Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA.
Wayne State University School of Medicine, Detroit, MI, USA.
J Nutr. 2023 Jan;153(1):322-330. doi: 10.1016/j.tjnut.2022.11.007. Epub 2022 Dec 20.
Breastfeeding (BF) provides optimal nutrition during the first 6 mo of life and is associated with reduced infant mortality and several health benefits for children and mothers. However, not all infants in the United States are breastfed, and sociodemographic disparities exist in BF rates. Experiencing more BF-friendly maternity care practices at the hospital is associated with better BF outcomes, but limited research has examined this association among mothers enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a population at risk of low BF rates.
We assessed the association between BF-related hospital practices (rooming-in, support from hospital staff, and provision of a pro-formula gift pack) and the odds of any or exclusive BF through 5 mo among infants and mothers enrolled in WIC.
We analyzed data from the WIC Infant and Toddler Feeding Practices Study II, a nationally representative cohort of children and caregivers enrolled in WIC. Exposures included maternal experience of hospital practices reported at 1 mo postpartum, and BF outcomes were surveyed at 1, 3, and 5 mo. ORs and 95% CIs were obtained using survey-weighted logistic regression, adjusting for covariates.
Rooming-in and strong hospital staff support were associated with higher odds of any BF at 1, 3, and 5 mo postpartum. Provision of a pro-formula gift pack was negatively associated with any BF at all time points and with exclusive BF at 1 mo. Each additional BF-friendly hospital practice experienced was associated with 47% to 85% higher odds of any BF over the first 5 mo and 31% to 36% higher odds of exclusive BF over the first 3 mo.
Exposure to BF-friendly hospital practices was associated with BF beyond the hospital stay. Expanding BF-friendly policies at the hospital could increase BF rates in the United States WIC-served population.
母乳喂养(BF)在婴儿生命的头 6 个月提供最佳营养,并与降低婴儿死亡率和儿童及母亲的多项健康益处相关。然而,并非所有美国婴儿都进行母乳喂养,母乳喂养率存在社会人口统计学差异。在医院体验更多支持母乳喂养的护理实践与更好的母乳喂养结果相关,但有限的研究调查了这一关联,这些研究对象是参加特殊补充营养计划(WIC)的妇女、婴儿和儿童,这是一个母乳喂养率低的风险人群。
我们评估了与母乳喂养相关的医院实践(母婴同室、医院工作人员的支持以及提供配方奶粉赠品包)与 WIC 登记婴儿和母亲在 5 个月内任何形式或纯母乳喂养的可能性之间的关联。
我们分析了 WIC 婴儿和幼儿喂养实践研究 II 的数据,这是一项全国代表性的儿童和照顾者队列,参加了 WIC。暴露因素包括产后 1 个月报告的医院实践经验,母乳喂养结果在 1、3 和 5 个月时进行调查。使用调查加权逻辑回归,调整协变量后获得比值比(OR)和 95%置信区间(CI)。
母婴同室和医院工作人员强有力的支持与产后 1、3 和 5 个月任何形式母乳喂养的几率更高相关。提供配方奶粉赠品包与所有时间点的任何形式母乳喂养以及 1 个月时的纯母乳喂养呈负相关。在医院体验到的每增加一项支持母乳喂养的实践,与头 5 个月期间任何形式母乳喂养的几率增加 47%至 85%,与头 3 个月期间纯母乳喂养的几率增加 31%至 36%相关。
暴露于支持母乳喂养的医院实践与母乳喂养持续至出院后相关。在医院扩大支持母乳喂养的政策可能会提高美国 WIC 服务人群的母乳喂养率。