母乳喂养困难、离乳原因及影响因素的系统综述
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摘要
目的对母乳喂养困难、离乳原因、影响因素进行系统综述,以总结母乳喂养困难、提前离乳的原因。方法计算机检索护理学及医疗相关文献累计索引(CINAHL)、PubMed、Embase、维普、中国生物医学文献数据库,收集母乳喂养困难、离乳原因、影响因素的相关研究,根据纳入和排除标准筛选文献、提取资料及质量评价,并对文献进行定性分析。结果共纳入35篇文献,分析纳入研究结果显示,母亲在母乳喂养过程中尤其是产后最初的几周会遇到很多困难,导致母亲停止(纯)母乳喂养的原因多种多样,影响母乳喂养的可能因素很多,但有些因素仍存在争议。结论现有研究结果对母乳喂养行为的改变机制阐述仍不明确,还需进一步探索。
Objective To conduct a system review on published literatures related to breastfeeding difficulties,reasons of weaning and factors affecting breastfeeding practices. Methods Databases of CINAHL,PubMed,Embase,Wip and CBM were searched. Relevant studies were enrolled according to definite inclusion and exclusion criteria and were analyzed to summarize interventions supporting breastfeeding. Results Totally 35 studies were included. Most of breastfeeding mothers have experienced a lot of breastfeeding difficulties,especially in the first few weeks after giving birth. Various reasons are reported for stopping(exclusive) breastfeeding. There are many influencing factors for breastfeeding,but remains controversial. Conclusion The mechanism underlying breastfeeding behavior change is not clear,and further study is clearly warranted.
Objective To conduct a system review on published literatures related to breastfeeding difficulties,reasons of weaning and factors affecting breastfeeding practices. Methods Databases of CINAHL,PubMed,Embase,Wip and CBM were searched. Relevant studies were enrolled according to definite inclusion and exclusion criteria and were analyzed to summarize interventions supporting breastfeeding. Results Totally 35 studies were included. Most of breastfeeding mothers have experienced a lot of breastfeeding difficulties,especially in the first few weeks after giving birth. Various reasons are reported for stopping(exclusive) breastfeeding. There are many influencing factors for breastfeeding,but remains controversial. Conclusion The mechanism underlying breastfeeding behavior change is not clear,and further study is clearly warranted.
引文
[1] World Health Organization.Health topics:breastfeeding[R/OL].Geneva:WHO, 2012[2018-12-22].https://www.who.int/topics/breastfeeding/en/.
[2] United Nations Children′s Fund.Global UNICEF global databases:Infant and young child feeding[EB/OL].new York:UNICEF, 2018[2018-10-12].https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding/#
[3] 国家卫生计生委疾病预防控制局.中国居民营养与慢性病状况报告(2015年)[M].北京:人民卫生出版社,2016.
[4] Joanna Briggs Institute.JBI critical appraisal checklist for cohort studies[EB/OL].2017[2018-8-26].http://joannabriggs.org/research/critical-appraisal-tools.html.
[5] Joanna Briggs Institute.JBI critical appraisal checklist for studies reporting prevalence data[EB/OL].2017[2018-8-26].http://joannabriggs.org/research/critical-appraisal-tools.html.
[6] Joanna Briggs Institute.JBI critical appraisal checklist for analytical cross sectional studies[EB/OL].2017[2018-8-26].http://joannabriggs.org/research/critical-appraisal-tools.html.
[7] Hall H, McLelland G, Gilmour C, et al.‘It's those first few weeks’:Women's views about breastfeeding support in an Australian outer metropolitan region[J].Women Birth, 2014,27(4):259-265.
[8] 吴缃琦, 孙晓勉, 何珊茹.6个月内婴儿纯母乳喂养现状及影响因素分析[J].中国儿童保健杂志, 2017,25(1):90-93.
[9] de Jager E, Broadbent J, Fuller-Tyszkiewicz M, et al.A longitudinal study of the effect of psychosocial factors on exclusive breastfeeding duration[J].Midwifery, 2015,31(1):103-111.
