| ObjectiveThe purpose of this study is to compare the breastfeeding conditions and implementations of maternal and infant health care services between primiparae and multiparae,as well as those differences between two parities of multiparae,analyze influencing factors on breastfeeding,and explore the optimal methods to promote breastfeeding and maternal and infant health care services under the two-child policy in China.Methods1.Sample:Using multistage stratified randomly selection method,1046 mothers were selected from Hangzhou and Shanghai which are located in eastern China,465 and 581 respectively from these two cities.Among them,there were 811 primiparae and 235 multipare.2.Contents:This study analyzed differences on breastfeeding implementation,as well as maternal and infant health care services between primiparae and multipare,plus those differences between two parities of multipare,including pregnancy assessment conditions,feeding patterns within 6 months,exclusive breastfeeding duration and breastfeeding duration,weaning reasons,whether having experienced breastfeeding difficulties and the most effective help,pregnancy schools participation and postpartum visit conditions.3.Statistical analysis:By using SPSS 20.0,methods were used including general descriptive statistics,Pearson χ2 test,Kruskal-Wallis test;McNemar’s test,Bowker’s test,plus Somers’d analysis,Contingency Coefficient analysis or Pearson correlation analysis for paired samples.Paired sample t-test was used for homologous pairing samples,while two independent sample t-test was used for independent samples;Kaplan-Meier univariate survival analysis and Cox multivariate regression analysis were also included to analyze influence factors.ResultsThe comparison of multiparae and primiparae:1.Cesarean section rate,the portion of stay-at-home mother after delivery in two years was higher among multiparae,and the rate of gaining help from grandparentswere was higher among primiparae significantly.There was no significant difference in getting help from maternity matron or galactagogue division between primiparae and multiparae.2.The initial breastfeeding rate was higher among multiparae than that of primiparae significantly.There existed significant difference on feeding patterns during 0-6 months between primiparae and multipare,with similar EBF rate but higher AEBF rate of multiparae.There was no significant difference onexclusive breastfeeding duration,while there was significant difference onbreastfeeding duration between primiparae and multipare.3.Weaning reasons were different significantly between multiparae and primiparae.’Lack of breast milk by self-perception’’Work limits’and ’No comprehensive and sufficientnutrition of breast milkas child grows up’were the top 3 weaning reasons.4.The rate of experiencing breastfeeding difficulties was significantly higher of primiparae than multiparae.’Lack of breast-milk by self-perception’’Lactiferous duct plugging’ and ’Milk regurgitation after stopping breastfeeding for some time due to specific reasons’ were the top 3 difficulties.’Searching for information by myself’ and’Feeding experience for 1st baby’ was the most effective help of primiparae and multiparae respectively.5.Participation of pregnancy school of primiparae was higher than that of multiparae significantly.There existed significant difference on postpartum visit times of primiparae and multiparae.The comparison of different parities of multiparae:6.There existed significant difference on reproductive assessment preference between different gestational age among multiparae,and there was correlation between reproductive assessment preference and the second gestational age.Cesarean section rate was higher for the second childbirth than the first one of multiparae.There was correlation between working status after deliveries in different fetal times,with no significant difference.7.The initial breastfeeding rate was lower for the second baby by multiparaesignificantly.There was the correlation of breastfeeding patterns in two parities of multiparae,with no difference by parity.Exclusive breastfeeding duration and breastfeeding duration were both higher than the first baby’s significantly,with correlation.8.There was no significant difference on weaning reasons between different parities of multiparae,with correlation.9.The rate of experiencing breastfeeding difficulties was significantly lower for the second parity than the first significantly,with correlation.10.There existed correlation between participation of pregnancy school in different two parities of multiparae,without significant difference.There existed correlation between times of postpartum visit in different two parities of multiparae,with significan11.There was significant different on scores of breastfeeding knowledge test between primiparae and multiparae.Influence factors of breastfeeding duration:12.Mothers with high education level,having association with grandparents when taking care of infant,having breastfeeding difficulties were hazards for breastfeeding duration,and participating pregnancy school was the protective factor for breastfeeding duration.Conclusion1.There existed significant differences on breastfeeding practices and maternal and infant health care services between primiparae and multiparae.2.There existed significant differences on breastfeeding practices and maternal and infant health care services between different parities of multiparae.3.There were some misunderstanding and dead zone on the concept and superiority ofbreastfeeding among a great number of mothers.4.More moms chose to solve breastfeeding problems on themselves by searching information,or seek help from relatives and friends with breastfeeding experiences,rather than doctors.5.Medical staff should pay more attention to those mothers who are with higher education level,breastfeeding difficulties,lower pregnancy school participation,and assistance of grandparents of babies.6.Further improvements are needed on reforming the form,contents and education objects of pregnancy schools on the basis of low participation of pregnancy schools.7.There existed a possibility that general practitioners could play a role in inverting the negative influence by grandparents. |
PDF Full Text Request