促进社区母乳喂养成功的对策研究

目的 为了将出生４个月内婴儿的母乳喂养率提高到２０００年的８０％。方法 在试点社区通过干预前调查，找出问题，进行干预，再通过终末调查评估干预措施的可行性。结果 试点社区内爱婴医院的服务质量提高，母亲接受母乳喂养知识和指导的效果得到最终纯母喂养纺和母乳喂养率均显著提高，出生后４个月内的母乳喂养充过８３．２％《     

爱婴医院出院产妇坚持纯母乳喂养行为多因素分析

对广州市两所爱婴医院追踪调查２２１例４个月婴儿的母乳喂养情况，结果发现：产妇出院后纯母乳喂养率逐月显著下降。在单因素分析的基础上，采用多元回归分析的方法，筛选出影响纯母乳喂养持续行为的５个因素，根据回归系数绝对值大小，各影响因素强度依次为：母乳量；母乳喂养咨询门诊；母亲患病；家庭经济收入；对“纯母乳喂养完全能满足４个月婴儿全部营养而不必给婴儿添加任何辅食”的看法。     

伊犁察布查尔县婴儿代乳品、辅食添加现状及原因分析

目的 了解伊犁察布查尔地区6个月以内婴儿母乳喂养与辅食添加现状,分析影响婴儿过早添加辅食的可能因素。方法 队列研究方法,对伊犁察布察尔地区2008年出生的婴儿母亲进行问卷调查及产后6个月的逐月随访,样本量226例。结果 （1）婴儿出生时纯母乳喂养率是82.06%,3个月时纯母乳喂养率（72.81%）开始明显下降,4个月时纯母乳喂养率降到55.92%,6个月仅有43.09%的婴儿是纯母乳喂养。（2）婴儿1月、2月、3月、4月、6月时辅食添加率分别是16.4%、16.8%、20.8%、27.4%、41.6%,其中有27.4%的婴儿在4个月前已经开始添加了一种或一种以上的辅食,已添代乳品、水、水果蔬菜、谷类、蛋类的比例分别占62.9%、53.2%、27.4%、27.4%、35.5%;6个月时大部分婴儿未及时添加辅食,辅食添加率仅为41.6%,代乳品、水、水果蔬菜、谷类、蛋类的比例分别占77.7%、40.4%、42.6%、35.1%、57.4%。（3）代乳品添加中鲜牛奶的比例最高,4个月时已达82.1%,6个月时所占比例为84.9%。（4）婴儿辅食添加过旱的影响因素有：母亲年龄、孩子是否第一个、吸吮时间、孩子每天睡眠时间等。结论伊犁察布查尔地区纯母乳喂养率低;在辅食添加时间上存在较大的问题;加强少数民族母亲婴儿喂养知识的教育,重点在及时合理的添加辅食。     

社区内四年纯母乳喂养调查研究

为了解创建爱婴医院以来４个月婴儿纯母乳喂养情况，我们对９１３婴儿４月时喂养方式进行了调查，结果表明：四年来４月纯母乳喂养率无显著增加，人工喂养率有明显下降；未坚持４月纯母乳喂养主要原因是乳量不足及传统喂养习惯的影响。建议进一步创建爱婴医院，在产前健康教育中强调４－６月纯母乳喂养，建立健全促进母乳喂养的支持组织，这是提高４个月婴儿纯母乳喂养率，实现２０００年４个月纯母乳喂养率达８０％总目标的关键所在     

昆明市西坝社区纯母乳喂养现状分析

[目的]了解目前昆明地区4个月婴儿纯母乳喂养现状，为今后促进母乳喂养工作提供依据。[方法]对西坝社区内2005年出生的439名婴儿的喂养方式进行了问卷调查。[结果]2005年西坝社区4个月婴儿纯母乳喂养率、混合喂养率和人工喂养率分别为48，5％、30．5％和20．9％；母亲年龄在30岁以上、从事脑力劳动者纯母乳喂养比率要低；各种喂养方式与是否在爱婴医院出生差异无统计学意义；不能坚持4个月纯母乳喂养的主要原因是母乳不足或产后无母乳、母亲工作忙无喂奶时间、母亲或婴儿生病等。[结论]昆明地区4个月婴儿纯母乳喂养率低于全国平均水平，政府及有关部门应加强促进母乳喂养工作，加强对爱婴医院的监管。     

