临夏州6个月内婴儿纯母乳喂养现状及相关因素研究

目的调查分析临夏州6个月内婴儿纯母乳喂养现状并探讨其相关因素,为改善喂养状况提供理论依据。方法随机抽取2016年1月—12月临夏州妇幼保健院儿童保健门诊接受健康体检和计划免疫室接种疫苗的864例6个月内婴儿作为研究对象,自行设计问卷调查婴儿母乳喂养情况,分析不同喂养方式婴儿相关资料的差异,通过非条件logistic回归探讨影响纯母乳喂养的相关因素。结果 (1)出生7 d时婴儿纯母乳喂养所占比例最高,为90.05%,出生第1个月、3个月和6个月时纯母乳喂养所占比例分别为81.94%、68.52%和31.94%,呈逐渐下降趋势(χ~2=787.941,P0.05);(2)经非条件单因素logistic回归分析发现婴儿月龄、分娩方式、产妇年龄、妊娠期糖尿病、文化程度、工作性质、胎次及产假均为6个月内婴儿纯母乳喂养的影响因素(P0.05);(3)经非条件多因素logistic回归发现,剖宫产、产妇年龄≥30岁、文化程度为本科及以下、全职以及无产假均为导致6个月内婴儿纯母乳喂养率逐渐下降的独立影响因素(P0.05)。结论目前,临夏州6个月内婴儿纯母乳喂养率呈逐渐下降趋势,且剖宫产、产妇年龄≥30岁、文化程度为本科及以下、全职以及无产假均为其独立影响因素。     

1304名产妇分娩情况分析

目的:探讨产科患者的一般情况,为加强产科管理、提高妇婴健康提供科学依据。方法:回顾性分析1 304例产妇的年龄、职业、孕次、产次、分娩方式、剖宫产指征、婴儿情况。结果:1 304例产妇中剖宫产332例,剖宫产率25.46%,剖宫产指征第1位是瘢痕子宫151例占45.48%;早产率2.22%,过期产率0.76%,低出生体重率2.45%,巨大儿发生率7.41%。结论:应加强孕期合理营养指导,降低巨大儿发生率;加强对孕妇分娩方式选择的正确引导,严把初产妇剖宫产指征;加强医务人员对疤痕子宫阴道试产适应证的培训,有效降低剖宫产率。     

北京市海淀区海淀街道6个月内婴儿母乳喂养现状及影响因素研究

目的 了解北京市海淀区海淀街道6个月内婴儿母乳喂养现状及其影响因素,为提高母乳喂养率提供科学依据。方法 随访2014年1月1日-12月31日出生的890例6个月内婴儿母乳喂养现状及影响因素,并采用Logistic回归法分析危险因素。结果 6个月内婴儿纯母乳喂养率为31.82%,部分母乳+人工喂养率为68.18%。6个月内婴儿纯母乳喂养率随月龄增加呈降低趋势,顺产儿童纯母乳喂养率高于剖宫产,差异有统计学意义。Logistic回归分析显示,母亲年龄＜30岁(OR=0.70,95%CI=0.53~0.93)、顺产(OR=0.63,95%CI=0.44~0.81)、非全职者(OR=0.52,95%CI=0.35~0.76)均是母乳喂养的保护因素。结论 降低剖宫产率,加强爱婴社区创建,全社会共同参与,能有效地提高母乳喂养率,延长母乳喂养时间。     

