Xu Huilan, Marshall Sarah, Jones Jennifer M, Phongsavan Philayrath, Wen Li Ming
Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, NSW, Australia.
Sydney School of Public Health, Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.
Birth. 2022 Mar;49(1):97-106. doi: 10.1111/birt.12578. Epub 2021 Jul 18.
Breastfeeding practices are determined by complex multilevel factors. This study assessed pregnant women's knowledge of breastfeeding and intention to breastfeed and investigated modifiable predictors for breastfeeding status (exclusive or any breastfeeding) and duration at 6 and 12 months postpartum.
Longitudinal data were extracted from a trial in Sydney, Australia, 2017-19. Women (n = 1155) were recruited from antenatal clinics and followed up for telephone interviews at baseline (third trimester), then at 6 and 12 months postpartum. Data collected included mothers' demographics; knowledge of breastfeeding and intention to breastfeed; work status; support from caregivers; breastfeeding environment; breastfeeding status and duration. Multiple logistic and Cox regression models were built to identify predictors for breastfeeding.
At baseline, most mothers knew the recommendation to exclusively breastfeed until 6 months (66%) and the benefits (65%). The modifiable predictors for breastfeeding duration at 12 months included the following: mothers' knowledge of the recommendation (adjusted hazard ratio (AHR) 0.73, 95% confidence interval (CI) 0.60-0.90) and the benefits of exclusive breastfeeding (AHR 0.68, 95% CI 0.55-0.82), intention to meet the recommendation (AHR 0.76, 95% CI 0.63-0.93), and intention to breastfeed for two years (AHR 0.38, 95% CI 0.27-0.52) measured at baseline; mothers not working or studying (AHR 0.70, 95% CI 0.55-0.89), having support from other caregivers (AHR 0.64, 95% CI 0.43-0.96), and having breastfeeding women around (AHR 0.80, 95% CI 0.65-0.98) measured at 6 months.
Support for women to meet the breastfeeding recommendations should commence during pregnancy and focus on breastfeeding education and enabling environments.
母乳喂养行为由复杂的多层次因素决定。本研究评估了孕妇对母乳喂养的知识和母乳喂养意愿，并调查了产后6个月和12个月时母乳喂养状况（纯母乳喂养或任何形式的母乳喂养）及持续时间的可改变预测因素。
纵向数据取自2017 - 19年在澳大利亚悉尼进行的一项试验。从产前诊所招募了1155名女性，并在基线期（孕晚期）、产后6个月和12个月进行电话随访。收集的数据包括母亲的人口统计学信息；母乳喂养知识和母乳喂养意愿；工作状态；来自照顾者的支持；母乳喂养环境；母乳喂养状况和持续时间。建立了多个逻辑回归模型和Cox回归模型来确定母乳喂养的预测因素。
在基线期，大多数母亲知道纯母乳喂养至6个月的建议（66%）和其益处（65%）。产后12个月母乳喂养持续时间的可改变预测因素包括：母亲在基线期对该建议的了解（调整后风险比[AHR] 0.73，95%置信区间[CI] 0.60 - 0.90）和纯母乳喂养的益处（AHR 0.68，95% CI 0.55 - 0.82）、达到该建议的意愿（AHR 0.76，95% CI 0.63 - 0.93）以及母乳喂养两年的意愿（AHR 0.38，95% CI 0.27 - 0.52）；母亲在产后6个月时不工作或不学习（AHR 0.70，95% CI 0.55 - 0.89）、得到其他照顾者的支持（AHR 0.64，95% CI 0.43 - 0.96）以及身边有进行母乳喂养的女性（AHR 0.80，95% CI 0.65 - 0.98）。
对女性达到母乳喂养建议的支持应在孕期开始，并侧重于母乳喂养教育和有利环境。
