Determinants of breastfeeding initiation and cessation among employed mothers: a prospective cohort study
Determinants of breastfeeding initiation and cessation among employed mothers: a prospective cohort study
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DOI：
10.1186/s12884-016-0965-1
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发表时间：
2016-07-29
影响因子：
3.1
通讯作者：
Randall, Xian J.
中科院分区：
文献类型：
--
作者：
Dagher, Rada K.;McGovern, Patricia M.;Randall, Xian J.
背景资料：美国仍然是工业化国家中母乳喂养率最低的国家之一。研究表明，全职工作和提前重返工作岗位减少了母乳喂养持续时间，但对休假政策与母乳喂养开始和停止之间的关系知之甚少。本研究旨在找出产后6个月内与母乳喂养开始和停止有关的工作场所相关障碍和促进者。方法：采用前瞻性队列研究设计，招募817名18岁及以上住院分娩的明尼苏达州妇女。选择标准包括会说英语、有工作、出生健康的独生子女母亲。这些妇女在分娩后6周、12周和6个月时进行了电话采访。主要的研究结果是在入院时测量的母乳喂养开始，以及产后6个月停止母乳喂养。结果：女性30岁，86%是白人，73%已婚。分娩时母乳喂养率为81%，6周时为67%，12周时为49%，产后6个月时为33%。Logistic回归分析显示，从事专业工作、初产妇、研究生学历、产前不吸烟、没有母乳喂养问题、有母乳喂养的家人或朋友的女性开始母乳喂养的几率较高。生存分析显示，产后6个月内任何时候重返工作岗位的产妇停止母乳喂养的危险性高于未重返工作岗位的产妇，专业工作者的危险性低于未重返工作岗位的产妇，单身妇女高于已婚妇女，所有教育类别的产妇均高于研究生，无亲友哺乳的产妇停止母乳喂养的危险性高于研究生。结论：虽然雇主带薪休假政策不影响母乳喂养的开始或停止，但产假较短的妇女在产后前6个月更有可能停止母乳喂养。未来的研究应该检查妇女对雇主关于带薪假和无薪假政策的认识。
Background: The U.S. continues to have one of the lowest breastfeeding rates in the industrialized world. Studies have shown that full-time employment and early return to work decreased breastfeeding duration, but little is known about the relationship between leave policies and breastfeeding initiation and cessation. This study aimed to identify workplace-related barriers and facilitators associated with breastfeeding initiation and cessation in the first 6 months postpartum.Methods: A prospective cohort study design was utilized to recruit 817 Minnesota women aged 18 and older while hospitalized for childbirth. Selection criteria included English-speaking, employed mothers with a healthy, singleton birth. These women were followed up using telephone interviews at 6 weeks, 12 weeks, and 6 months after childbirth. The main study outcomes were breastfeeding initiation, measured during hospital enrollment, and breastfeeding cessation by 6 months postpartum.Results: Women were 30 years old; 86 % were White, and 73 % were married. Breastfeeding rates were 81 % at childbirth, 67 % at 6 weeks, 49 % at 12 weeks, and 33 % at 6 months postpartum. Logistic regression revealed the odds of breastfeeding initiation were higher for women who: held professional jobs, were primiparae, had graduate degree, did not smoke prenatally, had no breastfeeding problems, and had family or friends who breastfeed. Survival analyses showed the hazard for breastfeeding cessation by 6 months was: higher for women who returned to work at any time during the 6 months postpartum versus those who did not return, lower for professional workers, higher among single than married women, higher for every educational category compared to graduate school, and higher for those with no family or friends who breastfeed.Conclusions: While employer paid leave policy did not affect breastfeeding initiation or cessation, women who took shorter leaves were more likely to stop breastfeeding in the first 6 months postpartum. Future research should examine women's awareness of employer policies regarding paid and unpaid leave.