Health Systems & Policy Department, Health Services Academy, Islamabad, Pakistan
College of Public Health Sciences, Chulalongkorn University College of Public Health Sciences, Bangkok, Thailand.
BMJ Open. 2023 Feb 1;13(2):e069902. doi: 10.1136/bmjopen-2022-069902.
The objective of this study was to determine the prevalence and correlates of early initiation of breast feeding and prelacteal feeding in highly disadvantaged districts in Pakistan.
This cross-sectional study design.
This study was carried out in twelve districts of the Sindh province of Pakistan.
A total of 4800 mothers with children under 2 years, selected through a multistage random sampling method.
Bivariate association, survival analysis (Kaplan-Meier and Cox proportional hazard techniques), multivariate linear regression and the ordinary least square model were used.
The results show that the prevalence of early initiation of breast feeding was 68% and prelacteal feeding was 32%. Adequate treatment, proper guidance at antenatal care visits, postpartum health check, normal birth with skilled birth attendants, institutional birth, skin-to-skin contact at birth and birth size were all associated with early breastfeeding initiation (p<0.001). The odds of early initiation of breast feeding after birth are higher if the respondents received proper guidance (OR 2.05; 95% CI 1.02 to 4.11) or made skin-to-skin contact (OR 10.65; 95% CI 6.82 to 16.65). Bivariate association between the prelacteal feeding and a set of correlates suggests that all variables under study were significantly associated with the outcome variable of interest at a 95% or higher significance level. The factors which significantly reduced the odds of prelacteal feeding were adequate treatment (OR 0.29; 95% CI 0.23 to 0.37) and postpartum health check (OR 0.65; 95% CI 0.53 to 0.80).
Sudy concludes that the correlates like adequate treatment of mothers during labour, postpartum health check-up, normal birth with skilled birth attendants, institutional births and skin-to-skin contact between mother and the baby determine the early initiation of breast feeding and prelecteal feeding. Early initiation of breast feeding needs to be encouraged, and communities must be educated against the use of prelacteal feeding.
本研究旨在确定在巴基斯坦高度贫困地区母乳喂养和开奶的早期开始率及其相关因素。
本研究采用了横断面研究设计。
本研究在巴基斯坦信德省的 12 个区进行。
通过多阶段随机抽样方法选择了 4800 名 2 岁以下儿童的母亲。
使用了双变量关联、生存分析（Kaplan-Meier 和 Cox 比例风险技术）、多变量线性回归和普通最小二乘法模型。
结果显示，母乳喂养的早期开始率为 68%，开奶率为 32%。充分的治疗、产前护理期间的适当指导、产后健康检查、有熟练助产士接生的正常分娩、机构分娩、出生时的皮肤接触和出生体重都与早期母乳喂养的开始有关（p<0.001）。如果受访者接受了适当的指导（OR 2.05；95%CI 1.02 至 4.11）或进行了皮肤接触（OR 10.65；95%CI 6.82 至 16.65），那么产后早期开始母乳喂养的可能性更高。开奶与一组相关因素的双变量关联表明，在 95%或更高的显著水平下，所有研究变量都与感兴趣的结果变量显著相关。显著降低开奶可能性的因素是充分的治疗（OR 0.29；95%CI 0.23 至 0.37）和产后健康检查（OR 0.65；95%CI 0.53 至 0.80）。
研究表明，母亲在分娩期间得到充分的治疗、产后健康检查、有熟练助产士接生的正常分娩、机构分娩和母婴之间的皮肤接触等因素决定了母乳喂养和开奶的早期开始。需要鼓励早期开始母乳喂养，并对社区进行教育，反对使用开奶。
