Fatemeh College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran.
School of Public Health, Curtin University, Perth 6845, Australia.
Int J Environ Res Public Health. 2020 Feb 13;17(4):1192. doi: 10.3390/ijerph17041192.
A prospective cohort study was conducted in Shiraz in the south west of Iran to investigate breastfeeding from birth to six months of age. Mothers were recruited in a face-to-face interview within 48 h of giving birth in three public and two private hospitals (n = 700). They were then followed-up at 4, 12, 16, and 26 weeks postpartum in local Maternal and Child Health Clinics. Upon being discharge from hospital, 98.7% of mothers were breastfeeding and 74.3% were 'fully' breastfeeding, but only 29.9% of mothers had breastfed 'exclusively' since birth. The median duration of 'full' breastfeeding was 13 weeks and less than 1 week for exclusive breastfeeding. In a multivariable Cox proportional hazard regression, after adjustment, shorter durations of 'exclusive', 'full', and 'any' breastfeeding were associated with the introduction of a pacifier. The in-hospital use of formula and prelacteal feeds were also associated with a shorter duration of full and any breastfeeding. Breastfeeding on demand at 3 months and beyond was associated with a longer duration of breastfeeding. The risk factors associated with the premature discontinuation of breastfeeding identified in this study are all related to the "Ten steps to successful breastfeeding" and the Baby Friendly Hospital Initiative (BFHI). The principles that the BFHI provide are reaffirmed in this study as the basis for future breastfeeding promotion programs.
本研究在伊朗西南部的设拉子进行了一项前瞻性队列研究，旨在调查婴儿从出生到 6 个月时的母乳喂养情况。研究人员在公立和私立医院（n=700）中，于产后 48 小时内通过面对面访谈招募了母亲，并在产后 4、12、16 和 26 周时在当地母婴保健诊所对其进行随访。出院时，98.7%的母亲正在母乳喂养，74.3%的母亲进行“完全”母乳喂养，但只有 29.9%的母亲从出生开始就进行“纯”母乳喂养。“完全”母乳喂养的中位数持续时间为 13 周，而纯母乳喂养的中位数持续时间不到 1 周。在多变量 Cox 比例风险回归中，经过调整后，使用安抚奶嘴与“纯”母乳喂养、“完全”母乳喂养和任何母乳喂养时间缩短有关。在医院使用配方奶和开奶也与“完全”母乳喂养和任何母乳喂养时间缩短有关。在 3 个月及以上按需母乳喂养与母乳喂养时间延长有关。本研究确定的与母乳喂养过早停止相关的危险因素都与“成功母乳喂养的 10 个步骤”和“爱婴医院倡议（BFHI）”有关。本研究再次肯定了 BFHI 提供的原则是未来母乳喂养促进计划的基础。
