School of Nutrition, Food Sciences and Technologies, Faculty of Agronomics Sciences, University of Abomey-Calavi, Abomey-Calavi, Republic of Benin.
Laboratory of Nutrition, Department of Animal Biology, Faculty of Sciences and Techniques, University Cheikh Anta Diop, Dakar, Senegal.
Int Breastfeed J. 2020 Jun 26;15(1):58. doi: 10.1186/s13006-020-00302-y.
Evidence of interventions that are effective in improving exclusive breastfeeding (EBF) practices is needed to help countries revise their strategies. To assess whether mothers who had participated in the Nutrition at the Centre (N@C) project effectively demonstrated better EBF practices than did those who did not participate, we documented the processes of this nutritional intervention in Benin.
This study was a cross-sectional design comparing the intervention group, namely, the Village Saving and Loan Association (VSLA-N@C), to the control group. The N@C project was an educational intervention based on behavioural and social changes related to nutrition. Through VSLA groups installed in communities, mothers were connected to the project; had weekly discussions around the process, benefits and challenges linked to EBF, and advocated during Breastfeeding Week celebrations. The study participants were mothers with children aged 4-5.5 months from the VSLA-N@C group (n = 53) and mothers (n = 50) from non-intervention areas who served as controls. With the deuterium oxide dose-to-mother technique, we quantified human milk intake (HMI) and non-milk oral intake (NMOI) and compared both groups using Student's t-test. A child is considered to be exclusively breastfed if the NMOI is less than 86.6 g/day. Multivariate regression logistics adjusted for VSLA membership, mothers' body mass index, and children's age, weight-for-age and weight-for-length, thus enabling us to measure differences in EBF rates.
Children of mothers from the VSLA-N@C group consumed significantly more human milk than those of mothers in the control group (900.2 ± 152.5 g/day vs 842.2 ± 188.6 g/day, P = 0.044). Children in the VSLA-N@C group had significantly less non-milk oral intake than did those in the control group (difference: 148.2 g/day, P = 0.000). Therefore, the EBF rate was significantly higher in the VSLA group (38% vs 8%, P < 0.0001), and mothers in VSLAs were 14 times more likely to practise EBF than were those in the control group (adjusted odds ratio [AOR] = 13.9, 95% CI 1.9-116.5, P = 0.015).
The EBF rate was significantly higher in the group of mothers who participated in the VSLA-N@C project than in those who did not receive the intervention. The N@C model could be promoted as a strategy for increasing EBF practices in poor and rural contexts, where it is possible to organize mothers into VSLA groups to discuss the process, benefits and challenges of EBF.
需要有证据表明干预措施能有效改善纯母乳喂养（EBF）实践，以帮助各国修订其策略。为了评估参与营养中心（N@C）项目的母亲是否比未参与的母亲更有效地展示了更好的 EBF 实践，我们记录了贝宁的这一营养干预过程。
本研究采用了一种横向设计，将干预组（即乡村储蓄和贷款协会（VSLA-N@C））与对照组进行比较。N@C 项目是一项基于与营养相关的行为和社会变化的教育干预。通过在社区中设立 VSLA 小组，母亲们与项目建立了联系；每周围绕 EBF 的过程、益处和挑战进行讨论，并在母乳喂养周庆祝活动中进行倡导。研究参与者是来自 VSLA-N@C 组的 4-5.5 个月大的儿童的母亲（n=53）和来自非干预区的母亲（n=50）作为对照组。我们使用重水剂量 - 母亲技术来量化人乳摄入量（HMI）和非乳口服摄入量（NMOI），并使用学生 t 检验比较两组。如果 NMOI 小于 86.6 g/天，则认为孩子是纯母乳喂养的。多变量回归逻辑调整了 VSLA 成员、母亲的体重指数以及儿童的年龄、体重 - 年龄和体重 - 长度，从而能够衡量 EBF 率的差异。
来自 VSLA-N@C 组的儿童的人乳摄入量明显高于对照组的儿童（900.2 ± 152.5 g/天 vs 842.2 ± 188.6 g/天，P=0.044）。VSLA-N@C 组儿童的非乳口服摄入量明显少于对照组（差异：148.2 g/天，P=0.000）。因此，VSLA 组的 EBF 率明显更高（38% 对 8%，P<0.0001），VSLA 组的母亲进行 EBF 的可能性是对照组的 14 倍（调整后的优势比 [AOR] = 13.9，95%CI 1.9-116.5，P=0.015）。
参与 VSLA-N@C 项目的母亲的 EBF 率明显高于未接受干预的母亲。N@C 模式可以作为在贫困和农村地区增加 EBF 实践的一种策略进行推广，在这些地区，可以组织母亲加入 VSLA 小组讨论 EBF 的过程、益处和挑战。
