression model), a lack of support during the lactation period ( p = .001), difficulty breastfeeding ( p = .003), a breastfeeding duration shorter than 12 months in a previous pregnancy ( p = .001), and infants' birth weight less than 2,300 g ( p < .001) were the factors associated with breastfeeding cessation. The main reasons for weaning cited by mothers of twins were insufficient human milk supply, infants' behavior, and returning to work.
We have identified the factors associated with weaning in twin infants during the first 180 days of life. This knowledge can help improve strategies to increase breastfeeding rates in twins.
许多因素可能会影响女性开始和维持母乳喂养的决定。研究目的:本研究旨在调查与双胞胎婴儿出生后前 6 个月内停止母乳喂养相关的因素,并描述双胞胎母亲断奶的主要原因。
这是在巴西进行的一项前瞻性随机试验的二次数据分析。数据通过纵向定量和定性自我报告访谈获得。128 名怀有双胞胎的妇女及其 256 名婴儿接受了长达约 6 个月的随访,在此期间,通过产后 3 个不同时间点的面对面访谈获得母乳喂养数据:30-40 天(时间 1)、90 天(时间 2)和 180 天(时间 3)。使用生存分析方法研究断奶与调查因素之间的关系。
非纯母乳喂养(p=0.004,Cox 比例风险回归模型)、哺乳期缺乏支持(p=0.001)、母乳喂养困难(p=0.003)、前一次妊娠母乳喂养持续时间短于 12 个月(p=0.001)和婴儿出生体重低于 2300g(p<0.001)是与母乳喂养停止相关的因素。双胞胎母亲断奶的主要原因是母乳供应不足、婴儿行为和重返工作岗位。
我们已经确定了与双胞胎婴儿出生后 180 天内断奶相关的因素。这些知识可以帮助改善提高双胞胎母乳喂养率的策略。