影响新生儿母乳喂养的相关因素及分析

目的:了解产妇产后母乳喂养的情况,探讨影响母乳喂养的相关因素,正确指导产后母乳喂养,期望提高母乳喂养率。方法:采用随机整群抽样方法抽取480例产妇及新生儿,并对其进行了母乳喂养调查。结果:产妇中92.08%(442/480)接受过母乳喂养教育,母乳喂养率为80.21%;开奶时间早的母乳喂养率明显高于开奶时间晚者(P<0.01);未使用奶瓶喂养者的母乳喂养率高于使用奶瓶者(P<0.01);自然分娩者的母乳喂养率高于其它分娩方式(P<0.05);产妇不同心理状态的母乳喂养差异有显著性(P<0.01);产妇睡眠时间长者母乳喂养率明显高于睡眠时间短者(P<0.01)。结论:影响母乳喂养的相关因素有开奶时间、开奶前使用奶瓶、分娩方式、产妇心理状态、睡眠时间等;积极开展母乳喂养健康教育是保证母乳喂养成功的关键。     

2002-2015年舟山市母乳喂养情况及其影响因素

目的 描述2002-2015年浙江省舟山市母乳喂养情况,探索可能的影响因素。方法 提取2002-2015年舟山市妇幼保健院电子医疗记录,应用Logistic回归分析各因素对母乳喂养的影响。结果 以2011年为节点,舟山市产妇的母乳喂养率呈现先下降后上升的趋势。调整相关变量后,市区的产妇第1、3、9个月的母乳喂养率更高。较高学历的产妇第1、3个月母乳喂养率较高,但第9个月则相对较低。职业类型为脑力型的产妇第6、9、12个月母乳喂养率较高。巨大儿在第6、9个月母乳喂养率较高。剖宫产、早产、低体重儿、初产妇、产妇年龄大于30岁或小于25岁均为母乳喂养的危险因素。冬春季出生的婴儿其母乳喂养率在第1、3、6个月均较低。结论 来自市区、职业类型为脑力型的产妇、巨大儿为母乳喂养的保护因素。较高的学历在第1、3个月为母乳喂养的保护因素,但在第9个月为危险因素。剖宫产、早产、低体重出生儿、初产妇、产妇年龄大于30岁或小于25岁、冬春季出生的婴儿均为母乳喂养的危险因素。     

影响新生儿母乳喂养因素的调查研究

目的:分析影响新生儿母乳喂养的因素,以期提高纯母乳喂养率。方法:调查2005年3月~2006年12月产后复查的310例产妇,对其母婴一般状况、分娩方式、产后开奶时间、奶瓶的使用情况、新生儿喂养方式、产妇的心理状态及文化程度等进行分析。结果:分娩方式、开奶时间、奶瓶的使用与否、产妇的心理及文化程度等均为影响新生儿母乳喂养的因素。结论:阴道分娩、开奶时间早、不使用奶瓶以及产妇良好的心理状态和对母乳喂养的正确态度都是提高母乳喂养率的健康方式。     

不同母乳喂养问题和使用吸奶器对乳汁不足产妇产后42d母乳喂养的影响

目的 探讨不同母乳喂养问题、使用吸奶器对乳汁不足产妇产后42 d母乳喂养的影响。方法 选取2021年3—10月在金杨社区卫生服务中心接受产后访视的60名产妇为研究对象。通过问卷调查采集产妇的人口学资料,随访其第1次产后访视后7 d内的乳汁分泌情况和产后42 d的母乳喂养情况。分析产后42 d纯母乳喂养率低的影响因素,比较使用和未使用吸奶器产妇产后7 d内的乳汁分泌量。结果 60名产妇产后42 d纯母乳喂养率为18.3%。吸奶器使用是产后42 d纯母乳喂养率的影响因素,使用吸奶器的产妇第3、4、5天的日平均泌乳量高于未使用吸奶器产妇,差异有统计学意义（P<0.05）。结论 乳汁不足产妇产后42 d的纯母乳喂养率较低,产后访视时医师应指导其正确、合理地使用吸奶器,以增加产后早期的乳汁分泌量,提高纯母乳喂养率。     

