上海地区婴儿母亲返岗及工作场所母乳喂养支持状况研究

目的:了解上海地区婴儿母亲返岗工作及工作场所对母乳喂养的支持条件。方法:对上海市徐汇区和闵行区402位产后12～15个月的婴儿母亲进行问卷调查,对8位产后12个月的婴儿母亲进行个人深入访谈。结果:332位婴儿母亲在产后12个月前已返岗工作,返岗时间中位数为产后4.0个月,134位母亲由于返岗工作而停止母乳喂养。在198位返岗后仍继续母乳喂养的母亲中,15.7%的乳母工作6个月后仍能继续母乳喂养,83.3%的乳母能享受每天1 h的哺乳假,但该假对改善母乳喂养的实际帮助并不大;80.8%的乳母工作场所有冰箱可以存放乳汁,但乳母多半很难为哺乳或挤奶腾出时间、找到地方或携带工具;45.9%的母亲认为工作单位并非积极支持母乳喂养。结论:大部分婴儿母亲在产后12个月前已经返岗工作,多数因上班而停止母乳喂养;大部分婴儿母亲工作单位能遵守法定产假和哺乳假,仍有大部分工作单位缺乏支持母乳喂养的配套设施,缺乏支持母乳喂养的工作环境,因此亟待营造一个支持职业女性母乳喂养的工作环境。     

婴儿期母乳喂养与孤独症发生的关系

目的:探讨婴儿期母乳喂养与孤独症发生之间的关系。方法:选取2004年1月～2005年12月期间在我院就诊的372例孤独症患儿作为孤独症组,同时随机抽取在我院儿童保健门诊参加系统保健的正常儿童1116例作为对照组,两组儿童的年龄、性别构成一致。参照国外同类调查问卷并结合我国具体情况设计自制调查问卷对研究对象的生长发育情况和婴儿期喂养情况等进行调查,分析婴儿期母乳喂养与孤独症发生之间的关系。结果:单因素分析发现孤独症组儿童4个月内纯母乳喂养率为20.97%,对照组儿童4个月内的纯母乳喂养率为51.08%,对照组明显高于孤独症组(χ2=102.874,P<0.01)。在母乳喂养持续时间方面,孤独症组儿童平均母乳喂养持续时间为(3.82±0.46)月,对照组为(6.61±0.49)月,两组儿童的平均母乳喂养持续时间不同(t=2.74,P<0.01);孤独症组儿童母乳喂养持续时间小于3个月和3～6个月的比例分别是26.34%和15.32%,对照组分别是9.23%和10.66%,孤独症组高于对照组(P<0.01,0.05);孤独症组儿童母乳喂养持续时间大于或等于9个月的比例为35.22%,而对照组为55.02%,孤独症组低于对照组(P<0.01)。多因素Logistic回归分析发现喂养类型是孤独症发生的危险因素(OR=1.429),母乳喂养持续时间是孤独症发生的保护因素(OR=0.528)。结论:婴儿期喂养方式与孤独症的发生有关;4个月内母乳喂养比例越高,母乳喂养持续时间越长,儿童孤独症的发生率越低。     

299名初产妇住院期间母乳喂养行为与家庭支持相关性研究

目的:了解初产妇住院期间的母乳喂养行为以及感知到的家庭支持程度,并分析两者之间的相关性。方法:采用问卷调查法,对299名住院分娩的初产妇进行调查。结果:初产妇住院期间的全母乳喂养率为40.1%,感知到的家庭支持为中等程度,采取全母乳喂养的初产妇的家庭支持高于混合喂养及人工喂养者,差异有统计学意义。结论:初产妇住院期间的母乳喂养率较低,初产妇感知到的家庭支持可以影响其母乳喂养行为。     

