我国催乳师选择情况及影响因素分析

Analysis on the selection and influence factors of the lactagogue practitioner in China

目的了解我国催乳师选择情况及原因,探讨其影响因素。方法 2019年12月至2020年5月采用多阶段整群抽样方法,在我国3个一线城市(北京、成都、郑州),4个非一线城市(滨州、南宁、利川、麦盖提)共计纳入390名乳母,采用问卷调查方法收集乳母一般人口学资料、孕产及哺乳特征、医疗机构服务情况、促乳方式选择情况等。结果选择催乳师的人数为85例(21.8%),婴儿产后第3天及以上喝到初乳、母乳喂养遇到困难、哺乳期间得过乳腺炎、医保类型为城镇医疗保险、乳母所在生产医院有推荐催乳师或相关机构,均是选择催乳师的促进因素,其OR值及95%CI分别为2.327(1.164~4.652)、2.103(1.178~3.755)、3.476(1.525~7.924)、4.636(1.421~15.126)、3.137(1.626~6.054),均P<0.05;进一步调查乳母选择催乳师的原因,结果显示选择催乳师的前三位原因分别为"自认为需要"占45.4%、"亲友建议"占28.2%、"医生建议"占14.2%;未选择催乳师的前三位原因分别为"奶水很好,不需要"占33.9%、"自认为自己可以解决,不需要"占33.3%、"知道其存在,但对效果存在质疑"占18.4%。结论母乳喂养情况、医保类型及医疗机构对催乳师的推荐情况均影响乳母对催乳师的选择。

Objective To investigate the status quo and reasons of the selection of the lactagogue practitioner in China, and to explore the influencing factors.Methods A total of 390 lactating mothers were selected from three first-tier cities(Beijing, Chengdu, Zhengzhou) and four non-first-tier cities(Binzhou, Nanning, Lichuan, Maigaiti) in China through multistage cluster sampling method from December 2019 to May 2020.The general demographic data, characteristics of pregnancy and lactation, service of medical institutions and selection of lactation promotion methods of lactating mothers were collected by questionnaire survey.Results 85 cases(21.8%) chose lactagogue practitioners.Drinking breast milk on the third day or more after delivery, encountering difficulties in breastfeeding, suffering from mastitis during breastfeeding, urban medical insurance as the type of medical insurance, and recommendation of lactagogue practitioner or relevant institutions in the production hospital of the mother were all the promoting factors for choosing lactagogue practitioner.The OR values and 95%CIs were 2.327(1.164~4.652),2.103(1.178~3.755),3.476(1.525~7.924),4.636(1.421~15.126),and 3.137(1.626~6.054),all P<0.05.Further investigation of the reasons why lactating mothers chose a lactagogue practitioner showed that the top three reasons for choosing a lactagogue practitioner were 45.4% of "self-deemed need",28.2% of "recommendation of relatives and friends",and 14.2% of "recommendation of doctor".The top three reasons for not choosing a lactagogue practitioner were 33.9% of "milk is very good and do not need",33.3% of "I think I can solve it, I don’t need it",and 18.4% "know it exists, but have doubts about the effect".Conclusion Breastfeeding status, medical insurance type and the recommendation of medical institutions to the lactagogue practitioner all affect the selection of the lactagogue practitioner.