Branger B, Cebron M, Picherot G, de Cornulier M
Service d'épidémiologie et d'hygiène, CHU Pontchaillou, Rennes, France.
Arch Pediatr. 1998 May;5(5):489-96. doi: 10.1016/S0929-693X(99)80312-1.
The duration of breast feeding has not yet been thoroughly described in France. A prospective survey has been performed on 150 breast feeding mothers to determine its duration. The objective of this study was to analyse predicting factors of this duration.
A questionnaire including sociological, psychological and medical variables was completed by the mothers and fathers. After discharge, the mothers were contacted every month by a physician until the completion of weaning.
The median duration was 10 weeks. By univariate analysis, several variables were associated with a longer duration: decision to breast feed before pregnancy (12 weeks vs 9 weeks; P < 0.01), multiparity (17 weeks vs 12 weeks, P < 0.05), high paternal social level (14 weeks vs 9 weeks, P < 0.001), high maternal education level (12 weeks vs 9 weeks; P < 0.05), mother's idea of "bad" milk (9 weeks vs 30 weeks; P < 10(-6), satisfied mothers (11 weeks vs 2 weeks; P < 0.001), motivation to breast feed (P < 0.05), baby and mother in the same room during the night (13 weeks vs 10 weeks; P < 0.05), and formula supplementation (6 weeks vs 13 weeks; P < 0.01). The mother's return to work was related to a decline in the breast feeding rate at 12 weeks, yet working women generally breast fed the most frequently before returning to work, and many women breast fed and worked concomitantly. A Cox multivariate analysis took into account six significant variables: "bad" milk (lower duration), mother who had been fed, mother satisfied with breast feeding, multiparity, high maternal education, closer proximity of baby to mother (longer duration).
The duration in our study is longer than in other studies in France. Predictive factors are sociological, linked to maternal education, and psychological, with antecedent of mother breast feeding and decision before pregnancy. The role of the mother's occupation was not very important because working women are generally at a higher social level. The role of the father was analysed, as well as the role of professional workers, family and breast feeding women's associations.
Factors of breast feeding duration can be somewhat modified, but it is necessary to respect the plans of both the mother and the father. However, early assistance in the hospital and after discharge can help parents realize their plans for prolonged breast feeding and helps obviating the cessation of 20% of mothers during the 1st month.
在法国，母乳喂养的持续时间尚未得到充分描述。我们对150名母乳喂养的母亲进行了一项前瞻性调查，以确定其持续时间。本研究的目的是分析该持续时间的预测因素。
母亲和父亲填写了一份包含社会学、心理学和医学变量的问卷。出院后，医生每月与母亲联系一次，直至断奶结束。
母乳喂养的中位数持续时间为10周。单因素分析显示，几个变量与较长的母乳喂养持续时间相关：孕前决定母乳喂养（12周对9周；P<0.01）、多胎妊娠（17周对12周，P<0.05）、父亲社会地位高（14周对9周，P<0.001）、母亲教育水平高（12周对9周；P<0.05）、母亲认为母乳“不好”（9周对30周；P<10⁻⁶）、母亲满意（11周对2周；P<0.001）、母乳喂养动机（P<0.05）、夜间母婴同室（13周对10周；P<0.05）以及添加配方奶（6周对13周；P<0.01）。母亲重返工作岗位与12周时母乳喂养率下降有关，但职业女性在重返工作岗位前通常母乳喂养频率最高，而且许多女性边工作边母乳喂养。Cox多因素分析考虑了六个显著变量：认为母乳“不好”（持续时间较短）、母亲曾接受母乳喂养、母亲对母乳喂养满意、多胎妊娠、母亲教育水平高、婴儿与母亲距离更近（持续时间较长）。
我们研究中的母乳喂养持续时间比法国其他研究中的要长。预测因素包括社会学因素，与母亲教育水平有关，以及心理学因素，与母亲母乳喂养经历和孕前决定有关。母亲职业的作用不太重要，因为职业女性通常社会地位较高。分析了父亲的作用，以及专业人员、家庭和母乳喂养女性协会的作用。
母乳喂养持续时间的因素可以在一定程度上得到改变，但有必要尊重母亲和父亲双方的计划。然而，在医院及出院后的早期援助可以帮助父母实现延长母乳喂养的计划，并有助于避免20%的母亲在第一个月停止母乳喂养。