石河子市6个月内婴儿喂养情况的队列研究

目的为了解石河子市婴儿6个月内的喂养现状。方法对2007~2010年在石河子市人民医院,石河子大学医学院第二附属医院,石河子妇幼保健院分娩的605例产妇进行问卷调查,并逐月进行电话随访至6个月,了解其婴儿的喂养情况。结果一周内水(糖水)的添加比例为37.5%;6个月的母乳喂养率为72.9%,纯母乳喂养率为1.0%;6月龄时添加过至少一种辅食的比例为99.0%,辅食添加的时间多集中在4~6个月之间。结论石河子市婴儿纯母乳喂养率低,6个月前添加辅食现象普遍。婴儿喂养方式不符合世界卫生组织推荐的方式,需要进一步对该地区医护人员和婴儿父母进行提高纯母乳喂养率和辅食添加的培训。     

南通市市区4个月内婴儿母乳喂养情况调查

南通市市区４个月内婴儿母乳喂养情况调查南通市妇幼保健所陈美姚鑫为了解南通市市区４个月内婴儿母乳喂养情况、影响因素及存在问题，总结和评价爱婴医院及社区母乳喂养支持组织的服务质量，为制定和完善服务内容，实现２０００年４个月内纯母乳喂养达到８０％的目标，我...     

陕西部分农村母亲婴幼儿喂养知信行现况调查

目的:了解农村婴幼儿喂养现状,为进一步干预提供依据。方法:采用定量方法利用自编问卷对陕西泾阳县6个乡的311名儿童母亲进行现况调查;采用定性方法组织12名儿童母亲进行专题小组讨论,了解影响母亲喂养行为的因素。使用中位数、均数、标准差、频数、卡方检验等方法分析定量资料;使用分类归纳法分析定性资料。结果:定量调查显示,88.4%的母亲认为婴儿6个月内纯母乳喂养好,但6个月内纯母乳喂养率为55.3%;44.4%的母亲了解正确添加辅食的时间,但适时添加辅食率为26.1%;分别有92.9%、97.4%、76.2%的母亲认为应该每天给6个月及以上的孩子吃鸡蛋、蔬菜或肉类,但每周给6个月及以上的孩子添加6次及以上鸡蛋的比例为38.9%、蔬菜47.9%;给7个月及以上孩子每周添加1次以上肉类的比例只有21.6%。定性结果表明,没有坚持纯母乳喂养的母亲主要是自认为母乳不足而过早加辅食;过晚添加辅食的母亲主要是认为8个月以下的孩子对乳类以外的食物难以消化;不给孩子添加肉类食物的母亲主要是认为孩子1岁牙长好了才能消化肉类。结论:6个月婴儿纯母乳喂养率和适时添加辅食率低于同期其他农村地区水平,辅食种类单调,动物性食物摄入明显不足。建议加强对妇幼保健人员的培训,更新相关知识,提高健康教育技能;开发适合农村家长的科普书报、杂志等健康教育材料。     

上海市4个月内纯母乳喂养现状调查

上海市４个月内纯母乳喂养现状调查朱丽萍，杨文蔚，周冰华，华嘉增上海市妇女保健所２００４０１为了解上海市在创建爱婴医院促进母乳喂养活动后母乳喂养率及存在问题，为创建爱婴市提供基础资料，为实现２０００年４个月内纯母乳喂养率达８０％的目标提出切实有效的干预...     

