Abstract：
Pakistan has extremely poor breastfeeding indicators: fewer than half of infants under 6 months are exclusively breastfed, only 20% of infants are breastfed within the first hour of life, and nearly half are never fed colostrum. The country\'s high infant morbidity and mortality is in part due to this suboptimal infant feeding. A network of lady health workers (LHWs) employed by the government facilitate maternal and child health programs, including breastfeeding support in their communities. This study describes LHWs\' perspectives and experiences regarding breastfeeding. We conducted semi-structured interviews with 14 LHWs and used thematic qualitative analysis to code and analyze the data. Our research revealed that LHWs use their role as members of the community and involve influential members of the family to build trust. Frequent home visits beginning prenatally help them address misconceptions about infant feeding. While they have strong knowledge about the benefits of breastfeeding and the importance of colostrum, they demonstrate gaps in their knowledge regarding breast conditions, the safe preparation of human milk substitutes, the physiology of milk production, and supporting mothers who are separated from their baby. Future training should address these areas where LHWs lack knowledge to help mothers facilitate early and exclusive breastfeeding. With adequate training, LHWs are uniquely positioned to use their role as trusted members of the community to effectively counsel families on the importance of breastfeeding and support the clinical needs of women during the perinatal time.
摘要：
巴基斯坦的母乳喂养指标极差：只有不到一半的6个月以下婴儿是纯母乳喂养，只有20%的婴儿在出生后的第一个小时内接受母乳喂养，近一半的人从不吃初乳。该国的高婴儿发病率和死亡率部分是由于这种不理想的婴儿喂养。政府雇用的女性卫生工作者（LHW）网络促进了母婴健康计划，包括社区的母乳喂养支持。这项研究描述了LHWs关于母乳喂养的观点和经验。我们对14名LHW进行了半结构化访谈，并使用主题定性分析对数据进行编码和分析。我们的研究表明，LHW利用他们作为社区成员的角色，并让有影响力的家庭成员建立信任。产前开始的频繁家访帮助他们解决关于婴儿喂养的误解。虽然他们对母乳喂养的好处和初乳的重要性有很强的了解，他们展示了他们对乳房状况的知识差距，母乳替代品的安全制备，牛奶生产的生理学，并支持与婴儿分离的母亲。未来的培训应针对这些LHW缺乏知识的领域，以帮助母亲促进早期和纯母乳喂养。经过充分的培训，LHW具有独特的地位，可以利用其作为社区可信赖成员的角色，有效地指导家庭母乳喂养的重要性，并在围产期支持妇女的临床需求。
