National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China.
Beijing Fengtai District Maternal and Child Health Hospital, Beijing, China.
Int Breastfeed J. 2020 Nov 23;15(1):99. doi: 10.1186/s13006-020-00343-3.
Breastfeeding is critical to promote maternal and child health. China has set national targets to further improve the exclusive breastfeeding rate. We aimed to examine associations between the provision of early essential newborn care (EENC) and breastfeeding outcomes among full term vaginally delivered neonates in the first 6 months of life.
We conducted a quasi-experimental study in eight maternal and children's hospitals in Mianyang City and Deyang City in Sichuan Province of western China. Four hospitals were randomly selected as the intervention group with the implementation of EENC while others as the control group receiving routine care. We assessed effects of EENC on breastfeeding initiation time, duration of first-time breastfeeding, and exclusive breastfeeding rates up to 6 months of age. Data were collected after delivery, at hospital discharge, 1 month, 3 months, and 6 months post birth in the baseline phase from May to June 2017 and post-EENC phase from October to December 2017. We performed univariate analyses to ascertain differences between the two groups, and difference in difference (DID) models to explore the net effects.
Of the 1349 enrolled mother and newborn pairs in our study, 1131 (83.9%) were followed up at 1 month of age, 1075 (79.7%) at 3 months, and 981 (72.7%) at 6 months. EENC was associated with earlier median time to initiate breastfeeding (25 min vs. 33 min, P < 0.01), an increased chance of successful first-time breastfeeding (OR 5.53; 95% CI 2.69, 11.40), longer duration of skin to skin contact (SSC) (21.53 min; 95% CI 18.17, 24.89) and longer duration of the first breastfeed (4.16 min; 95% CI 2.10, 6.22), and an increased likelihood of being exclusively breastfed at discharge (74.5% vs. 55.0%, P < 0.001), 3 months (OR 3.20; 95% CI 1.01, 10.15), and 6 months (OR 4.91; 95% CI 1.71, 14.13) of age.
EENC enhances breastfeeding initiation and increases exclusive breastfeeding at 6 months of age. Our evidence suggests that nationwide scale up of EENC would increase the exclusive breastfeeding rate in the first 6 months of life.
母乳喂养对促进母婴健康至关重要。中国已设定国家目标，进一步提高纯母乳喂养率。我们旨在研究早期基本新生儿护理（EENC）的提供与足月阴道分娩新生儿在生命的头 6 个月内母乳喂养结果之间的关联。
我们在中国西部四川省绵阳市和德阳市的八家妇幼保健院进行了一项准实验研究。随机选择四家医院作为干预组，实施 EENC，而其他医院作为对照组，接受常规护理。我们评估了 EENC 对母乳喂养开始时间、首次母乳喂养持续时间和 6 个月龄时纯母乳喂养率的影响。数据是在 2017 年 5 月至 6 月的基线阶段和 2017 年 10 月至 12 月的 EENC 后阶段在分娩后、出院时、1 个月、3 个月和 6 个月时收集的。我们进行了单变量分析，以确定两组之间的差异，并采用差异中的差异（DID）模型来探索净效应。
在我们的研究中，共有 1349 对母婴接受了随访，其中 1131 对（83.9%）在 1 个月时、1075 对（79.7%）在 3 个月时和 981 对（72.7%）在 6 个月时进行了随访。EENC 与更短的中位母乳喂养开始时间（25 分钟对 33 分钟，P<0.01）、更高的首次母乳喂养成功率（OR 5.53；95%CI 2.69，11.40）、更长的皮肤接触时间（SSC）（21.53 分钟；95%CI 18.17，24.89）和更长的第一次母乳喂养时间（4.16 分钟；95%CI 2.10，6.22）相关，并且在出院时（74.5%对 55.0%，P<0.001）、3 个月（OR 3.20；95%CI 1.01，10.15）和 6 个月（OR 4.91；95%CI 1.71，14.13）时更有可能纯母乳喂养。
EENC 可促进母乳喂养的开始，并增加 6 个月龄时的纯母乳喂养率。我们的证据表明，在全国范围内推广 EENC 将提高生命最初 6 个月的纯母乳喂养率。
