Sebastian Rachel A, Coronado Eirian, Otero Maria D, McKinney Courtney R, Ramos Mary M
Child Policy Research Consulting, LLC, 124 Basswood Circle, Fort Wright, KY, 41011, USA.
New Mexico Department of Health, 1190 S. St. Francis Drive, Santa Fe, NM, 87505, USA.
Matern Child Health J. 2019 Jun;23(6):858-867. doi: 10.1007/s10995-018-02711-2.
Objectives This study examines the associations between specific maternity care practices and breastfeeding duration for Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White women. Methods We analyzed data from the 2012-2014 New Mexico Pregnancy Risk Assessment Monitoring System. We used survey language as a proxy measure of acculturation and categorized women as Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White. We conducted bivariate analyses to compare rates of breastfeeding at 2 months and experiences of maternity care practices and logistic regression analysis to estimate the effects of these practices on breastfeeding duration for each group. Results Hispanic women were less likely than non-Hispanic women to breastfeed for at least 2 months (67.9% vs. 76.6%; p = 0.000); however, this varied significantly by acculturation level: 78.1% of Spanish-speaking Hispanic women compared to 66.1% of English-speaking Hispanic women breastfed for at least 2 months (p = 0.000). The effects of specific maternity care practices on duration varied across groups. Among non-Hispanic White, Native American, and English-speaking Hispanic women, breastfeeding while at the hospital had the strongest effect (AOR 2.09, 95% CI 1.67-2.61; AOR 2.71, 95% CI 2.08-3.52; and AOR 1.99, 95% CI 1.76-2.25, respectively). Among Spanish-speaking Hispanic women, being encouraged to breastfeed on demand had the strongest effect (AOR 5.179, 95% CI 3.86-6.94). Conclusions for Practice The effects of maternity care practices on breastfeeding duration vary by race, ethnicity, and acculturation level. Health care systems must acknowledge the diversity of their patient populations when seeking to develop and implement breastfeeding-friendly practices.
目的 本研究探讨了讲西班牙语的西班牙裔、讲英语的西班牙裔、非西班牙裔美国原住民和非西班牙裔白人女性的特定孕产护理做法与母乳喂养持续时间之间的关联。方法 我们分析了2012 - 2014年新墨西哥州妊娠风险评估监测系统的数据。我们将调查语言用作文化适应的替代指标，并将女性分为讲西班牙语的西班牙裔、讲英语的西班牙裔、非西班牙裔美国原住民和非西班牙裔白人。我们进行了双变量分析以比较2个月时的母乳喂养率和孕产护理做法的经历，并进行了逻辑回归分析以估计这些做法对每组母乳喂养持续时间的影响。结果 西班牙裔女性比非西班牙裔女性进行至少2个月母乳喂养的可能性更小（67.9%对76.6%；p = 0.000）；然而，这因文化适应水平而有显著差异：78.1%的讲西班牙语的西班牙裔女性进行了至少2个月的母乳喂养，而讲英语的西班牙裔女性这一比例为66.1%（p = 0.000）。特定孕产护理做法对持续时间的影响因群体而异。在非西班牙裔白人、美国原住民和讲英语的西班牙裔女性中，在医院时进行母乳喂养的影响最强（调整后比值比分别为2.09，95%置信区间1.67 - 2.61；2.71，95%置信区间2.08 - 3.52；1.99，95%置信区间1.76 - 2.25）。在讲西班牙语的西班牙裔女性中，被鼓励按需母乳喂养的影响最强（调整后比值比5.179，95%置信区间3.86 - 6.94）。实践结论 孕产护理做法对母乳喂养持续时间的影响因种族、族裔和文化适应水平而异。医疗保健系统在寻求制定和实施有利于母乳喂养的做法时，必须认识到其患者群体的多样性。