产妇0～6个月母乳喂养现状及其影响因素

目的：了解0～6个月产妇对婴儿进行母乳喂养的情况,探讨影响6个月纯母乳喂养的因素。方法采用多阶段分层整群抽样的方法进行抽样,在全国的东、中、西部分别抽取一个省（市）;在每个省（市）分城乡两层,全国共抽取24个社区卫生服务中心、24个乡镇卫生院。由社区卫生服务中心（乡镇卫生院）召集所有其辖区范围内或曾在该医院分娩的0～6个月产妇,由调查员对产妇进行问卷调查。调查使用“母乳喂养的现况及影响因素调查问卷”,对产妇母乳喂养情况进行分析。结果0～6个月产妇纯母乳喂养率为34.5％,65.5％产妇未能坚持纯母乳喂养,主要原因为产妇自觉“乳汁分泌不足”。多因素分析结果显示,汉族、教育水平不高、无业、剖宫产、县级以上医院分娩以及分娩后1 h 以上开奶是影响0～6个月产妇进行纯母乳喂养的重要因素。结论为保证0～6个月纯母乳喂养率持续稳步提升,应针对影响纯母乳喂养的因素,采取特殊时点强力干预、特殊人群个性指导、县级机构加强管理、认知误区及时纠正等应对措施。     

我国5城市已婚育龄妇女母乳喂养影响因素分析

目的 :了解城市居民中母乳喂养状况及其影响因素。方法 :以“计划生育问卷调查”的方式 ,对广州等 5城市已婚育龄妇女进行抽样调查 ,以寿命表法等统计方法进行分析。结果 :5城市妇女产后母乳喂养率为 94 .5 7%。平均母乳喂养时间 8.0 1月 ,4个月后继续母乳喂养率为 6 1.0 3%。母亲文化程度高者、初产婴儿产后母乳喂养率高。但继续母乳喂养率 ,受母亲生理及自身文化程度等社会心理特征和家庭多种因素的影响。结论 :母乳喂养受母亲、家庭和社会的多种因素的影响 ,应有针对性地加强产妇出院后继续母乳喂养的宣教工作     

浦东新区爱婴医院母乳喂养情况调查

目的:了解当前爱婴医院内产后母乳喂养情况,探讨影响新生儿母乳喂养的相关因素,有针对性地指导母乳喂养,以提高出院后母乳喂养率。方法:采用随机整群抽样方法,抽取7家爱婴医院350名产妇及新生儿,设计调查问卷,对其进行母乳喂养调查。结果:产妇中93.14%(326/350)在医院接受过母乳喂养教育,其中以孕妇学校宣教比例最高,产后病房宣教比例最低;母乳喂养率61.42%,混合喂养30.86%;自然分娩者母乳喂养率高于手术分娩者(P0.01);未使用奶瓶喂养婴儿的母乳喂养率高于使用奶瓶者(P0.01);开展早接触、早吸吮者母乳喂养率高于未开展者(P0.05);78.52%的产妇添加代乳品的原因是觉得乳汁不够,58.52%的添加代乳品行为由产妇本人决定。结论:爱婴医院内母乳喂养工作还有待加强,影响母乳喂养的相关因素有分娩方式、开奶前是否使用奶瓶、是否进行早吸吮、早接触等。加强爱婴医院管理,积极开展产前、产时、产后各环节的母乳喂养健康教育,提高产妇的母乳喂养意识及掌握实用技巧,对于提高母乳喂养成功率有积极影响。     

二胎新生儿纯母乳喂养情况及影响因素分析

目的 分析二胎新生儿纯母乳喂养情况及其相关影响因素。方法 选取2020年1月—2021年3月宁波市李惠利医院产后未出院二胎产妇90例作为研究对象,回顾性收集其一般资料,根据二胎新生儿纯母乳喂养情况分为纯母乳喂养组32例、非纯母乳喂养组58例,纯母乳喂养定义为分娩后6个月内婴儿在母乳喂养的基础上不接受任何配方奶喂养。分析二胎新生儿纯母乳喂养现状,通过单因素和多因素logistic回归分析法分析二胎新生儿非纯母乳喂养的危险因素。结果 90例二胎产妇纯母乳喂养32例,纯母乳喂养率为35.56%。多因素logistic分析结果显示,产妇乳头凹陷、两次分娩间隔>5年、一胎喂养方式为非纯母乳喂养、外祖母不支持母乳喂养、二胎新生儿分娩方式为剖宫产为二胎新生儿非纯母乳喂养的危险因素(P<0.05)。结论 二胎新生儿纯母乳喂养率不容乐观,二胎新生儿非纯母乳喂养与产妇乳头凹陷、两次分娩间隔>5年、一胎喂养方式为非纯母乳喂养、外祖母不支持母乳喂养、二胎新生儿分娩方式为剖宫产等因素息息相关,临床可根据以上因素对产妇进行健康宣教,提高产妇家庭支持,进而提高二胎纯母乳喂养率。     

