奶粉推荐、试用对农村贫困地区0~6月龄婴幼儿母亲母乳喂养行为影响

Impact of infant formula sales promotion-recommendation and trial use on breastfeeding practice among mothers of 0-6 months infants in poverty-stricken rural areas of China

目的探究奶粉推荐、试用两类奶粉宣传活动对中国农村贫困地区0~6月龄婴幼儿母亲母乳喂养行为的影响及作用机制。方法随机抽取秦巴山区13个县、447户0~6月龄婴幼儿家庭作为调研样本,于2019年3—4月开展调研,收集婴幼儿母乳喂养情况、母亲接触配方奶粉宣传情况、母亲营养健康知识、婴儿喂养态度和母乳喂养自我效能等信息,采用logit回归和多元线性回归进行分析。结果收到奶粉试用装是基本母乳喂养的风险因素(OR=0.60,95%CI=0.38~0.93,P=0.02),出生后第一口喂奶粉是母乳喂养的风险因素(OR=0.54,95%CI=0.31~0.95,P=0.03),但收听/收看奶粉广告和他人建议喂配方奶粉与母乳喂养行为无显著相关关系(均P>0.1)。收看奶粉广告与更高的营养健康知识(β=0.33,P=0.01)、婴儿喂养态度得分(β=1.04,P=0.04)相关,他人建议、奶粉试用与母亲营养健康知识、婴儿喂养态度均不相关(均P>0.1),但收到试用装显著降低母乳喂养自我效能(β=–3.22,P=0.03)。结论中国农村贫困地区母亲喂养技能不足,奶粉试用会增加母亲或婴幼儿对配方奶粉的依赖,降低母亲母乳喂养自我效能,进而降低母乳喂养率。

Objective To explore the impact and influence mechanisms of infant formula recommendation and trial use on breastfeeding practice among mothers of infants aged 0-6 months in poverty-stricken rural areas of China.Methods We randomly selected 447 households with 0-6 months old infants in 123 villages in two national-level poverty-stricken counties locating at Qinba mountainous region and conducted a survey among mothers of the infants of the households selected in March-April 2019.Information about breastfeeding of the infants,maternal exposure to infant formula sales promotion,maternal nutrition health knowledge,maternal attitude towards breastfeeding and breastfeeding self-efficacy were collected with a self-designed questionnaire,Iowa Infant Feeding Attitude Scale(IIFAS),and The Breastfeeding Self-Efficacy Scale-Short Form(BSES-SF).Logit regression and multivariate linear regression were used in analyses.Results The logit regression analysis demonstrated that receiving infant formula samples for sales promotion(odds ratio[OR]=0.60,95%confidence interval[95%CI]:0.38-0.93;P=0.02)was a hindering factor for basic breastfeeding and feeding a newborn first time with infant formula(OR=0.54,95%CI:0.31-0.95,P=0.03)was a hindering factor for breastfeeding;the analysis did not indicate significant correlation between exposed to infant formula sales promotion(advertisements or advices for infant formula use from others)and breastfeeding practice(both P>0.1).Exposure to infant formula advertisements was related with higher score for nutrition health knowledge(β=0.33,P=0.01)and higher score for breastfeeding attitude(β=1.04,P=0.04);while exposure to advices for infant formula use and receiving infant formula samples for sales promotion were not associated with scores for nutrition health knowledge and breastfeeding attitude(both P>0.1),but receiving infant formula samples for sales promotion was correlated with significantly reduced breastfeeding self-efficacy(β=-3.22,P=0.03).Conclusion In poverty-stricken rural areas in Qinba mountainous region,the mothers of infants aged 0-6 months have no sufficient feeding skills;the usage of infant formula for sales promotion could increase maternal dependence on infant formula but reduce breastfeeding self-efficacy and thus decrease breastfeeding rate among the mothers.