■母乳喂养被认为是婴儿的最佳营养,在儿童的生长发育中起着重要作用。在这方面,世界卫生组织(WHO)强烈建议在生命的头6个月进行纯母乳喂养,以及在引入安全和适当的辅助食品时继续母乳喂养,2岁或以上。尽管如此,在世界许多地区,母乳喂养的做法仍然是次优的.在这方面,许多儿童在6个月大的时候没有母乳喂养,或者在生命的头几个小时没有母乳喂养,或者过早断奶。这允许使用婴儿配方食品,由于卫生条件差,可能危及生命,储存条件或不适当的食物。同样,中东和北非(MENA)地区的母乳喂养率低于全球平均水平.在阿尔及利亚,根据以往的多指标类集调查(MICS)报告,6月龄以下的母乳喂养率是世界上最低的.此外,到第六个月底,纯母乳喂养的儿童比例不到3%,只有23%的儿童在22-23个月接受母乳。母乳喂养的中位持续时间为12周。然而,这些报告没有探讨与这种次优母乳喂养做法相关的社会人口因素,因为在这种情况下使用其他数据进行的研究和研究很少,而且大多在有限的地理区域进行。
■这代表对MICS数据库中所有母乳喂养儿童的描述性横断面研究,2019年进行,8709名儿童,包括4471名男孩和4238名女孩,在数据库中注册。探讨母乳喂养持续时间的相关因素,我们只纳入了断奶儿童,以尽量减少与仍在母乳喂养的儿童相关的偏倚.这允许分析来自3761名儿童的数据,包括1930名男孩(5.4%)和1831名女孩(48.6%)。通过使用逻辑回归模型,我们可以评估不同社会人口的作用,维持6个月以上母乳喂养的经济和地理因素。
■母乳喂养的患病率为81.1%;0-6个月儿童的纯母乳喂养率为28.7%。与母乳喂养超过六个月相关的因素是居住地,母亲的职业地位和财富五分之一。事实上,农村地区似乎是有利于母乳喂养持续超过六个月的因素,与市区相比(OR=1.29;CI[1.032-1.369])。与居住在南部地区的母亲相比,居住在东部高地地理区域的母亲维持母乳喂养超过六个月的可能性似乎是其1.56倍(OR=1.56;CI[1.123-1.677])。非工作母亲的孩子在6个月后接受母乳喂养的可能性几乎是工作母亲的1.5倍(OR=1.489;CI[1.107-1.947])。与属于“最贫穷”五分之一的父母相比,“最富有”五分之一的父母在6个月后继续母乳喂养的机会似乎增加了1.24倍(OR=1.24;CI[1.086-1.812])。孩子的性别等因素,孕产妇教育水平,和功能困难似乎不是六个月后继续母乳喂养的决定因素。
■开始和继续母乳喂养的患病率和相关因素因国家而异。尽管进行了大量研究以更好地理解母亲的母乳喂养行为以及各种促进母乳喂养行为的举措,许多国家的税率很低。因此,母乳喂养的下降趋势与工业奶的生产和销售的进步直接相关,母亲缺乏信息和意识,缺乏卫生专业人员的培训。在这方面,强烈建议鼓励行为改变,为了改善有关母乳喂养持续时间的沟通,根据支持母亲的建议,增加产后咨询和辅助医务人员培训的使用。这项研究对阿尔及利亚等发展中国家非常感兴趣,为了采取预防性干预措施,并在母乳喂养项目中组织沟通和产前及产后咨询。显然,本研究应通过关于早期停止母乳喂养因素的补充定性研究得到加强.
Breastfeeding is considered the best nutrition for infants and plays a significant role in a child\'s growth and development. In this regard, the World Health Organization (WHO) strongly recommends exclusive breastfeeding for the first 6 months of life, as well as continued breastfeeding when safe and appropriate complementary foods are introduced, up to 2 years of age or beyond. Nonetheless, breastfeeding practices remain sub-optimal in many parts of the world. In this respect, many children have shown not to be breastfed up to 6 months of age or are not breastfed during their first hours of life or are weaned too early. This allows for the use of infant formula, which can be life threatening due to poor hygiene, storage conditions or inappropriate foods. Likewise, breastfeeding rates in the Middle East and North Africa (MENA) region are lower than the global average. In
Algeria, the breastfeeding rate up to 6 months of age is among the lowest in the world according to previous Multiple Indicators Cluster Surveys (MICS) reports. In addition, by the end of the sixth month, the percentage of children exclusively breastfed is less than 3% and only 23% of children receive breast milk at 22-23 months. The median duration of breast-feeding is 12 weeks. However, the socio-demographic factors associated with this sub-optimal breastfeeding practice are not explored in these reports, as studies and research conducted in this context using other data are few and mostly conducted in limited geographical areas.
This stands for a descriptive cross-sectional study of all children who were breastfed in the MICS database, carried out in 2019, 8 709 children, including 4 471 boys and 4 238 girls, registered in the database. To explore factors associated with the duration of breastfeeding, we only included weaned children to minimize bias related to children who were still breastfeeding. This allowed to analyze data from 3 761 children, including 1 930 boys (5.4%) and 1,831 girls (48.6%). Through using a logistic regression model, we could attain the assessment of the role of different socio-demographic, economic and geographical factors in the maintenance of breastfeeding beyond 6 months.
The prevalence of breastfeeding is 81.1%; the rate of exclusive breastfeeding of children aged 0-6 months is 28.7%. The factors associated with breastfeeding beyond six months are area of residence, mother\'s occupational status and wealth quintile. In fact, rural area appears to be a factor favoring the continuation of breastfeeding beyond six months, compared with urban area (OR = 1.29; CI [1.032-1.369]). Mothers living in the Eastern Highlands geographic region appear to be 1.56 times more likely to maintain breastfeeding for more than six months compared to those living in the Southern region (OR = 1.56; CI [1.123 - 1.677]). Children of non-working mothers are almost 1.5 times more likely to be breastfed after 6 months than those of working mothers (OR = 1.489; CI [1.107 - 1.947]). Parents belonging to the \"richest\" wealth quintiles appear to increase the chance of continued breastfeeding after 6 months with a 1.24-fold increase compared to those belonging to the \"poorest\" quintile (OR = 1.24; CI [1.086 - 1.812]). Factors such as the child\'s gender, maternal education level, and functional difficulties do not appear to be determining factors for the continuation of breastfeeding after six months.
The prevalence and factors associated with the initiation and continuation of breastfeeding vary from one country to another. Notwithstanding the numerous studies to better comprehend mothers\' breastfeeding behaviour and various initiatives for promotion thereof, many countries have low rates. In consequence, the downward trend in breastfeeding is directly linked to advances in the production and marketing of industrial milks, the lack of information and awareness among mothers and the lack of training of health professionals. In this respect, it is highly recommended to encourage behavioural changes, to improve communication about the duration of breastfeeding, to increase the use of postnatal counselling and training of paramedical staff according to the recommendations with support for mothers.This study is of great interest in developing countries like
Algeria, in order to adopt preventive interventions, and to organise communication and pre- and post-natal counselling in the breastfeeding project. Clearly, this study should be enhanced with supplementary qualitative studies concerning the factors contributing to early discontinuation of breastfeeding.