Department of Anesthesiology, American University of Beirut, Beirut, Lebanon.
Biostatistics Unit, Faculty of Medicine, Clinical Research Institute, American University of Beirut, Beirut, Lebanon.
PLoS One. 2020 Sep 4;15(9):e0238735. doi: 10.1371/journal.pone.0238735. eCollection 2020.
The optimal frequency, duration, and form of professional lactation support needed to continue exclusive breastfeeding (EBF) for six months have not yet been specifically identified. This study investigates the association between six-month EBF and the frequency, duration, and form (face-to-face vs. telephone contact) of professional lactation support in a cohort of Lebanese mothers, and explores barriers to EBF during the first six months postpartum.
An observational study was nested in a breastfeeding support randomized controlled trial. Secondary analysis of data from 159 trial participants who received professional lactation support was conducted. (1) Six-month EBF with professional lactation support frequency, duration, and form was investigated using bivariate and multivariate regression analyses. (2) Barriers to breastfeeding were explored using content analysis of narrative data collected about breastfeeding mothers by the lactation experts.
Six-month EBF was achieved by 57/159 (35.8%) participants. Professional lactation support was received by more mothers continuing six months of EBF (100% vs. 83.3%, p = 0.001). In crude analysis, those mothers had a higher number of overall contacts with lactation experts (mean ± SD of 9.5 ± 2.9 vs. 7.0 ± 4.4, p = 0.001), and longer duration of face-to-face contacts (mean ± SD of 261.9 ± 209.1 vs. 201.0 ± 117.4 minutes, p = 0.035). In adjusted analysis, frequencies of overall and of telephone contacts with the lactation experts were positively associated with six-month EBF (OR = 1.15; 95% CI: 1.04 to 1.27, p = 0.007; OR = 1.12; 95% CI: 1.00 to 1.26, p = 0.05; respectively). Participants discontinuing EBF early were described as inexperienced, lacking breastfeeding knowledge, concerned about milk insufficiency, and showing negative attitudes towards night feeds.
Need-based telephone contact augmenting face-to-face professional lactation support may positively influence six-month EBF. Early identification of mothers at risk for early discontinuation of EBF can help tailor interventions specific to their concerns.
尚未明确持续纯母乳喂养（EBF）六个月所需的最佳专业母乳喂养支持频率、时长和形式。本研究在黎巴嫩母亲队列中调查了 EBF 六个月与专业母乳喂养支持频率、时长和形式（面对面与电话联系）之间的关系，并探讨了产后头六个月 EBF 的障碍。
一项观察性研究嵌套在母乳喂养支持随机对照试验中。对 159 名接受专业母乳喂养支持的试验参与者的数据进行二次分析。（1）使用双变量和多变量回归分析研究 EBF 六个月与专业母乳喂养支持频率、时长和形式的关系。（2）通过对哺乳专家收集的关于母乳喂养母亲的叙述性数据进行内容分析，探讨母乳喂养的障碍。
159 名参与者中有 57 名（35.8%）实现了 EBF 六个月。继续 EBF 六个月的母亲接受了更多的专业母乳喂养支持（100% vs. 83.3%，p=0.001）。在粗分析中，这些母亲与哺乳专家的总体联系次数更多（平均±SD 为 9.5±2.9 次 vs. 7.0±4.4 次，p=0.001），面对面接触的时长也更长（平均±SD 为 261.9±209.1 分钟 vs. 201.0±117.4 分钟，p=0.035）。在调整分析中，与哺乳专家的总体联系和电话联系频率与 EBF 六个月呈正相关（OR=1.15；95%CI：1.04 至 1.27，p=0.007；OR=1.12；95%CI：1.00 至 1.26，p=0.05）。早期停止 EBF 的参与者被描述为经验不足、缺乏母乳喂养知识、担心奶量不足以及对夜间喂奶持消极态度。
按需的电话联系补充面对面的专业母乳喂养支持可能会对 EBF 六个月产生积极影响。早期识别可能会早期停止 EBF 的母亲，可以帮助针对她们的具体问题量身定制干预措施。
