Institute of Social Medicine, Medical Faculty University of Belgrade, Belgrade, Serbia.
Front Public Health. 2020 Jun 30;8:277. doi: 10.3389/fpubh.2020.00277. eCollection 2020.
Exclusive breastfeeding is essential for early childhood development, although the use of adaptive milk formulas instead of breastfeeding is widespread nowadays. This study aimed to examine the prevalence of exclusively breastfed infants under the age of 6 months in non-Roma and Roma population and factors associated with this practice. This study is a secondary analysis of the Serbian Multiple Indicator Cluster Survey investigating non-Roma and Roma infants under the age of 6 months. The study included mothers of 321 non-Roma and 164 Roma infants younger than 6 months. Univariate and multivariate logistic regression served to analyze factors associated with the practice of exclusive breastfeeding in both populations. The prevalence of exclusive breastfeeding was almost the same among mothers in both non-Roma and Roma population (13.3 vs. 13%, = 0.910). Exclusive breastfeeding was significantly more often ( < 0.001) among wealthier women, women whose newborns were over 2,500 g on birth, multipara, and women who had not established menstrual cycle among both populations. Living outside the capital significantly diminishes the chance for exclusively breastfed infants in the non-Roma community (Vojvodina: OR 0.16, CI 95% 0.03-0.92; eastern Serbia: OR 0.02, CI 95% 0.01-0.35) as well as living in the rural area (urban: OR 10.35, CI 95% 1.94-55.28). Unexpectedly, in the non-Roma population, not staying in the same room with the newborn in the maternity ward increases the chance for the baby to be exclusively breastfed (OR 7.19, CI 95% 1.80-28.68). The same pattern has been observed in Roma population. Non-Roma mothers multipara are more likely to exclusively breastfeed their children than primipara (OR 7.78, CI 95% 1.09-20.93), while among Roma mothers, the inverse association has been found although not significant (OR 0.42, CI 95% 0.14-1.23). Attending a childbirth preparation program more than 18 times increases the chances of infants being exclusively breastfed (OR 18.65, CI 95% 1.34-53.67). In the Roma population, there was no single woman that attended a childbirth preparation program. The pattern of exclusive breastfeeding significantly differs between non-Roma and Roma populations. Preventive work should have focus on strengthening support to mothers and medical staff in maternity wards.
纯母乳喂养对儿童早期发展至关重要，但目前广泛使用适应性配方奶而非母乳喂养。本研究旨在调查非罗姆人和罗姆人 6 个月以下婴儿的纯母乳喂养率，并分析与该行为相关的因素。本研究是塞尔维亚多指标类集调查的二次分析，该调查研究了 6 个月以下的非罗姆人和罗姆婴儿。研究纳入了 321 名非罗姆人和 164 名罗姆母亲，其婴儿年龄均小于 6 个月。采用单变量和多变量逻辑回归分析了两个群体中与纯母乳喂养相关的因素。非罗姆人和罗姆母亲的纯母乳喂养率几乎相同（13.3% vs. 13%，=0.910）。在两个群体中，财富较多的母亲、新生儿出生体重超过 2500 克的母亲、多产妇和尚未恢复月经周期的母亲中，纯母乳喂养更为常见（均<0.001）。居住在首都以外地区会显著降低非罗姆人群中纯母乳喂养婴儿的比例（伏伊伏丁那：OR 0.16，95%CI 0.03-0.92；塞尔维亚东部：OR 0.02，95%CI 0.01-0.35），居住在农村地区（城市：OR 10.35，95%CI 1.94-55.28）也会降低该比例。出乎意料的是，在非罗姆人群中，新生儿在产房与母亲不同室会增加婴儿纯母乳喂养的可能性（OR 7.19，95%CI 1.80-28.68）。罗姆人群中也观察到了同样的模式。非罗姆人多产妇比初产妇更有可能纯母乳喂养孩子（OR 7.78，95%CI 1.09-20.93），而罗姆人产妇中虽然没有显著关联（OR 0.42，95%CI 0.14-1.23），但呈相反趋势。参加分娩准备课程超过 18 次会增加婴儿纯母乳喂养的可能性（OR 18.65，95%CI 1.34-53.67）。罗姆人群中，没有一个单身母亲参加过分娩准备课程。非罗姆人和罗姆人纯母乳喂养的模式存在显著差异。预防工作应侧重于加强对产妇和产房医护人员的支持。