中国西部5省农村婴儿纯母乳喂养影响因素分析

目的:了解中国西部农村婴儿的母乳喂养现状,探讨影响4个月内婴儿纯母乳喂养的相关因素。方法:利用"2006年中国十省农村7岁以下儿童体格发育调查"资料,选取西部5省的农村婴儿作为研究对象。结果:西部5省农村婴儿母乳喂养率为71.97%;4个月内纯母乳喂养率为52.02%。单因素分析结果显示,影响婴儿4个月内纯母乳喂养的因素包括婴儿性别、胎数、出生体重、患病情况,父母亲年龄、母亲文化水平和职业、家庭年收入;多因素分析结果显示,双胎、有疾病史、出生体重低、母亲年龄大、母亲文化水平高、家庭年收入高是婴儿4个月内纯母乳喂养的危险因素。结论:中国西部5省农村婴儿4个月内纯母乳喂养率较低,受婴儿自身因素、母亲因素和家庭经济因素的影响,应加强孕期保健服务,积极宣传和普及科学喂养知识,提高母亲母乳喂养意识。     

苏州市早产与低出生体重的趋势及危险因素研究

目的了解苏州市活产分娩婴儿中早产儿和低出生体重儿的发生率并探讨相关危险因素。方法选取2009-2013年苏州市单胎分娩的产妇189 935例为研究对象,收集产妇年龄、产次、孕次、孕周、新生儿出生体重等指标,利用χ~2检验及多因素Logistic回归模型评估相关性。结果 2009-2013年苏州市早产率及低出生体重率均呈现上升趋势,总体早产率为7.0%,低出生体重率为5.2%。孕妇文化程度为高中/职高、大专及以上、产次为2次是早产与低出生体重的保护因素,孕妇年龄40岁、剖宫产是早产与低出生体重的危险因素,孕次≥5次是早产的危险因素,孕妇年龄为20~40岁、孕次2~4次是低出生体重的保护因素。结论早产及低出生体重的发生是多因素联合作用造成的,因此在妇幼保健工作中应有计划、有针对性、有重点地开展孕前及孕期保健宣传,提高自我保健意识,对降低早产及低出生体重发生率有重要意义。     

舟山市2002-2015年出生体重变化与不良出生结局及影响因素分析

目的 描述舟山市2002-2015年新生儿出生体重变化,分析不良出生结局的发生率及影响因素。方法 利用舟山市电子医疗数据库,收集孕产妇及新生儿的相关信息,描述新生儿出生体重和不良出生结局发生率的变化趋势,采用多元Logistic回归分析其影响因素。结果 37 141例新生儿的平均出生体重为（3 388±462） g,低出生体重儿、巨大儿、早产的发生率分别为2.34%,9.42%和3.61%;高危妊娠（OR=1.80,95%CI:1.42~2.28）是低出生体重儿的危险因素;出生季节为夏季、秋季、母亲年龄<25岁、孕前消瘦等是巨大儿的保护因素。母亲孕前超重和肥胖是巨大儿的危险因素;母亲年龄<25岁是早产发生的保护因素。母亲年龄>30岁（OR=1.38,95%CI:1.19~1.60）、冬季出生（OR=1.24,95%CI:1.06~1.45）、母亲孕前超重和肥胖、高危妊娠（OR=1.95,95%CI:1.66~2.29）等是早产的危险因素。结论 舟山市2002-2015年新生儿出生体重呈下降趋势,低出生体重儿和早产儿发生率呈上升趋势。新生儿性别、出生季节,母亲年龄、孕前体质指数（body mass index,BMI）、高危妊娠等因素影响低出生体重儿、巨大儿或早产儿的发生。     

6个月内婴儿母乳喂养现状及影响因素研究

目的了解永康市6个月内婴儿的母乳喂养现状及影响因素。方法采用随机整群抽样方法对永康市9个镇(街道)667名0~6个月婴儿的母亲进行调查。结果婴儿在出生7 d、1个月、3个月和4~6个月时纯母乳喂养率分别为69.72%、77.66%、58.32%和27.97%;几乎纯母乳喂养率分别为1.95%、0.45%、0.60%和1.69%;部分母乳喂养率分别为13.34%、14.39%、30.13%和47.46%;人工喂养率分别为14.99%、7.50%、10.95%和22.88%。各组之间比较差异均有统计学意义(P0.05)。经非条件Logistic回归分析显示,母亲年龄30岁、初中及以下文化程度、非全职者均是母乳喂养的保护因素,其OR值及95%CI分别为0.464(0.315~0.682)、0.507(0.305~0.842)和0.517(0.352~0.758);家庭月收入6 000元是母乳喂养的危险因素,其OR值及95%CI为1.923(1.306~2.833)。结论永康市3个月内婴儿纯母乳喂养率较高,4~6个月时纯母乳喂养率急剧下降,母亲年龄≥30岁者、全职者、家庭收入较高者和受教育程度越高者,其母乳喂养率相对较低。     

