Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh.
Int Breastfeed J. 2020 Mar 16;15(1):18. doi: 10.1186/s13006-020-00259-y.
Early initiation of breastfeeding within 1 hour after birth is essential for newborns, because it reduces risk of neonatal mortality and hypothermia to a great extent and also helps in preventing the long-term chronic diseases and in increasing energy and immunity to newborn. In order to reach the 'very good state' of timely or early initiation of breastfeeding recommended by WHO, Bangladesh needs to increase the current rate of 51.24 to 100%. An attempt has been made in this study to examine how the early breastfeeding practice changes among male and female children with time controlling the factors associated with this practice.
Data from last four consecutive Bangladesh Demographic and Health Surveys (BDHS) have been used in the study. The participants were included whose child born within the last 5 years preceding the surveys of 2004, 2007 and 2011, and within the last 3 years preceding the survey of 2014 in the study and the respective selected participants were 5145, 4765, 7099 and 4370. To conduct the trend analysis, the descriptive statistics of selected variables along with prevalence of early initiation of breastfeeding have been computed by different years and a multiple logistic regression model has been fitted to the pooled dataset of 2004-2014 considering survey years as time.
Rate of early initiation of breastfeeding increased as time progressed and it was faster for female child compared to male child. For example, female children were significantly 10 and 6% less likely to be initiated early than their counterparts in 2004 and 2007, respectively; whereas after 2007 both male and female children were equally treated for breastfeeding practice. It was also found that rate of early initiation significantly increased for one unit increased in survey year and this increasing rate was higher for female child compared to male child. For example, for one unit of increased in survey year, the early initiation of breastfeeding increased by 60% for male child and by 67% for female child. Besides, survey time, gender, education of parents, wanted index child, mode of delivery, antenatal care visits, wealth index, exposure to media and division were found to have potential influence on early initiation of breastfeeding.
Demographic and health surveys conducted in Bangladesh since 2011 have shown no evidence of gender discrimination regarding timely initiation of breastfeeding. In order to achieve the target rate of early initiation of breastfeeding recommended by WHO, it requires to take effective intervention regarding maternal and child health education.
新生儿出生后 1 小时内尽早开始母乳喂养至关重要，因为这可以在很大程度上降低新生儿死亡率和体温过低的风险，还有助于预防长期的慢性疾病，并增加新生儿的能量和免疫力。为了达到世卫组织建议的“及时或尽早开始母乳喂养”的“非常好的状态”，孟加拉国需要将目前 51.24%的比例提高到 100%。本研究试图在控制与这一实践相关因素的情况下，考察男童和女童的早期母乳喂养实践随时间的变化情况。
本研究使用了最近四次孟加拉国人口与健康调查（BDHS）的数据。研究对象包括在调查前 5 年内（2004 年、2007 年和 2011 年）和调查前 3 年内（2014 年）出生的儿童，研究中分别选取了 5145、4765、7099 和 4370 名参与者。为了进行趋势分析，按年份计算了所选变量的描述性统计数据和早期母乳喂养的流行率，并考虑调查年份作为时间，对 2004 年至 2014 年的汇总数据集拟合了多因素逻辑回归模型。
随着时间的推移，早期母乳喂养的比例增加，且女童的速度快于男童。例如，与 2004 年和 2007 年相比，2007 年后男女童的早期母乳喂养比例分别显著降低了 10%和 6%；而在 2007 年之后，男女童的母乳喂养实践都得到了同等对待。还发现，调查年份每增加一个单位，早期母乳喂养的比例就会增加，且这种增加率在女童中高于男童。例如，调查年份每增加一个单位，男童的早期母乳喂养比例增加 60%，女童增加 67%。此外，调查时间、性别、父母的教育程度、期望的儿童指数、分娩方式、产前护理次数、财富指数、媒体接触和行政区都对早期母乳喂养的启动有潜在影响。
自 2011 年以来在孟加拉国进行的人口与健康调查没有显示出在及时启动母乳喂养方面存在性别歧视。为了实现世卫组织建议的早期母乳喂养的目标比例，需要采取有效的母婴健康教育干预措施。
