Salim Yusuf M, Stones William
Karonga District Hospital, Private Bag 1, Karonga, Malawi.
College of Medicine, Private Bag 360, Blantyre, Malawi.
BMC Pregnancy Childbirth. 2020 Aug 17;20(1):472. doi: 10.1186/s12884-020-03160-y.
UNICEF and WHO recommend that all children should be exclusively breastfed for the first 6 months of life as breastmilk contains all the nutrients an infant needs during this period. In Malawi, exclusive breastfeeding has been declining from 72% (2009), 70.2% (2014) and 61% in the most recent survey (2015-16). We aimed to determine factors associated with exclusive breastfeeding in Malawi.
We used data from the Malawi Demographic and Health Survey (MDHS) 2015-2016. Survey records for 2059 mothers of children aged 6 months and below were identified and potential factors influencing infant feeding were examined. Logistic regression analysis was carried out to model determinants of exclusive breastfeeding (EBF).
EBF declined in proportion to the age of the infant. Significant associations with continuing EBF were age of the mother, ethnicity of the mother, sex of infant and number of siblings. Members of the Tumbuka (OR = 1.71, CI. 1.13-2.59) and Ngoni (OR = 2.05, CI. 1.38-3.05) communities were more likely to practice EBF. In addition, mothers with female babies (OR = 1.35, CI. 1.08-1.70) and those with 3-4 children (OR = 1.47, CI. 1.04-2.08) were more likely to engage in EBF.
We identify important variations in EBF practices among population sub-groups in Malawi that need to be considered when framing health education messaging. Work is needed to assess the impact of more targeted messaging, whether delivered via 'ten steps' to successful breastfeeding under Baby Friendly Hospital Initiative (BFHI) programming or other health education and awareness campaigns to sensitize communities on implications of some cultural practices on the lives of babies. The potential role for mass media, targeted Health Surveillance Assistants' (HSA) home visits and male involvement also require exploration.
联合国儿童基金会和世界卫生组织建议，所有儿童在出生后的前6个月应纯母乳喂养，因为母乳包含婴儿在此期间所需的所有营养。在马拉维，纯母乳喂养率一直在下降，从2009年的72%、2014年的70.2%降至最近一次调查（2015 - 2016年）的61%。我们旨在确定马拉维与纯母乳喂养相关的因素。
我们使用了2015 - 2016年马拉维人口与健康调查（MDHS）的数据。识别出2059名6个月及以下儿童母亲的调查记录，并检查影响婴儿喂养的潜在因素。进行逻辑回归分析以建立纯母乳喂养（EBF）的决定因素模型。
纯母乳喂养率随婴儿年龄增长而下降。与持续纯母乳喂养有显著关联的因素包括母亲年龄、母亲种族、婴儿性别和兄弟姐妹数量。通布卡族（OR = 1.71，CI. 1.13 - 2.59）和恩戈尼族（OR = 2.05，CI. 1.38 - 3.05）社区的成员更有可能进行纯母乳喂养。此外，生女孩的母亲（OR = 1.35，CI. 1.08 - 1.70）和有3 - 4个孩子的母亲（OR = 1.47，CI. 1.04 - 2.08）更有可能进行纯母乳喂养。
我们确定了马拉维不同人群亚组在纯母乳喂养实践方面的重要差异，在制定健康教育信息时需要考虑这些差异。需要开展工作来评估更有针对性的信息传递的影响，无论是通过“爱婴医院倡议”（BFHI）计划中的“成功母乳喂养十步骤”，还是通过其他健康教育和宣传活动，以使社区认识到某些文化习俗对婴儿生活的影响。大众媒体、有针对性的健康监测助理家访以及男性参与的潜在作用也需要探索。