上海市社区婴儿喂养情况评价

目的 了解上海市城区某社区2009年以来的婴儿喂养情况及存在的问题,并提出建议.方法 对上海市城区某社区儿童保健系统中2009-2011年原始的儿童常规体检资料进行筛选,筛选出1 789名对象纳入研究,对纳入的儿童母乳喂养持续时间、断奶年龄、辅食添加时间以及辅食添加种类和数量进行分析.结果 上海市城区某社区婴儿4、6个月纯母乳喂养率分别为33.0％和22.8％,平均断奶年龄为6.4个月;4月龄前已有61.3％的婴儿添加了辅食,添加辅食的种类较齐全,6月龄内添加3类辅食的婴儿达到54.3％,且6月龄和12月龄时加多类辅食的婴儿体重和身高均高于添加单一辅食的婴儿;但直到12月龄,奶类、谷类和蔬菜的日摄入量仍有52.7％、50.5％、57.9％的婴儿未达到营养学会妇幼分会提出的婴儿食物推荐量.结论 该社区的4、6个月纯母乳喂养率低且断奶年龄早;辅食添加存在不合理现象,辅食添加过早、某些种类的辅食添加量过少.     

An educational intervention on promotion of breast feeding complemented by continuing support

The study, aiming to document the effect of continued support for mothers on frequency of exclusive breast feeding, was carried out by inclusion of breast feeding counselling in the context of well-baby care. One hundred and forty-six mothers who had been exposed to two educational sessions on breast feeding after delivery were given appointments to bring their baby to the paediatric hospital for well-baby care. The mother-infant pairs were followed by the same two residents for 4 months. Mean number of visits was six. A conscious effort was made during all visits to influence the mothers and their close relatives towards exclusive breast feeding. It was observed that in a large proportion of the infants, breast milk was being supplemented with water at the time of the first visit and no further effort was made to change this traditional behaviour. Comparison of the results with a group of mothers who had been exposed to similar educational sessions after delivery but without further support showed a striking increase in frequency of exclusive breast feeding (breast milk and water) in the supported group.     

连云港市4个月婴儿喂养现状

目的了解连云港市4个月婴儿纯母乳喂养情况及不能坚持纯母乳喂养的原因。方法选择在院出生的508名婴儿进行调查。结果4个月纯母乳喂养率为44.9%。结论影响纯母乳喂养的最重要因素为产后奶量不足,加强有关母乳喂养的知识教育可大大提高母乳喂养率。     

Evaluation of an Australian intervention to encourage breast feeding in primiparous women

Breast feeding has nutritional, immunologic and antiallergicadvantages for the infant. Although it has been widely recommendedthat infants be exclusively breast fed until 4–6 monthsof age, only about half of all Australian babies currently receiveextended breast feeding. The present study evaluated an intensiveprogramme designed to increase the proportion ofprimi-parousmothers who breast fed for 4 months or longer. Women who registeredwith the hospital at least 20 weeks before delivery and whointended to breastfeed were eligible for the study. Two hundredand thirty-five women were allocated to receive either usualcare or an intensive breast feeding programme when they registeredwith the hospital. The intensive programme consisted of writtenmaterials, and group and individual sessions with a lactationcounsellor. It also included a visit from a breastfeeding consultantwhile in hospital after the birth and contact on return home.Women were followed up 6 weeks and 4 months after delivery.There were no significant differences in breastfeeding ratesbetween the control and intervention groups at either follow-uppoint. Breast feeding until 4 months was more likely among womenwhose baby did not receive a bottle feed while still in hospitaland who did not smoke, use the combined oral contraceptive pillor introduce solid food before 4 months. Those mothers who enjoyedand felt satisfied with breastfeeding were more likely to continueto 4 months. It seems likely that programmes designed to increasebreastfeeding will need to address underlying factors such ashospital policy rather than simply providing more health education.     

