분만 후 시간대별 모유수유 여부에 영향을 미치는 요인 = Factors Affecting Breastfeeding Initiation: Analysis by Time Sequences after Delivery

다국어 초록 (Multilingual Abstract)

Objectives : The purpose of this study is to analyze the factors affecting breastfeeding initiation by time sequences after delivery.
Methods : We retrospectively reviewed medical records of the mothers and neonates in 22 hospitals with over 500 beds selected by proportional stratified random sampling according to location and bed size. We randomly sampled 60 cases per each delivery type (vaginal delivery and C-section) from each hospital, from the patients who had discharged between September 1st and November 30th, 2006. If there were no enough sample size in one hospital, we reviewed all cases during discharged 3 months period. A total of 1,506 medical records were selected but 281 were excluded because of breastfeeding contraindication (54 cases), refusal of breastfeeding(187 cases), and no breastfeeding initiation time record (40 cases). Total number of subjects included for analysis was 1,225. We reviewed breastfeeding initiation time after delivery and conducted Chi-square test and multiple logistic regression analysis. Seven variables (maternal age, delivery type, gestational age, birth weight, 5 minutes APGAR score, mother's hospital duration, and Baby-friendly Hospital Initiative) were used in multiple logistic regression analysis. Multiple logistic regression was carried out using SPSS WIN 12.0 program to identify the factors affecting initiation time of breast feeding.
Results : The proportion of mothers who breastfed within 30 minutes after delivery was 12.3% in vaginal delivery and 0% in C-section. Adjusted odds ratios associated with no breastfeeding within 120 minutes after delivery were 0.04(95% CI:0.01-0.19) for C-section with local anesthesia, 0.21 (95% CI: 0.09~0.48) for C-section with general anesthesia compared with vaginal delivery. Adjusted odds ratios associated with no breastfeeding within 180 minutes after delivery were 0.14 (95% CI: 0.06~ 0.31) for C-section with local anesthesia, 0.24 (95% CI: 0.12~0.48) for C-section with general anesthesia compared with vaginal delivery. Adjusted odds ratios associated with no breastfeeding within 24 hours after delivery were 0.19 (95% CI: 0.10~0.37) for C-section with local anesthesia, 0.05 (95% CI: 0.02~0.10) for C- section with general anesthesia compared with vaginal delivery.
Conclusion : The results of this study suggest that delivery type, anesthesia type, and Baby-friendly Hospital Initiative are significant factors affecting breastfeeding initiation time after delivery. Because early breastfeeding after delivery is associated with higher breastfeeding rate, policymakers should establish appropriate policies to promote breastfeeding initiation time after delivery.

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