Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
Palladium, Washington, DC, USA.
J Hum Lact. 2023 Nov;39(4):584-594. doi: 10.1177/08903344231193734. Epub 2023 Sep 7.
Accurate measurement of exclusive breastfeeding is important in maternal and child health research. Exclusive breastfeeding is often measured using the 24-hour recall or the since birth method for the first 6 months. These methods can produce different estimates, introducing problems in interpreting breastfeeding behavior and making accurate comparisons across settings or countries.
Our aim was to compare the exclusive breastfeeding rates between the 24-hour recall and since birth methods among a diverse cohort of birthing people using the ecological momentary assessments method. In addition, we compared the exclusive breastfeeding rates between the two methods across race and other maternal characteristics.
This study is a secondary analysis using data from the Postpartum Mothers Mobile Study (PMOMS), a prospective longitudinal study which recruited participants during pregnancy and followed them for 12 months after delivery. Participants completed surveys in real-time via ecological momentary assessment. Individual exclusive breastfeeding rates from months 1-6 were computed using 24-hour recall and since birth methods for 284 participants. We calculated the percentage point difference between the two methods across child age and maternal characteristics. We used a two-sample test of proportions to determine if the differences observed in the proportions were significant.
Exclusive breastfeeding rates from the 24-hour recall were higher than the since birth rates across all ages and maternal characteristics. The difference between the two methods at 3 months was 25.7 percentage points and at 6 months was a 17.2 percentage points. Irrespective of the method used to measure exclusive breastfeeding, White participants had higher exclusive breastfeeding rates than Black participants.
The 24-hour recall and the since birth methods of assessing exclusive breastfeeding provided substantially different estimates. These findings highlight the importance of specificity in measuring and reporting exclusive breastfeeding.
准确测量纯母乳喂养在母婴健康研究中很重要。纯母乳喂养通常使用 24 小时回忆法或出生后前 6 个月的方法进行测量。这些方法可能会产生不同的估计值，从而导致对母乳喂养行为的解释出现问题，并使在不同环境或国家进行准确比较变得困难。
我们的目的是使用生态瞬时评估法比较不同分娩人群中 24 小时回忆法和出生后法测量的纯母乳喂养率。此外，我们还比较了这两种方法在不同种族和其他产妇特征下的纯母乳喂养率。
本研究是对产后母亲移动研究（PMOMS）数据的二次分析，这是一项前瞻性纵向研究，在妊娠期间招募参与者，并在分娩后 12 个月对其进行随访。参与者通过生态瞬时评估实时完成调查。对于 284 名参与者，我们使用 24 小时回忆法和出生后法计算了第 1 至 6 个月的个体纯母乳喂养率。我们计算了两种方法在儿童年龄和产妇特征方面的百分比差异。我们使用两样本比例检验来确定观察到的比例差异是否显著。
在所有年龄和产妇特征下，24 小时回忆法的纯母乳喂养率均高于出生后法。两种方法在 3 个月时的差异为 25.7 个百分点，在 6 个月时的差异为 17.2 个百分点。无论使用哪种方法测量纯母乳喂养，白人参与者的纯母乳喂养率均高于黑人参与者。
24 小时回忆法和出生后法评估纯母乳喂养提供了截然不同的估计值。这些发现强调了在测量和报告纯母乳喂养时特异性的重要性。