加强领导 积极创建爱婴市

联合国儿童基金会对厦门市进行爱婴市评估时给予了高度评价，认为“厦门所取得的成绩可以向其他国家和地区推广”。他们的经验是各级政府高度重视、各职能部门紧密配合，共同参与、严格执行《母乳代用品销售管理办法》、认真搞好女职工保健、宣传部门积极介入，同时建立完善的社区妇幼保健体系，该市母乳喂养率从创建爱婴医院前的５７．５％上升至１９９７年４月的９３．５％，其中纯母乳喂养率达５３．３％，所有综合性医院，中心卫生院均通过了爱婴医院评估，其中７２．０％的医院接受并一次性通过了国家级评估     

产后4个月内坚持纯母乳喂养情况分析

通过对128对母婴进行产后4个月内的访视,说明创建爱婴医院实行母婴同室及母乳喂养系列化服务是提高母乳喂养率的关键。     

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。     

Onset and duration of breast feeding among Israeli mothers: Relationships with smoking and type of delivery

A study of 190 mothers of firstborn, 6 month-old infants showed that different mechanisms affect onset and duration of breast feeding. Maternal education is related both to onset and duration of breast feeding; more highly educated women begin breast feeding and they breast feed for a longer period. Type of delivery is significantly associated with onset of breast feeding, even when controlling for educational level: cesarean delivered women are less likely to begin breast feeding than mothers delivered vaginally, although once breast feeding has begun, type of delivery no longer plays any role. Smoking is associated only with duration of breast feeding and not with onset. Among those women who breast feed for a long period, all are non-smokers. Women usually do not resume smoking immediately after giving birth which may explain why smoking is associated only with duration and not with onset of breast feeding. The results suggest the importance of influencing mothers so they do not resume or, at least, delay resumption of smoking as long as possible after parturition, in order to increase the likelihood of breast feeding. Caesarean delivered women should be encouraged to begin breast feeding while still in hospital.     

Who is responsible for artificial feeding? An evaluation

Artificial feeding has been found to be on the increases in India. In this research study, 320 infants who were artificially fed before 6 months of age and attended the child health clinic of the Department of Community Medicine, SKIMS Srinagar, between March and November, 1991, were surveyed. Information was obtained from mothers on personnel who advised artificial feeding by type of medical care unit. The sample of mothers included 59.3% who were illiterate. 52.25% of all mothers were housewives and 43.75% had a middle socioeconomic status, while 31.5% had a low socioeconomic status. 53.75% of the artificially fed babies were born at a hospital, of which 2.5% received intensive care. 46.25% were born at home. 76.87% were first or second births. 3.55% of babies were completely artificially fed from birth; at 3 months, 18.76% were exclusively artificially fed. Mixed feeding of breast and artificial milk was 10.76% at birth and 25.97% by 3 months and 42.10% by 6 months. 51.25% of mothers were advised by pediatricians to use artificial feeding; 24.65% of mothers were advised by general practitioners and 10.31% by paramedical. 40% were advised at private clinics and 26.25% in hospital wards at the time of discharge. 18.12% were advised in outpatient departments, and 15.62% at other health centers, such as immunization clinics, health clinics, or nutrition education centers. 66.25% received recommendations to use tinned milk (Lactogen/Milk-care) and 30%, for cows milk. 45.31% of mothers received advice from pediatricians about tinned milk and 5.93% about cow's milk. 5.93% of infants received advice from general practitioners about tinned milk and 5.31 about cow's milk. Over 80% of mothers were given instructions on the amount of dilution and frequency of feeding. 60.93% of mothers received information on feeding equipment and 56.15% on sterilization of feeding equipment. Only 59.37% and 65.37% were able to understand instructions on equipment and sterilization, respectively. The reasons given by mothers for using artificial feeding were low milk output (49.68%), nonacceptance of breast milk by the baby (22.50%), working mothers (12.18%), and baby illness (8.12%). Mothers attributed infections, colic, and regurgitation to artificial feedings. Clearly, the professional community is not complying with the professional code promoted by the World Health Assembly and Indian legislation in 1986 on not recommending milk formula.     

