与 COVID-19 大流行期间以色列纯母乳喂养相关的因素：IMAgINE EURO 横断面研究的一个子组。
Factors associated with exclusive breastfeeding in Israel during the COVID-19 pandemic: a subset of the IMAgiNE EURO cross-sectional study.
机构信息
School of Nursing, College of Health Sciences and Professions, Ohio University, Athens, OH, USA.
WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
出版信息
Int Breastfeed J. 2023 Jun 9;18(1):30. doi: 10.1186/s13006-023-00568-y.
BACKGROUND
Evidence has shown that restrictions during the COVID-19 pandemic have negatively affected breastfeeding support and outcomes in hospitals in many countries. The aims of the study were to describe exclusive breastfeeding rates and identify factors associated with exclusive breastfeeding at hospital discharge among women who gave birth during the COVID-19 pandemic in Israel.
METHODS
A cross-sectional online anonymous survey based on WHO standards for improving quality of maternal and newborn care in health facilities was conducted among a sample of women who gave birth to a healthy singleton infant in Israel during the pandemic (between March 2020 and April 2022). The socio-ecological approach was employed to examine intrapersonal, interpersonal, organizational, and community/society factors associated with exclusive breastfeeding at hospital discharge according to women perspectives.
RESULTS
Among the 235 Israeli participants, 68.1% exclusively breastfed, 27.7% partially breastfed, and 4.2% did not breastfeed at discharge. Results of the adjusted logistic regression model showed that factors significantly associated with exclusive breastfeeding were the intrapersonal factor of multiparity (adjusted OR 2.09; 95% Confidence Interval 1.01,4.35) and the organizational factors of early breastfeeding in the first hour (aOR 2.17; 95% CI 1.06,4.45), and rooming-in (aOR 2.68; 95% CI 1.41,5.07).
CONCLUSIONS
Facilitating early breastfeeding initiation and supporting rooming-in are critical to promoting exclusive breastfeeding. These factors, reflecting hospital policies and practices, along with parity, are significantly associated with breastfeeding outcomes and highlight the influential role of the maternity environment during the COVID-19 pandemic. Maternity care in hospitals should follow evidence-based breastfeeding recommendations also during the pandemic, promoting early exclusive breastfeeding and rooming-in among all women, with particular attention to providing lactation support to primiparous women.
TRIAL REGISTRATION
Clinical Trials NCT04847336.
背景
有证据表明，在许多国家，COVID-19 大流行期间的限制措施对医院的母乳喂养支持和结果产生了负面影响。本研究的目的是描述 COVID-19 大流行期间在以色列分娩的妇女在出院时进行纯母乳喂养的比例，并确定与纯母乳喂养相关的因素。
方法
本研究采用基于世卫组织改善卫生机构中孕产妇和新生儿护理质量的标准的横断面在线匿名调查，对以色列 COVID-19 大流行期间（2020 年 3 月至 2022 年 4 月）分娩健康单胎婴儿的妇女进行了抽样调查。采用社会生态方法，根据妇女的观点，检查与出院时纯母乳喂养相关的个体内部、人际间、组织和社区/社会因素。
结果
在 235 名以色列参与者中，68.1%的人完全母乳喂养，27.7%的人部分母乳喂养，4.2%的人在出院时不进行母乳喂养。调整后的逻辑回归模型结果表明，与纯母乳喂养显著相关的因素是个体因素中的多胎产次（调整后的 OR 2.09；95%置信区间 1.01，4.35）和组织因素中的产后 1 小时内开始母乳喂养（调整后的 OR 2.17；95%置信区间 1.06，4.45）和母婴同室（调整后的 OR 2.68；95%置信区间 1.41，5.07）。
结论
促进早期母乳喂养的开始和支持母婴同室对于促进纯母乳喂养至关重要。这些因素反映了医院的政策和实践，以及产次，与母乳喂养结果显著相关，突出了 COVID-19 大流行期间产妇环境的重要作用。医院的产妇保健应在大流行期间遵循基于证据的母乳喂养建议，促进所有妇女早期进行纯母乳喂养和母婴同室，特别注意为初产妇提供母乳喂养支持。
试验注册
ClinicalTrials NCT04847336。
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