Um Sopheak, Chan Ying Zhen Charissa, Tol Bunkea, Sopheab Heng
The School of Public Health at the National Institute of Public Health, Phnom Penh, Cambodia.
The University of Melbourne, Parkville, Victoria 3010, Australia.
J Pregnancy. 2020 Aug 24;2020:2097285. doi: 10.1155/2020/2097285. eCollection 2020.
Practicing exclusive breastfeeding (EBF) in an infant's first six months of life is recommended by the World Health Organization because of its proven effectiveness as a method to support the infant's short- and long-term physical and cognitive development. However, many countries, including Cambodia, face contextually driven challenges in meeting this optimum standard of breastfeeding. The recent declining EBF rate in Cambodia is a concerning indicator of the impact of these challenges.
We used existing data from the 2014 Cambodian Demographic and Health Survey (CDHS) to analyze 717 Cambodian mother-infant pairs. CDHS 2014 used a two-stage stratified cluster sampling approach to select samples. A multivariable logistic regression analysis was used to assess determinants of EBF, taking into account the sampling weight in the analysis. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and significance level was considered at value < 0.05.
Our findings indicate that among mothers with infants under six months, EBF was more likely if they resided rurally (AOR = 2.28; 95% CI 1.23-4.23) and if they delivered at a public hospital (AOR = 2.64; 95% CI 1.28-5.47). On the other hand, mothers of middle wealth index practiced EBF less than mothers of low wealth index (AOR = 0.58; 95% CI 0.34-0.99). And as expected, our analysis confirmed that the older the infants grew, the less likely they were to be exclusively breastfed than those younger than one month old (2-3 months: AOR = 0.49; 95% CI 0.26-0.92; 4-5 months: AOR = 0.25; 95% CI 0.15-0.43).
The findings emphasize the need to address these determinants adequately by appropriate interventions to halt the declining trend of EBF practice. We recommend a multifaceted approach to improve EBF rates in Cambodia. Advocacy around EBF at public hospitals should continue, and private hospital staff should receive training to provide EBF counselling and support to mothers.
世界卫生组织建议在婴儿出生后的前六个月实行纯母乳喂养（EBF），因为它作为一种支持婴儿短期和长期身体及认知发展的方法已被证明是有效的。然而，包括柬埔寨在内的许多国家在达到这一最佳母乳喂养标准方面面临着因具体情况而产生的挑战。柬埔寨近期纯母乳喂养率的下降是这些挑战影响的一个令人担忧的指标。
我们使用了2014年柬埔寨人口与健康调查（CDHS）的现有数据来分析717对柬埔寨母婴。2014年的CDHS采用两阶段分层整群抽样方法来选取样本。使用多变量逻辑回归分析来评估纯母乳喂养的决定因素，并在分析中考虑抽样权重。计算了调整后的优势比（AOR）及95%置信区间（CI），显著性水平设定为p值<0.05。
我们的研究结果表明，在有六个月以下婴儿的母亲中，如果她们居住在农村地区（AOR = 2.28；95% CI 1.23 - 4.23）以及在公立医院分娩（AOR = 2.64；95% CI 1.28 - 5.47），则更有可能进行纯母乳喂养。另一方面，中等财富指数的母亲进行纯母乳喂养的比例低于低财富指数的母亲（AOR = 0.58；95% CI 0.34 - 0.99）。正如预期的那样，我们的分析证实，婴儿年龄越大，与小于一个月大的婴儿相比，进行纯母乳喂养的可能性就越小（2 - 3个月：AOR = 0.49；95% CI 0.26 - 0.92；4 - 5个月：AOR = 0.25；95% CI 0.15 - 0.43）。
研究结果强调需要通过适当干预措施充分解决这些决定因素，以阻止纯母乳喂养率下降的趋势。我们建议采取多方面的方法来提高柬埔寨的纯母乳喂养率。应继续在公立医院围绕纯母乳喂养进行宣传，私立医院工作人员应接受培训，以便为母亲提供纯母乳喂养咨询和支持。
