Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China.
Front Public Health. 2023 Aug 30;11:1089764. doi: 10.3389/fpubh.2023.1089764. eCollection 2023.
Breastfeeding generates short-term and long-term benefits for both mother and child. Exclusive breastfeeding (EBF) is promoted in China for years, but its practice still lags far behind the international average, even among low- and middle- income countries. This study aimed to investigate factors associated with EBF during postpartum.
This study was conducted in a tertiary referral hospital in Gansu Province, Northwest China from October 2019 to April 2020. 3,738 postnatal women were finally included and each of them completed an elaborately designed questionnaire. Infant feeding patterns (EBF or not) and reasons for NEBF (non-exclusive breastfeeding) were collected. The feeding knowledge score was based on 17 questions in relation to breastfeeding. The total score ranges from 0 to 17. Higher score means better understanding about breastfeeding knowledge. Multivariate logistic regression models were used to determine associated factors of EBF during postpartum. A subgroup analysis was conducted to investigate the association between feeding knowledge score and exclusive breastfeeding.
Six weeks after childbirth, 1891 mothers (50.6%) maintained EBF. Among the NEBF mothers, 57.01% ( = 1,053) of them stopped exclusive breastfeeding due to self-perceived lack of breast milk production. Factors associated with NEBF were higher maternal age, ethnic minorities and cesarean section. Protective factors of EBF included multipara, positive feeding attitude and high breastfeeding knowledge score. In subgroup analysis, we found the breastfeeding knowledge score had a significant impact on the mothers of Han nationality, underwent cesarean or natural delivery, both primiparous and multiparous, and those with positive attitude towards breastfeeding ( < 0.05).
We need a comprehensive and individualized framework of strategies to support children, mothers and their families. During puerperium, improving maternal knowledge of breastfeeding is beneficial to EBF practice. However, for ethnic minorities and those with less active breastfeeding attitudes, breastfeeding knowledge is of limited use, more researches are needed to explore the uncovered reasons, so that more personalized interventions could be developed for them.
母乳喂养对母婴均有短期和长期益处。中国多年来一直提倡纯母乳喂养（EBF），但其实践仍远远落后于国际平均水平，甚至低于中低收入国家。本研究旨在调查产后与 EBF 相关的因素。
本研究于 2019 年 10 月至 2020 年 4 月在中国西北部甘肃省的一家三级转诊医院进行。最终纳入 3738 名产后妇女，每位妇女均完成了精心设计的问卷。收集了婴儿喂养模式（EBF 或非 EBF）和非 EBF 的原因。喂养知识评分基于 17 个与母乳喂养相关的问题。总分为 0 至 17 分。得分越高表示对母乳喂养知识的理解越好。多变量逻辑回归模型用于确定产后 EBF 的相关因素。进行了亚组分析以调查喂养知识评分与 EBF 之间的关联。
产后 6 周时，有 1891 名母亲（50.6%）坚持 EBF。在非 EBF 母亲中，由于自我感知母乳不足，有 57.01%（=1053 人）停止了 EBF。与非 EBF 相关的因素是母亲年龄较大、少数民族和剖宫产。EFB 的保护因素包括经产妇、积极的喂养态度和高母乳喂养知识评分。在亚组分析中，我们发现母乳喂养知识评分对汉族母亲、经剖宫产或自然分娩的母亲、初产妇和经产妇以及对母乳喂养持积极态度的母亲有显著影响（<0.05）。
我们需要一个综合和个体化的策略框架来支持儿童、母亲及其家庭。在产褥期，提高母亲的母乳喂养知识有助于 EBF 实践。然而，对于少数民族和那些母乳喂养态度不积极的母亲来说，母乳喂养知识的作用有限，需要更多的研究来探索未被发现的原因，以便为她们制定更个性化的干预措施。
