Thompson Gretchen H, Sefa Eunice, Deshpande Ashwini S, Mensah Ransford, Lenzi-Weisbecker Rachel, Wilder Rose, Pennas Thad, Martinez Andres, Boadi Kingsley K, Abdul-Hamid Adnan, Asabire Godwin, Aboagye Dacosta, Yakubu Eliasu, Abubakari Abdulai, Mensah David Yao
Division of Global Research, Family Health International 360, Durham, North Carolina, United States of America.
Ghana Accelerating Social and Behavior Change Project, Family Health International 360, Accra, Ghana.
PLOS Glob Public Health. 2024 Nov 14;4(11):e0003887. doi: 10.1371/journal.pgph.0003887. eCollection 2024.
Despite consistent evidence highlighting the benefits of exclusive breastfeeding (EBF) for the first six months, EBF duration sometimes falls short of six months or exceeds it. This research seeks to explore factors influencing the practice of optimal duration of EBF and identify factors associated with suboptimal EBF durations. A cross-sectional survey was conducted in 16 districts across four Northern regions of Ghana with 2000 caregivers of children under five years old. The analysis specifically focused on a subset of 1761 biological mothers. Logistic regression was conducted to discern socio-demographic, care-seeking, and behavioral determinants influencing the practice of EBF for a six-month duration. Additionally, multinomial logistic regression was used to identify factors associated with suboptimal EBF durations, categorized as less than and beyond six months. All biological mothers breastfed their youngest child, varying in durations: 75% exclusively breastfed for six months, 19.2% for less than six months, and 5.9% for beyond six months. Several behavioral determinants influenced EBF for six months, with biological mothers ' confidence in their ability to EBF (aOR: 6.8 95% CI, 4.13-11.33), willingness to recommend EBF practice to friends and family (aOR: 10.5 95% CI, 4.13-26.62) and perception of practicing EBF as normative in the community showing statistically significant associations (aOR: 6.3, 95% CI, 4.41-9.10). Education and religion of biological mothers were also significantly associated with EBF for six months. While there was overlap in behavioral factors associated with EBF for less than and beyond six months, the socio-demographic characteristics of biological mothers associated with these suboptimal durations of EBF differed. Among the factors included in this study, social norms, caregiver confidence, and approval of EBF were key factors influencing the recommended duration of EBF practices. These findings highlight the importance of community and cultural contexts in shaping biological mothers' behavior and emphasize the need to address socio-cultural barriers and facilitators that influence EBF practices, as well as empower biological mothers to adopt and sustain these practices.
尽管有持续的证据表明纯母乳喂养头六个月有益，但纯母乳喂养的持续时间有时不足六个月或超过六个月。本研究旨在探讨影响纯母乳喂养最佳持续时间的因素，并确定与次优纯母乳喂养持续时间相关的因素。在加纳北部四个地区的16个区对2000名五岁以下儿童的照料者进行了横断面调查。分析特别关注1761名亲生母亲的子集。进行逻辑回归以辨别影响六个月纯母乳喂养行为的社会人口统计学、寻求护理和行为决定因素。此外，多项逻辑回归用于识别与次优纯母乳喂养持续时间相关的因素，分为少于六个月和超过六个月。所有亲生母亲都对其最小孩子进行母乳喂养，持续时间各不相同：75%纯母乳喂养六个月，19.2%少于六个月，5.9%超过六个月。几个行为决定因素影响了六个月的纯母乳喂养，亲生母亲对自己纯母乳喂养能力的信心（调整后比值比：6.8，95%置信区间，4.13 - 11.33）、向朋友和家人推荐纯母乳喂养行为的意愿（调整后比值比：10.5，95%置信区间，4.13 - 26.62）以及认为在社区中进行纯母乳喂养是规范行为的认知显示出具有统计学意义的关联（调整后比值比：6.3，95%置信区间，4.41 - 9.10）。亲生母亲的教育程度和宗教信仰也与六个月的纯母乳喂养显著相关。虽然与少于六个月和超过六个月的纯母乳喂养相关的行为因素存在重叠，但与这些次优纯母乳喂养持续时间相关的亲生母亲的社会人口统计学特征有所不同。在本研究纳入的因素中，社会规范、照料者信心和对纯母乳喂养的认可，是影响推荐纯母乳喂养持续时间的关键因素。这些发现凸显了社区和文化背景在塑造亲生母亲行为方面的重要性，并强调需要解决影响纯母乳喂养行为的社会文化障碍和促进因素，以及增强亲生母亲采用和维持这些行为的能力。
