Centre for Woman and Child Health (CWCH), Savar, Dhaka, 1349, Bangladesh.
Nutrition International, Gulshan, Dhaka, 1212, Bangladesh.
Int Breastfeed J. 2020 Mar 4;15(1):14. doi: 10.1186/s13006-020-00258-z.
Rapid increases in hospital and cesarean deliveries threaten an already falling exclusive breastfeeding rate (EBR) in Bangladesh. There is neither a sustained Baby-Friendly Hospital Initiative (BFHI) nor any community support for breastfeeding mothers. Our aim was to find out whether breastfeeding support after hospital delivery and subsequently by mobile phone at home is effective in improving EBR in infants under six-months of age.
A quasi-experimental study was carried out in 2010 at the Centre for Woman and Child Health (CWCH), Savar, Bangladesh. A total of 129 mothers delivered at CWCH were recruited in pre-intervention phase and their infants followed up between 0 and 5 months of age in the community for exclusive breastfeeding (EBF), anthropometry and illness. An intervention package was then implemented with postpartum support for first hour breastfeeding initiation, correction of position and attachment and face-to-face counseling in hospital followed by mobile phone support by two trained Research Assistants once every 15 days after discharge up to six months of age. During the intervention phase, 164 pregnant women delivered at CWCH were recruited and followed up as in the pre-intervention phase.
In the pre-intervention phase among 114 infants, 66 (58%) were found to be exclusively breastfed. In the intervention phase among 151 infants, 118 (78%) were exclusively breastfed (p = 0.000). In the pre-intervention phase EBR at less than one month and five months were 85 and 42% as in the intervention phase these EBR were 89 and 71% respectively. Wasting (weight-for-height Z-score < - 2.00), stunting (height-for-age Z-score < - 2.00), and underweight (weight-for-age Z-score < - 2.00) was 17 (15%), 7 (6%), and 14 (13%) respectively in the pre-intervention phase. In the intervention phase wasting, stunting, and underweight was 16 (11%), 16 (11%), and 15 (10%) respectively. Therefore, there was no statistically significant differences in nutritional status of the infants in the two phases. There was also no significant differences in child morbidity (pneumonia and diarrhea) between the two phases.
A combination of hospital support and mobile phone counseling in the community sustained higher rates of EBF in the community after hospital delivery.
医院和剖腹产数量的快速增加，威胁到孟加拉国本已下降的纯母乳喂养率（EBR）。既没有持续的爱婴医院倡议（BFHI），也没有任何社区支持母乳喂养的母亲。我们的目的是了解在医院分娩后以及随后通过家庭移动电话提供母乳喂养支持是否能有效提高 6 个月以下婴儿的 EBR。
2010 年在孟加拉国萨瓦尔的妇女与儿童健康中心（CWCH）进行了一项准实验研究。在预干预阶段，共招募了 129 名在 CWCH 分娩的母亲，在社区中对其婴儿进行了 0 至 5 个月的随访，以了解他们的纯母乳喂养（EBF）、人体测量和患病情况。然后实施了一整套干预措施，包括产后第一小时支持母乳喂养的开始、纠正体位和附着以及在医院面对面咨询，然后在出院后每 15 天由两名经过培训的研究助理通过移动电话提供支持，直至 6 个月大。在干预阶段，共招募了 164 名在 CWCH 分娩的孕妇，并按照预干预阶段的方式进行了随访。
在预干预阶段的 114 名婴儿中，有 66 名（58%）被发现是纯母乳喂养的。在干预阶段的 151 名婴儿中，有 118 名（78%）是纯母乳喂养的（p=0.000）。在预干预阶段，一个月和五个月时的 EBR 分别为 85%和 42%，而在干预阶段，这两个时期的 EBR 分别为 89%和 71%。在预干预阶段，消瘦（体重身高 Z 评分<−2.00）、发育迟缓（身高年龄 Z 评分<−2.00）和体重不足（体重年龄 Z 评分<−2.00）的比例分别为 17 名（15%）、7 名（6%）和 14 名（13%）。在干预阶段，消瘦、发育迟缓、体重不足的比例分别为 16 名（11%）、16 名（11%）和 15 名（10%）。因此，这两个阶段婴儿的营养状况没有统计学上的显著差异。两个阶段的儿童发病率（肺炎和腹泻）也没有显著差异。
医院支持与社区移动电话咨询相结合，可维持医院分娩后社区中更高的纯母乳喂养率。
