尼日尔农村和城市地区纯母乳喂养做法的相关因素：基于社区的横断面研究。
Correlates of exclusive breastfeeding practices in rural and urban Niger: a community-based cross-sectional study.
机构信息
1Leading Program Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan.
2Department of Nursing Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
出版信息
Int Breastfeed J. 2019 Jul 30;14:32. doi: 10.1186/s13006-019-0226-9. eCollection 2019.
BACKGROUND
Exclusive breastfeeding (EBF) can prevent death and disease among young children. The proportion of EBF is low in Niger. This study aimed to identify the prevalence and correlates of exclusive breastfeeding.
METHODS
We conducted a community-based cross-sectional study in urban and rural areas of Niger among mothers of infants under 7 months old. We used a structured questionnaire to investigate breastfeeding practices, sociodemographic factors, and health service use. We used multivariate analysis to explore the correlates of EBF since birth.
RESULTS
The study involved 234 urban and 283 rural mothers. Colostrum was almost universally given to newborns (98.7% [231/234] urban and 97.9% [277/283] rural) and many mothers started breastfeeding within an hour of giving birth (69.2% [162/234] and 90.5% [256/283]). The proportion of EBF since birth in urban and rural areas was 15.8% (37/234) and 54.4% (154/283), respectively. Among mothers who had ceased EBF, proportion of prelacteal feeding was 85.3% (168/197) in urban areas and 62.0% (80/129) in rural areas, while 93.4% (183/196) and 72.7% (88/121) had stopped EBF within 1 week after birth respectively. The median duration of EBF was 1 week in urban and 2 months in rural areas. In urban areas, EBF was more likely in mothers with infants 3 months old or younger (Adjusted Odds Ratio [AOR] 2.78; 95% Confidence Interval 95% [CI] 1.07, 7.21) and problems with delivery including Caesarean section (AOR 3.60; 95% CI 1.17, 11.01). In rural areas, lower socioeconomic status (AOR 1.89; 95% CI 1.12, 3.18), early initiation of breastfeeding (AOR 4.04; 95% CI 1.50, 10.83) and delivery assisted by a traditional birth attendant (AOR 3.49; 95% CI 1.37, 8.89) were correlated with exclusive breastfeeding.
CONCLUSIONS
Exclusive breastfeeding was uncommon. Most mothers ceased EBF within 1 week after birth. Adequate information about EBF by health professionals around delivery seems to encourage its use. To encourage EBF in Niger, it is important to educate health professionals, including traditional birth attendants, and enable them to discuss the practice with mothers through individual counselling or group education.
背景
纯母乳喂养（EBF）可以预防幼儿死亡和疾病。尼日尔的 EBF 比例很低。本研究旨在确定 EBF 的流行率及其相关因素。
方法
我们在尼日尔城市和农村地区进行了一项基于社区的横断面研究，研究对象为 7 个月以下婴儿的母亲。我们使用结构化问卷调查母乳喂养做法、社会人口学因素和卫生服务利用情况。我们使用多变量分析来探讨自出生以来 EBF 的相关因素。
结果
该研究涉及 234 名城市母亲和 283 名农村母亲。初乳几乎普遍给予新生儿（城市 98.7%[231/234]，农村 97.9%[277/283]），许多母亲在分娩后 1 小时内开始母乳喂养（城市 69.2%[162/234]，农村 90.5%[256/283]）。城市和农村地区自出生以来 EBF 的比例分别为 15.8%（234 名中的 37 名）和 54.4%（283 名中的 154 名）。在已经停止 EBF 的母亲中，城市地区的代乳品喂养比例为 85.3%（197 名中的 168 名），农村地区为 62.0%（129 名中的 80 名），而分别有 93.4%（196 名中的 183 名）和 72.7%（121 名中的 88 名）在产后 1 周内停止 EBF。城市地区 EBF 的中位持续时间为 1 周，农村地区为 2 个月。在城市地区，3 个月或以下婴儿的母亲更有可能进行 EBF（调整后的优势比[OR]2.78；95%置信区间 95%[CI]1.07，7.21），并且存在分娩问题，包括剖腹产（OR 3.60；95%CI 1.17，11.01）。在农村地区，较低的社会经济地位（OR 1.89；95%CI 1.12，3.18）、早期开始母乳喂养（OR 4.04；95%CI 1.50，10.83）和由传统助产士协助分娩（OR 3.49；95%CI 1.37，8.89）与 EBF 相关。
结论
纯母乳喂养并不常见。大多数母亲在产后 1 周内停止 EBF。分娩前后卫生专业人员提供足够的 EBF 信息似乎鼓励了其使用。为了在尼日尔鼓励 EBF，重要的是教育卫生专业人员，包括传统助产士，并使他们能够通过个别咨询或小组教育与母亲讨论该做法。
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