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6-12 个月龄婴儿早期终止纯母乳喂养及相关因素的生存分析。

Time to early cessation of exclusive breast feeding and associated factors among 6-12 months old children: Survival analysis.

机构信息

Department of Public Health, College of Medicine and Health Science, Werabe University, Werabe, Ethiopia.

Department of Nutrition and Dietetics, College of Health Science, Jimma University, Jimma, Ethiopia.

出版信息

Clin Nutr ESPEN. 2022 Aug;50:283-288. doi: 10.1016/j.clnesp.2022.04.030. Epub 2022 May 12.

Abstract

BACKGROUND

WHO and UNICEF (1990) have recommended EBF for six months, followed by an introduction of complementary foods at the age of six months with continued breastfeeding for the first 24 months or more. Exclusive breastfeeding (EBF) during the first 6 months of life reduces infant morbidity and mortality. According to Ethiopia Demographic Health Survey (DHS), only 58% of children were exclusively breastfed during the first 6 months of age.

OBJECTIVE

The study aimed to identify time to early cessation of EBF and associated factors among 6-12 months old children in Lanfuro Woreda, Silte Zone.

METHODS

A community-based cross-sectional study was conducted in Lanfuro Woreda, Silte Zone, from March to April 2017. A total of 636 mothers with 6-12 months old infants from ten randomly selected kebeles were included. Both quantitative and subjective information assortment techniques were utilized. The Kaplan-Meier curve with log-rank test was used to compare the survival difference by the selected covariates. Both bivariate (P < 0.25) and multivariable (P < 0.05) Cox Proportional Hazards model were fitted to identify factors predicting time to early cessation of EBF.

RESULTS

The median duration of exclusive breastfeeding was 6.22 months. The highest proportion of cessation of exclusive breastfeeding occurred during the first four to five months. Early cessation of exclusive breastfeeding was observed in 295 (48%). Place of residence (AHR: 1.6; 95% CI = 1.14-2.20), knowledge on EBF (AHR = 1.31; 95% CI = 1.02-1.68), type of delivery (AHR: 2.41; 95% CI = 2.24-3.68), pre-lacteal feeding (AHR = 1.8; 95% CI = 1.32-2.36) and household food insecurity (AHR = 5.02; 95% CI = 3.89-6.50) were significant independent factors which were associated with time to early cessation of exclusive breastfeeding.

CONCLUSION AND RECOMMENDATION

There are still sizable proportions of children not enjoying exclusive breastfeeding for the first full six months. Being an urban resident and coming from food-insecure households, giving birth by CS, having low knowledge on EBF, and giving pre-lacteal feeding were factors associated with time to early cessation of EBF. Multi-sectoral action should be taken for respective predictors of time to early cessation of EBF.

摘要

背景

世界卫生组织和联合国儿童基金会(1990 年)建议婴儿在出生后最初 6 个月内进行纯母乳喂养,此后在添加辅食的基础上继续母乳喂养至 24 个月或更长时间。纯母乳喂养(EBF)可降低婴儿的发病率和死亡率。根据埃塞俄比亚人口与健康调查(DHS),只有 58%的儿童在 6 个月龄前完全接受纯母乳喂养。

目的

本研究旨在确定兰富罗区西尔特县 6-12 个月龄婴儿 EBF 早期中断的时间,并分析相关因素。

方法

本研究为 2017 年 3 月至 4 月在兰富罗区进行的一项基于社区的横断面研究。从 10 个随机选定的 kebeles 中纳入了 636 名 6-12 个月大的婴儿及其母亲。同时采用定量和主观信息收集技术。采用 Kaplan-Meier 曲线和对数秩检验比较选择的协变量的生存差异。采用单变量(P<0.25)和多变量(P<0.05)Cox 比例风险模型来确定预测 EBF 早期中断的因素。

结果

纯母乳喂养的中位持续时间为 6.22 个月。最早的 EBF 中断发生在第 4-5 个月。有 295(48%)名婴儿 EBF 早期中断。居住地(AHR:1.6;95%CI=1.14-2.20)、EBF 知识(AHR:1.31;95%CI=1.02-1.68)、分娩方式(AHR:2.41;95%CI=2.24-3.68)、开奶前喂养(AHR:1.8;95%CI=1.32-2.36)和家庭食物不安全(AHR:5.02;95%CI=3.89-6.50)是与 EBF 早期中断时间相关的显著独立因素。

结论和建议

仍有相当大比例的儿童在前 6 个月内未完全接受纯母乳喂养。居住在城市、来自食物不安全家庭、经剖宫产分娩、对 EBF 知识了解程度低以及开奶前喂养是与 EBF 早期中断时间相关的因素。应针对 EBF 早期中断时间的预测因素采取多部门行动。

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