Department of Pediatrics, Cumming School of Medicine, University of Calgary, 1403 29th Street NW, Calgary, AB, T2N 2T9, Canada.
BP Koirala Institute of Health Sciences, Dharan, Nepal.
BMC Pregnancy Childbirth. 2020 Jan 30;20(1):59. doi: 10.1186/s12884-020-2754-0.
The World Health Organization recommends initiation of breastfeeding within 1 hour of birth and exclusive breastfeeding up to 6 months of age. Infant feeding practices, including suboptimal breastfeeding practices, are associated with stunting. Rate of stunting was highest in the Mid-western region and lowest in the Eastern region of Nepal. This study aimed to assess the breastfeeding practices in these two regions, as well as to identify factors associated with partial breastfeeding.
We conducted a health facility-based cross-sectional study in the Mid-western and Eastern regions of Nepal from December 2017 to May 2018. Investigators administered a pre-tested questionnaire among consecutive 574 mother-infant dyads at different levels of health facilities. We dichotomized the breastfeeding pattern to partial breastfeeding and full (exclusive or predominant) breastfeeding. We conducted multivariable logistic regression to identify factors associated with partial breastfeeding within 6 months of age.
There were 574 infants included in the study, all of which received at least some breastfeeding. Only 23.2% of infants were exclusively breastfed until 6 months, with 28.2% predominantly breastfed and 48.6% partially breastfed. Partial breastfeeding rate was 52.3% in the Mid-western region and 44.4% in the Eastern region. Breastfeeding was initiated within an hour from birth in 67.2% of infants. One-quarter of infants were given pre-lacteal feed, honey being the commonest. Knowledge of the recommended duration of exclusive breastfeeding was inadequate in 16, and 65% of mothers reported breastfeeding problems in the first 6 months. Firstborn and low birth weight infants had a significantly higher rate of partial breastfeeding. Partial breastfeeding was also higher when infants were not breastfed within 1 hour from birth, mothers reported having breastfeeding-related problems or had inadequate knowledge of the duration of exclusive breastfeeding.
Nearly half of the infants were fully breastfed at 6 months of age in Nepal. The rate of partial breastfeeding was higher with inadequate knowledge on duration of exclusive breastfeeding or late initiation of breastfeeding or perceived breastfeeding problems. Hence, programs should address knowledge and practice gaps in breastfeeding practices, particularly among mothers of low birth weight and firstborn infants.
世界卫生组织建议婴儿在出生后 1 小时内开始母乳喂养，并在 6 个月内纯母乳喂养。婴儿喂养方式，包括不适当的母乳喂养方式，与发育迟缓有关。尼泊尔中西部地区的发育迟缓率最高，东部地区最低。本研究旨在评估这两个地区的母乳喂养情况，并确定与部分母乳喂养相关的因素。
我们于 2017 年 12 月至 2018 年 5 月在尼泊尔中西部和东部地区的医疗机构进行了一项基于卫生机构的横断面研究。调查人员在不同级别的医疗机构中对 574 对母婴进行了预测试问卷。我们将母乳喂养模式分为部分母乳喂养和完全（纯母乳喂养或主要母乳喂养）母乳喂养。我们进行多变量逻辑回归分析，以确定 6 个月内部分母乳喂养的相关因素。
本研究共纳入 574 名婴儿，所有婴儿均接受了至少部分母乳喂养。只有 23.2%的婴儿在 6 个月内纯母乳喂养，28.2%的婴儿主要母乳喂养，48.6%的婴儿部分母乳喂养。中西部地区部分母乳喂养率为 52.3%，东部地区为 44.4%。67.2%的婴儿在出生后 1 小时内开始母乳喂养。四分之一的婴儿接受了代乳品喂养，最常见的是蜂蜜。16%的母亲对纯母乳喂养的推荐持续时间认识不足，65%的母亲在头 6 个月报告母乳喂养存在问题。初产妇和低出生体重儿部分母乳喂养率显著较高。当婴儿出生后 1 小时内未进行母乳喂养、母亲报告母乳喂养存在问题或对纯母乳喂养持续时间的知识不足时，部分母乳喂养的比例也较高。
尼泊尔近一半的婴儿在 6 个月时完全母乳喂养。部分母乳喂养率较高的原因是对纯母乳喂养持续时间的知识不足，或母乳喂养开始较晚或认为母乳喂养存在问题。因此，相关计划应解决母乳喂养实践中的知识和实践差距问题，特别是针对低出生体重和初产妇的母亲。
