School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia.
School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Int Breastfeed J. 2022 May 11;17(1):36. doi: 10.1186/s13006-022-00475-8.
Caesarean birth is associated with higher rate of non-exclusive breastfeeding (non-EBF) than vaginal birth. Non-EBF refers to providing food or fluid besides breast milk, excluding drugs and vitamins, to infants before six months of age. This study determined the prevalence and factors associated with non-EBF during the first six months after an elective Caesarean birth.
This prospective cohort study recruited 171 mothers who underwent an elective caesarean birth at two tertiary hospitals in Kelantan, Malaysia. Face-to-face interviews were conducted two days after the birth to obtain information on the variables of interest. Follow-up phone calls were made at one, three and six months after birth to determine the prevalence of non-EBF. Simple and multiple logistic regressions were used for data analysis.
The prevalence of non-EBF was 19.9%, 40.4% and 57.9% at one, three and six months, respectively. Women who perceived that they had no breast milk, or their breast milk was inadequate were more likely to practise non-EBF at one month [Adjusted Odds Ratio (AOR) 4.83; 95% CI 1.06, 21.96], three months (AOR 4.97; 95% CI 1.67, 14.85) and six months (very often / often AOR 10.06; 95% CI 2.41, 41.99; sometimes / seldom AOR 3.27; 95% CI 1.46, 7.32). Women with at least one child were less likely to practise non-EBF at one month (age of last child ≤ 2 years old AOR 0.10; 95% CI 0.02, 0.66; 3-5 years old AOR 0.10; 95% CI 0.02, 0.53; and > 5 years AOR 0.15; 95% CI 0.02, 0.92).
Perceived breast milk insufficiency was the only factor associated with non-EBF at all time points. The issue of perceived breast milk insufficiency therefore needs to be explored further and addressed by lactation consultants and other maternal and child health professionals. Strategies may include breastfeeding education prior to the surgery and provision of a helpline to provide information and emotional support to the mothers following delivery. The important roles of lactation support groups in early detection and intervention of the problem cannot be emphasised enough.
剖宫产分娩与阴道分娩相比，非纯母乳喂养（非 EBF）的比例更高。非 EBF 是指在婴儿 6 个月前，除母乳、药物和维生素外，还提供其他食物或液体。本研究旨在确定择期剖宫产分娩后 6 个月内非 EBF 的流行率及其相关因素。
本前瞻性队列研究招募了马来西亚吉兰丹州两家三级医院的 171 名择期剖宫产产妇。分娩后 2 天进行面对面访谈，以获取感兴趣变量的信息。分娩后 1、3 和 6 个月进行电话随访，以确定非 EBF 的流行率。采用简单和多因素逻辑回归进行数据分析。
1 个月、3 个月和 6 个月时非 EBF 的流行率分别为 19.9%、40.4%和 57.9%。分娩后 1 个月时，认为自己没有母乳或母乳不足的女性更有可能进行非 EBF[校正优势比（AOR）4.83；95%可信区间（CI）1.06，21.96]、3 个月（AOR 4.97；95% CI 1.67, 14.85)和 6 个月（非常频繁/频繁 AOR 10.06；95% CI 2.41, 41.99；有时/偶尔 AOR 3.27；95% CI 1.46, 7.32）。至少有一个孩子的女性在 1 个月时不太可能进行非 EBF[上次分娩孩子年龄≤2 岁 AOR 0.10；95% CI 0.02, 0.66；3-5 岁 AOR 0.10；95% CI 0.02, 0.53；>5 岁 AOR 0.15；95% CI 0.02, 0.92]。
仅认为母乳不足与所有时间点的非 EBF 相关。因此，需要进一步探讨和解决认为母乳不足的问题，这需要由哺乳顾问和其他母婴健康专业人员来解决。策略可能包括手术前进行母乳喂养教育，并提供热线电话，为产妇提供信息和情感支持。强调哺乳支持小组在早期发现和干预问题方面的重要作用是不够的。
