背景:母乳对婴儿和母亲都有很大的好处。由于职业障碍,女医生有无意中停止母乳喂养的高风险.然而,麻醉医师的证据有限.这项研究的目的是调查与中国产假后女性麻醉医师停止母乳喂养时间相关的职业因素。
方法:我们对2015年1月1日以来分娩的女性麻醉师进行了一项全国性调查。制定了60项匿名问卷,以收集有关母乳喂养做法和相关因素的信息。根据15名专家的建议和试点调查的反馈意见,对问卷进行了修订。该调查由中国麻醉学学会分发。
结果:完成率为57.9%。总的来说,分析了来自中国大陆31个省的1364名响应者。总的来说,1311名(96.1%)响应者报告说,重返工作岗位后母乳供应减少。在停止母乳喂养的1161名响应者中,836(72.0%)由于职业因素未达到预期目标。产假长度和母乳喂养时间的中位数[四分位数范围]分别为5[4-6]个月和10[7-12]个月,分别。在调整了个人因素的混杂效应后,以下职业因素与更长的母乳喂养终止时间相关:产假时间(风险比[HR]每月0.44;95%置信区间[CI],0.36-0.54;P<.001),在工作时间抽母乳(HR,0.04;95%CI,0.02-0.08;P<.001),同事的支持(HR,0.92;95%CI,0.86-0.99;P=0.032),和额外的非临床活动(HR,0.87;95%CI,0.77-0.98;P=0.022)。受训人员在监督下(人力资源,1.20;95%CI,1.06-1.43;P=.005)和病例期间需要留在手术室(HR,2.59;95%CI,1.09-6.12;P=0.031)与母乳喂养终止时间较短相关。大约有899名(65.9%)的响应者在工作时间抽取母乳。其中,泵浦频率的降低(HR,1.17;95%CI,1.00-1.36;P=0.049)和难以寻找抽水机会(HR,2.34;95%CI,1.36-4.03;P=0.002)与母乳喂养终止时间较短相关。
结论:我们确定了与母乳喂养终止时间相关的可改变的职业因素。这些发现强调了在工作场所促进母乳喂养的必要性,包括鼓励延长产假和哺乳时间,考虑到在日常案例分配中抽水的可行性,建立支持性文化,提供哺乳室,并提供非临床活动。
BACKGROUND: Breast milk is of great benefit to both infants and mothers. Due to occupational barriers, female physicians are at high risk of unintentionally discontinuing breastfeeding. However, evidence among anesthesiologists was limited. The purpose of this study was to investigate occupational factors associated with time to breastfeeding discontinuation among female anesthesiologists following maternity leave in
China.
METHODS: We conducted a nationwide survey of female anesthesiologists who had given birth since January 1, 2015. A 60-item anonymous questionnaire was developed to collect information regarding breastfeeding practices and related factors. The questionnaire was revised based on the recommendations of 15 experts and feedback from the pilot survey. The survey was distributed by the Chinese Society of Anesthesiology.
RESULTS: The completion rate was 57.9%. In total, 1364 responders were analyzed from all 31 provinces of Mainland
China. In total, 1311 (96.1%) responders reported a reduction in breast milk supply on returning to work. Among the 1161 responders who discontinued breastfeeding, 836 (72.0%) did not achieve desired goals due to occupational factors. The median [interquartile range] of maternity leave length and breastfeeding duration were 5 [4-6] months and 10 [7-12] months, respectively. The following occupational factors were associated with longer time to breastfeeding discontinuation after adjusting for confounding effects of personal factors: length of maternity leave (hazard ratio [HR] per month 0.44; 95% confidence interval [CI], 0.36-0.54; P < .001), pumping breast milk during work time (HR, 0.04; 95% CI, 0.02-0.08; P < .001), support from colleagues (HR, 0.92; 95% CI, 0.86-0.99; P = .032), and additional nonclinical activities (HR, 0.87; 95% CI, 0.77-0.98; P = .022). Trainees under supervision (HR, 1.20; 95% CI, 1.06-1.43; P = .005) and the need to remain in the operating room during cases (HR, 2.59; 95% CI, 1.09-6.12; P = .031) were associated with shorter time to breastfeeding discontinuation. Approximately 899 (65.9%) responders pumped breast milk during work time. Among them, reduction in pumping frequency (HR, 1.17; 95% CI, 1.00-1.36; P = .049) and difficulty in finding opportunities for pumping (HR, 2.34; 95% CI, 1.36-4.03; P = .002) were associated with shorter time to breastfeeding discontinuation.
CONCLUSIONS: We identified modifiable occupational factors associated with time to breastfeeding discontinuation. These findings underscored the necessity of facilitating breastfeeding in the workplace, including encouraging longer maternity leave and breastfeeding breaks, considering the feasibility of pumping in daily case assignments, establishing supportive culture, providing lactation rooms, and offering nonclinical activities.