产妇母乳喂养自信心的影响因素分析及围生期护理干预效果

目的:探讨产妇母乳喂养自信心的影响因素及围生期护理干预对提高母乳喂养率的效果。方法:对120例待产妇采用一般情况调查表、母乳喂养自信心量表(中文版)进行调查。并按入院时间分为对照组(54例)和干预组(66例),实施相应护理措施,于产后42天回访干预效果。结果:对照组与干预组临床一般情况比较差异无统计学意义(P>0.05)。多因素回归分析显示产后预计喂养方式、丈夫对母乳喂养的态度和产假情况是产妇母乳喂养自信心的主要影响因素。围生期护理干预后,干预组母乳喂养自信心评分和母乳喂养率均显著高于对照组(P<0.05)。结论:产妇母乳喂养自信心受到家庭支持和社会支持因素影响较大,围产期护理干预有助于提高母乳喂养自信心和母乳喂养率。     

新生儿母乳喂养影响因素的初步研究

目的:探讨新生儿母乳喂养的相关影响因素,为产妇产后母乳喂养提供有力的参考依据。方法:选择我院2016年05月-2016年07月收治的产妇以及新生儿150例作为本次实验对象;针对新生儿母乳喂养的相关影响因素加以分析。结果:在150例产妇中,选择对新生儿实施母乳喂养的产妇包括135例,所占比例为90.00%;选择对新生儿实施混合喂养的产妇包括11例,所占比例为7.33%;选择对新生儿实施人工喂养的产妇包括4例,所占比例为2.67%;在母乳喂养方式选择方面,表现出显著差异(P0.05)。医院对母乳喂养的宣传及采取相应措施及产妇对新生儿选择的喂养方法、信心、配合程度、身体状况以及对所采取措施认知程度、产妇临床选择的分娩方式、产妇的开奶时间、产妇分娩后的心理状态以及使用奶瓶的情况为对新生儿实施母乳喂养的影响因素。结论:产妇的开奶时间、临床选择的分娩方式以及内心状态等,会对产妇是否选择实施母乳喂养产生一定程度的影响,对此临床对产妇实施母乳喂养健康教育以及指导表现出显著的价值,最终可以将母乳喂养率显著提高。     

甘肃省农村地区婴儿母乳喂养及其影响因素的调查研究

目的:了解甘肃省农村地区1岁以下儿童4个月以内喂养方式及其影响因素,为改善该地区儿童的喂养现状提供科学依据。方法:采用分层随机整群抽样方法抽取甘肃省4市县农村地区1岁以下9个年龄组2 691例儿童及其主要抚养人进行喂养方式的问卷调查;用二分类Logistic多元回归筛选儿童喂养方式的影响因素。结果:胎次增加、母亲文化程度较低是4个月内纯母乳喂养的危险因素,产次是纯母乳喂养的保护因素;胎次增加、母亲年龄增加是婴儿母乳喂养的危险因素,产次增加、父母亲职业为农民是母乳喂养的保护因素。部分母乳喂养的4月龄婴儿的低体重率高于完全母乳喂养的婴儿(P=0.003)。结论:母乳喂养受家庭、社会等多方面因素的影响,应有针对性地加强我省农村地区科学喂养方式的健康教育。     

Maternal,paternal and environmental tobacco smoking and breast feeding

The effects of environmental tobacco smoke (ETS) on breast-feeding patterns are poorly understood, while those of parental smoking on breast-feeding initiation vs. duration have not been clearly delineated. We conducted a prospective, population-based birth cohort study to examine the independent effects of maternal, paternal and ETS on breast-feeding initiation and duration. A total of 6747 Hong Kong Chinese infants were recruited and followed up in 1997-8. We obtained detailed household smoking history and recorded breast-feeding patterns in three follow-up interviews over 9 months. We found that both maternal and paternal smoking were associated with not initiating breast feeding (odds ratio [OR] for ever maternal smoking = 2.51, 95% confidence interval [CI] = 1.63, 3.86; OR for ever paternal smoking = 1.22, 95% CI = 1.08, 1.39). Exposure to ETS in utero and post partum were also related to not starting breast feeding (OR(ETS in utero) = 1.10, 95% CI = 0.99,1.24; OR(ETS post partum) = 1.21, 95% CI = 1.08, 1.36). These effects, however, did not persist for breast-feeding duration of < or = 4 months. Cox proportional hazards modelling confirmed the lack of association between any form of smoking and breast-feeding duration. Our findings suggest that smoking of any kind, during or after pregnancy, is a strong risk indicator for not initiating breast feeding. Smoking as a risk indicator for underlying socio-economic, demographic and psychosocial factors is probably responsible for most of the observed adverse effects, although we cannot rule out direct contributions from pathophysiological mechanisms. Public health strategies directed at these underlying factors should be vigorously pursued to reduce the adverse effects of tobacco on breast feeding and infant health in general.     