剖宫产术后母乳喂养合理指导

母乳含有婴儿出生后4～6个月内生长发育所需要的全部营养物质,是保证婴儿健康生长发育,提高人口质量的重要措施。由于剖宫产日益增多,致产妇术后创伤疼痛,进食少,泌乳开始时间晚,为了提高剖宫产术后母乳喂养率。由专业医护工作者对有针对性的合理指导和心理疏导,采用产前健康教育,指导产妇正确的哺乳技巧,增进母乳喂养,及时疏通乳腺管等,提高纯母乳喂养率。结果产妇术后乳汁充足达到85%,纯母乳喂养率90%,比过去产妇乳汁充足和纯母乳喂养有了提高。     

剖宫产术后母乳喂养合理指导

母乳舍有婴儿出生后4～6个月内生长发育所需要的全部营养物质,是保证婴儿健康生长发育,提高人口质量的重要措施。由于剖宫产日益增多,致产妇术后创伤疼痛,进食少,泌乳开始时间晚,为了提高剖宫产术后母乳喂养率。由专业医护工作者对有针对性的合理指导和心理疏导,采用产前健康教育,指导产妇正确的哺乳技巧,增进母乳喂养,及时疏通乳腺管等,提高纯母乳喂养率。结果产妇术后乳汁充足达到85％,纯母乳喂养率90%,比过去产妇乳汁充足和纯母乳喂养有了提高。     

四川省泸州市纯母乳喂养现状及其影响因素分析

目的 了解纯母乳喂养现状,分析影响纯母乳喂养的因素,为提高纯母乳喂养率提供理论依据。方法 以2019年4—6月在泸州市某医科大学附属医院、附属中医院和泸州市人民医院分娩活产儿的产妇为研究对象,在产后6个月时进行问卷调查,内容包括基本信息、婴儿6个月内喂养情况及相关信息,采用描述流行病学方法对纯母乳喂养现状进行描述,并采用单、多因素分析方法对纯母乳喂养的影响因素进行分析。结果 本研究共调查泸州市448名产后6个月的新生儿母亲。产妇年龄19~46岁,以26~35岁为主,占56.7%,文化程度以大专及以上为主,占94.8%,所在地以城市为主,占95.8%,以初产妇为主,占58.3%。纯母乳喂养率为61.16%。多因素Logistic回归分析结果显示,年龄大（OR=0.548、0.453）、乳头凹陷或扁平（OR=0.386）、产后抑郁情绪（OR=0.556）、睡眠质量差（OR=0.557）的产妇纯母乳喂养的可能性较低。婴儿出生后1 h内进行了母乳喂养（OR=2.375）、家人尤其是丈夫支持母乳喂养（OR=7.050）、孕期参加产前健康教育等知识讲座（OR=1.578）的产妇纯母乳喂养的可能性较高。结论 泸州市纯母乳喂养现状较好,影响纯母乳喂养的因素较多,可根据当地产妇特点制定相应干预措施,提升纯母乳喂养率。     

Breastfeeding pattern and the duration of lactational amenorrhea in urban Chilean women