[10] Ouyang Y, Su M, Redding SR.A survey on difficulties and desires of breast-feeding women in Wuhan, China[J].Midwifery, 2016,37(6):19-24.
[11] Demirci JR, Bogen DL.An ecological momentary assessment of primiparous women′s breastfeeding behavior and problems from birth to 8 weeks[J].J Hum Lact, 2017,33(2):285-295.
[12] Nnebe-Agumadu UH, Racine EF, Laditka SB, et al.Associations between perceived value of exclusive breastfeeding among pregnant women in the United States and exclusive breastfeeding to three and six months postpartum:a prospective study[J].Int Breastfeed J, 2016,11(4):8.
[13] Dunn RL, Kalich KA, Fedrizzi R, et al.Barriers and contributors to breastfeeding in WIC mothers:A social ecological perspective[J].Breastfeed Med, 2015,10(10):493-501.
[14] Wang W, Lau Y, Chow A, et al.Breast-feeding intention, initiation and duration among Hong Kong Chinese women:A prospective longitudinal study[J].Midwifery, 2014,30(6):678-687.
[15] Colombo L, Crippa B, Consonni D, et al.Breastfeeding determinants in healthy term newborns[J].Nutrients, 2018,10(1):48.
[16] Robert E, Coppieters Y, Swennen B, et al.Breastfeeding duration:A survival analysis-data from a regional immunization survey[J].Biomed Res Int, 2014,2014:e529790.
[17] Miller AS, Miller JE, Taylor AM.Demographic profile of 266 mother-infant dyads presenting to a multidisciplinary breastfeeding clinic:a descriptive study[J].J Clin Chiro Pediatr, 2017,16(1):1344-1349.
[18] El Shafei AMH, Labib JR.Determinants of exclusive breastfeeding and introduction of complementary foods in rural Egyptian communities[J].Glob J Health Sci, 2014,6(4):236.
[19] Machado MC, Assis KF, Oliveira FC, et al.Determinants of the exclusive breastfeeding abandonment:psychosocial factors[J].Rev Saude Publica, 2014,48(6):985-994.
[20] Feenstra MM, J?rgine Kirkeby M, Thygesen M, et al.Early breastfeeding problems:A mixed method study of mothers’ experiences[J].Sex Reprod Healthc, 2018,16:167-174.
[21] Waits A, Guo C, Chien L.Evaluation of factors contributing to the decline in exclusive breastfeeding at 6 months postpartum:The 2011-2016 National Surveys in Taiwan[J].Birth, 2018,45(2):184-192.
[22] Maonga AR, Mahande MJ, Damian DJ, et al.Factors affecting exclusive breastfeeding among women in muheza district tanga northeastern tanzania:A mixed method community based study[J].Matern Child Health J, 2016,20(1):77-87.
[23] Saffari M, Pakpour AH, Chen H.Factors influencing exclusive breastfeeding among Iranian mothers:A longitudinal population-based study[J].Health Promot Perspect, 2017,7(1):34-41.
[24] Balogun OO, Kobayashi S, Anigo KM, et al.Factors influencing exclusive breastfeeding in early infancy:a prospective study in north central Nigeria[J].Matern Child Health J, 2016,20(2):363-375.
[25] Ratnasari D, Paramashanti BA, Hadi H, et al.Family support and exclusive breastfeeding among Yogyakarta mothers in employment[J].Asia Pac J Clin Nutr, 2017,26(Suppl 1):31-35.
[26] Porta F, Mussa A, Baldassarre G, et al.Genealogy of breastfeeding[J].Eur J Pediatr, 2016,175(1):105-112.
[27] Glassman ME, McKearney K, Saslaw M, et al.Impact of breastfeeding self-efficacy and sociocultural factors on early breastfeeding in an Urban, Predominantly Dominican Community[J].Breastfeed Med, 2014,9(6):301-307.
