早期开始母乳喂养和母乳喂养持续时间与儿童死亡率有什么关系？35 个撒哈拉以南非洲国家基于人群的 pooled 数据分析。
What does early initiation and duration of breastfeeding have to do with childhood mortality? Analysis of pooled population-based data in 35 sub-Saharan African countries.
机构信息
Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Kanifing, The Gambia.
出版信息
Int Breastfeed J. 2021 Dec 7;16(1):91. doi: 10.1186/s13006-021-00440-x.
BACKGROUND
Breastfeeding practices and their impact on infant health and survival are unquestionably of global interest. The aim of this study was to examine the link between breastfeeding initiation within one hour of birth, breastfeeding duration and childhood mortality in sub-Saharan Africa.
METHODS
This study used data from the Demographic and Health Survey, which was conducted in 35 Sub-Saharan African countries between 2008 and 2017. Early initiation and duration of breastfeeding, food consumption indices, and infant mortality were all important variables. Analysis used percentage, median/interquartile range, and regression models (logistic, linear, Cox).
RESULTS
Early initiation of breastfeeding within one hour after birth was lowest in Chad (23.0%) and highest in Burundi (85.0%). The pooled median duration of breastfeeding was 12 months. Female children had 3% significant lower odds of consuming tinned, powdered or fresh milk, compared with male children (OR 0.97; 95% CI 0.94, 0.99). Conversely, female children were more likely to be put to breast within one hour after birth, compared with male children (OR 1.03; 95% CI 1.01, 1.05). Results from the pooled sample showed approximately 20% (HR 0.80; 95% CI 0.67, 0.96) and 21% (HR 0.79; 95% CI 0.77, 0.80) reduction in infant mortality for children breastfed within one hour after birth and for every unit increase in the months of breastfeeding respectively. In addition, countries with the leading infant mortality rate include; Sierra Leone (92 deaths per 1000 live births), Chad (72 deaths per 1000 live births), Nigeria (69 deaths per 1000 live births), Cote d' Ivoire (68 deaths per 1000 live births), Guinea (67 deaths per 1000 live births), Burkina-Faso (65 deaths per 1000 live births) and Mozambique (64 deaths per 1000 live births) respectively.
CONCLUSIONS
The findings from this study underscores the need for early breastfeeding initiation and prolong breastfeeding to be considered in programmes on improving childhood survival. Efforts should be made to improve optimal breastfeeding practices as only about half of children in the pooled sample had best practices of breastfeeding.
背景
母乳喂养的做法及其对婴儿健康和生存的影响无疑具有全球意义。本研究的目的是研究撒哈拉以南非洲地区出生后一小时内开始母乳喂养、母乳喂养持续时间和儿童死亡率之间的联系。
方法
本研究使用了 2008 年至 2017 年在 35 个撒哈拉以南非洲国家进行的人口与健康调查的数据。早期母乳喂养的开始和持续时间、食物消费指数和婴儿死亡率都是重要的变量。分析采用百分比、中位数/四分位距和回归模型（逻辑、线性、Cox）。
结果
出生后一小时内开始母乳喂养的比例在乍得最低（23.0%），在布隆迪最高（85.0%）。母乳喂养的平均持续时间为 12 个月。与男童相比，女童食用罐装、粉状或新鲜牛奶的可能性低 3%（OR 0.97；95%CI 0.94，0.99）。相反，与男童相比，女童更有可能在出生后一小时内进行母乳喂养（OR 1.03；95%CI 1.01，1.05）。来自汇总样本的结果表明，对于出生后一小时内开始母乳喂养的儿童，婴儿死亡率降低了约 20%（HR 0.80；95%CI 0.67，0.96），每增加一个月母乳喂养，婴儿死亡率降低了 21%（HR 0.79；95%CI 0.77，0.80）。此外，婴儿死亡率最高的国家包括塞拉利昂（每 1000 例活产 92 例死亡）、乍得（每 1000 例活产 72 例死亡）、尼日利亚（每 1000 例活产 69 例死亡）、科特迪瓦（每 1000 例活产 68 例死亡）、几内亚（每 1000 例活产 67 例死亡）、布基纳法索（每 1000 例活产 65 例死亡）和莫桑比克（每 1000 例活产 64 例死亡）。
结论
本研究的结果强调需要考虑早期开始母乳喂养和延长母乳喂养，以改善儿童的生存。应努力改善最佳母乳喂养做法，因为只有大约一半的儿童在汇总样本中具有最佳的母乳喂养做法。
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