Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya.
Epidemiology and Prevention Group, National Cancer Center, Tokyo, Japan.
Matern Child Nutr. 2021 Oct;17(4):e13191. doi: 10.1111/mcn.13191. Epub 2021 Apr 8.
Exclusive breastfeeding (EBF) during the first 6 months of life is crucial for optimizing child growth, development and survival, as well as the mother's wellbeing. Mother's employment may hinder optimal breastfeeding, especially in the first 6 months. We assessed the effectiveness of a baby-friendly workplace support intervention on EBF in Kenya. This pre-post intervention study was conducted between 2016 and 2018 on an agricultural farm in Kericho County. The intervention targeted pregnant/breastfeeding women residing on the farm and consisted of workplace support policies and programme interventions including providing breastfeeding flexi-time and breaks for breastfeeding mothers; day-care centres (crèches) for babies near the workplace and lactation centres with facilities for breast milk expression and storage at the crèches; creating awareness on available workplace support for breastfeeding policies; and home-based nutritional counselling for pregnant and breastfeeding women. EBF was measured through 24-h recall. The effect of the intervention on EBF was estimated using propensity score weighting. The study included 270 and 146 mother-child dyads in the nontreated (preintervention) group and treated (intervention) group, respectively. The prevalence of EBF was higher in the treated group (80.8%) than in the nontreated group (20.2%); corresponding to a fourfold increased probability of EBF [risk ratio (RR) 3.90; 95% confidence interval (CI) 2.95-5.15]. The effect of the intervention was stronger among children aged 3-5 months (RR 8.13; 95% CI 4.23-15.64) than among those aged <3 months (RR 2.79; 95% CI 2.09-3.73). The baby-friendly workplace support intervention promoted EBF especially beyond 3 months in this setting.
纯母乳喂养（EBF）在生命的头 6 个月对于优化儿童的生长、发育和生存以及母亲的健康至关重要。母亲就业可能会阻碍最佳母乳喂养，尤其是在前 6 个月。我们评估了肯尼亚婴儿友好型工作场所支持干预措施对 EBF 的有效性。这项在 2016 年至 2018 年期间在克里乔县的一个农业农场进行的干预前后研究，针对居住在农场的孕妇/哺乳期妇女，干预措施包括为哺乳期母亲提供母乳喂养弹性工作时间和休息时间；在工作场所附近为婴儿设立日托中心（托儿所）；在托儿所设立哺乳中心，为母乳喂养提供设施；宣传现有的支持母乳喂养政策的工作场所；以及为孕妇和哺乳期妇女提供家庭营养咨询。通过 24 小时回忆来测量 EBF。使用倾向评分加权来估计干预对 EBF 的影响。研究包括未经处理（干预前）组的 270 对母婴对子和经处理（干预）组的 146 对母婴对子。处理组的 EBF 发生率（80.8%）高于未经处理组（20.2%）；母乳喂养的可能性增加了四倍[风险比（RR）3.90；95%置信区间（CI）2.95-5.15]。干预措施在 3-5 个月大的儿童中效果更强（RR 8.13；95% CI 4.23-15.64），而在 3 个月以下的儿童中效果较弱（RR 2.79；95% CI 2.09-3.73）。在这种情况下，婴儿友好型工作场所支持干预措施促进了 EBF，特别是在 3 个月后。
