Directorate of Strategy and Studies, Ministry of Planning and Development, Abidjan, Côte d'Ivoire.
Center for Population and Health Policy and Systems Research, National Institute of Public Health, Abidjan, Côte d'Ivoire.
Int Breastfeed J. 2023 Aug 15;18(1):43. doi: 10.1186/s13006-023-00573-1.
Despite benefits of exclusive breastfeeding (EBF) and its strategic place in the national guidelines for infant and young child feeding, its practice remains insufficient in Cote d'Ivoire. It is therefore important to identify its early stopping associated factors. We aimed to (i) assess the extent of children's exposure to exclusive breastfeeding and the associated explanatory factors for discontinuation before six months, and (ii) to profile non-exclusively breastfed children and interrelationships between these factors.
A secondary analysis of data from the 2016 Cote d'Ivoire Fifth Multi Indicator Cluster Survey (MICS5) of 980 children under six months of age was conducted in this study. Data were analyzed using the actuarial method of survival hazard estimation combined with the Wilcoxon (Gehan) test, discrete time proportional hazards regression models, and Multiple Correspondence Analysis (MCA) to profile the children.
Maternal exposure to counseling session, age at delivery, and child sex were significantly associated with the likelihood of discontinuing exclusive breastfeeding before the first six months of life. Children deprived of EBF resided in urban areas, in high and very high economic welfare households. Their mothers had a secondary education or higher and had three or fewer children. Logistic analysis showed that health status and sex of the child were significantly associated (P < 0.001) with exclusive breastfeeding. An extremely important and rarely studied factor is that children who were sick in weeks prior to the survey were more likely to remain exclusive breastfeeding (adjusted OR 1.80; 95% Confidence Interval (CI) 1.452, 2.234). Girls are less likely to be exclusively breastfed than boys (adjusted OR 1.48; 95% CI 1.22, 1.798). Low standard of living was associated with early cessation of EBF (adjusted OR 2.15; CI 1.325, 3.499). The duration of the exclusive breastfeeding was significantly longer among mothers with high exposure to medical discourse (adjusted OR 0.74; CI 0.595, 0.91).
Improving the practice of exclusive breastfeeding in Cote d'Ivoire requires strengthening the capacities of health professionals in terms of advice and assistance to mothers for the practice of exclusive breastfeeding and its maintenance until six months of age, regardless of the health status and sex of the child.
尽管纯母乳喂养（EBF）有诸多益处，并且在婴幼儿喂养的国家指南中占有重要地位，但在科特迪瓦，其实施情况仍不尽人意。因此，确定其早期中断的相关因素非常重要。我们的目的是：（i）评估儿童接触纯母乳喂养的程度，以及在六个月之前中断母乳喂养的相关解释因素；（ii）描述非纯母乳喂养的儿童，并分析这些因素之间的相互关系。
本研究对 2016 年科特迪瓦第五次多指标类集调查（MICS5）中 980 名六个月以下儿童的数据进行了二次分析。采用生存风险估计的 actuarial 方法与 Wilcoxon（Gehan）检验、离散时间比例风险回归模型和多对应分析（MCA）相结合对数据进行分析，以描述儿童的特征。
母亲接受咨询、分娩年龄和儿童性别与六个月前中断纯母乳喂养的可能性显著相关。未接受纯母乳喂养的儿童居住在城市地区，家庭经济福利水平较高或非常高。他们的母亲接受过中等或高等教育，并且有三个或更少的孩子。Logistic 分析表明，儿童的健康状况和性别与纯母乳喂养显著相关（P<0.001）。一个非常重要且很少被研究的因素是，在调查前几周生病的儿童更有可能继续进行纯母乳喂养（调整后的 OR 1.80；95%置信区间（CI）1.452，2.234）。女孩比男孩更不可能进行纯母乳喂养（调整后的 OR 1.48；95%CI 1.22，1.798）。低生活水平与 EBF 的早期中断有关（调整后的 OR 2.15；CI 1.325，3.499）。母亲接受的医学话语暴露程度越高，纯母乳喂养的持续时间显著越长（调整后的 OR 0.74；CI 0.595，0.91）。
为了提高科特迪瓦纯母乳喂养的实践水平，需要加强卫生专业人员的能力，为母亲提供关于纯母乳喂养的建议和帮助，使其能够持续到六个月大，无论儿童的健康状况和性别如何。
