Syeda Batool, Agho Kingsley, Wilson Leigh, Maheshwari Greesh Kumar, Raza Muhammad Qasim
Western Sydney University, School of Science and Health, Narellan Road, Campbelltown, NSW, 2570, Australia.
Peoples University of Medical and Health Sciences for Women, Department of Community Medicine, Hospital Road, Nawabshah, 67450, Pakistan.
Int J Pediatr Adolesc Med. 2021 Mar;8(1):10-17. doi: 10.1016/j.ijpam.2020.01.006. Epub 2020 Jan 25.
The World Health Organization recommends that a child should be breastfed up to 2 years of age as it is essential for proper growth and development but population-based studies around the world have found conflicting results on the subject. Our study aims to analyze whether there is a relationship between the duration of breastfeeding and undernutrition among children aged from birth up to 3 years of age in Pakistan.
A secondary analysis of the Pakistan Demographic and Health Survey 2013-2014 with 1072 children aged 3 years and under was conducted. The relationship between breastfeeding duration and undernutrition status was estimated through multiple logistic regression analysis.
The prevalence of stunting, wasting and underweight were 40.6%, 15.8% and 33.9% respectively, while prevalence of severe stunting is at 22.5%; severe wasting at 4.5% and severe underweight at 12.2% in children in our study. Odds of being stunted were significantly higher for children in their 3rd year of life [AOR: 4.35, CI 95% = (2.01, 9.33)] compared to children being breastfed in their 2nd year of life [AOR: 2.43, CI 95% = (1.55, 3.79) after being adjusted for maternal, child, demographic and healthcare access variables. Similarly, children being breastfed in their third year of life were more susceptible to developing severe stunting [AOR: 6.19, CI 95% = (3.31, 11.56)] in comparison to children in their second year [AOR: 2.84, CI 95% = (1.81, 4.46)]. There was no significant association between breastfeeding and wasting/severe wasting, or between breastfeeding and underweight/severe underweight.
Breastfeeding in the 2nd and 3rd year of life was found to have significant relationship with stunting and severe stunting. Mothers need to be educated about the risks of prolonged breastfeeding to reduce the burden of undernutrition in the country.
世界卫生组织建议儿童应母乳喂养至2岁，因为这对其正常生长发育至关重要，但世界各地基于人群的研究在该问题上得出了相互矛盾的结果。我们的研究旨在分析在巴基斯坦，从出生到3岁的儿童中，母乳喂养时长与营养不良之间是否存在关联。
对2013 - 2014年巴基斯坦人口与健康调查进行二次分析，该调查涉及1072名3岁及以下儿童。通过多元逻辑回归分析评估母乳喂养时长与营养不良状况之间的关系。
在我们的研究中，儿童发育迟缓、消瘦和体重不足的患病率分别为40.6%、15.8%和33.9%，而严重发育迟缓的患病率为22.5%；严重消瘦为4.5%，严重体重不足为12.2%。与1岁时母乳喂养的儿童相比，3岁儿童发育迟缓的几率显著更高[调整后的比值比（AOR）：4.35，95%置信区间（CI）=(2.01, 9.33)] [调整后的比值比（AOR）：2.43，95%置信区间（CI）=(1.55, 3.79)]，在对母亲、儿童、人口统计学和医疗保健可及性变量进行调整后。同样，与1岁时母乳喂养的儿童相比，3岁时母乳喂养的儿童更易出现严重发育迟缓[调整后的比值比（AOR）：6.19，95%置信区间（CI）=(3.31, 11.56)] [调整后的比值比（AOR）：2.84，95%置信区间（CI）=(1.81, 4.46)]。母乳喂养与消瘦/严重消瘦之间，或母乳喂养与体重不足/严重体重不足之间均无显著关联。
发现1岁和3岁时的母乳喂养与发育迟缓和严重发育迟缓存在显著关联。需要对母亲进行关于延长母乳喂养风险的教育，以减轻该国的营养不良负担。
