Global Health Research Center, Duke Kunshan University, Jiangsu, China.
Centre for Health Statistics and Information, National Health Commission, 38 Beilishi Road, Xicheng, Beijing, 100810, NO, China.
Int Breastfeed J. 2023 Aug 11;18(1):40. doi: 10.1186/s13006-023-00572-2.
The World Health Organization and the government of China have made many efforts to improve breastfeeding practices. The evidence of breastfeeding practices over the past decade in China is limited. The current study aimed to describe the current prevalence, variation trends, and determinants of breastfeeding practices in China using data from the National Household Health Service Surveys (NHHSS) in 2013 and 2018.
Women who had at least one live birth in the five years from the 2013 NHHSS numbered 10,544, and 12,766 women from the 2018 NHHSS were included in the current study. The rates of breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months since birth, and continued breastfeeding accompanied by adequate complementary feeding for over two years were measured. Logistic regressions were performed to study the associations between breastfeeding practices and maternal-based, healthcare-based, and infant-based characteristics.
In the 2018 survey, the rates of practiced any breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months, and continued breastfeeding for over two years were 91.50%, 28.16%, 47.90%, and 4.78%, respectively, showing significant improvements compared to the 2013 survey period. Women who received high education, were from a household with high incomes, had more than one child, and had more antenatal and postnatal visits, were more likely to practice breastfeeding and initiate it within the first hour, but they were less likely to breastfeed the infants for two years. Births by caesarean section and low birthweight were associated with worse breastfeeding practices.
The rates of practicing breastfeeding and exclusive breastfeeding for six months or more in China improved over the past decades, suggesting improved awareness and knowledge of breastfeeding among women. However, individual and social factors may impact practices of early initiation and continued breastfeeding. Strengthening breastfeeding support from family, community, and health professionals (e.g., family member engagement, friendly work environment, and professional consultation, etc.) during the postpartum and infant period may improve women's confidence in breastfeeding practices.
世界卫生组织和中国政府为改善母乳喂养实践做出了许多努力。过去十年中国母乳喂养实践的证据有限。本研究旨在使用 2013 年和 2018 年全国家庭健康服务调查（NHHSS）的数据，描述中国目前母乳喂养实践的流行率、变化趋势和决定因素。
2013 年 NHHSS 中至少有一次五年内活产的女性有 10544 人，2018 年 NHHSS 中有 12766 名女性纳入本研究。测量母乳喂养、出生后 1 小时内早期开始母乳喂养、出生后至少 6 个月纯母乳喂养以及持续母乳喂养伴适当补充喂养两年以上的比例。采用 logistic 回归研究母乳喂养实践与基于产妇、基于医疗保健和基于婴儿特征的关联。
在 2018 年的调查中，实践任何母乳喂养、出生后 1 小时内早期开始母乳喂养、至少 6 个月纯母乳喂养和持续母乳喂养两年以上的比例分别为 91.50%、28.16%、47.90%和 4.78%，与 2013 年调查期间相比，均有显著提高。接受高等教育、家庭收入较高、有多个孩子、产前和产后检查次数较多的女性更有可能进行母乳喂养并在出生后 1 小时内开始母乳喂养，但她们不太可能让婴儿母乳喂养两年。剖宫产分娩和低出生体重与较差的母乳喂养实践有关。
过去几十年，中国母乳喂养和纯母乳喂养 6 个月以上的比例有所提高，这表明妇女对母乳喂养的认识和知识有所提高。然而，个人和社会因素可能会影响早期启动和持续母乳喂养的实践。在产后和婴儿期加强家庭、社区和卫生专业人员（如家庭成员参与、友好的工作环境和专业咨询等）对母乳喂养的支持，可能会提高妇女对母乳喂养实践的信心。
