目的 调查和分析北京市某城区婴儿母乳喂养困难的现状及影响因素,为促进母乳喂养的干预措施提供依据。方法 选取2016年1月1日-12月31日在本院儿童保健门诊进行常规体检,进行母乳喂养的120例婴儿及母亲作为研究对象,采用统一问卷(一般情况、产科史、Via Christi母乳喂养评价量表)进行横断面调查研究。结果 120例研究对象Via Christi量表的平均得分为8.2±1.4,70%的婴儿仅存在轻微或不存在母乳喂养困难,30%的婴儿存在中度母乳喂养困难。量表5个条目中得分最低的两项客观指标分别为“含接到有效吸吮之间持续时间”(1.0±0.9)和“乳头含接”(1.7±0.4)。影响因素的分析结果显示,出生后1周内进行纯母乳喂养[OR=0.140,95%CI:(0.024~0.802)]和顺产[OR=0.343,95%CI:(0.174~0.879)]是母乳喂养的保护因素(P均<0.05),流动人口[OR=8.679,95%CI:(1.558~48.338)]和早产[OR=5.470,95%CI:(1.216~25.030)]是母乳喂养的危险因素(P均<0.05)。结论 母乳喂养过程中发生问题最多的是“乳头含接”和“含接后到有效吸吮”这两个环节;流动人口、出生后1周内混合喂养、早产儿和剖宫产是发生母乳喂养困难的危险因素,在临床实际工作中应给予重点关注。

Objective To investigate the present situation of breastfeeding difficulties and its influencing factors in an urban area in Beijing,so as to provide scientific evidence for formulating interventions. Methods A cross-sectional survey was conducted to collect data of 120 cases of infants aged 0 to 5 months fed by breast milk and their mothers from Jan.1^st to Dec.31^th,2016.Participants were investigated with general information questionnaire and Via Christi breastfeeding assessment tool. Results The mean score of Via Christi tool was 8.2±1.4.Seventy percent of infants were assessed as low risk while the rest as medium risk.The items of "length of time before latch-on and suckle" and "latch-on" received lowest scores with 1.0±0.9 and 1.7±0.4.Exclusive breastfeeding during the first week after birth [OR=0.140,95%CI:(0.024~0.802)] and vaginal birth [OR=0.343,95%CI:(0.174~0.879)] were two protective factors of breastfeeding(P<0.05).Floating population [OR=8.679,95%CI:(1.558~48.338)] and preterm [OR=5.470,95%CI:(1.216~25.030)] were two hazardous factors(P<0.05). Conclusions The most problematic procedures during breastfeeding were "latch-on" and "length of time before latch-on and suckle".Priority attention should be given to infants with hazardous factors including floating population,mixed feeding during the first week after birth,preterm,and C-section.