Breastfeeding practices in the United Kingdom: Is the neighbourhood context important?
Breastfeeding practices in the United Kingdom: Is the neighbourhood context important?
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DOI：
10.1111/mcn.12626
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发表时间：
2018-10-01
影响因子：
3.4
通讯作者：
Jivraj, Stephen
中科院分区：
文献类型：
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作者：
Peregrino, Andressa B.;Watt, Richard G.;Jivraj, Stephen
母乳喂养是世界范围内一个重要的公共卫生问题。英国的母乳喂养率，特别是纯母乳喂养率，与其他经合组织国家相比很低，尽管它对母亲和孩子都有广泛的健康益处。有证据表明，社区结构和社会组织的匮乏与儿童的不良后果有关。本研究旨在探讨在具有全国代表性的英国样本中，开始母乳喂养、纯母乳喂养至少3个月，以及任何类型的母乳喂养至少6个月是否与邻里关系的剥夺和母亲的邻里观念相关联。使用千年队列研究的数据进行了横断面分析。对17,308名受访者进行了Logistic回归，并对个人和家庭层面的社会人口特征进行了调整。邻里关系的剥夺与母乳喂养的开始是独立的，并且是负相关的。与最贫困地区相比，最贫困地区开始母乳喂养的可能性低40%(OR：0.60，95%CI[0.50，0.72])。在对潜在混杂因素进行调整后，分别在3个月和6个月时纯母乳喂养和任何类型的母乳喂养与邻里剥夺之间的关系不完全是线性的。母乳喂养开始时间(OR：0.78，95%CI[0.71，0.85])、母乳喂养3个月(OR：0.84，95%CI[0.75，0.95])、母乳喂养6个月(OR：0.82，95%CI[0.73，0.93])分别减少了约20%。提高母乳喂养率的政策应考虑以区域为基础的办法和社会不平等的更广泛的决定因素。
Breastfeeding is an important public health issue worldwide. Breastfeeding rates in the United Kingdom, particularly for exclusive breastfeeding, are low compared with other OECD countries, despite its wide-ranging health benefits for both mother and child. There is evidence that deprivation in the structural and social organisation of neighbourhoods is associated with adverse child outcomes. This study aimed to explore whether breastfeeding initiation, exclusive breastfeeding for at least 3 months, and any type of breastfeeding for at least 6 months were associated with neighbourhood context measured by neighbourhood deprivation and maternal neighbourhood perceptions in a nationally representative U.K. sample. A cross-sectional analysis was conducted using data from the Millennium Cohort Study. Logistic regression was carried out on a sample of 17,308 respondents, adjusting for individual- and familial-level socio-demographic characteristics. Neighbourhood deprivation was independently and inversely associated with breastfeeding initiation. Compared with the least deprived areas, the likelihood of initiating breastfeeding was 40% lower in the most deprived neighbourhoods (OR: 0.60, 95% CI [0.50, 0.72]). The relationship between both exclusive and any type of breastfeeding at 3 and 6 months respectively with neighbourhood deprivation after adjustment for potential confounders was not entirely linear. Breastfeeding initiation (OR: 0.78, 95% CI [0.71, 0.85]), exclusivity for 3 months (OR: 0.84, 95% CI [0.75, 0.95]), and any breastfeeding for 6 months (OR: 0.82, 95% CI [0.73, 0.93]) were each reduced by about 20% among mothers who perceived their neighbourhoods lacking safe play areas for children. Policies to improve breastfeeding rates should consider area-based approaches and the broader determinants of social inequalities.