Mary J Jenifer Florence, Sindhuri R, Kumaran A Arul, Dongre Amol R
Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.
Department of Pediatrics, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.
Clin Exp Pediatr. 2022 Apr;65(4):201-208. doi: 10.3345/cep.2021.00129. Epub 2021 Oct 18.
According to the National Family Health Survey- 4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery.
To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them.
This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24.
The median breastfeeding initiation time was 90 minutes (interquartile range, 30-180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12-16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57- 13.92; P=0.005), and mother's poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44-14.72; P=0.010) were more likely to delay the initiation of breastfeeding.
EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby's birth weight, and mothers' awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals' training to facilitate EIBF, even in circumstances such as cesarean section.
根据《第四次国家家庭健康调查》,在印度,78.9%的分娩在医疗机构进行,尽管只有42.6%的新妈妈在分娩后1小时内开始母乳喂养。
评估三级护理医院出院时新妈妈中早期开始母乳喂养(EIBF)的比例,并确定其中母乳喂养延迟开始的决定因素。
这是一项基于医院的对108名新妈妈的分析性横断面研究。在获得机构审查委员会批准并获得知情同意后,我们在新妈妈出院当天对她们进行了访谈。使用IBM SPSS Statistics 24版进行多变量逻辑回归分析。
母乳喂养开始时间的中位数为90分钟(四分位间距,30 - 180分钟)。总体而言,43.5%的妈妈进行了早期开始母乳喂养,77.4%进行了纯母乳喂养,43.5%在出院时母婴同室。母乳喂养延迟的原因包括腰麻后恢复时间延长、产妇疲倦以及剖宫产术后疼痛导致的母乳喂养姿势不舒服。在多变量分析中,出生体重低于2500克(调整后的优势比[aOR],4.33;95%置信区间[CI],1.12 - 16.82;P = 0.03)、剖宫产分娩(aOR,4.68;95% CI,1.57 - 13.92;P = 0.005)以及妈妈对母乳喂养的知识欠缺(aOR,4.61;95% CI,1.44 - 14.72;P = 0.010)更有可能延迟母乳喂养的开始。
根据剖宫产、婴儿出生体重和妈妈对母乳喂养的认知情况判断,不到一半的新妈妈进行了早期开始母乳喂养。因此,在产前期间改善妈妈们的母乳喂养和营养咨询,并改善医护人员的培训以促进早期开始母乳喂养至关重要,即使在剖宫产等情况下也是如此。