Breast feeding in Israel: maternal factors associated with choice and duration.

STUDY OBJECTIVES--To determine the influence of maternal characteristics on the incidence and duration of breast feeding. DESIGN--All the women who delivered in three obstetric wards within a two year period were surveyed. These three wards cover 93% of all births in the Jerusalem district. Women were interviewed on breast feeding of the previous child on the first or second day post partum by a research nurse. PARTICIPANTS--Altogether 8486 women whose previous pregnancy had resulted in a live born singleton who survived for at least one year. MEASUREMENTS AND MAIN RESULTS--Breast feeding information was linked to demographic and health information from hospital records. Using logistic regression analysis, failure to start breast feeding was best predicted (p < 0.001) by caesarean delivery, infant's birth weight, maternal smoking habits, and mother being non-immigrant. Maternal age (< 24 or > 40 years) and father being an ultraorthodox Jew were also positively (p < 0.05) associated with the decision to breast feed. Long term breast feeding (three months or more) was strongly affected (p < 0.001) by maternal education level, with both women with the fewest and the greatest number of years of schooling more likely to breast feed. A similar association was observed in all ethnic groups. Primipara and grandmultipara (parity > 4), new immigrants, ultraorthodox Jews, and non-smokers breast fed their babies for longer. CONCLUSIONS--The importance of maternal characteristics in relation to breast feeding was shown. Caesarean delivery and the infant's birth weight were strongly related to the decision to breast feed as were the demographic characteristics of mother's age and her country of birth. Education was not related to this decision but was strongly associated with the duration of breast feeding, as was parity. The behavioural characteristics of smoking and being ultraorthodox were related to both the decision to start and the duration of breast feeding. Efforts to encourage breast feeding ought to be targeted during the hospital stay and post partum period towards women identified as being at increased risk.     

上海市2003～2007年母乳喂养情况调查

目的:了解上海市近5年母乳喂养状况及其影响因素。方法:以不同时段的产妇为对象,使用统一问卷,收集资料。结果:母乳喂养率在90.0%上下波动,而纯母乳喂养率则在45.0%～60.0%之间;奶水不够是添加代乳品的主要原因,添加工具主要为奶瓶奶头,职业女性和剖宫产分娩的妇女纯母乳喂养率低。结论:母乳喂养受职业、分娩方式及社会多因素的影响,应针对性减少不利因素,提高纯母乳喂养率。     

Development of a prenatal psychosocial screening tool for post-partum depression and anxiety

McDonald S, Wall J, Forbes K, Kingston D, Kehler H, Vekved M, Tough S. Development of a prenatal psychosocial screening tool for post‐partum depression and anxiety. Paediatric and Perinatal Epidemiology 2012; ?? : ??–??. Background: Post‐partum depression (PPD) is the most common complication of pregnancy in developed countries, affecting 10–15% of new mothers. There has been a shift in thinking less in terms of PPD per se to a broader consideration of poor mental health, including anxiety after giving birth. Some risk factors for poor mental health in the post‐partum period can be identified prenatally; however prenatal screening tools developed to date have had poor sensitivity and specificity. The objective of this study was to develop a screening tool that identifies women at risk of distress, operationalized by elevated symptoms of depression and anxiety in the post‐partum period using information collected in the prenatal period. Methods: Using data from the All Our Babies Study, a prospective cohort study of pregnant women living in Calgary, Alberta (N = 1578), we developed an integer score‐based prediction rule for the prevalence of PPD, as defined as scoring 10 or higher on the Edinburgh Postnatal Depression Scale (EPDS) at 4‐months postpartum. Results: The best fit model included known risk factors for PPD: depression and stress in late pregnancy, history of abuse, and poor relationship quality with partner. Comparison of the screening tool with the EPDS in late pregnancy showed that our tool had significantly better performance for sensitivity. Further validation of our tool was seen in its utility for identifying elevated symptoms of postpartum anxiety. Conclusion: This research heeds the call for further development and validation work using psychosocial factors identified prenatally for identifying poor mental health in the post‐partum period.     

