Decelles Stéphane, Nardocci Milena, Mildon Alison, Salameh Bana, Batal Malek
TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development Université de Montréal Canada TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Université de Montréal, Canada.
Independent Consultant Toronto Canada Independent Consultant, Toronto, Canada.
Rev Panam Salud Publica. 2022 Jul 16;46:e84. doi: 10.26633/RPSP.2022.84. eCollection 2022.
To identify the determinants of exclusive breastfeeding (EBF) among children under 6 months of age from three regions in the South and Grand'Anse Departments of Haiti.
Data were pooled from three cross-sectional surveys conducted yearly from 2017 to 2019 with the guardians of 638 children under 6 months of age. A non-quantitative 24-hour dietary recall was used to assess EBF the day before the survey. Using unadjusted and adjusted prevalence ratios, associations were assessed between EBF and several explanatory factors: infant's age and sex; maternal age, educational attainment, mid-upper arm circumference (MUAC), dietary diversity, number of children under 5 years of age, responsibility for the main or secondary source of income of the household, initiation of breastfeeding within one hour, knowledge of EBF duration; household severe food insecurity, socioeconomic status, dependency ratio, region, and residential zone (urban/rural).
Prevalence of EBF was 68% in the study sample. From the fully adjusted model, prevalence of EBF was statistically significantly higher among younger infants, mothers with larger MUAC, who met or exceeded Minimum Dietary Diversity for Women (MDD-W), who initiated breastfeeding within one hour, who were knowledgeable of the recommendations for EBF duration, and living in the Jérémie region.
The main determinants of EBF identified in this study attest to the importance of breastfeeding mothers' access to nutritious food for the practice and maintenance of EBF and the need for geographically equitable access to health services and education that support breastfeeding.
确定海地南部和大湾省三个地区6个月以下儿童纯母乳喂养（EBF）的决定因素。
数据来自2017年至2019年每年对638名6个月以下儿童的监护人进行的三次横断面调查。采用非定量的24小时饮食回顾法评估调查前一天的纯母乳喂养情况。使用未调整和调整后的患病率比，评估纯母乳喂养与几个解释因素之间的关联：婴儿的年龄和性别；母亲的年龄、教育程度、上臂中段周长（MUAC）、饮食多样性、5岁以下儿童数量、家庭主要或次要收入来源的责任、一小时内开始母乳喂养、对纯母乳喂养持续时间的了解；家庭严重粮食不安全、社会经济地位、抚养比、地区和居住区域（城市/农村）。
研究样本中纯母乳喂养的患病率为68%。在完全调整模型中，年龄较小的婴儿、MUAC较大的母亲、达到或超过女性最低饮食多样性（MDD-W）的母亲、在一小时内开始母乳喂养的母亲、了解纯母乳喂养持续时间建议的母亲以及居住在热雷米地区的母亲中，纯母乳喂养的患病率在统计学上显著更高。
本研究确定的纯母乳喂养的主要决定因素证明了母乳喂养母亲获得营养食品对于纯母乳喂养的实践和维持的重要性，以及在地理上公平获得支持母乳喂养的卫生服务和教育的必要性。