我国城市产妇母乳喂养知识 态度与喂养行为的关联研究

目的了解我国城市产妇母乳喂养的知识、态度,探讨母乳喂养知识、态度与喂养行为的关系。方法通过自填式问卷了解产妇的母乳喂养知识、态度和喂养行为,比较不同社会人口学特征下母乳喂养知识和态度的差异。通过Logistic回归校正社会人口学特征,评价母乳喂养知识、态度对喂养行为的独立影响。结果产妇母乳喂养知识的平均得分为(8.5±1.5)分,母乳喂养组产妇母乳喂养知识的掌握程度普遍优于混合/人工喂养组,进行早期母乳喂养的可能性随母乳喂养知识得分的增加而增加(OR=1.305)。98.1%的产妇愿意坚持母乳喂养,认为自己能坚持6个月以上的占92.4%,母乳喂养的消极态度将影响母乳喂养行为的实现(OR=0.233)。结论母乳喂养知识和态度是影响早期母乳喂养行为的独立因素。加强孕产期母乳喂养知识的宣传教育,增强产妇母乳喂养的信心,将有利于促进母乳喂养行为的实现。     

From initiation to cessation: Turning points and coping resources in the breastfeeding experience of first-time mothers

While most mothers initiate breastfeeding, many do not continue for recommended durations. This study aimed to understand the gap between breastfeeding initiation and duration through an in-depth exploration of first-time mothers’ breastfeeding experiences. Contextual factors that may facilitate or deter breastfeeding maintenance were explored by identifying common turning points (significant events or periods promoting a change in thoughts/behaviors or facilitating maintenance) described by mothers with varied breastfeeding durations. In semistructured interviews conducted from March to June 2015, twenty-eight first-time mothers in Iowa were asked to describe their breastfeeding experiences from initiation through cessation. Using thematic analysis, seven turning points, consistent across varied durations and experiences were identified: breastfeeding problems, the unknowns, recurring stressors, living new life with baby, reentering social roles, special occasions, and letting go. Turning points were usually associated with stressful situations, and mothers described intrapersonal (e.g., determination) and interpersonal (e.g., social support) coping resources as facilitators of breastfeeding maintenance. These findings highlight contextual factors that may trigger turning points, representing critical intervention periods, and the importance of enhancing support networks. Interventions to facilitate longer breastfeeding durations should consider key turning points and availability of coping resources to determine strategies that best fit the mother at each point.     

24月龄以下儿童母乳喂养时间与营养不良相关性的初步探讨

目的 初步探讨2岁以下儿童母乳喂养时间与营养不良之间的关系,为进一步研究二者之间的关联程度提出病因假设.方法 采用WHO制定的儿童生长参考标准对营养不良进行评价,单因素分析采用单因素Logistic回归分析,多因素分析采用多因素Logistic回归,对调查时已经断奶的婴幼儿的母乳喂养时间与HAZ评分和WAZ评分进行相关分析,采用Pearson积差相关系数.结果 控制住混杂因素影响后,母乳喂养时间在6～12月的发生生长迟缓的风险为6月以下的0.142倍(P=0.026),超过12月的为6月以下的0.184倍(P=0.035).母乳喂养时间在6～12月的发生低体重的风险为6月以下的0.126倍(P=0.035).母乳喂养时间与HAZ评分的相关系数r=-0.189,P=0.007;母乳喂养时间与WAZ评分的相关系数r=-0.192,P=0.006.结论 母乳喂养时间可能与儿童营养状况有关,需要进行前瞻性研究,进一步证实二者之间的关联程度.     

城乡初产妇母乳喂养差异及其原因

目的:探讨城乡初产妇母乳喂养的差异及其原因。方法:随机抽取乡村初产妇120名,城市初产妇180名,调查纯母乳喂养率、部分母乳喂养率和象征性母乳喂养率。结果:乡村初产妇的纯母乳喂养率明显大于城市初产妇;而象征性母乳喂养率则明显小于之。结论:城市初产妇纯母乳喂养率小于乡村初产妇,主要原因为精神紧张、饮食结构、担心哺乳影响形体及美容、不适宜的文胸、内衣与乳罩因素等。     

The communicative characteristics of musical interactions compared with play interactions between mothers and their one-year-old infants

The objective of this study was to compare the communicative characteristics of musical interactions with play interactions between mothers and their one-year-old infants. The characteristics were physical proximity and eye contact, mothers’ and infants’ emotional expressions, length of communication chains, synchronisation, and maternal mediation behaviours. A 10-minute musical interaction followed by a 10-minute play interaction was videotaped at each of the 93 participants’ homes. The data were analysed using Observer5 software, which combines viewing the interaction with simultaneous coding. The analysis of variance revealed that the durations of physical contact, eye contact, and positive emotions and the length of communication chains were significantly longer during the musical interactions. The frequency of mothers’ mediation and incompatible mediation behaviours was significantly higher in the play interactions. Musical interactions were found to provide more opportunities for positive emotional arousal and synchronisation, which are the basic characteristics of quality interactions and essential for future child development.     

