母乳喂养行为的决定因素及其与婴儿人体测量学的关联：来自印度南部一项前瞻性队列研究的结果。
Determinants of Breastfeeding Practices and Its Association With Infant Anthropometry: Results From a Prospective Cohort Study in South India.
作者信息
Koya Srinidhi, Babu Giridhara R, Deepa R, Iyer Veena, Yamuna A, Lobo Eunice, Prafulla S, Kinra Sanjay, Murthy G V S
机构信息
DTA3 MSCA Research Fellow, School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, United Kingdom.
Public Health Foundation of India and Wellcome Trust-DBT India Alliance Research Fellow in Public Health, New Delhi, India.
出版信息
Front Public Health. 2020 Oct 14;8:492596. doi: 10.3389/fpubh.2020.492596.
INTRODUCTION
Despite national efforts for promoting exclusive breastfeeding (EBF) during the first 6 months of the infants' life, breastfeeding rates are low in India. Evidence on the interference of supplementary food on optimal nourishment and growth of the infant has also been well-established. Our study was undertaken to assess the effect of breastfeeding practices on infant anthropometry and determine the various factors affecting breastfeeding practices.
METHODS
A prospective cohort study - Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI) was conducted at a tertiary care public hospital in Bengaluru, South India. From the consenting women, data such as obstetric history, infant feeding practices, anthropometry of mother and child, the psychosocial status of the women using the Edinburgh Postnatal Depression Scale (EPDS), was collected at baseline and subsequent follow-up: post-delivery and 14 weeks after birth. In this study, we analyzed data collected from April 2016 to April 2018, with descriptive statistics presented in mean and standard deviation, and logistic regression adjusting for confounders.
RESULTS
Among the 240 women enrolled in the study, 33% (n= 80) were using supplementary food for their infants at 14 weeks of infants age. Infants who received supplementary feeding at age 14 weeks had nearly 2.5 times higher odds of being wasted (OR: 2.449, -value: 0.002) as compared to exclusively breastfed infants.
CONCLUSION
Infants between 14 to 16 weeks of age who received supplementary feeding were at risk of wasting as compared to exclusively breastfed infants. Despite strong evidence in support of the benefits of exclusive breastfeeding, awareness in urban women in India is low. Increased focus on promoting exclusive breastfeeding is necessary to ensure proper nutritional intake and healthy growth of infants.
引言
尽管印度在全国范围内努力推广婴儿出生后头6个月的纯母乳喂养（EBF），但其母乳喂养率仍然很低。关于辅食对婴儿最佳营养和生长的干扰的证据也已得到充分证实。我们开展这项研究是为了评估母乳喂养方式对婴儿人体测量指标的影响，并确定影响母乳喂养方式的各种因素。
方法
在印度南部班加罗尔的一家三级护理公立医院进行了一项前瞻性队列研究——肥胖的母体先兆及高血糖和胰岛素的跨代作用研究（MAASTHI）。从同意参与研究的女性中，收集诸如产科病史、婴儿喂养方式、母婴人体测量指标，以及使用爱丁堡产后抑郁量表（EPDS）评估的女性心理社会状况等数据，在基线以及随后的随访中收集：分娩后和出生后14周。在本研究中，我们分析了2016年4月至2018年4月期间收集的数据，描述性统计以均值和标准差呈现，并采用逻辑回归对混杂因素进行校正。
结果
在参与研究的240名女性中，33%（n = 80）在婴儿14周龄时给其添加了辅食。与纯母乳喂养的婴儿相比，14周龄时接受辅食喂养的婴儿消瘦的几率高出近2.5倍（比值比：2.449，P值：0.002）。
结论
与纯母乳喂养的婴儿相比，14至16周龄接受辅食喂养的婴儿有消瘦风险。尽管有充分证据支持纯母乳喂养的益处，但印度城市女性对此的认知度较低。有必要加大对推广纯母乳喂养的关注，以确保婴儿获得适当的营养摄入和健康成长。
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