采用围产期社会营养方法,改善不同文化背景的低收入妇女群体的母乳喂养状况。

Elise Carbonneau, Alex Dumas, Suzanne Lepage, Audrée-Anne Dumas, Bénédicte Fontaine-Bisson
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摘要

围产期社会营养中心 Alima 是一个成熟的社区组织,它采用围产期社会营养方法,为生活在弱势条件下的妇女,尤其是那些移民身份不稳定的妇女提供多方面的支持。本研究的目的是:(a) 确定哪些产妇特征、与妊娠有关的变量以及 Alima 干预措施的结构特征与母乳喂养有关;(b) 研究参加母乳喂养讲习班与母乳喂养特征之间的关联是否因产妇因素而异。我们利用 Alima 数字数据库分析了 2013 年至 2020 年期间接受围产期干预的妇女的数据。检索了产后两周(T0,人数=2925)、产后两个月(T2,人数=1475)和产后四个月(T4,人数=890)的婴儿喂养数据。根据社会人口学特征、妊娠相关变量和干预措施的特点,采用逻辑回归法估算了总体母乳喂养和纯母乳喂养的几率。总体母乳喂养率和纯母乳喂养率在 T0 分别为 96.1%和 60.7%;在 T2 分别为 93.0%和 58.5%;在 T4 分别为 83.0%和 48.4%。在每个时间点,教育程度较高、有过母乳喂养经历和新近移民都与母乳喂养的可能性较高有关。参加母乳喂养研讨会与T2和T4时总体母乳喂养和纯母乳喂养的可能性增加有关,对35岁或以下、教育程度较低和妊娠体重增加过多的妇女的影响更大。总之,ALIMA 干预措施与母乳喂养的积极成果有关,尤其是在加拿大移民身份不稳定的弱势妇女中。
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A perinatal social nutrition approach to improve breastfeeding in a culturally diverse group of low-income women.

Alima, Perinatal Social Nutrition Centre, is an established community organization that adopts a perinatal social nutrition approach to provide multidimensional support to women living in vulnerable conditions, particularly those with a precarious migratory status. This study aims to (i) determine which maternal characteristics, pregnancy-related variables, and structural features of the Alima intervention are associated with breastfeeding; and (ii) examine whether the association between attending breastfeeding workshops and breastfeeding characteristics differ according to maternal factors. The Alima digital database was used to analyze data from women who received the perinatal intervention between 2013 and 2020. Infant feeding data were retrieved at 2 weeks postpartum (T0, n = 2925), 2 months postpartum (T2, n = 1475), and 4 months postpartum (T4, n = 890). Logistic regressions were used to estimate the odds of overall and exclusive breastfeeding depending on sociodemographic characteristics, pregnancy-related variables, and features of the intervention. The prevalence of overall and exclusive breastfeeding was, respectively, 96.1% and 60.7% at T0; 93.0% and 58.5% at T2; 83.0% and 48.4% at T4. Higher education, previous breastfeeding experience, and recent immigration were associated with a higher likelihood of breastfeeding at each time point. Breastfeeding workshop attendance was associated with a greater likelihood of overall and exclusive breastfeeding at T2 and T4, with a stronger effect among women aged 35 or less, those with lower education, and those with excessive gestational weight gain. In conclusion, the Alima intervention is associated with positive breastfeeding outcomes, especially among vulnerable women living with precarious migratory status in Canada.

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