ABSTRACT
Introducción: Los beneficios de la lactancia materna (LM) son bien conocidos. En estudios previos se constata que aproximadamente un 20% de las madres deciden no iniciarla. Existe un escaso conocimiento de los factores que predicen tal decisión y los motivos maternos para ello. En este estudio analizamos la prevalencia de inicio de la LM, los factores asociados y las razones maternas al respecto. Método: Estudio de prevalencia de inicio de la LM de gestaciones ≥ 36 semanas. Recogida de variables mediante encuestas presenciales en las primeras 24 horas posparto. Estudio multivariante de los factores asociados al inicio de la LM. Resultados: Se estudió un total de 452 pares, madre-recién nacido. El 81% inició la LM. Los factores favorecedores fueron la opinión favorable de la pareja (odds ratio [OR]= 28,49; intervalo de confianza [IC] del 95%: 5,34-151,95), la opinión neutral de la abuela materna (OR= 4,79; IC del 95%: 0,99-23,76), haber dado LM al hijo previo (OR= 22,63; IC del 95%: 5,68-90,07) y residir en la misma provincia donde está ubicado el hospital (OR= 47,34; IC del 95%: 16,09-139,31). Los factores desfavorecedores fueron: el hábito tabáquico de la madre (OR= 0,37; IC del 95%: 0,15-0,92), haber tenido abortos previos (OR= 0,35; IC del 95%: 0,20-0,60) y precisar tratamiento farmacológico al iniciar la lactancia (OR= 0,25; IC del 95%: 0,08-0,74). Conclusiones: Aportamos ciertos factores conocidos y otros novedosos asociados al inicio de la LM y los motivos de la madre para la toma de su decisión. Los tratamientos farmacológicos maternos son un factor asociado para no iniciar la LM, corregible con un asesoramiento adecuado. Urge adoptar medidas correctoras para conseguir tasas de inicio de la LM cercanas al 100%. Es necesaria la unificación de criterios respecto a lo que se considera «inicio de la LM» para comparar resultados de futuras investigaciones (AU)
Introduction: Breastfeeding benefits have been clearly demonstrated, but nearly 20% of mothers dont start breastfeeding. Related factors to this decision and maternal reasons have been poorly investigated. We asses initiation breastfeeding rate, maternal reasons and the factors linked to their decision. Method: This is a prevalence study of initiation breastfeeding rate in a sample of mothers who delivered after 36 weeks of gestation. Six trained investigators collected variables by structured questionnaires, asking the mothers in the hospital within the first 24 hours after delivery. Bivariate and multivariate analysis of the data were performed. Results: Eighty one percent of the mothers started breastfeeding. Positive associated factors were: a good opinion of mothers partner about breastfeeding (OR= 28.49; CI 95%: 5.34-151.95), neutral opinion of grandmother about breastfeeding (OR= 4.79; CI 95%: 0.99-23.76), positive breastfeeding experience with previous sibling (OR= 22.63; CI 95%: 5.68-90.07) and coming from the same province where the hospital is located (OR= 47.34; CI 95%: 16.09- 139.31). Negative related factors were: maternal smoking habit (OR= 0.37; CI 95%: 0.15-0.92), previous abortions (OR= 0.35; CI 95%: 0.20-0.60) and maternal pharmacological treatment at the beginning of breastfeeding (OR= 0.25; CI 95%: 0.08-0.74). Conclusions: We have described not only known but other new factors associated with the breastfeeding initiation, and maternal reasons for making their decisions. Pharmacological treatment is one of the factors clearly implicated in the beginning of formula-feeding, and this decision is avoidable with a correct counselling. Increasing breastfeeding initiation rates is strongly recommended with new public health interventions. Common criteria of what consider as a breastfeeding initiation are required for future research (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Adult , Breast Feeding/trends , Bottle Feeding/statistics & numerical data , Health Knowledge, Attitudes, Practice , Milk, Human/metabolism , Pregnancy, Twin/statistics & numerical data , Nutrition Surveys , Data Collection , Logistic Models , Odds Ratio , Multivariate Analysis , Risk Assessment/statistics & numerical dataABSTRACT
