ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India.
Department of Health & Family Welfare, Government of West Bengal, Kolkata, West Bengal, India.
Int Breastfeed J. 2021 Jan 21;16(1):13. doi: 10.1186/s13006-021-00359-3.
Despite established benefits, exclusive breastfeeding (EBF) rate remains poor in India. This study measured the rate of early initiation of breastfeeding and EBF up to 42 days postpartum period and the reasons associated with early interruption of it.
In this study we followed a cohort 319 mother-newborn dyads, on a scheduled day of each week for six postpartum weeks (42 postpartum days), during May 2017 - March 2019. We used standard maternal 24 h recall method to collect data on newborn feeding practices. Additionally, using content the analysis method, we analysed the data captured through open ended question on current breastfeeding practice and reasons to identify the sociocultural facilitators/barriers of exclusive breastfeeding .
Of the retained 306 newborns, early initiation of breastfeeding rate was 60% (184/306), whereas, EBF rate was 47% (143/306). Mothers' educational level did not emerge as a risk for unsuccessful breastfeeding practices, whereas, father being not the major earner of the family (Relative risk [RR] 2.4; 95% Confidence interval [CI] 1.7,3.3), mothers who did not believe that effect of breastfeeding is longstanding (RR 1.8; 95% CI 1.3, 2.1) emerged as a risk for unsuccessful EBF practices. Lack of self-conviction about EBF among mothers; significant family members' influence; cultural beliefs; emerged as major socio-environmental barriers of early interruption of exclusive breastfeeding. Repeated counselling by the healthcare provider particularly focusing on exclusive breastfeeding, supportive family environment in terms of the elders being aware of the positive health outcomes of it, and prior positive experience emerged as the socio-environmental facilitators for successful EBF until 42 postpartum days.
We conclude that the socio-environmental causes need to be addressed through the present healthcare delivery system for ensuring better infant feeding outcome.
尽管母乳喂养有既定的益处，但在印度，纯母乳喂养（EBF）率仍然很低。本研究旨在测量产后 42 天内婴儿早期开始母乳喂养和 EBF 的比例，以及导致母乳喂养提前中断的原因。
在这项研究中，我们对 319 对母婴队列进行了随访，在产后每周的预定日期进行随访，持续 6 周（42 天）。我们使用标准的产妇 24 小时回忆法收集新生儿喂养方式的数据。此外，我们通过开放式问题收集当前母乳喂养实践的数据，并使用内容分析法识别影响 EBF 的社会文化因素。
在保留的 306 名新生儿中，早期开始母乳喂养的比例为 60%（184/306），而 EBF 的比例为 47%（143/306）。母亲的教育水平并不是母乳喂养失败的风险因素，而父亲不是家庭的主要经济支柱（相对风险 [RR] 2.4；95%置信区间 [CI] 1.7,3.3），母亲不认为母乳喂养的效果是持久的（RR 1.8；95% CI 1.3,2.1）是 EBF 失败的风险因素。母亲对 EBF 缺乏自信；主要家庭成员的影响；文化信仰；这些都是导致 EBF 提前中断的主要社会环境障碍。医疗保健提供者反复进行母乳喂养咨询，特别是强调 EBF，创造一个支持性的家庭环境，让长辈了解其对健康的积极影响，以及之前的积极经验，这些都是成功实施 EBF 直至产后 42 天的社会环境促进因素。
我们得出结论，需要通过现有的医疗保健系统来解决社会环境因素，以确保更好的婴儿喂养结果。
