Huang Yi-Yan, Wang Rong, Huang Wei-Peng, Wu Tian, Wang Shi-Yun, R Redding Sharon, Ouyang Yan-Qiong
School of Nursing, Wuhan University, Wuhan, China.
Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China.
J Med Internet Res. 2024 Dec 17;26:e51566. doi: 10.2196/51566.
A low breastfeeding rate causes an increased health care burden and negative health outcomes for individuals and society. Coparenting is an essential tactic for encouraging breastfeeding when raising a child. The efficacy of the coparenting interventions in enhancing breastfeeding-related outcomes is controversial.
This study aimed to examine the effects of coparenting interventions on exclusive breastfeeding rates, exclusive breastfeeding duration, breastfeeding knowledge, parenting sense of competence, coparenting relationships, depressive symptoms in new couples at 1 and 6 months post partum, and the BMI of infants 42 days post partum.
This was a randomized, single-blinded controlled clinical trial. Eligible couples in late pregnancy in a hospital in central China were randomly assigned to 2 groups. While couples in the control group received general care, couples in the intervention group had access to parenting classes, a fathers' support group, and individual counseling. Data were collected at baseline (T0), 1 month post partum (T1), and 6 months post partum (T2). Data on exclusive breastfeeding rate and exclusive breastfeeding duration were analyzed using the chi-square, Fisher exact, or Mann-Whitney U tests; coparenting relationships and the infant's BMI were analyzed using an independent samples t test; and breastfeeding knowledge, parenting sense of competence, and depressive symptoms were analyzed using a generalized estimation equation.
A total of 96 couples were recruited, and 79 couples completed the study. The intervention group exhibited significantly higher exclusive breastfeeding rates at T1 (90% vs 65%, P=.02) and T2 (43.6% vs 22.5%, P=.02), compared with the control group. Exclusive breastfeeding duration was extended in the intervention group than in the control group at T1 (30, range 30-30 days vs 30, range 26.5-30 days; P=.01) and T2 (108, range 60-180 days vs 89, range 28-149.3 days; P<.05). The intervention group exhibited greater improvements in maternal breastfeeding knowledge (β=.07, 95% CI 0.006-0.13; P=.03) and maternal parenting sense of competence (β=5.49, 95% CI 2.09-8.87; P<.01) at T1, enhanced coparenting relationships at T1 (P<.001) and T2 (P=.02), paternal breastfeeding knowledge at T2 (β=.25, 95% CI 0.15-0.35, P<.001), paternal parenting sense of competence at T1 (β=5.35, 95% CI 2.23-8.47, P<.01), and reduced paternal depressive symptoms at T2 (β=.25, 95% CI 0.15-0.35, P<.001), and there was a rise in infants' BMI at 42 days post partum (β=.33, 95% CI 0.01-0.64, P=.04).
An evidence-based breastfeeding coparenting intervention is effective in improving exclusive breastfeeding rate, prolonging exclusive breastfeeding duration within the initial 6 months post partum, enhancing parental breastfeeding knowledge, levels of parenting sense of competence and coparenting relationship, infant's BMI, and reducing paternal depressive symptoms.
Chinese Clinical Trial Registry ChiCTR2300069648; https://tinyurl.com/2p8st2p8.
低母乳喂养率会增加医疗保健负担，并给个人和社会带来负面健康后果。共同育儿是养育孩子时鼓励母乳喂养的一项重要策略。共同育儿干预措施在改善母乳喂养相关结果方面的效果存在争议。
本研究旨在探讨共同育儿干预措施对产后1个月和6个月时纯母乳喂养率、纯母乳喂养持续时间、母乳喂养知识、育儿胜任感、共同育儿关系、新父母抑郁症状以及产后42天婴儿体重指数（BMI）的影响。
这是一项随机、单盲对照临床试验。在中国中部一家医院，将符合条件的晚期妊娠夫妇随机分为两组。对照组夫妇接受常规护理，干预组夫妇参加育儿课程、父亲支持小组并接受个体咨询。在基线（T0）、产后1个月（T1）和产后6个月（T2）收集数据。使用卡方检验、Fisher精确检验或Mann-Whitney U检验分析纯母乳喂养率和纯母乳喂养持续时间的数据；使用独立样本t检验分析共同育儿关系和婴儿BMI；使用广义估计方程分析母乳喂养知识、育儿胜任感和抑郁症状。
共招募了96对夫妇，79对夫妇完成了研究。与对照组相比，干预组在T1（90% 对 65%，P = 0.02）和T2（43.6% 对 22.5%，P = 0.02）时的纯母乳喂养率显著更高。干预组在T1（30天，范围30 - 30天 对 30天，范围26.5 - 30天；P = 0.01）和T2（108天，范围60 - 180天 对 89天，范围28 - 149.3天；P < 0.05）时的纯母乳喂养持续时间比对照组延长。干预组在T1时母亲母乳喂养知识（β = 0.07，95%CI 0.006 - 0.13；P = 0.03）和母亲育儿胜任感（β = 5.49，95%CI 2.09 - 8.87；P < 0.01）有更大改善，在T1（P < 0.001）和T2（P = 0.02）时共同育儿关系增强，T2时父亲母乳喂养知识（β = 0.25，95%CI 0.15 - 0.35，P < 0.001）、T1时父亲育儿胜任感（β = 5.35，95%CI 2.23 - 8.47，P < 0.01）提高，T2时父亲抑郁症状减轻（β = 0.25，95%CI 0.15 - 0.35，P < 0.001），且产后42天婴儿BMI升高（β = 0.33，95%CI 0.01 - 0.64，P = 0.04）。
基于证据的母乳喂养共同育儿干预措施在提高纯母乳喂养率、延长产后最初6个月内的纯母乳喂养持续时间、增强父母母乳喂养知识、育儿胜任感水平和共同育儿关系、婴儿BMI以及减轻父亲抑郁症状方面是有效的。
中国临床试验注册中心ChiCTR2300069648；https://tinyurl.com/2p8st2p8 。
