Ali Mohammed Seid, Zegeye Alebachew Ferede, Workneh Belayneh Shetie, Zeleke Gebreeyesus Abera, Mekonen Enyew Getaneh, Aemro Agazhe, Tekeba Berhan, Tamir Tadesse Tarik, Wassie Mulugeta, Terefe Bewuketu
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2024 Dec 26;19(12):e0311945. doi: 10.1371/journal.pone.0311945. eCollection 2024.
Formula feeding is providing infants with prepared formula as an alternative to or alongside breastfeeding. While breast milk is widely regarded as the optimal source of nutrition for infants, formula feeding is a common practice. The recommended approach is exclusive breastfeeding for the first six months, followed by the introduction of complementary foods after that period, which is crucial for child growth and development. Formal feeding has a negative impact on an infant's health, causing malnutrition and other illnesses. Therefore, this study was investigated to assess formula feeding and determinant factors among mothers with infants in six sub-Saharan African countries.
A total weighted sample of 26,119 mothers with infants and young children less than two years was included in this study. The data were taken from a recent demographic and health survey in six sub-Sahara African countries. A multilevel, multivariable logistic regression model was used to identify the determinant factors associated with formula feeding. In the multivariable analysis, the adjusted odds ratio with a 95% CI was used to declare a statistically significant association with formula feeding among mothers with infants.
In this study, the proportion of mothers with infants who use formula feeding was 17.1%. In multilevel logistic analysis (model III), the significant factors associated with formula feeding were the age of the mothers; 25-34 years (AOR = 1.3; 95% CI (1.2-1.41)), 35-49 years (AOR = 1.4; 95% CI (1.22-1.54)), multiple children (AOR = 1.4; 95% CI (1.23-1.77)), maternal educational status; secondary and higher (AOR = 2.4; 95% CI (2.11-2.66)), mother's employment status; (AOR = 1.24; 95% CI (1.14-1.5));, richer households (AOR = 1.2; 95% CI (1.10-1.36)), place of delivery (AOR = 2.1; 95% CI (1.83-2.44)), household media exposure (AOR = 1.5; 95% CI (1.3-1.68))place of residence (AOR = 1.97; 95% CI (1.79-2.17)), community illiteracy level (AOR = 1.17; 95% CI (1.02-1.34)), and community media exposure (AOR = 1.2; 95% CI (1.03-1.38)).
Formula feeding among mothers with infants in Sub-Saharan Africa has emerged as a public health concern. The recommended approach is to promote exclusive breastfeeding for the first six months, followed by the introduction of complementary feeding after that period. Factors associated with formula feeding include older maternal age, secondary and higher education, delivery in health institutions, employment status, higher household income, twin births, urban residence, low community illiteracy rates, and increased community media exposure. Stakeholders and health policymakers should be focused on strategies to improve breast feeding and discourage infant formula feeding.
配方奶喂养是指给婴儿提供调配好的配方奶，作为母乳喂养的替代方式或补充方式。虽然母乳被广泛认为是婴儿最佳的营养来源，但配方奶喂养也很常见。推荐的方法是在婴儿出生后的前六个月进行纯母乳喂养，之后引入辅食，这对儿童的生长发育至关重要。配方奶喂养会对婴儿健康产生负面影响，导致营养不良和其他疾病。因此，本研究旨在评估撒哈拉以南非洲六个国家中婴儿母亲的配方奶喂养情况及其决定因素。
本研究纳入了26119名有2岁以下婴幼儿的母亲作为总加权样本。数据来自撒哈拉以南非洲六个国家最近的人口与健康调查。采用多水平、多变量逻辑回归模型来确定与配方奶喂养相关的决定因素。在多变量分析中，使用调整后的比值比及95%置信区间来表明与有婴儿的母亲的配方奶喂养存在统计学显著关联。
在本研究中，使用配方奶喂养的有婴儿的母亲比例为17.1%。在多水平逻辑分析（模型III）中，与配方奶喂养相关的显著因素包括母亲的年龄；25 - 34岁（比值比 = 1.3；95%置信区间(1.2 - 1.41)），35 - 49岁（比值比 = 1.4；95%置信区间(1.22 - 1.54)），多子女（比值比 = 1.4；95%置信区间(1.23 - 1.77)），母亲的教育程度；中学及以上（比值比 = 2.4；95%置信区间(2.11 - 2.66)），母亲的就业状况；（比值比 = 1.24；95%置信区间(1.14 - 1.5)），富裕家庭（比值比 = 1.2；95%置信区间(1.10 - 1.36)），分娩地点（比值比 = 2.1；95%置信区间(1.83 - 2.44)），家庭媒体接触情况（比值比 = 1.5；95%置信区间(1.3 - 1.68)），居住地点（比值比 = 1.97；95%置信区间(1.79 - 2.17)），社区文盲率（比值比 = 1.17；95%置信区间(1.02 - 1.34)），以及社区媒体接触情况（比值比 = 1.2；95%置信区间(1.03 - 1.38)）。
撒哈拉以南非洲有婴儿的母亲中的配方奶喂养已成为一个公共卫生问题。推荐的方法是在前六个月推广纯母乳喂养，之后引入辅食。与配方奶喂养相关的因素包括母亲年龄较大、中学及以上教育程度、在医疗机构分娩、就业状况、家庭收入较高、双胞胎出生、城市居住、社区文盲率较低以及社区媒体接触增加。利益相关者和卫生政策制定者应专注于改善母乳喂养并劝阻婴儿配方奶喂养的策略。
