Jakobsen M S, Sodemann M, Mølbak K, Aaby P
Danish Epidemiology Science Centre, Statens Seruminstitut, Copenhagen, Denmark.
Int J Epidemiol. 1996 Feb;25(1):115-21. doi: 10.1093/ije/25.1.115.
In third world countries the length of breastfeeding often has a major influence on child mortality, morbidity and nutritional status. When evaluating the impact of length of breastfeeding the reason why a mother terminates breastfeeding is usually not taken into consideration.
Risk factors for termination of breastfeeding were studied in a prospective community study following 1678 children in Guinea Bissau, West Africa from birth to cessation of breastfeeding, migration or death.
The median weaning age was 22.6 months. Illness of the child, new pregnancy of the mother and illness of the mother were associated with significantly shorter lactation period compared with children weaned because they were 'healthy' or 'old enough'. These explanations had an impact independent of other determinants for weaning, including ethnic group, mother's age, mother's education, birth order and number of dead siblings. Weaning before 12 months of age was only associated with illness of the mother or child and new pregnancy and not with any socioeconomic or cultural factors.
Health workers should pay special attention to the encouragement of breastfeeding in connection with illness of the mother or child; these considerations may also be important in the planning of breastfeeding promotion campaigns. Since premature termination of breastfeeding is associated with new pregnancy, family planning should be part of any breastfeeding promotion programme.
在第三世界国家,母乳喂养的时长往往对儿童的死亡率、发病率及营养状况有重大影响。在评估母乳喂养时长的影响时,通常未考虑母亲终止母乳喂养的原因。
在一项前瞻性社区研究中,对西非几内亚比绍的1678名儿童从出生至母乳喂养停止、迁移或死亡进行跟踪,研究母乳喂养终止的风险因素。
断奶的中位年龄为22.6个月。与因“健康”或“年龄足够大”而断奶的儿童相比,孩子生病、母亲再次怀孕及母亲患病与哺乳期显著缩短有关。这些因素对断奶的影响独立于其他断奶决定因素,包括种族、母亲年龄、母亲教育程度、出生顺序及夭折兄弟姐妹的数量。12个月前断奶仅与母亲或孩子患病及母亲再次怀孕有关,而与任何社会经济或文化因素无关。
卫生工作者在母亲或孩子患病时应特别重视鼓励母乳喂养;这些考量在母乳喂养促进活动的规划中可能也很重要。由于母乳喂养过早终止与再次怀孕有关,计划生育应成为任何母乳喂养促进项目的一部分。