全面二孩政策下二孩纯母乳喂养现状及影响因素分析

Current status of exclusive breastfeeding for the second child and factors influencing exclusive breastfeeding in the context of the universal two-child policy

摘要:

目的 调查全面二孩政策下二孩纯母乳喂养现状，并分析影响二孩纯母乳喂养的因素。方法 采用自行设计的二孩母乳喂养现状及影响因素调查表，通过整群抽样法抽取浙江衢州836名二孩母亲进行问卷调查。结果 共收回有效问卷680份。二孩6月龄内的纯母乳喂养率低于一孩（34.9% vs 42.2%，P < 0.05）。单因素分析显示，二孩母亲的年龄、学历、职业、产假时间、一孩分娩方式、一孩性别、一孩喂养方式、二孩分娩方式、二孩是否重症监护、父亲是否支持母乳喂养、祖母是否支持母乳喂养、外祖母是否支持母乳喂养在纯母乳喂养组和非纯母乳喂养组之间的差异有统计学意义（P < 0.05）。多因素logistic回归分析显示，一孩喂养方式为人工喂养+部分母乳喂养（OR=12.286，P < 0.05）、二孩分娩方式为剖宫产（OR=1.724，P < 0.05）、外祖母不支持母乳喂养（OR=1.651，P < 0.05）是影响二孩纯母乳喂养的主要因素。结论 全面二孩政策下二孩的纯母乳喂养现状不容乐观，应重视一孩母乳喂养宣教，降低剖宫产率，同时强调家人支持和共同参与纯母乳喂养，以改善二孩纯母乳喂养状况。

Abstract:

Objective To investigate the current status of exclusive breastfeeding for the second child in the context of the universal two-child policy and the factors influencing exclusive breastfeeding. Methods A self-designed questionnaire for the current status of breastfeeding and related factors influencing breastfeeding for the second child were used to survey 836 mothers with a second child, who were selected by cluster sampling, in Quzhou, Zhejiang, China. Results A total of 680 usable questionnaires were obtained. The rate of exclusive breastfeeding for the second child was significantly lower than for the first child (34.9% vs 42.2%; P < 0.05). The univariate analysis revealed that there were significant differences between the exclusive and non-exclusive breastfeeding groups in the mother's age, education background, occupation and time of maternity leave, mode of delivery of the first child, sex of the first child, feeding pattern of the first child, mode of delivery of the second child, whether the second child was admitted to the intensive care unit, whether the father supported breastfeeding, and whether the grandmother/maternal grandmother supported breastfeeding (P < 0.05). The multivariate logistic regression analysis showed that artificial feeding+partial breastfeeding for the first child (OR=12.286, P < 0.05), cesarean section for the second child (OR=1.724, P < 0.05), and having no breastfeeding support from the maternal grandmother (OR=1.651, P < 0.05) were main factors for influencing exclusive breastfeeding. Conclusions The current status of exclusive breastfeeding for the second child is not optimistic in the context of the universal two-child policy. Education about breastfeeding should be taken seriously at the birth of the first child, the rate of cesarean section should be reduced, and the family members should support exclusive breastfeeding, in order to improve the status of exclusive breastfeeding.