[28] Onah S, Osuorah DIC, Ebenebe J, et al.Infant feeding practices and maternal socio-demographic factors that influence practice of exclusive breastfeeding among mothers in Nnewi South-East Nigeria:a cross-sectional and analytical study[J].Int Breastfeed J, 2014,9(1):6.
[29] Brown S, Stuart-Butler D, Leane C, et al.Initiation and duration of breastfeeding of Aboriginal infants in South Australia[J].Women Birth, 2018, https://doi.org/10.1016/j.wombi.2018.07.009.
[30] Donnan PT, Dalzell J, Symon A, et al.Prediction of initiation and cessation of breastfeeding from late pregnancy to 16 weeks:the Feeding Your Baby(FYB) cohort study[J].BMJ Open, 2013,3(8):e3274.
[31] Dashti M, Scott J, Edwards C, et al.Predictors of breastfeeding duration among women in Kuwait:results of a prospective cohort study[J].Nutrients, 2014,6(2):711-728.
[32] O Connor M, Allen J, Kelly J, et al.Predictors of breastfeeding exclusivity and duration in a hospital without Baby Friendly Hospital Initiative accreditation:A prospective cohort study[J].Women Birth, 2018,31(4):319-324.
[33] Jessri M, Farmer AP, Maximova K, et al.Predictors of exclusive breastfeeding:observations from the Alberta pregnancy outcomes and nutrition(APrON) study[J].BMC Pediatr, 2013,13(1):77.
[34] Sonko A, Worku A.Prevalence and predictors of exclusive breastfeeding for the first six months of life among women in Halaba special woreda, Southern Nations, Nationalities and Peoples’ Region/SNNPR/, Ethiopia:a community based cross-sectional study[J].Arch Public Health, 2015,73(1):53-63.
[35] Buttham S, Kongwattanakul K, Jaturat N, et al.Rate and factors affecting non-exclusive breastfeeding among Thai women under the breastfeeding promotion program[J].Int J Womens Health, 2017, 9(26):689-694.
[36] Bai DL, Fong DYT, Lok KYW, et al.Relationship between the infant feeding preferences of Chinese mothers’ immediate social network and early breastfeeding cessation[J].J Hum Lact, 2016,32(2):301-308.
[37] Laugen CM, Islam N, Janssen PA.Social support and exclusive breast feeding among Canadian women[J].Paediatr Perinat Epidemiol, 2016,30(5):430-438.
[38] Ramakrishnan R, Oberg CN, Kirby RS.The association between maternal perception of obstetric and pediatric care providers′ attitudes and exclusive breastfeeding outcomes[J].J Hum Lact, 2014,30(1):80-87.
[39] de Jager E, Broadbent J, Fuller-Tyszkiewicz M, et al.The role of psychosocial factors in exclusive breastfeeding to six months postpartum[J].Midwifery, 2014,30(6):657-666.
[40] Zhang Z, Zhu Y, Zhang L, et al.What factors influence exclusive breastfeeding based on the theory of planned behaviour[J].Midwifery, 2018,62(6):177-182.
[41] Biro MA, Yelland JS, Brown SJ.Why are young women less likely to breastfeed? evidence from an australian population-based survey[J].Birth, 2014,41(3):245-253.
[2] United Nations Children′s Fund.Global UNICEF global databases:Infant and young child feeding[EB/OL].new York:UNICEF, 2018[2018-10-12].https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding/#
[3] 国家卫生计生委疾病预防控制局.中国居民营养与慢性病状况报告(2015年)[M].北京:人民卫生出版社,2016.
[4] Joanna Briggs Institute.JBI critical appraisal checklist for cohort studies[EB/OL].2017[2018-8-26].http://joannabriggs.org/research/critical-appraisal-tools.html.
[5] Joanna Briggs Institute.JBI critical appraisal checklist for studies reporting prevalence data[EB/OL].2017[2018-8-26].http://joannabriggs.org/research/critical-appraisal-tools.html.
