母乳喂养风险较高的妇女对母乳喂养的态度和障碍：一项前瞻性观察研究。
Attitudes and barriers to breastfeeding among women at high-risk for not breastfeeding: a prospective observational study.
机构信息
Department of Obstetrics and Gynecology, Louisiana State University Health and Sciences Center, Baton Rouge, LA, 70817, USA.
Woman's Hospital Research Center, Woman's Hospital, Baton Rouge, LA, 70817, USA.
出版信息
BMC Pregnancy Childbirth. 2024 Jan 24;24(1):81. doi: 10.1186/s12884-024-06264-x.
BACKGROUND
Rates of breastfeeding are lower among minority and underserved populations in the United States. Our study objective was to assess pregnant persons attitudes and barriers to breastfeeding among a cohort at high risk for not breastfeeding.
METHODS
We disseminated the Iowa Infant Feeding Attitude Scale (IIFAS) to 100 pregnant persons at least 18 years of age attending a prenatal visit in a low-resource, academic practice in south-central Louisiana (Woman's Hospital). The IIFAS, as well as questions collecting information on breastfeeding experience and sociodemographic characteristics, were administered via interview. Medical records were reviewed to investigate associations between attitudes about breastfeeding in pregnancy and patient's feeding choices during the delivery hospital stay. Fisher exact tests and Wilcoxon rank-sum tests were used to assess associations between categorical and continuous variables respectively.
RESULTS
Of the 98 participants who completed the study, 8% were Hispanic, 63% were Black, 95% were Medicaid eligible, and 50% were unemployed. 59% (n = 58) went on to breastfeed/combination breast-formula feed (called "Any-Breastfeeding Group") during the delivery stay. Total IIFAS score during pregnancy was significantly higher among those who went on to breastfeed during delivery hospital stay (Any-Breastfeeding Group vs. Formula-Feeding-Only Group: 58.9 ± 5.5 vs. 53.7 ± 6.2 respectively, p < 0.001). In the group that went on to only formula feed (Formula-Feeding-Only Group), only 4% agreed breastfeeding was more convenient when surveyed during pregnancy, compared to 45% of the Any-Breastfeeding Group. 60% of Formula-Feeding-Only Group agreed formula is as healthy as breast milk.
CONCLUSION
The three major themes that coincided with favorability toward breastfeeding in the study, and can be addressed during prenatal counseling, are: mother-infant bonding, convenience, and health benefits. By identifying attitudes and barriers to breastfeeding for patients during pregnancy who went on to not breastfeed, directed educational opportunities can be developed to address these specific attitudes to ultimately increase breastfeeding initiation and continuation.
背景
在美国，少数族裔和服务不足人群的母乳喂养率较低。我们的研究目的是评估在一个高风险不母乳喂养的人群中，孕妇对母乳喂养的态度和障碍。
方法
我们向在路易斯安那州中南部一家资源匮乏的学术实践中至少 18 岁的 100 名孕妇分发了爱荷华州婴儿喂养态度量表（IIFAS）。通过访谈，孕妇还回答了有关母乳喂养经验和社会人口统计学特征的问题。审查医疗记录以调查怀孕期间对母乳喂养的态度与患者在分娩住院期间的喂养选择之间的关联。Fisher 确切检验和 Wilcoxon 秩和检验分别用于评估分类变量和连续变量之间的关联。
结果
在完成研究的 98 名参与者中，8%是西班牙裔，63%是黑人，95%有资格获得医疗补助，50%失业。59%（n=58）在分娩期间继续母乳喂养/混合母乳喂养（称为“任何母乳喂养组”）。在分娩住院期间继续母乳喂养的孕妇在怀孕期间的总 IIFAS 评分明显更高（任何母乳喂养组与仅配方奶喂养组：58.9±5.5 vs. 53.7±6.2，p<0.001）。在仅配方奶喂养组（仅配方奶喂养组）中，只有 4%的人在怀孕期间调查时表示母乳喂养更方便，而任何母乳喂养组的这一比例为 45%。60%的仅配方奶喂养组同意配方奶与母乳一样健康。
结论
在研究中与母乳喂养有利的三个主要主题是：母婴结合、方便和健康益处。通过在孕妇怀孕期间识别不母乳喂养的患者对母乳喂养的态度和障碍，可以开展有针对性的教育机会，以解决这些特定的态度，最终提高母乳喂养的开始和持续率。
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