Université de Paris, CRESS, INSERM, INRA, Paris, France.
INED, INSERM, Joint Unit Elfe, Paris, France.
Matern Child Nutr. 2019 Oct;15(4):e12872. doi: 10.1111/mcn.12872. Epub 2019 Aug 12.
Previous studies have shown a high level of noncompliance with recommendations on breastfeeding duration, especially in France. The objective was to describe the association between breastfeeding initiation and duration and the statutory duration of postnatal maternity leave, the gap between the end of legal maternity leave and the mother's return to work, and maternal working time during the first year post-partum. Analyses were based on 8,009 infants from the French nationwide ELFE cohort. We assessed the association with breastfeeding initiation by using logistic regression and, among breastfeeding women, with categories of breastfeeding duration by using multinomial logistic regression. Among primiparous women, both postponing return to work for at least 3 weeks after statutory postnatal maternity leave (as compared with returning to work at the end of the statutory period) and working less than full-time at 1 year post-partum (as compared with full-time) were related to higher prevalence of breastfeeding initiation. Among women giving birth to their first or second child, postponing the return to work until at least 15 weeks was related to a higher prevalence of long breastfeeding duration (at least 6 months) as compared with intermediate duration (3 to <6 months). Working part-time was also positively related to breastfeeding duration. Among women giving birth to their third child or more, working characteristics were less strongly related to breastfeeding duration. These results support extending maternity leave or working time arrangements to encourage initiation and longer duration of breastfeeding.
先前的研究表明,母乳喂养持续时间的建议遵守率很高,尤其是在法国。本研究旨在描述母乳喂养的开始和持续时间以及法定产后产假、法定产假结束与母亲返回工作岗位之间的差距以及产后第一年母亲的工作时间与母乳喂养持续时间之间的关联。分析基于法国全国性 ELFE 队列中的 8009 名婴儿。我们使用逻辑回归评估了与母乳喂养开始的关联,在母乳喂养的女性中,使用多项逻辑回归评估了母乳喂养持续时间的类别。对于初产妇,与法定产后产假结束时返回工作岗位相比,至少推迟 3 周返回工作岗位(与法定期间结束时返回工作岗位相比)以及产后 1 年工作时间少于全职(与全职相比)与更高的母乳喂养开始率相关。对于生育第一或第二个孩子的女性,与中间持续时间(3 至<6 个月)相比,至少推迟 15 周返回工作与长母乳喂养持续时间(至少 6 个月)的更高流行率相关。兼职工作也与母乳喂养持续时间呈正相关。对于生育第三个孩子或更多孩子的女性,工作特征与母乳喂养持续时间的相关性较弱。这些结果支持延长产假或工作时间安排,以鼓励母乳喂养的开始和持续时间更长。