Mukora-Mutseyekwa Fadzai, Gunguwo Hilary, Mandigo Rugare Gilson, Mundagowa Paddington
1Lifestyle & Prevention Medicine Unit, Africa University Clinical Research Centre, Mutare, Zimbabwe.
JSI Research & Training Institute, MCHIP Project, Harare, Zimbabwe.
Matern Health Neonatol Perinatol. 2019 Jan 15;5:2. doi: 10.1186/s40748-018-0097-x. eCollection 2019.
The World Health Organization recommends initiation of breastfeeding within the first hour of delivery. Early initiation is beneficial for both mother and baby. Previous Zimbabwe Demographic and Health Surveys (ZDHS) have shown reduction in early initiation of breast feeding from 68% (2005/06) to 58% (2015). This study sought to investigate factors associated with early initiation of breast feeding among women aged 15-49 years in Zimbabwe.
Secondary analysis of ZDHS 2015 data was done to investigate the association between early initiation of breast feeding and maternal, provider and neonatal factors using multivariate logistic regression ( = 2192).
The majority of the study sample (78%) reported having practised early initiation of breastfeeding during their most recent delivery (preceding 24 months).Children who were put on skin to skin contact (AOR = 1.51, 95% CI 1.13-2.02) and those delivered by skilled attendants (AOR = 4.36, 95% CI 1.07-17.77) had greater odds of early initiation compared to those who were not. Other factors associated with early initiation were multiparity (AOR 1.82 95% CI 1.33-2.49) and rural residence (AOR 2.10 95% 1.12-3.93). However, having an abnormal birth weight, i.e. low birth weight (AOR 0.60 95% CI 0.36-0.99) and macrosomia (AOR = 0.42, CI 0.22-0.79) as well as delivery by caesarean section (AOR 0.1195% CI 0.06-0.19) were associated with reduced odds of early initiation.
Early initiation of breast feeding in Zimbabwe is mainly associated with residing in the rural areas and multiparity. The 78% rate of early initiation of breastfeeding was contrary to the 58% reported in the ZDHS findings. Interventions targeting an improvement in early initiation of breastfeeding must aim at women who deliver by caesarean section, women with babies of abnormal birth weight, primi-parous women and women residing in rural areas.
世界卫生组织建议在分娩后第一小时内开始母乳喂养。尽早开始母乳喂养对母婴双方都有益。以往的津巴布韦人口与健康调查（ZDHS）显示，早期母乳喂养率从68%（2005/06年）降至58%（2015年）。本研究旨在调查津巴布韦15至49岁女性中与早期母乳喂养相关的因素。
对2015年ZDHS数据进行二次分析，采用多因素logistic回归（n = 2192）研究早期母乳喂养与产妇、医护人员及新生儿因素之间的关联。
大部分研究样本（78%）报告在其最近一次分娩（前24个月内）时进行了早期母乳喂养。与未进行皮肤接触的婴儿相比，进行皮肤接触的婴儿（调整后比值比[AOR]=1.51，95%置信区间[CI]为1.13 - 2.02）以及由熟练医护人员接生的婴儿（AOR = 4.36，95% CI为1.07 - 17.77）早期母乳喂养的几率更高。与早期母乳喂养相关的其他因素包括经产（AOR 1.82，95% CI 1.33 - 2.49）和农村居住（AOR 2.10，95% CI 1.12 - 3.93）。然而，出生体重异常，即低出生体重（AOR 0.60，95% CI 0.36 - 0.99）和巨大儿（AOR = 0.42，CI 0.22 - 0.79）以及剖宫产分娩（AOR 0.11，95% CI 0.06 - 0.19）与早期母乳喂养几率降低有关。
津巴布韦早期母乳喂养主要与农村居住和经产有关。78%的早期母乳喂养率与ZDHS调查结果报告的58%相反。旨在改善早期母乳喂养的干预措施必须针对剖宫产分娩的妇女、出生体重异常婴儿的母亲、初产妇以及农村居住的妇女。
