巴基斯坦农村地区纯母乳喂养的障碍和促进因素：一项定性探索性研究。
Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study.
机构信息
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Department of Obstetrics and Gynaecology, Aga Khan University, Karachi, Pakistan.
出版信息
Int Breastfeed J. 2022 Aug 19;17(1):59. doi: 10.1186/s13006-022-00495-4.
BACKGROUND
Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study aimed to explore barriers to EBF in a rural context of Pakistan.
METHODS
The study was conducted in the rural district Matiari of Sindh, Pakistan, during Jan-March 2020. We used a qualitative exploratory study design and conducted 36 focus group discussions (FGDs). Participants were purposively selected mothers who had not practiced EBF during their previous childbirth, their spouses and mothers-in-law, and lady health workers (LHWs) serving in the study catchment. FGDs were audio-recorded, transcribed, and translated into English from the local language and analysed using thematic content analysis.
RESULTS
Barriers to EBF included low awareness and cultural practices of prelacteal feeds, insufficient breast milk production, undernutrition of mothers, mothers' occupation as fieldworkers, less birth spacing, low awareness about the correct technique of breastfeeding, maternal and child ailments, abnormal breasts, and influence of in-laws to start top-up feeds. Several facilitators were identified: family support, appropriate maternal diet, maternal awareness, and support in the neighborhood.
CONCLUSION
Barriers to EBF are multifaceted in rural areas, and interventions aiming to improve adherence to EBFshould be multipronged. Awareness-raising alone might not be sufficient, and other interventions should be designed to address the barriers of maternal malnutrition, insufficient milk production, and socio-cultural practices. In addition, safe alternatives to breast milk may be necessary if breastfeeding is truly not feasible. Lack of breast milk substitutes is particularly challenging for poor rural women who cannot afford infant formula milk.
背景
将儿童纯母乳喂养至 6 个月被认为是解决儿童营养不足问题的最关键干预措施之一。在巴基斯坦，纯母乳喂养率不理想，尤其是在儿童营养不足最为普遍的农村地区。本研究旨在探讨巴基斯坦农村地区纯母乳喂养的障碍因素。
方法
本研究于 2020 年 1 月至 3 月在巴基斯坦信德省的农村地区马蒂亚里进行。我们采用定性探索性研究设计，进行了 36 次焦点小组讨论（FGD）。参与者是在之前分娩时没有进行纯母乳喂养的母亲、她们的配偶和婆婆，以及在研究覆盖地区服务的妇幼保健员（LHW）。FGD 进行了录音，并用当地语言转录，并从当地语言翻译成英语，然后使用主题内容分析进行分析。
结果
纯母乳喂养的障碍因素包括：对开奶前喂养的低认识和文化习俗、母乳不足、母亲营养不良、母亲职业为外勤人员、生育间隔较短、对正确母乳喂养技术的认识不足、母婴疾病、乳房异常以及婆婆的影响开始添加补充食物。确定了几个促进因素：家庭支持、适当的产妇饮食、产妇意识以及邻里支持。
结论
农村地区纯母乳喂养的障碍因素是多方面的，旨在提高对纯母乳喂养的依从性的干预措施应该是多管齐下的。仅提高认识可能还不够，应该设计其他干预措施来解决母亲营养不良、母乳不足和社会文化习俗等障碍。此外，如果母乳喂养真的不可行，可能需要安全的母乳替代品。缺乏母乳替代品对贫困的农村妇女来说是一个特别的挑战，她们买不起婴儿配方奶粉。
Zotero 插件