Gabay Zarina Paltiel, Gondwe Kaboni Whitney, Topaz Maxim
School of Nursing, University of Haifa, Haifa, Israel.
College of Nursing, University of Wisconsin, Milwaukee, USA.
Matern Child Health J. 2022 Jun;26(6):1261-1272. doi: 10.1007/s10995-021-03292-3. Epub 2021 Dec 2.
This study aimed to 1) Examine factors associated with cessation of exclusive breastfeeding in Israel and 2) Develop predictive models to identify women at risk for early exclusive breastfeeding cessation.
The study used data from longitudinal national representative infant nutrition survey in Israel (n = 2119 participants). Logistic regression was used to identify risk factors and build predictive models.
The rate of exclusive breastfeeding cessation increased from 45.4% at 2 months to 85.7% at 6 months. Five factors were significantly associated with higher odds of exclusive breastfeeding cessation at 2 months: being a primapara, low educational level, lack of previous breastfeeding experience, negative attitude towards birth, and lack of intention to breastfeed. Six factors were significantly associated with higher odds of exclusive breastfeeding cessation at 6 months: younger age, being in a relationship with a partner, lower religiosity level, cesarean delivery, not taking folic acid during pregnancy, and negative attitude towards birth. Both 2 and 6-months models had good predictive performance (C-statistic of .72 and .68, accordingly).
This nationwide study successfully identified several predictors of exclusive breastfeeding cessation and created breastfeeding cessation prediction tools for two time periods (2 and 6 months). The resulting tools can be applied to identify women at risk for stopping exclusive breastfeeding in hospitals or at community clinics. Further studies should examine practical aspects of applying these tools in practice and explore whether applying those tools can lead to higher exclusive breastfeeding rates.
本研究旨在1)调查以色列纯母乳喂养停止的相关因素,以及2)建立预测模型,以识别有早期纯母乳喂养停止风险的女性。
本研究使用了以色列全国代表性婴儿营养纵向调查的数据(n = 2119名参与者)。采用逻辑回归来识别风险因素并建立预测模型。
纯母乳喂养停止率从2个月时的45.4%上升到6个月时的85.7%。五个因素与2个月时纯母乳喂养停止几率较高显著相关:初产妇、教育水平低、缺乏先前母乳喂养经验、对分娩持消极态度以及缺乏母乳喂养意愿。六个因素与6个月时纯母乳喂养停止几率较高显著相关:年龄较小、与伴侣有关系、宗教信仰程度较低、剖宫产、孕期未服用叶酸以及对分娩持消极态度。2个月和6个月模型均具有良好的预测性能(C统计量分别为0.72和0.68)。
这项全国性研究成功识别了纯母乳喂养停止的几个预测因素,并创建了两个时间段(2个月和6个月)的母乳喂养停止预测工具。所得工具可用于识别医院或社区诊所中面临停止纯母乳喂养风险的女性。进一步的研究应考察在实践中应用这些工具的实际情况,并探索应用这些工具是否能提高纯母乳喂养率。