Child Population Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Department of Maternal Fetal Medicine, Royal Hospital for Women, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2021 Aug;57(8):1288-1295. doi: 10.1111/jpc.15464. Epub 2021 Mar 25.
Despite international recommendations, less than one-third of Australian women exclusively breastfeed for 6 months. The aims of this study were to prospectively determine rates and factors associated with the type and duration of breastfeeding in the first year and examine the effect of minimal supplementation.
We conducted a sub-study of a randomised controlled trial in Sydney, Australia, which included 635 women with uncomplicated term births who intended to breastfeed. Data were collected daily for 56 days, and then at 2, 6 and 12 months post-partum.
Breastfeeding outcomes were evaluated for 553 (87%), 480 (76%) and 392 (62%) women at 2, 6 and 12 months. Exclusive breastfeeding was 81% at 2 months and 8% at 6 months. Partial breastfeeding was 75% at 6 months and 54% at 12 months. Factors associated with breastfeeding cessation included caesarean birth, low milk supply, problems latching, increased time to breastfeed, use of formula >7 days in the first 2 months, return to work and early introduction of solids. Breast pain in the first week was associated with a 10% decrease in exclusive breastfeeding. Cracked nipples and no previous breastfeeding experience were associated with supplementation of ≤7 days but had no effect on long-term breastfeeding duration.
Exclusive breastfeeding declined significantly between 2 and 6 months post-partum. Early intervention and education to prolong breastfeeding duration should include strategies to manage breast pain and nipple damage to minimise prolonged supplementation. Consistent guidelines about introduction of complementary foods, improved maternity leave and workplace incentives could be effective in prolonging breastfeeding.
尽管有国际建议，但澳大利亚只有不到三分之一的女性完全母乳喂养 6 个月。本研究旨在前瞻性地确定母乳喂养的类型和持续时间在第一年的比例和相关因素，并研究最小补充的效果。
我们在澳大利亚悉尼进行了一项随机对照试验的子研究，该研究包括 635 名分娩正常的打算母乳喂养的妇女。数据在产后 56 天内每天收集，然后在 2、6 和 12 个月时收集。
553（87%）、480（76%）和 392（62%）名妇女在 2、6 和 12 个月时评估了母乳喂养结果。2 个月时纯母乳喂养率为 81%，6 个月时为 8%。部分母乳喂养在 6 个月时为 75%，12 个月时为 54%。与母乳喂养终止相关的因素包括剖宫产、乳汁供应不足、哺乳困难、哺乳时间增加、前 2 个月使用配方奶>7 天、重返工作岗位和早期引入固体食物。产后第一周的乳房疼痛与纯母乳喂养率降低 10%相关。乳头皲裂和无母乳喂养经验与≤7 天的补充喂养相关，但对长期母乳喂养持续时间没有影响。
产后 2-6 个月纯母乳喂养显著下降。为延长母乳喂养时间而进行的早期干预和教育应包括管理乳房疼痛和乳头损伤的策略，以尽量减少长期补充喂养。关于引入补充食品的一致指南、延长产假和工作场所激励措施可能会有效地延长母乳喂养时间。
