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克服老挝人民民主共和国纯母乳喂养障碍:社会转移干预随机对照试验

Overcoming Barriers to Exclusive Breastfeeding in Lao PDR: Social Transfer Intervention Randomised Controlled Trial.

作者信息

Karimian-Marnani Najmeh, Tilley Elizabeth, Wallenborn Jordyn T

机构信息

Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland.

Department of Mechanical and Process Engineering, Swiss Federal Institute of Technology (ETH) Zurich, Rämistrasse 101, 8092 Zürich, Switzerland.

出版信息

Nutrients. 2025 Jul 22;17(15):2396. doi: 10.3390/nu17152396.

Abstract

: Despite the numerous health benefits of exclusive breastfeeding (EBF) for the infant and the mother, EBF rates in Lao People's Democratic Republic, Lao PDR, remain at 40%. We investigate how barriers to EBF were overcome by a social transfer intervention. : Data from the Social Transfers for Exclusive Breastfeeding ongoing randomised controlled trial (RCT) ( = 298) in Vientiane, Lao PDR, was used. Mothers in the RCT were randomised equally into a control group, an unconditional transfer group and a conditional transfer group and followed up to six months ( = 280). We used logistic and Cox proportional hazards regression models to investigate the association of predictor variables with EBF at six months and the risk of EBF cessation in each of the three groups. : Greater breastfeeding self-efficacy increased the odds of EBF at six months in both intervention groups (unconditional transfer OR 1.39 [95% CI 1.09, 1.87, = 0.02] and conditional transfer OR 1.26 [1.01, 1.61, = 0.05]) and reduced the risk of EBF cessation (unconditional transfer HR 0.87 [0.77, 0.98, = 0.02]). Maternal secondary and tertiary education in the intervention groups showed higher odds of EBF at six months and lower EBF cessation risk. Participants in the intervention group that intended to exclusively breastfeed in pregnancy showed a reduced EBF cessation risk in both intervention groups. : Social transfers helped overcome the exclusive breastfeeding barrier of a higher education level and working status and improved EBF outcomes for mothers who intended to exclusively breastfeed and wanted the pregnancy. Breastfeeding self-efficacy positively influences EBF outcome, regardless of whether the mother received a social transfer or not.

摘要

尽管纯母乳喂养对婴儿和母亲有诸多健康益处,但老挝人民民主共和国(老挝)的纯母乳喂养率仍维持在40%。我们调查了一项社会转移干预措施是如何克服纯母乳喂养障碍的。:使用了来自老挝万象正在进行的纯母乳喂养社会转移随机对照试验(RCT)(n = 298)的数据。该RCT中的母亲被平均随机分为对照组、无条件转移组和有条件转移组,并随访至六个月(n = 280)。我们使用逻辑回归和Cox比例风险回归模型来研究预测变量与六个月时纯母乳喂养之间的关联以及三组中每组纯母乳喂养停止的风险。:更高的母乳喂养自我效能感增加了两个干预组在六个月时纯母乳喂养的几率(无条件转移组优势比1.39 [95%置信区间1.09, 1.87,P = 0.02],有条件转移组优势比1.26 [1.01, 1.61,P = 0.05]),并降低了纯母乳喂养停止的风险(无条件转移组风险比0.87 [0.77, 0.98,P = 0.02])。干预组中接受过中等和高等教育的母亲在六个月时纯母乳喂养的几率更高,纯母乳喂养停止风险更低。干预组中打算在孕期进行纯母乳喂养的参与者在两个干预组中纯母乳喂养停止风险均降低。:社会转移有助于克服高等教育水平和工作状态带来的纯母乳喂养障碍,并改善了打算纯母乳喂养且有怀孕意愿的母亲的纯母乳喂养结果。无论母亲是否接受社会转移,母乳喂养自我效能感都会对纯母乳喂养结果产生积极影响。

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本文引用的文献

1
Conditional and Unconditional Social Transfers, Early-Life Nutrition, and Child Growth: A Randomized Clinical Trial.
JAMA Pediatr. 2025 Feb 1;179(2):129-136. doi: 10.1001/jamapediatrics.2024.5079.
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Can J Diet Pract Res. 2025 Mar 1;86(1):479-483. doi: 10.3148/cjdpr-2024-019. Epub 2024 Dec 6.
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PLoS One. 2023 Dec 12;18(12):e0279691. doi: 10.1371/journal.pone.0279691. eCollection 2023.
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The heterogeneous associations of universal cash-payouts with breastfeeding initiation and continuation.
SSM Popul Health. 2023 Feb 10;22:101362. doi: 10.1016/j.ssmph.2023.101362. eCollection 2023 Jun.
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The Association Between Breastfeeding Self-Efficacy and Mode of Infant Feeding.
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