The influence of the breastfeeding pattern and several clinical variables upon the duration of postpartum amenorrhea was assessed in a group of healthy women selected for having had a normal pregnancy and delivery and being highly motivated for prolonged breastfeeding on demand. 676 women who were fully nursing at the second month postpartum entered the study. Supplements were administered to 11% and 48% of the infants by the end of the 3rd and 6th month, respectively. The first bleeding was experienced before the end of the sixth month postpartum by 57% of the cases. Supplementation had a strong negative influence while nursing frequency had a significant positive influence upon the length of amenorrhea. Notwithstanding, a frequency of 8+ suckling episodes per 24 h could not maintain amenorrhea in around half of the subjects. Age and parity had a moderate negative influence upon the risk of experiencing the first postpartum bleeding. Maternal weight and ponderal index, infant sex, birth weight and growth rate showed no significant influence upon the length of amenorrhea. In this urban population selected for having the highest motivation and best breastfeeding performance, the association of breastfeeding with amenorrhea was weak in comparison with what has been described for other populations. The risk of experiencing the first bleeding was reduced while fully breastfeeding with a high number of nursing episodes per day and night, particularly in older women with higher parity. But even in such situation 25% and 50% of the women had started to cycle by the end of the fifth and eight postpartum month.     

Impact of a Well Baby Care Program on the promotion of exclusive breastfeeding

A historical cohort of children born between January 2000 and December 2002 from low-income families attending a primary health care facility on the periphery of Pelotas, Rio Grande do Sul, Brazil, was studied in relation to prevalence of exclusive breastfeeding. Analysis was based on a life table focusing on interruption of exclusive breastfeeding (month-by-month after birth) as the target outcome. Among the 112 children followed up from birth by the Well Baby Program, prevalence of exclusive breastfeeding in the first month of life was 95.0%, declining progressively to 81.0%, 64.0%, 53.0%, 39.0%, and 35.0%, respectively, from the second to the sixth month after birth. Median duration of exclusive breastfeeding was four months. Median duration of exclusive breastfeeding and prevalence among six-month-old infants were both higher than the Brazilian national rates and indicate the Program's adequacy in promoting breastfeeding. However, more effort should be made to increase the prevalence of exclusive breastfeeding until the sixth month of life.     

Feeding practices and growth of infants from birth to 12 months in the central region of the Limpopo Province of South Africa

OBJECTIVE: We evaluated feeding practices and growth patterns of infants in the central region of the Limpopo Province over the first 12 mo of life. METHODS: A follow-up study on a cohort of term infants born to 276 mothers recruited during their third trimester of pregnancy was undertaken. The mothers were recruited by the nursing staff at nine randomly selected clinics. From this sample, 219 women gave birth at the local hospital and the infants were followed from birth to 12 mo. Data collected included infant feeding practices and anthropometry at regular intervals (1, 3, 6, 9 and 12 mo). The anthropometric measurements taken were body weight, length, and head circumference. RESULTS: At birth 8.8% of infants had a low birth weight, 9.6% were stunted, 48.9% were underweight, and 7.3% were wasted. Mothers in this study breastfed their infants for long periods with more than 80% still breastfeeding by the ninth month. However, exclusive breastfeeding during the first 3 mo was uncommon as mothers tended to introduce supplementary feeds at an early age, with 56% of the infants receiving some form of supplement by the end of the first month. The most common supplementary foods were maize meal porridge and mabella (sorghum). Stunting became increasingly apparent in the early months with 30% of infants being stunted (<-2 standard deviations [SD] of the National Center for Health Statistics [NCHS] reference curves) by the first month, and this percentage remained high for the 12-mo period, remaining at below - 1 SD NCHS height-for-age standard. Increased weight gain was seen during the first 3 mo and then declined until mean weight-for-age at 12 mo was below 0 SD NCHS. Twelve percent of infants were overweight (>2 SD NCHS) by the 12th month. Postnatally the infants showed a pattern of gradual stunting. Postnatal factors associated with this pattern were related to maternal socioeconomic status, and these included the mother's level of education, employment status, parity, and access to electricity. CONCLUSION: There was a high frequency of underweight infants at birth but stunting was less common. With respect to feeding practices, the mothers tended to introduce supplementary feeds at an early age.     

