Catala Patricia, Peñacoba Cecilia, Carmona Javier, Marin Dolores
1 Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
2 Critical Care Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.
Breastfeed Med. 2018 Dec;13(10):680-686. doi: 10.1089/bfm.2018.0034. Epub 2018 Nov 7.
The benefits of breastfeeding are well known for mother and child. Research about the predictive factors related to the initiation and maintenance of breastfeeding is of great interest to public health.
To analyze the factors associated with the timely initiation of breastfeeding at immediate postpartum and the variables that facilitate their maintenance 4 months after birth.
A longitudinal prospective design was used, including four stages: first trimester of pregnancy (personality), third trimester (childbirth expectations, breastfeeding intention, pregnancy worries, and coping strategies), immediately after childbirth (initiation of breastfeeding and childbirth satisfaction), and 4 months after birth (continuation of breastfeeding).
A sample of 116 women took part in the study from the first trimester to 4 months after birth. Timely initiation of breastfeeding is associated with vaginal birth (p < 0.000) and with variables related to the absence of stress factors: fewer worries regarding childbirth (p = 0.009), higher satisfaction during birth in relation to holding the baby (p > 0.000), and the meeting of expectations (p = 0.017). These associations disappear when the type of birth is introduced. Maintenance of breastfeeding is associated with maternal personality and psychosocial variables: openness to experience (p = 0.007), increased worries about coping with the baby (p = 0.046), relationship with partner (p = 0.047), and overt emotional expression (p = 0.040).
Different factors are associated with initiation and maintenance of breastfeeding. Specific prevention strategies are needed, aimed toward health care staff for improving breastfeeding initiation and to empower women during the entire pregnancy for breastfeeding maintenance.
母乳喂养对母婴的益处众所周知。与母乳喂养的开始和持续相关的预测因素研究对公共卫生具有重要意义。
分析与产后立即及时开始母乳喂养相关的因素以及有助于产后4个月持续母乳喂养的变量。
采用纵向前瞻性设计，包括四个阶段：妊娠早期（个性）、妊娠晚期（分娩期望、母乳喂养意愿、妊娠担忧及应对策略）、产后即刻（开始母乳喂养及分娩满意度）和产后4个月（母乳喂养的持续情况）。
116名女性参与了从妊娠早期到产后4个月的研究。及时开始母乳喂养与阴道分娩相关（p < 0.000），也与无压力因素相关的变量有关：对分娩的担忧较少（p = 0.009）、分娩时抱婴儿的满意度较高（p > 0.000）以及期望得到满足（p = 0.017）。当引入分娩类型时，这些关联消失。母乳喂养的持续与母亲的个性和社会心理变量有关：经验开放性（p = 0.007）、对照顾婴儿的担忧增加（p = 0.046）、与伴侣的关系（p = 0.047）以及明显的情绪表达（p = 0.040）。
不同因素与母乳喂养的开始和持续有关。需要制定具体的预防策略，针对医护人员以改善母乳喂养的开始情况，并在整个孕期增强女性维持母乳喂养的能力。
