Psychology School, Pontificia Universidad Catolica de Chile, Santiago, Chile
Department of Clinical Psychology, University of Edinburgh School of Health in Social Science, Edinburgh, UK.
J Epidemiol Community Health. 2019 Jul;73(7):637-644. doi: 10.1136/jech-2018-211148. Epub 2019 Mar 13.
Given the support for the numerous benefits of breastfeeding, a better understanding of social and health determinants is necessary, particularly in under-researched populations. We examined determinants of breastfeeding initiation and duration using a national cohort of Chilean mothers.
Participants included 13 738 families enrolled in the Encuesta Longitudinal de la Primera Infancia cohort. Data were collected in 2010 and 2012. Families from all regions of the country were considered. Breastfeeding information was collected via maternal report and standardised assessments were used to collect information on maternal IQ and personality. Logistic and linear regressions were used to identify predictors of breastfeeding initiation and duration.
Breastfeeding was initiated by 95.2% of mothers. Variation in duration of breastfeeding was large, ranging from 1 to 48 months (M = 11.74; SD = 8.74). Maternal IQ, low-risk prenatal behaviours, conditions at birth and the presence of a partner were relevant predictors of both initiation and duration of breastfeeding, whereas personality and contextual/socioeconomic factors were relevant only for breastfeeding duration. Differences between regions were observed. Rates of caesarean deliveries are alarmingly high and triple that of the global WHO recommendations, at 45% of deliveries in Chile, which are implicated in both initiation and duration.
Breastfeeding rates exceed Chilean target goals although vary by region. Global targets now need to be focused on. Social and health determinants are implicated in both initiation and duration of breastfeeding. These findings suggest important targets for policy development and breastfeeding initiatives in Chile, particularly concerning the reduction of surgical deliveries.
鉴于母乳喂养有诸多益处，因此需要更好地了解社会和健康决定因素，尤其是在研究较少的人群中。我们使用智利母亲的全国队列研究了母乳喂养开始和持续时间的决定因素。
参与者包括参加“儿童初期纵向调查”队列的 13738 个家庭。数据收集于 2010 年和 2012 年。考虑了来自全国所有地区的家庭。通过母亲报告收集母乳喂养信息，并使用标准化评估收集有关母亲智商和个性的信息。使用逻辑回归和线性回归确定母乳喂养开始和持续时间的预测因素。
95.2%的母亲开始母乳喂养。母乳喂养持续时间的变化很大，范围从 1 到 48 个月（M=11.74；SD=8.74）。母亲智商、低风险产前行为、出生时的状况和伴侣的存在是母乳喂养开始和持续时间的相关预测因素，而个性和环境/社会经济因素仅与母乳喂养持续时间相关。观察到了地区之间的差异。剖腹产的比例惊人地高，是全球卫生组织建议的三倍，在智利，剖腹产的比例为 45%，这与母乳喂养的开始和持续时间都有关。
尽管母乳喂养率因地区而异，但已超过智利的目标。现在需要将全球目标集中在这个问题上。社会和健康决定因素与母乳喂养的开始和持续时间都有关。这些发现表明，智利的政策制定和母乳喂养倡议有重要目标，特别是要减少手术分娩。
