LeMoine Felicia V, Witt Caitlin, Howard Shelby, Chapple Andrew, Pam LaKedra, Sutton Elizabeth F
Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, Baton Rouge, Louisiana, USA.
Department of Biostatistics, School of Public Health, Louisiana State University Health and Sciences Center, New Orleans, Louisiana, USA.
Womens Health Rep (New Rochelle). 2022 Jul 7;3(1):624-632. doi: 10.1089/whr.2022.0045. eCollection 2022.
Increasing breastfeeding rates is a national health objective, however substantial barriers and disparities continue to exist in breastfeeding initiation and continuation. Our study aim is to identify factors associated with birthing persons' breastfeeding "success" (patients admitted to Labor & Delivery desiring to breastfeed and discharged breastfeeding) and breastfeeding "failure" (patients admitted to Labor & Delivery desiring to breastfeed and discharged exclusively formula feeding).
We conducted a retrospective cohort study between July 2015 and June 2016. Patients were asked infant feeding plan intentions (breast, formula, combination) upon admission for delivery. Feeding plan was reassessed at discharge from delivery stay and validated to serve as proxy for feeding status at discharge. Logistic regression was used to identify the population(s) most likely to voice intent to breastfeed and to identify predictors of altered breastfeeding intent at discharge.
Between July 2015 and June 2016, 6690 patients met criteria for analysis. Patients reporting intent to breastfeed before delivery were more likely Caucasian ( < 0.0001), married ( < 0.001), nulliparous ( < 0.01), privately insured ( < 0.0001), educated ( < 0.0001), and older ( < 0.01) compared with patients not intending to breastfeed. These characteristics were similar in those who were "successful breastfeeders," that is, breastfeeding at discharge. The strongest predictor of breastfeeding at discharge was intent to breastfeed before delivery ( < 0.0001). African American race was the strongest predictor of nonbreastfeeding intent at admission ( < 0.0001) and conversion to formula feeding by hospital discharge ( < 0.001).
Intent to breastfeed before delivery was the strongest predictor of breastfeeding at discharge; thus, prenatal breastfeeding education within the at-risk population is crucial to increasing breastfeeding rates.
提高母乳喂养率是一项国家卫生目标，然而在母乳喂养的开始和持续方面，仍然存在重大障碍和差异。我们的研究目的是确定与产妇母乳喂养“成功”（入住分娩室时希望母乳喂养且出院时仍进行母乳喂养的患者）和母乳喂养“失败”（入住分娩室时希望母乳喂养且出院时完全采用配方奶喂养的患者）相关的因素。
我们在2015年7月至2016年6月期间进行了一项回顾性队列研究。患者在入院分娩时被询问婴儿喂养计划意向（母乳喂养、配方奶喂养、混合喂养）。在分娩住院出院时重新评估喂养计划，并进行验证以作为出院时喂养状况的替代指标。采用逻辑回归来确定最有可能表示母乳喂养意向的人群，并确定出院时母乳喂养意向改变的预测因素。
在2015年7月至2016年6月期间，6690名患者符合分析标准。与不打算母乳喂养的患者相比，分娩前报告有母乳喂养意向的患者更可能是白人（<0.0001）、已婚（<0.001）、初产妇（<0.01）、有私人保险（<0.0001）、受过教育（<0.0001）且年龄较大（<0.01）。这些特征在“成功母乳喂养者”（即出院时进行母乳喂养的患者）中也相似。出院时母乳喂养的最强预测因素是分娩前母乳喂养的意向（<0.0001）。非裔美国人种族是入院时非母乳喂养意向（<0.0001）以及到出院时转为配方奶喂养（<0.001）的最强预测因素。
分娩前母乳喂养的意向是出院时母乳喂养的最强预测因素；因此，对高危人群进行产前母乳喂养教育对于提高母乳喂养率至关重要。
