Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh.
Matern Child Nutr. 2020 Jul;16(3):e12971. doi: 10.1111/mcn.12971. Epub 2020 Feb 11.
Exclusive breastfeeding (EBF) has significant effect on morbidity and mortality. EBF is established when breastmilk alone is exclusively fed from birth until 6 months of age. However, feeding during the first 3 days after birth is often ignored for various reasons. We aimed to assess the role of feeding during the first 3 days in respect of early cessation of EBF. Data of 1,040 children aged under 6 months was derived from the baseline survey of Suchana, a large-scale nutrition program, conducted in Sylhet, Bangladesh, and subsequently analysed. Guidelines established by World Health Organization were used to define EBF and feeding during the first 3 days. The strength of the association between feeding during the first 3 days and early cessation of EBF was established using multiple logistic regression after adjusting for other covariates. Among all children, around 62% and 13% were exclusively breastfed and were fed something other than breastmilk within the first 3 days of birth, respectively. Feeding during the first 3 days was independently and significantly associated with early cessation of breastfeeding (adjusted odds ratio: 1.94, 95% confidence interval [1.31, 2.88], p = .001). Less than four antenatal care (ANC) visits, increased child's age and increased household size were also independently associated with early cessation of EBF. Feeding during the first 3 days of birth is a significant predictor of early cessation of EBF. Simple counselling activities to discourage feeding anything within the first few days of birth may increase the prevalence of EBF in rural Bangladesh without investing additional resources.
纯母乳喂养（EBF）对发病率和死亡率有显著影响。当婴儿从出生到 6 个月仅接受母乳喂养时，就建立了纯母乳喂养。然而，由于各种原因，出生后前 3 天的喂养往往被忽视。我们旨在评估出生后前 3 天的喂养在早期停止 EBF 方面的作用。这项研究的数据来源于孟加拉国锡尔赫特开展的一项大规模营养计划“Suchana”的基线调查，调查了 1040 名年龄在 6 个月以下的儿童，随后进行了分析。采用世界卫生组织制定的指南来定义 EBF 和出生后前 3 天的喂养。使用多因素逻辑回归分析调整其他协变量后，确定了出生后前 3 天的喂养与早期停止 EBF 之间的关联强度。在所有儿童中，分别有 62%和 13%的儿童在出生后前 3 天内纯母乳喂养和除母乳外还喂养其他食物。出生后前 3 天的喂养与早期停止母乳喂养独立且显著相关（调整后的优势比：1.94，95%置信区间 [1.31, 2.88]，p =.001）。少于 4 次产前保健（ANC）就诊、儿童年龄增加和家庭规模增加也与 EBF 的早期停止独立相关。出生后前 3 天的喂养是早期停止 EBF 的一个重要预测因素。在孟加拉国农村地区，不投入额外资源，仅通过简单的劝阻在出生后几天内喂养其他食物的咨询活动，就可能增加 EBF 的流行率。