The combined effect of employment status and transcultural marriage on breast feeding: a population-based survey in Taiwan

In recent decades there has been a marked rise in both the labour market participation of women with infants and transcultural marriage in Taiwan. The objectives of this study were to explore the combined effect of employment status and transcultural marriage on the prevalence and factors relating to initiation and continuation of breast feeding in Taiwan. We used multistage stratified systematic sampling to recruit 2048 postpartum women from the Taiwan National Birth Registration database for the period November to December 2003. They were interviewed at home within 6 months of delivery using a structured questionnaire; 87% of the sampled population completed the interview. We used logistic regression analysis to estimate the odds ratio (OR) of breast-feeding initiation and Cox regression (survival) analysis to predict continued breast feeding. The prevalences of initial breast feeding for employed Taiwanese mothers, unemployed Taiwanese mothers, employed foreign-born mothers and unemployed foreign-born mothers were 84.4%, 83.7%, 79.1% and 79.7%, respectively. Among the four groups of mothers who initiated breast feeding, 12.9%, 27.2%, 14.7% and 39.7% of their infants, respectively, were still breast feeding at the age of 6 months. Factors associated with initiation of breast feeding were high maternal education (OR 3.80; 95% confidence interval [CI] 1.81, 7.98) and normal spontaneous delivery (OR 1.36; 95% CI 1.04, 1.78). The main reason for not breast feeding in 52% of the mothers was insufficient or no milk. There existed a combined effect of employment status and transcultural marriage on the continuation of breast feeding. Employed Taiwanese mothers were earlier than others at weaning. Unemployed foreign-born mothers breast fed the longest [hazard ratio (HR) 0.54; 95% CI 0.42, 0.70]. Other factors related to late weaning were high maternal education (HR 0.67; 95% CI 0.47, 0.96), older maternal age (HR 0.76; 95% CI 0.61, 0.94), mother sleeping with baby at night (HR 0.68; 95% CI 0.59, 0.78), and no supplemental baby food before the age of 6 months (HR 0.78; 95% CI 0.68, 0.90). The initiation of breast feeding was high but it decreased dramatically after the postpartum period in Taiwan. There was a significant combined effect of employment status and transcultural marriage on the continuation of breast feeding. Employment is a persistent barrier to continued breast feeding.     

The first weeks of breast feeding

The 2 main causes of the contemporary epidemic of breastfeeding failure appear to be urban life and hospital delivery. In rural areas, the majority of mothers breastfeed successfully. They have much emotional support from experienced women around them, and although some women experience problems, traditional birth attendants are skilled at both preventing and overcoming them. In town, a woman may be surrounded only by young friends as inexperienced as herself and a husband who is impatient of a crying infant. The most obvious solution to any difficulty is a feeding bottle which she can see many modern people using, including some health workers. Hospital delivery contributes to lactation failure by separating the mother and baby to allow them both to "rest," yet mothers who are separated from their babies for even 12 hours stop breastfeeding sooner than mothers who put their baby to the breast immediately after delivery. Possibly the emotional bonding that occurs during the 1st few hours gives a mother the motivation that she needs to persist with breastfeeding when it becomes difficult. In most societies it is customary to let the baby breastfeed immediately, and many traditional birth attendants are aware of how this helps both to stop uterine bleeding and to promote a better flow of milk. In hospitals a baby may be given feeds of formula milk or glucose water, while he/she "waits" for mother's milk to come in. Prelacteal feeds fill a baby's stomach, reduce his/her appetite, and make the baby less willing to suck at the breast. This delays the onset of lactation and increases the dangers of engorgement. If a baby is given his/her prelacteal feeds (or later feeds) from a bottle with a rubber teat, he/she is likely to develop "nipple confusion" and to fail to suck effectively from his/her mother. If hospitals are to be places in which babies may start to feed safely, the staff should let a mother suckle her baby immediately after delivery, and they should let her keep the baby with her and demand feed from the start. The majority of early breastfeeding problems are trivial and are easily if there is someone nearby who knows. Health service administrators should arrange for mothers to have care near home soon after delivery.