Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, Valencia, Spain.
Department of Nursing, Universitat de València, Valencia, Spain.
J Adv Nurs. 2021 Feb;77(2):703-714. doi: 10.1111/jan.14625. Epub 2020 Nov 18.
Research the association between health literacy (HL) and exclusive breastfeeding at 4-months postpartum.
Despite the benefits of breastfeeding (BF), its rates are low worldwide. Among the reasons for abandonment is the level of maternal education. Maternal education has been associated with HL, but evidence between HL and BF maintenance is limited.
A cross-sectional study.
The sample compromised 229 nursing mothers recruited from January 2018 to the end of December 2018 at Spain by systematic sampling method. Women were interviewed postpartum on parameters associated with the start and continuation of BF up to 4 months postpartum. Multivariate logistic regression models to explain exposure variables and exclusive BF cessation at 4 months.
Approximately 10% of the participants had inadequate HL. Factors associated with early cessation of exclusive BF at 4 months in the multivariate model adjusted using a stepwise variable selection process based on a likelihood ratio test were civil status, risk of pregnancy, type of delivery, limited or inadequate level of HL, and LATCH score at discharge, with an 85.6% area under the ROC curve.
Our study offers preliminary evidence regarding the hitherto inconsistent relation between HL and early cessation exclusive BF at 4 months, supporting the conduct of further studies with larger sample sizes and greater statistical power. Such studies are warranted before endorsing HL-based interventions aiming to mitigate early cessation exclusive BF.
Low or inadequate HL is linked to multiple poor health and clinical outcomes. We investigated the prevalence of exclusive BF at 4 months postpartum, and the impact of HL in maintaining optimal exclusive BF practices. Limited or inadequate HL was one of the factors associated with early cessation of exclusive BF in the multivariate regression model, although further research is needed.
研究健康素养（HL）与产后 4 个月纯母乳喂养的关系。
尽管母乳喂养（BF）有诸多益处，但全球范围内其普及率仍然较低。导致母乳喂养中断的原因之一是母亲的受教育程度。母亲的受教育程度与 HL 相关，但 HL 与 BF 维持之间的证据有限。
横断面研究。
该样本由 2018 年 1 月至 12 月期间通过系统抽样方法在西班牙招募的 229 名哺乳期母亲组成。产后对与开始和持续 BF 相关的参数对妇女进行访谈，直到产后 4 个月。使用多变量逻辑回归模型来解释暴露变量和 4 个月时的纯母乳喂养停止情况。
大约 10%的参与者 HL 水平不足。多变量模型中，基于似然比检验的逐步变量选择过程调整后，与 4 个月时纯母乳喂养早期停止相关的因素包括婚姻状况、妊娠风险、分娩方式、HL 水平有限或不足、以及出院时的 LATCH 评分，ROC 曲线下面积为 85.6%。
我们的研究提供了关于 HL 与产后 4 个月纯母乳喂养早期停止之间迄今不一致关系的初步证据，支持进行进一步的研究，这些研究需要更大的样本量和更大的统计能力。在支持基于 HL 的干预措施以减轻纯母乳喂养早期停止之前，需要开展此类研究。
HL 水平低或不足与多种不良健康和临床结局相关。我们调查了产后 4 个月纯母乳喂养的流行情况，以及 HL 对维持最佳纯母乳喂养实践的影响。在多变量回归模型中，HL 水平有限或不足是纯母乳喂养早期停止的相关因素之一，但需要进一步研究。