[6] Joanna Briggs Institute.JBI critical appraisal checklist for analytical cross sectional studies[EB/OL].2017[2018-8-26].http://joannabriggs.org/research/critical-appraisal-tools.html.
[7] Hall H, McLelland G, Gilmour C, et al.‘It's those first few weeks’:Women's views about breastfeeding support in an Australian outer metropolitan region[J].Women Birth, 2014,27(4):259-265.
[8] 吴缃琦, 孙晓勉, 何珊茹.6个月内婴儿纯母乳喂养现状及影响因素分析[J].中国儿童保健杂志, 2017,25(1):90-93.
[9] de Jager E, Broadbent J, Fuller-Tyszkiewicz M, et al.A longitudinal study of the effect of psychosocial factors on exclusive breastfeeding duration[J].Midwifery, 2015,31(1):103-111.
[10] Ouyang Y, Su M, Redding SR.A survey on difficulties and desires of breast-feeding women in Wuhan, China[J].Midwifery, 2016,37(6):19-24.
[11] Demirci JR, Bogen DL.An ecological momentary assessment of primiparous women′s breastfeeding behavior and problems from birth to 8 weeks[J].J Hum Lact, 2017,33(2):285-295.
[12] Nnebe-Agumadu UH, Racine EF, Laditka SB, et al.Associations between perceived value of exclusive breastfeeding among pregnant women in the United States and exclusive breastfeeding to three and six months postpartum:a prospective study[J].Int Breastfeed J, 2016,11(4):8.
[13] Dunn RL, Kalich KA, Fedrizzi R, et al.Barriers and contributors to breastfeeding in WIC mothers:A social ecological perspective[J].Breastfeed Med, 2015,10(10):493-501.
[14] Wang W, Lau Y, Chow A, et al.Breast-feeding intention, initiation and duration among Hong Kong Chinese women:A prospective longitudinal study[J].Midwifery, 2014,30(6):678-687.
[15] Colombo L, Crippa B, Consonni D, et al.Breastfeeding determinants in healthy term newborns[J].Nutrients, 2018,10(1):48.
[16] Robert E, Coppieters Y, Swennen B, et al.Breastfeeding duration:A survival analysis-data from a regional immunization survey[J].Biomed Res Int, 2014,2014:e529790.
[17] Miller AS, Miller JE, Taylor AM.Demographic profile of 266 mother-infant dyads presenting to a multidisciplinary breastfeeding clinic:a descriptive study[J].J Clin Chiro Pediatr, 2017,16(1):1344-1349.
[18] El Shafei AMH, Labib JR.Determinants of exclusive breastfeeding and introduction of complementary foods in rural Egyptian communities[J].Glob J Health Sci, 2014,6(4):236.
[19] Machado MC, Assis KF, Oliveira FC, et al.Determinants of the exclusive breastfeeding abandonment:psychosocial factors[J].Rev Saude Publica, 2014,48(6):985-994.
[20] Feenstra MM, J?rgine Kirkeby M, Thygesen M, et al.Early breastfeeding problems:A mixed method study of mothers’ experiences[J].Sex Reprod Healthc, 2018,16:167-174.
[21] Waits A, Guo C, Chien L.Evaluation of factors contributing to the decline in exclusive breastfeeding at 6 months postpartum:The 2011-2016 National Surveys in Taiwan[J].Birth, 2018,45(2):184-192.
[22] Maonga AR, Mahande MJ, Damian DJ, et al.Factors affecting exclusive breastfeeding among women in muheza district tanga northeastern tanzania:A mixed method community based study[J].Matern Child Health J, 2016,20(1):77-87.
[23] Saffari M, Pakpour AH, Chen H.Factors influencing exclusive breastfeeding among Iranian mothers:A longitudinal population-based study[J].Health Promot Perspect, 2017,7(1):34-41.
[24] Balogun OO, Kobayashi S, Anigo KM, et al.Factors influencing exclusive breastfeeding in early infancy:a prospective study in north central Nigeria[J].Matern Child Health J, 2016,20(2):363-375.
