2岁以下婴幼儿母乳喂养现状及相关因素分析

Current status of breast-feeding and its related factors among infants under 2 years old

目的调查广西壮族自治区防城港市2岁以下婴幼儿母乳喂养现状,分析可能的影响因素。方法采用整群抽样法抽取2021年6—12月到防城港市28个社区卫生服务中心、乡镇卫生院就诊的592名2~2岁3个月幼儿及幼儿家长进行回顾性问卷调查,调查幼儿3、6、12、18、24月龄母乳喂养现状,6月龄纯母乳喂养的影响因素及12、18月龄继续母乳喂养的影响因素。结果536名2~2岁3个月幼儿中,有466名幼儿3月龄时纯母乳喂养,3月龄纯母乳喂养率86.9%;有329名幼儿6月龄时纯母乳喂养,6月龄纯母乳喂养率61.4%;12、18、24月龄继续母乳喂养率分别为29.9%(160/536)、4.3%(23/536)、0.6%(3/536)。多因素logistic逐步回归模型显示,家庭居住地为城市(OR=1.678,95%CI:1.126~2.501)、主要看护人为母亲(OR=2.208,95%CI:1.357~3.593)、出生后第一口食物为母乳(OR=2.417,95%CI:1.482~3.942)是促进2~2岁3个月幼儿12月龄继续母乳喂养的影响因素。出生后≤1 h开始吃母乳(OR=3.005,95%CI:1.203~7.504)及添加辅食时间<4个月(OR=4.392,95%CI:1.479~13.039)是促进2~2岁3个月幼儿18月龄继续母乳喂养的影响因素。结论6月龄纯母乳喂养率已达《中国儿童发展纲要(2011—2020)》的要求,母乳喂养率随婴幼儿月龄增长降低,提示防城港市的6月龄以下纯母乳喂养卫生政策和措施实施效果较好,需加强基层卫生保健工作人员宣传继续母乳喂养的重要性,建议母乳喂养至2岁或2岁以上。

Objective To investigate the status quo of breastfeeding amongst infants under 2 years old in Fangchenggang City,Guangxi Zhuang Autonomous Region,and to analyze its possible influencing factors.Methods A retrospective questionnaire survey was conducted on 592 children aged 2 to 2 years and 3 months and their parents from 28 community health service centers and township health centers in Fangchenggang City from June to December 2021 by a cluster sampling method.The status quo of breastfeeding in infants at 3,6,12,18 and 24 months were investigated.The factors influencing exclusive breastfeeding at 6 months of age and continued breastfeeding at 12 and 18 months of age were surveyed.Results Of the 536 infants aged 2 to 2 years and 3 months,466 were exclusively breast-fed at 3 months of age,and the rate of exclusive breastfeeding at 3 months was 86.9%.329 were exclusively breastfed at 6 months of age,the rate of exclusive breastfeeding at six months of age was 61.4%,and the rates of continued breastfeeding at 12,18 and 24 months were 29.9%(160/536),4.3%(23/536)and 0.6%(3/536)respectively.Multifactor logistic stepwise regression model revealed that urban area as the family residence(OR=1.678,95%CI:1.126-2.501),mother as the primary caregiver(OR=2.208,95%CI:1.357-3.593)and breast milk as the first mouthful of food after birth(OR=2.417,95%CI:1.482-3.942)were the factors influencing continued breastfeeding at 12 months of age among infants aged 2 to 2 years and 3 months.Time to initiation of breastfeeding less than or equal to 1 hour of birth(OR=3.005,95%CI:1.203-7.504)and time to initiation of complementary food supplementation within 4 months(OR=4.392,95%CI:1.479-13.039)were the influential factors for promoting continued breastfeeding at 18 months of age among infants aged 2 to 2 years and 3 months.Conclusion The rate of exclusive breastfeeding at 6 months of age has met the requirements of the Program for the Development of Chinese Children(2011-2020),and the breastfeeding rate decreases with the infants’increasing age.The results suggest that the health policy and measures of exclusive breastfeeding under 6 months of age in Fangchenggang City are effective.Grass-roots health care workers should strengthen the publicity of importance of continued breastfeeding.Breastfeeding is recommended up to 2 years of age or above 2 years old.