Lactational amenorrhea and the recovery of ovulation and fertility in fully nursing Chilean women

The probability of experiencing the first postpartum bleeding, the first ovulation and the risk of pregnancy during exclusive breastfeeding was assessed in a selected group of urban Chilean women. Admission criteria included having had a normal pregnancy and a vaginal term delivery of a healthy infant and the desire to maintain breastfeeding for as long as possible. The risk of bleeding and the recovery of ovulation was assessed in 48 women selected for being amenorrheic and fully nursing at day 75 postpartum and their willingness to participate in the blood sampling protocol. The first bleeding and ovulation was experienced while fully nursing by 28% and 26% of these subjects, respectively, at day 180 postpartum. The probability of experiencing the first bleeding and the probability of pregnancy during full nursing were calculated for 236 women not contracepting who were enrolled during the first month postpartum. The cumulative probability of bleeding and of pregnancy was 52% and 9.4% at day 180 postpartum, respectively. The risk of pregnancy was less than 2% in the subset of amenorrheic cases. In this urban population selected for having the highest motivation and best breastfeeding performance, the association of breastfeeding with infertility was too weak to serve as an effective birth spacer, except for the period of lactational amenorrhea. When the first postpartum bleeding took place before the sixth postpartum month in fully nursing women, it had a good predictive value to indicate the onset of a higher risk period.     

Cesarean section and breastfeeding outcomes in an Indigenous Qom community with high breastfeeding support

Background and objectivesCesarean section may lead to suboptimal breastfeeding outcomes, though evidence has been mixed. Factors, such as premature birth, birth weight and maternal age may independently increase risk of cesarean and hinder breastfeeding initiation, while maternal preferences, support and sociostructural barriers may influence breastfeeding practices beyond the immediate postpartum period.MethodologyWe assessed impacts of cesarean section and gestational factors on breastfeeding duration among Indigenous Qom mothers in Argentina who have strong traditional breastfeeding support. We modeled transitions from exclusive breastfeeding to complementary feeding and from complementary feeding to full weaning in a Bayesian time-to-event framework with birth mode and gestational covariates (n = 89 infants).ResultsEstimated median time to full weaning was 30 months. Cesarean-delivered babies were weaned an average of 5 months later adjusting for gestational age, maternal parity and infant sex. No factors were associated with time-to-complementary feeding, and time-to-complementary feeding was not associated with time-to-full weaning.Conclusions and implicationsAmong Indigenous Qom mothers in Argentina, cesarean section was not associated with suboptimal breastfeeding outcomes. Although some Qom mothers do experience early breastfeeding problems, particularly following first birth, problems are not more frequent following cesarean delivery. Traditional postpartum kin and community support during prolonged postpartum periods may be instrumental in helping mothers to overcome early breastfeeding problems due to cesarean or other risk factors.     

新生儿早期基本保健对初产妇泌乳启动的影响

目的 研究新生儿早期基本保健(EENC)技术对初产妇母乳喂养得分、泌乳启动时间及产后前72 h纯母乳喂养率的影响。方法 2018年6-7月随机选取潍坊医学院附属医院自然分娩的89对初产妇及新生儿,分为干预组(n=45)及对照组(n=44)。干预组新生儿实施EENC,对照组进行常规护理。采用母乳喂养测量工具(BAT)进行母乳喂养评分,并在产后24、48、72 h随访记录产妇泌乳启动时间及纯母乳喂养情况。结果 干预组首次母乳喂养评分为(10.84±1.36)分,对照组为(10.23±1.43)分,差异有统计学意义(t=-2.085,P=0.040);干预组产妇泌乳启动时间[(48.51±10.71)h] 早于对照组[(53.66±10.99)h] ,差异有统计学意义(t=2.238,P=0.028);干预组产后24、48、72 h的纯母乳喂养率(33.3%、51.1%、71.1%)均高于对照组(13.6%、29.5%、50.0%),差异有统计学差异(χ²=4.788,4.295,4.155,P<0.05)。但两组首次母乳喂养或成功率和泌乳启动率间差异均无统计学意义(P>0.05)。结论 新生儿早期基本保健对母乳喂养评分及产妇泌乳启动有促进作用,能够提高早期纯母乳喂养率,值得推广。     

