Pérez-Escamilla R, Lutter C, Segall A M, Rivera A, Treviño-Siller S, Sanghvi T
Department of Nutritional Sciences, University of Connecticut, Storrs, USA.
J Nutr. 1995 Dec;125(12):2972-84. doi: 10.1093/jn/125.12.2972.
International health organizations have recommended exclusive breast-feeding (EBF) (i.e., breast milk as the only source of food) as the optimal infant feeding method during the first 4-6 mo of life. Therefore, it is important to document the determinants of EBF in different populations. Low-income urban women from Brazil (n = 446, 2 maternity wards), Honduras (n = 1582, 3 maternity wards) and Mexico (n = 765, 3 maternity wards) were interviewed at birth and in their homes at 1 mo and 2-4 mo after delivery. Multivariate survival analyses (Cox model) indicated that planned duration of EBF (all 3 countries), having a female infant, and not being employed (Brazil and Honduras), lower socioeconomic status (Honduras and Mexico) and higher birth weight (control hospital in Brazil and Honduras) were positively associated (P < or = 0.10) with EBF. Women who delivered in the maternity wards that had more developed breast-feeding promotion programs were more successful with EBF. The association between maternal education and EBF was modified by the maternity ward in Mexico and Honduras. Being > or = 18 y and having a partner living (Brazil) or not (Mexico) living at home were positively associated with EBF. These findings can contribute toward the design of EBF promotion efforts in Latin America.
国际卫生组织推荐纯母乳喂养（即仅以母乳作为食物来源）作为婴儿出生后头4至6个月的最佳喂养方式。因此，记录不同人群纯母乳喂养的决定因素很重要。对来自巴西（446名，2个产科病房）、洪都拉斯（1582名，3个产科病房）和墨西哥（765名，3个产科病房）的低收入城市妇女在分娩时以及产后1个月和2至4个月时进行了家访。多变量生存分析（Cox模型）表明，纯母乳喂养的计划持续时间（所有3个国家）、生女孩、未就业（巴西和洪都拉斯）、较低的社会经济地位（洪都拉斯和墨西哥）以及较高的出生体重（巴西和洪都拉斯的对照医院）与纯母乳喂养呈正相关（P≤0.10）。在实施了更完善的母乳喂养促进项目的产科病房分娩的妇女，纯母乳喂养的成功率更高。在墨西哥和洪都拉斯，产妇教育程度与纯母乳喂养之间的关联因产科病房而异。年龄≥18岁且有伴侣同住（巴西）或无伴侣同住（墨西哥）与纯母乳喂养呈正相关。这些研究结果有助于拉丁美洲设计纯母乳喂养促进措施。