新生儿体重下降与分娩期产妇输液量的相关性探讨

目的:探讨产妇在分娩过程中的输液量与新生儿产后72 h内体重下降的相关性。方法:记录109名产妇分娩过程中经口以及经静脉的液体入量,在产后3天内每隔12 h测量新生儿体重,此后每天测1次至第14天;此外还需要称量新生儿3天的排出量(大小便)。结果:96例出生后60 h新生儿的平均体重下降(6.57±2.51)%;根据产妇输液量进行分组之后两组比较,低输液量组(≤1 200 ml)新生儿体重下降5.51%,高输液量组(>1 200 ml)新生儿体重下降6.93%,差异有统计学意义(P=0.03)。在第24 h新生儿排出量与新生儿体重下降百分比正相关(P<0.001),分娩期间最后2 h产妇输液量与新生儿排出量正相关(P=0.012),在第72 h新生儿体重下降重量与产妇总输液量正相关(P=0.007)。结论:产妇静脉输液时间及输液量与新生儿排出量及体重下降相关。新生儿在出生后24 h内通过排尿调节体内的液体状态,因此建议衡量新生儿体重改变的基础体重在出生后24 h测量而不是使用出生时体重。     

产后访视对母婴保健的影响

目的 及时了解产后访视和护理指导对母婴健康状况及母乳喂养的影响。方法 对512例产妇进行产后建库、建册，选派护师以上长期从事妇产科临床护理工作，有专业理论知识，又有临床护理经验的护士按社区工作规定的时间分别在产后3-7d，10～14d及28-30d进行访视。结果 及时了解了母婴健康状况，解决了病人出院后护理支持不足的问题，产妇及其家属给予了充分的肯定，满意度达100％。结论 产后访视和护理指导，有利于母婴的健康教育，使母婴健康得到保障，使母乳喂养的实施得到普及，取得良好的社会效益。     

The relationship between maternal pre-pregnancy body mass index and exclusive breastfeeding initiation: Findings from an Australian obstetric cohort

BackgroundTo assess the type of infant nutrition at initiation of first feed in association with increasing maternal pre-pregnancy Body Mass Index in an Australian obstetric population.MethodsA retrospective cohort study from 2008 to 2013 was undertaken. Body Mass Index was available for 12,347 women categorised into groups according to: underweight (≤18 kg/m²); normal weight (19?24 kg/m²); overweight (25?29 kg/m²); obese class I (30?34 kg/m²); obese class II (35?39/kg²) and obese class III (40+ kg/m²). Type and initiation of infant feeding is routinely recorded in the study hospital’s birthing outcomes system. Six body mass index categories and mode of infant feeding were examined using logistic regression. Confounding factors that were controlled for included smoking status, parity, country of birth and maternal age.ResultsWithin this cohort, 609 (4.93%) women were underweight, 6235 (50.50%) had a normal BMI, 3116 (25.24%) were overweight, 1314 (10.64%) were obese class I, 596 (4.83%) were obese class II and 477 (3.86%) were obese class III. In adjusted models’, as BMI rose, women were significantly less likely to initiate exclusive breastfeeding and more likely to exclusively formula feed. Women with a BMI of 40+ kg/m² had an AOR of 2.91(CI 1.94?4.25) for initiating exclusive formula at the time of their infant’s first feed.ConclusionsWomen who are overweight or obese are significantly less likely to initiate exclusive breastfeeding and more likely to give exclusive formula at the time of their newborn infants first feed. Effective breastfeeding interventions are required for these high-risk groups in the days leading up to and within the first hours after birth.     