Breastfeeding Practices Among First-Time Mothers and Across Multiple Pregnancies

To investigate maternal characteristics associated with breastfeeding initiation and success. Women enrolled in the Mothers Outcomes After Delivery study reported breastfeeding practices 5?C10?years after a first delivery. Women were classified as successful breastfeeding initiators, unsuccessful initiators, or non-initiators. For the first birth, demographic and obstetrical characteristics were compared across these three breastfeeding groups. For multiparous women, agreement in breastfeeding status between births was evaluated. Multivariate regression analysis was used to identify characteristics associated with non-initiation and unsuccessful breastfeeding across all births. Of 812 participants, 740 (91%) mothers tried to breastfeed their first child and 593 (73%) reported breastfeeding successfully. In a multivariate analysis, less educated women were less likely to initiate breastfeeding (odds ratio (OR) for non-initiation 1.97; 95% confidence interval (CI) 1.23, 3.14). There was a notable decrease in breastfeeding initiation with increasing birth order: compared to the first birth, the odds for non-initiation after a second delivery almost doubled (OR 1.83, 95% CI 1.42, 2.35) and the odds for non-initiation after a third delivery were further increased (OR 2.44, 95% CI 1.56, 3.82). Successful breastfeeding in a first pregnancy was a predictor of subsequent breastfeeding initiation and success. Specifically, women who did not attempt breastfeeding or who reported unsuccessful attempts to breastfeed at first birth were unlikely to initiate breastfeeding at later births. Cesarean delivery was not associated with breastfeeding initiation (OR 1.01; 95% CI 0.68, 1.48) or success (OR 1.33; 95% CI 0.92, 1.94). Breastfeeding practices after a first birth are a significant predictor of breastfeeding in subsequent births.     

产后返岗女性母乳喂养持续时间及其影响因素的研究

目的 调查产后返岗女性母乳喂养现况,探讨母乳喂养持续时间的影响因素。 方法 采用一般资料调查表、母乳喂养知识量表、IOWA 婴儿喂养态度量表、母乳喂养家庭支持问卷、母乳喂养支持的员工感知问卷对344名产后返岗女性进行调查,应用Cox回归探讨产后返岗女性母乳喂养持续时间的影响因素。 结果 产后返岗女性6个月纯母乳喂养率为38.7%;母乳喂养持续时间均值为10.07个月;Cox回归显示,家庭月收入、最小孩子年龄、IOWA婴儿喂养态度对母乳喂养持续时间有显著影响（P<0.05）。 结论 产后返岗女性6个月纯母乳喂养率较低,母乳喂养持续时间不容乐观,应重点关注经济水平较低的家庭,完善母乳喂养体系,保障持续母乳喂养的成功实现。     

The effect of a breastfeeding education program on lactational amenorrhea in the Philippines

A study was conducted in two communities in the rural Philippines to determine whether breastfeeding mothers could intensify their nursing enough to increase the period of lactational amenorrhea. Women in one community were exposed to a breastfeeding education program before the birth and during lactation, while women in the other community served as a comparison group. Increased breastfeeding was observed in the group that received breastfeeding education, beginning in the sixth month postpartum. Bottle use began earlier and was more common in the comparison group, but the introduction of solid foods at five to six months was similar. No difference in the duration of postpartum amenorrhea (a proxy for the duration of infertility) was observed between the groups.