INTRODUCCIÓN: La lactancia materna (LM) tiene indudables beneficios para el recién nacido. En estudios previos se constata un abandono precoz de la misma, existiendo escasa evidencia sobre los factores asociados. Nuestro objetivo ha sido conocer la prevalencia de LM durante los primeros 12 meses posparto y analizar los factores asociados a su abandono. MATERIAL Y MÉTODOS: Estudio prospectivo, con inclusión consecutiva de pares (madre y recién nacido) hasta muestra requerida. Recogida de variables mediante encuestas maternas según el programa de seguimiento. Análisis estadístico bivariado y multivariado. RESULTADOS: Se seleccionaron 452 pares en los que se constató el inicio de la LM en el 81% de los casos, persistiendo a los 3 y 6 meses el 39 y 21% total, respectivamente. Los factores asociados al abandono precoz fueron: gestación tras técnicas de reproducción asistida (OR = 5,58; IC 95%: 2,62-11,91), hábito tabáquico materno (OR = 1,56; IC 95%: 1,10-2,22), expectativas pobres sobre la duración de la lactancia (OR = 2,19; IC 95%: 1,49-3,23), utilización de pezoneras (OR = 2,57; IC 95%: 1,69-3,90), uso rutinario del chupete durante el primer mes posparto (OR = 1,39; IC 95%: 1,02-1,91), madre con estudios universitarios (OR = 0,59; IC 95%: 0,40-0,88), asistencia a clases prenatales (OR = 0,68; IC 95%: 0,49-0,94), y sensación materna de leche suficiente al alta (OR = 0,66; IC 95%: 0,47-0,92). CONCLUSIONES: Las tasas de abandono de la LM en nuestro medio son elevadas, sin alcanzarse los objetivos de las recomendaciones internacionales al respecto. Se describen factores implicados ya conocidos y otros novedosos. Se recomiendan estrategias de intervención encaminadas a prolongar la LM
INTRODUCTION: Breastfeeding has undoubtedly great benefits. Previous studies have found anearly dropout. Only a few studies have investigated related factors. Our aim was to find outon-going breastfeeding rates along the first 12 months after birth and analyse factors associated with early weaning. MATERIAL AND METHODS: This is a prospective study including consecutive pairs (mother and newborn) till completion of the required sample. Variables were collected performing a structured program of surveys to the mothers. Bivariate and multivariate analysis of the data was performed. RESULTS: A total of 452 pairs were recruited. It was found that 81% of them started breastfeeding, with a prevalence of breastfeeding of 39% and 21% at 3 and 6 months after birth, respectively. Factors associated with early discontinuation of breastfeeding were: pregnancy induced by assisted reproduction methods (OR = 5.58; 95% CI: 2.62-11.91), maternal smoking(OR = 1.56; 95% CI: 1.10-2.22), poor maternal expectations about the duration of breastfeeding(OR = 2.19; 95% CI: 1.49-3.23), use of nipple shields for breastfeeding (OR = 2.57; 95% CI:1.69-3.90), pacifier use on a regular basis during the first month after delivery (OR = 1.39; 95%CI: 1.02-1.91), maternal university educational level (OR = 0,59; 95% CI: 0,40-0,88), attending birth preparation programs during pregnancy (OR = 0,68; 95% CI: 0,49-0,94), and believing having enough milk output at the time of discharge (OR = 0,66; 95% CI: 0,47-0,92). CONCLUSIONS: International recommendations about duration of breastfeeding are not achieved in our country because of high rates of early weaning. We describe the known factors involved and other novel factors. The implementation of interventions to increase breastfeeding rates and to prevent early weaning are strongly recommended