Supporting breastfeeding in rural Newfoundland and Labrador communities during COVID-19

Exclusive breastfeeding for the first 6 months of life has become the global standard of infant feeding for its extensive benefits to maternal and infant health. Public health programs, such as the Baby-Friendly Initiative, have helped increase the national breastfeeding initiation rate to 90%. However, initiation rates in Newfoundland and Labrador (NL) continue to rank the lowest in the country at 70%, with a 6-month exclusivity rate of 16%. This commentary will discuss the influence of geographical location, societal norms, and accessibility to health care services on breastfeeding in rural and remote NL communities. While the SARS-CoV-2 virus itself does not impact the mother’s ability to breastfeed, the indirect impacts of COVID-19 on health care services, social isolation, and economic burden challenge breastfeeding initiation and continuation. Priority solutions will draw on capacity building by emphasizing relationships within the community to deliver innovative and appropriate support programs. Continued education with health practitioners and further research into breastfeeding barriers in rural communities is critical moving forward.     

Local Landscapes of Breastfeeding: A comparison of breastfeeding amongst mothers in low- and high-income neighborhoods in Bristol,UK

This paper compares experiences of breastfeeding outside the home for women living in low-income and high-income neighborhoods of the same city. Our findings are based on an analysis of 22 interviews with breastfeeding mothers (11 in each of two study areas) undertaken in Bristol, UK in 2017. We extend existing scholarship by showing how experiences of breastfeeding vary not only at the regional level but between local areas of the same city, and outline how our findings can inform policy. We advance literature on maternal bodies by exploring how local “landscapes” of breastfeeding emerge as mothers encounter and negotiate different socio-material landscapes and locally-differentiated norms about “appropriate” maternal embodiment. We argue that these variegated interactions can lead to different orientations to space and forms of spatial practice on the part of breastfeeding mothers, as well as different kinds of maternal identities.     

Bodies, mothers and identities: rethinking obesity and the BMI

Despite the intense level of attention directed towards obesity, there has been limited success in addressing the rising rates of this public health phenomenon. This paper argues that current approaches to obesity fail to consider concepts of embodiment, and in particular, that gendered and class-based experiences of embodiment are ignored in health promotion practices and policies. Drawing on Bourdieu's concept of habitus, this ethnographic study sought to locate obesity within the biographies and everyday experiences of two groups of women from differing socio-economic settings. Rather than identify with the clinical category of obesity, these women constructed identities that were refracted through a gendered and classed habitus, and in particular, through their role as mothers. Food provision and practices were central to constructs of mothering, and these relational identities were at odds with the promotion of individual behavioural changes. Moreover, these women's daily lives were shaped by different class-based aspects of habitus, such as employment. In demonstrating the ways in which obesity is enmeshed in participants' taken-for-granted, everyday practices, we problematise the universality of health-promotion messages and highlight the integral role that the critical theory of habitus has in understanding the embodiment of obesity.     

Characteristics of social interactions between mothers and their disabled infants: a review

This paper examines interactional characteristics of disabled infants and young children and their mothers. Interactional characteristics of disabled infants and young children differ from those of non-disabled children in several ways: disabled children provide fewer and less readable cues to the mother; they demonstrate less positive affect, more negative affect, and more muted affect; and they have more difficulties synchronizing turn-taking than non-handicapped children. Maternal interactions with disabled children differ from those of mothers with non-disabled children in dimensions involving maternal activity and positive affect. It is suggested that the social deficits commonly observed in disabled preschoolers and older children may have begun in the altered social interactional patterns observed in infancy. Various intervention strategies are described which assist parents to achieve more pleasurable, reciprocal, child-centered interactions with their disabled infants.     

母乳喂养时间及辅食添加时机与婴幼儿过敏性疾病相关性研究

目的:探讨母乳喂养时间及辅食添加时机与婴幼儿过敏性疾病发生的相关性。方法:收集接受过敏性疾病诊断的婴幼儿160例,通过调查问卷方式调查每位婴幼儿母乳喂养时间及蛋黄和蛋白、鱼虾、坚果添加时机。结果:母乳喂养时间>3个月的婴幼儿过敏性疾病发生率显著低于母乳喂养时间≤3个月婴幼儿,6个月前和6个月后添加蛋黄和蛋白、8个月前和8个月后添加鱼虾的婴幼儿过敏性疾病发生率差异无统计学意义(P>0.05)。>1岁添加坚果的婴幼儿过敏性疾病发生率低于1岁前添加的婴幼儿。结论:婴幼儿母乳喂养时间应>3个月,蛋黄和蛋白可在6个月前添加,鱼虾可在8个月前添加,坚果应在1岁后添加。