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布勒地区小于 6 个月儿童的母亲回避初乳的做法及相关因素:一项基于社区的横断面研究。埃塞俄比亚阿姆哈拉地区西北区

Colostrum avoidance practice and associated factors among mothers of children aged less than six months in Bure District, Amhara Region, North West, Ethiopia: A community-based cross-sectional study.

机构信息

Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.

School of Nursing and Midwifery, Colleges of Health Sciences and Medicine, Haramaya University, Harar, Ethiopia.

出版信息

PLoS One. 2021 Jan 29;16(1):e0245233. doi: 10.1371/journal.pone.0245233. eCollection 2021.

Abstract

INTRODUCTION

The World Health Organization and the United Nations International Children's Emergency Fund jointly recommend colostrum feeding immediately following delivery of the newborn. Colostrum avoidance is the practice of discarding colostrum at least once within the first three days after delivery of the newborn. Colostrum contains antibodies that protect the newborn against disease. Despite this fact, many Ethiopian mothers see colostrum feeding as a cause of neonatal morbidity and mortality, and they believe colostrum should be discarded to alleviate its effects. However, the cause of this misconception about colostrum is not well researched in Ethiopia, particularly in the study area.

OBJECTIVE

To assess the prevalence of colostrum avoidance and associated factors among mothers of children aged less than six months in Bure district, Amhara Region, North West, Ethiopia.

METHODS

A community-based cross-sectional study was conducted from March 1st to 30th, 2019 in Bure district. Structured questionnaires and face to face interviews were used to collect data from 621 study participants. Multistage sampling technique was used to select study participants. Data were entered into Epi Data version 4.2.0 and then exported to Statistical Package for the Social Sciences version 23. Bivariate and multivariate logistic regression analyses were performed to identify predictors of colostrum avoidance practice.

RESULTS

Six hundred twenty-one (621) mothers of children aged less than six months participated. The prevalence of colostrum avoidance was 14.5% (95%CI; 11.5-17.4). The multivariate analysis indicated that home delivery [AOR = 3.350, (95%CI; 2.517-14.847)], giving birth through cesarean section [AOR = 3.368, (95%CI; 1.339-8.471)], no participation in an antenatal care group [AOR = 1.889, (95%CI; 1.144-3.533)], poor knowledge of mothers about colostrum [AOR = 3.44, (95%CI; 2.45-4.977)], and poor attitude of mothers towards colostrum [AOR = 3.053, (95%CI; 1.157-8.054)] were important predictors of colostrum avoidance practice.

CONCLUSION AND RECOMMENDATIONS

Home delivery, giving birth through cesarean section, no participation in an antenatal care group, poor knowledge of mothers about colostrum, and poor attitude of mothers towards colostrum were significantly associated with colostrum avoidance practice. Therefore, health care workers in the district should promote institutional delivery, reduce the magnitude of cesarean section, encourage pregnant mothers to participate in an antenatal care group, and enhance maternal awareness about the merits of colostrum feeding. Moreover, health educations for mothers to have a positive attitude towards colostrum are important recommendations to be taken to prevent the further practice of colostrum avoidance.

摘要

简介

世界卫生组织和联合国国际儿童紧急救援基金会联合推荐在新生儿出生后立即进行初乳喂养。丢弃初乳是指在新生儿出生后的头三天内至少丢弃一次初乳。初乳含有抗体,可以保护新生儿免受疾病的侵害。尽管如此,许多埃塞俄比亚母亲认为初乳喂养是新生儿发病率和死亡率的原因,并认为应该丢弃初乳以减轻其影响。然而,在埃塞俄比亚,特别是在研究地区,对这种关于初乳的误解的原因并没有很好的研究。

目的

评估布勒区 6 个月以下儿童母亲中丢弃初乳的流行情况及其相关因素,该地区位于埃塞俄比亚阿姆哈拉州西北部。

方法

这是一项 2019 年 3 月 1 日至 30 日在布勒区进行的基于社区的横断面研究。采用结构化问卷和面对面访谈的方式,从 621 名研究参与者中收集数据。采用多阶段抽样技术选择研究参与者。数据输入 EpiData 版本 4.2.0,然后导出到统计软件包第 23 版。进行了二变量和多变量逻辑回归分析,以确定丢弃初乳做法的预测因素。

结果

621 名 6 个月以下儿童的母亲参与了研究。丢弃初乳的流行率为 14.5%(95%CI;11.5-17.4)。多变量分析表明,家庭分娩(AOR=3.350,95%CI;2.517-14.847)、剖宫产分娩(AOR=3.368,95%CI;1.339-8.471)、未参加产前护理小组(AOR=1.889,95%CI;1.144-3.533)、母亲对初乳的知识贫乏(AOR=3.44,95%CI;2.45-4.977)以及母亲对初乳的态度不佳(AOR=3.053,95%CI;1.157-8.054)是丢弃初乳做法的重要预测因素。

结论和建议

家庭分娩、剖宫产分娩、不参加产前护理小组、母亲对初乳的知识匮乏以及母亲对初乳的态度不佳与丢弃初乳的做法显著相关。因此,该地区的卫生保健工作者应提倡住院分娩、减少剖宫产的数量、鼓励孕妇参加产前护理小组,并提高母亲对初乳喂养益处的认识。此外,为母亲提供健康教育,使其对初乳持积极态度,是防止进一步丢弃初乳的重要建议。

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