Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Breastfeed Med. 2024 Mar;19(3):177-186. doi: 10.1089/bfm.2023.0261.
Breastfeeding is recommended globally for most infants, especially during and after natural disasters when risk of adverse outcomes increases because of unsanitary conditions and lack of potable water. Using 2017-2019 data from Puerto Rico's Pregnancy Risk Assessment Monitoring System for 2,448 respondents with a recent live birth, we classified respondents into 4 hurricane exposure time periods based on infant birth month and year relative to when Hurricanes Irma and Maria occurred: (1) prehurricane; (2) acute hurricane; (3) posthurricane, early recovery; and (4) posthurricane, long-term recovery. We examined the association between maternity care practices during delivery hospitalization and exclusive breastfeeding at 3 months overall and stratified by time period. We also examined the associations between each maternity care practice and exclusive breastfeeding separately by time period. Exclusive breastfeeding at 3 months was higher during the acute hurricane time period (adjusted prevalence ratio [aPR]: 1.43, 95% confidence interval: 1.09-1.87) than the prehurricane time period. Supportive maternity care practices were positively associated with exclusively breastfeeding, and practices that are risk factors for discontinuing breastfeeding were negatively associated with exclusive breastfeeding. Breastfeeding in the first hour (aPR range: 1.51-1.92) and rooming-in (aPR range: 1.50-2.58) were positively associated with exclusive breastfeeding across all time periods, except the prehurricane time period. Receipt of a gift pack with formula was negatively associated with exclusive breastfeeding (aPR range: 0.22-0.54) across all time periods. Maternity care practices during delivery hospitalization may influence breastfeeding behaviors and can improve breastfeeding during and after natural disasters. Strategies to maintain and improve these practices can be further supported during and after natural disasters.
母乳喂养在全球范围内被推荐给大多数婴儿，尤其是在自然灾害期间和之后，因为不卫生的条件和缺乏饮用水会增加不良后果的风险。利用 2017-2019 年波多黎各妊娠风险评估监测系统的数据，对 2448 名最近分娩的受访者进行分析，我们根据婴儿出生月份和年份与飓风 Irma 和 Maria 发生的时间，将受访者分为 4 个飓风暴露时间段：（1）飓风前；（2）急性飓风；（3）飓风后，早期恢复；（4）飓风后，长期恢复。我们考察了分娩住院期间的产妇保健实践与总体 3 个月时的纯母乳喂养以及按时间段分层的纯母乳喂养之间的关联。我们还按时间段分别考察了每种产妇保健实践与纯母乳喂养之间的关联。在急性飓风时间段，3 个月时的纯母乳喂养率较高（调整后的患病率比 [aPR]：1.43，95%置信区间：1.09-1.87），高于飓风前时间段。支持性的产妇保健实践与纯母乳喂养呈正相关，而中断母乳喂养的风险因素与纯母乳喂养呈负相关。在所有时间段，包括飓风前时间段，产后 1 小时内（aPR 范围：1.51-1.92）和母婴同室（aPR 范围：1.50-2.58）与纯母乳喂养呈正相关。在所有时间段，包括飓风前时间段，收到包含配方奶粉的礼品包与纯母乳喂养呈负相关（aPR 范围：0.22-0.54）。分娩住院期间的产妇保健实践可能会影响母乳喂养行为，并可改善自然灾害期间和之后的母乳喂养。在自然灾害期间和之后，可以进一步支持维持和改善这些实践的策略。
