Aggarwal Ramnika, Garg Priyanka, Verma Madhur, Bindal Priya, Aditi Aditi, Kaur Inderdeep, Rohilla Minakshi, Kakkar Rakesh
Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda (Punjab), Bathinda, 151001, India.
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences Bathinda, Bathinda, India.
Int Breastfeed J. 2024 Dec 28;19(1):83. doi: 10.1186/s13006-024-00695-0.
Exclusive breastfeeding (EBF) is defined as feeding infants only breast milk of the mother or a wet nurse for the first six months, without additional food or liquids except the oral rehydration solution or drops/syrups of vitamins, minerals or medicines. The working status of women in developed countries adversely affects the EBF rates, which calls for an assessment in rapidly developing countries like India. Therefore, the primary aim of the present study is to determine the prevalence of EBF using the data from the National Family Health Surveys (NFHS 3, 4, 5) conducted between 2005 and 06, 2015-16 and 2019-21 to estimate the likelihood EBF according to mothers' employment status.
We did a secondary data analysis of the cross-sectional surveys. Exclusive breastfeeding was the primary dependent variable and defined as the percentage of youngest children under six months exclusively breastfed per last 24 h. The employment status of the mother was the primary independent variable and was coded dichotomously (yes/no). Chi-square analysis assessed the association of EBF with the outcome variable of interest. A multi-level modelling approach has been used for portioning variation in the prevalence of exclusive breastfeeding at different geographical levels.
From NFHS rounds 3 to 5, the overall prevalence of exclusive breastfeeding was 47.45%, 54.85%, and 64.01% respectively. On segregating the women as per their employment status, the prevalence among employed women was 51.1%, 51.1%, and 60.3%, while in unemployed women the prevalence was 45.9%, 54.8%, and 67.3% respectively. The odds of practising EBF in NFHS-5 doubled since NFHS-3 (Adjusted Odds Ratio: 2; 95% Confidence Interval: 1.08, 3.67). Employed mothers had a significantly lower odds ratio (0.94, 0.91, 0.98) of practising exclusive breastfeeding. The likelihood increased when mothers were exposed to media, had normal BMI, and visited health centres > 4 times during pregnancy. The likelihood decreased in older mothers, birth of infant in a health facility, female gender of the child, and late initiation of breastfeeding.
The lower prevalence of exclusive breastfeeding among working mothers calls for an urgent need to improve policies around maternity benefits at workplaces.
纯母乳喂养（EBF）的定义是在婴儿出生后的前六个月，仅喂养母亲或奶妈分泌的母乳，除口服补液溶液或维生素、矿物质或药物滴剂/糖浆外，不添加其他食物或液体。发达国家女性的工作状况对纯母乳喂养率产生不利影响，这就需要在像印度这样快速发展的国家进行评估。因此，本研究的主要目的是利用2005年至2006年、2015年至2016年以及2019年至2021年期间开展的全国家庭健康调查（NFHS 3、4、5）的数据来确定纯母乳喂养的患病率，以根据母亲的就业状况估计纯母乳喂养的可能性。
我们对横断面调查进行了二次数据分析。纯母乳喂养是主要因变量，定义为过去24小时内六个月以下最年幼子女纯母乳喂养的百分比。母亲的就业状况是主要自变量，采用二分法编码（是/否）。卡方分析评估了纯母乳喂养与感兴趣的结果变量之间的关联。我们采用了多层次建模方法来划分不同地理层面纯母乳喂养患病率的差异。
从NFHS第3轮到第5轮，纯母乳喂养的总体患病率分别为47.45%、54.85%和64.01%。根据就业状况对女性进行分类后，就业女性中的患病率分别为51.1%、51.1%和60.3%，而失业女性中的患病率分别为45.9%、54.8%和67.3%。自NFHS - 3以来，NFHS - 5中进行纯母乳喂养的几率增加了一倍（调整后的优势比：2；95%置信区间：1.08，3.67）。就业母亲进行纯母乳喂养的优势比显著较低（0.94、0.91、0.98）。当母亲接触媒体、BMI正常且孕期到健康中心就诊超过4次时，纯母乳喂养的可能性增加。年龄较大的母亲、在医疗机构分娩婴儿、孩子为女性以及母乳喂养开始较晚时，纯母乳喂养的可能性降低。
职业母亲中纯母乳喂养的患病率较低，这迫切需要改进有关工作场所产假福利的政策。
