Sağlam Neslihan Özkul, Bülbül Lida, Kazancı Selcen Yaroğlu, Hatipoğlu Sadık Sami
Department of Child Health and Disease, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2019 Jul 12;53(2):165-171. doi: 10.14744/SEMB.2018.91328. eCollection 2019.
The aim of this study was to evaluate factors that affected decisions regarding breastfeeding and complementary feeding practices in children aged 24 to 48 months.
Children aged 24 to 48 months who were presented at the outpatient clinic of a single hospital over a 6-month period were included in the study. Children who were born prematurely, hospitalized in the neonatal intensive care unit, and those with a chronic disease were excluded. A questionnaire was administered to parents who provided consent. Data related to demographic characteristics, socioeconomic status, and infant nutrition practices were collected and analyzed.
A total of 100 cases were included. The distribution of the gender of the children was 49% female and 51% male, and the mean age was 36.2±7.8 months. The mean duration of exclusive breastfeeding was 4.83±1.23 months, the mean length of total breastfeeding was 17.65±8.44 months, and the mean initiation of complementary feeding was 5.71±1.23 months of age. The most frequent reason provided for the cessation of breastfeeding was the mother's decision to wean. The duration of exclusive breastfeeding and the total length of breastfeeding feeding was significantly shorter among children who were born by cesarean section, and those who used a pacifier and or feeding bottle. Non-working mothers used formula for a longer period (p=0.043) and introduced solid foods and the use of utensils later than other mothers (p=0.001, p=0.03, respectively). Complementary food was provided to the infants of families whose monthly income level was less than TL 1000 earlier than in higher income level groups (p=0.04). The results of this study also showed that complementary food choices were most influenced by older members of the family and members of the mother's immediate circle (42%) and healthcare professionals (36%). Mothers who received information about the addition of complementary food did not demonstrate a significantly different length of time devoted to exclusive breastfeeding; however, the duration of breastfeeding overall, alone and in combination with solid foods, increased (p=0.03).
Before the birth, families should be informed and prepared regarding the necessity of exclusive breastfeeding for the first 6 months and the continuation of breastfeeding until 2 years of age, the potential impact of relevant factors related to the type of birth, and the potentially negative effects of the use of a pacifier or bottle. All members of the family, particularly mothers and close relatives, should be advised about proper complementary feeding techniques, including the need to increase the consistency of food gradually, introducing solid foods before the 10th month, and using natural, home-cooked items instead of prepared foods. The appropriate information and guidance should be provided to all families with consideration for their education level, social environment, and life conditions.
本研究旨在评估影响24至48个月儿童母乳喂养和辅食喂养决策的因素。
本研究纳入了在一家医院门诊6个月期间就诊的24至48个月儿童。排除早产、曾入住新生儿重症监护病房以及患有慢性病的儿童。对同意参与的家长进行问卷调查。收集并分析与人口统计学特征、社会经济状况及婴儿营养喂养方式相关的数据。
共纳入100例病例。儿童性别分布为女性49%,男性51%,平均年龄为36.2±7.8个月。纯母乳喂养的平均时长为4.83±1.23个月,总母乳喂养时长为17.65±8.44个月,辅食添加的平均起始年龄为5.71±1.23个月。母乳喂养停止的最常见原因是母亲决定断奶。剖宫产出生的儿童、使用安抚奶嘴和/或奶瓶的儿童,其纯母乳喂养时长和总母乳喂养时长显著较短。无工作的母亲使用配方奶的时间更长(p=0.043),且比其他母亲更晚引入固体食物和使用餐具(分别为p=0.001,p=0.03)。月收入水平低于1000土耳其里拉家庭的婴儿比高收入水平家庭更早添加辅食(p=0.04)。本研究结果还表明,辅食选择受家庭年长者和母亲直系亲属(42%)以及医护人员(36%)的影响最大。获得辅食添加信息的母亲在纯母乳喂养时长方面无显著差异;然而,总体母乳喂养时长,无论是单独母乳喂养还是与固体食物混合喂养,均有所增加(p=0.03)。
在分娩前,应告知家庭并使其做好准备,了解头6个月纯母乳喂养及持续母乳喂养至2岁的必要性、分娩方式相关因素的潜在影响以及使用安抚奶嘴或奶瓶的潜在负面影响。应向所有家庭成员,尤其是母亲和近亲,介绍正确的辅食喂养技巧,包括逐渐增加食物稠度、在10个月前引入固体食物以及使用天然的家常食物而非预制食品。应根据所有家庭的教育水平、社会环境和生活条件提供适当的信息和指导。