[25] Ratnasari D, Paramashanti BA, Hadi H, et al.Family support and exclusive breastfeeding among Yogyakarta mothers in employment[J].Asia Pac J Clin Nutr, 2017,26(Suppl 1):31-35.
[26] Porta F, Mussa A, Baldassarre G, et al.Genealogy of breastfeeding[J].Eur J Pediatr, 2016,175(1):105-112.
[27] Glassman ME, McKearney K, Saslaw M, et al.Impact of breastfeeding self-efficacy and sociocultural factors on early breastfeeding in an Urban, Predominantly Dominican Community[J].Breastfeed Med, 2014,9(6):301-307.
[28] Onah S, Osuorah DIC, Ebenebe J, et al.Infant feeding practices and maternal socio-demographic factors that influence practice of exclusive breastfeeding among mothers in Nnewi South-East Nigeria:a cross-sectional and analytical study[J].Int Breastfeed J, 2014,9(1):6.
[29] Brown S, Stuart-Butler D, Leane C, et al.Initiation and duration of breastfeeding of Aboriginal infants in South Australia[J].Women Birth, 2018, https://doi.org/10.1016/j.wombi.2018.07.009.
[30] Donnan PT, Dalzell J, Symon A, et al.Prediction of initiation and cessation of breastfeeding from late pregnancy to 16 weeks:the Feeding Your Baby(FYB) cohort study[J].BMJ Open, 2013,3(8):e3274.
[31] Dashti M, Scott J, Edwards C, et al.Predictors of breastfeeding duration among women in Kuwait:results of a prospective cohort study[J].Nutrients, 2014,6(2):711-728.
[32] O Connor M, Allen J, Kelly J, et al.Predictors of breastfeeding exclusivity and duration in a hospital without Baby Friendly Hospital Initiative accreditation:A prospective cohort study[J].Women Birth, 2018,31(4):319-324.
[33] Jessri M, Farmer AP, Maximova K, et al.Predictors of exclusive breastfeeding:observations from the Alberta pregnancy outcomes and nutrition(APrON) study[J].BMC Pediatr, 2013,13(1):77.
[34] Sonko A, Worku A.Prevalence and predictors of exclusive breastfeeding for the first six months of life among women in Halaba special woreda, Southern Nations, Nationalities and Peoples’ Region/SNNPR/, Ethiopia:a community based cross-sectional study[J].Arch Public Health, 2015,73(1):53-63.
[35] Buttham S, Kongwattanakul K, Jaturat N, et al.Rate and factors affecting non-exclusive breastfeeding among Thai women under the breastfeeding promotion program[J].Int J Womens Health, 2017, 9(26):689-694.
[36] Bai DL, Fong DYT, Lok KYW, et al.Relationship between the infant feeding preferences of Chinese mothers’ immediate social network and early breastfeeding cessation[J].J Hum Lact, 2016,32(2):301-308.
[37] Laugen CM, Islam N, Janssen PA.Social support and exclusive breast feeding among Canadian women[J].Paediatr Perinat Epidemiol, 2016,30(5):430-438.
[38] Ramakrishnan R, Oberg CN, Kirby RS.The association between maternal perception of obstetric and pediatric care providers′ attitudes and exclusive breastfeeding outcomes[J].J Hum Lact, 2014,30(1):80-87.
[39] de Jager E, Broadbent J, Fuller-Tyszkiewicz M, et al.The role of psychosocial factors in exclusive breastfeeding to six months postpartum[J].Midwifery, 2014,30(6):657-666.
[40] Zhang Z, Zhu Y, Zhang L, et al.What factors influence exclusive breastfeeding based on the theory of planned behaviour[J].Midwifery, 2018,62(6):177-182.
[41] Biro MA, Yelland JS, Brown SJ.Why are young women less likely to breastfeed? evidence from an australian population-based survey[J].Birth, 2014,41(3):245-253.