Patterns of variation in breast-feeding behaviors

This paper describes the range and patterning of variation in specific breast-feeding behaviors among a sample of 62 American mothers, as well as the relationship of the patterns to duration of exclusive breast feeding. Infant feeding data were collected using 24-hr records completed by mothers every 8 days through the first 6 months post partum. Behaviors examined were: number of daily feedings, minimum and maximum intervals between feedings, length of feedings and total daily nursing duration. Variation in magnitude of these behaviors ranged from three- to eight-fold. Principal components analysis found this variation patterned in two dimensions, relating to feeding frequency and length of time spent breast feeding. These dimensions accounted for approximately equal proportions of variance in the breast-feeding behaviors, totaling about 80% of all variance at 4 and 8 weeks. There was significant continuity of breast-feeding styles practiced by any one woman from 4 to 8 weeks. The feeding frequency dimension was strongly associated with duration of exclusive breast feeding. Three explanations--cultural, biological and biocultural--are proposed to account for this association. It is argued that the intracultural variation in breast-feeding styles in this sample may be sufficient to cause corresponding variation in breast milk production, in part accounting for variation in duration of exclusive breast feeding. Predictions of exclusive breast-feeding duration will be most accurate for women with a breast-feeding style of infrequent feedings, while predictions for women with a style of frequent feeding will be confounded by cultural factors which have an independent effect on breast-feeding supplementation.     

Breastmilk and transmission of HIV

The risk of vertical HIV transmission is greatest (20%) during late pregnancy and childbirth. Breast feeding is associated with an additional 14% risk. The risk of infection through breast feeding must be weighed against the dangers posed by artificial feeding. If HIV-positive mothers were to abandon breast feeding without safe alternatives, the resulting infant deaths from diarrhea and respiratory infections could vastly outnumber those from HIV. HIV-infected mothers should be assisted by HIV counselors or health professionals to weigh the risks of both vertical transmission through breast feeding and infections associated with artificial feeding. If an HIV-positive mother has access to adequate breast milk substitutes that she can prepare safely, she should consider artificial feeding. Access to voluntary, confidential HIV testing and counseling is key to any strategy to reduce vertical transmission. Prenatal and obstetric care services aimed at reducing the HIV transmission risk are also essential.     

豫粤两省孕产妇家庭暴力现况比较

目的:在不同地域的较大范围内初步了解我国孕期及产后妇女家庭暴力的发生现况,分析产生家庭暴力的原因及其影响因素。方法:采用整体抽样的方法,于2004年3月~2004年9月在河南省和广东省的部分城镇医院产科门诊和住院部对待产及产后复查的2 835名妇女进行问卷调查。结果:2 835人中孕期曾发生家庭暴力的327人,发生率为11.5%;河南省孕期家庭暴力发生率为16.8%,广东省发生率为6.4%。1 776名产后妇女调查对象中464人遭受家庭暴力,发生率26.1%;河南省发生率为33.7%,广东省发生率为17.4%,两地发生率明显不同(P<0.001,OR=3.0)。孕妇家庭暴力发生的影响因素主要包括:文化程度和职业、家庭收入、家庭生活状况、社会文化背景等。在与非暴力组相比,暴力组孕妇的各种身心健康问题发生率明显增高(P<0.001)。结论;家庭暴力在我国城镇妇女孕期及产后有一定发生,且产后发生率较高,家庭暴力严重影响孕产妇身心健康,应该从多方面进行干预。     

Polychlorobiphenyls in human milk, adipose tissue, plasma and umbilical cord blood; levels and correlates

In a longitudinal study involving 17 women, PCB concentrations (PCBs 138, 153 and 180) were determined in cord blood (17 newborns), breast milk (10 women), maternal adipose tissue (8 women), maternal plasma collected during the last trimester of pregnancy (17 women) and maternal plasma collected 10 days post partum (7 women). Significant correlations were found (p less than 0.05) between PCB levels in cord blood, breast milk and adipose tissue and maternal plasma collected before birth, and between breast milk and maternal plasma collected post partum. In 2 vegetarian women the PCB levels in maternal plasma and cord blood were significantly lower than in the other women (p less than 0.05). If in future studies the PCB levels observed prove to be detrimental to child development, these correlations may offer the possibility of identifying a group of newborns at risk for occurrence of developmental defects due to PCB exposure before birth.