摘要
Abstract
Objective To analyze the different conditions of breastfeeding and implementations of maternal and infant health care services between the first and second fetal time of multiparas,in order to explore the methods to promote breastfeeding & maternal and infant health care conditions under the two-child policy.Methods From January to March 2017,using the method of multistage stratified sampling,11 cities of Zhejiang Province was divided into 3 layers by economic levels ranking from high to low.This study randomly selected one city every layer,2 districts in each selected city,and one community health service center in each selected district.In all selected community health service centers,healthy mothers who had registered in community health service centers with no organic diseases and had a second baby aging from 6 months to 3 years old without birth defects were selected.The self-administered questionnaire was used and it contained basis information of respondents,main family members who took care of babies and pregnancy assessment conditions.This study compared and analyzed the different feeding patterns within 6 months of the first and second fetal times,different exclusive breastfeeding duration,different weaning reasons,whether having experienced breastfeeding difficulties and the source of the most effective help,different participation rates of pregnancy schools and postpartum visit situations between the first and second fetal times.Results There were 41 multiparas in the economic development class Ⅰ,73 multiparas in the economic development class Ⅱ and 54 in the economic development class There were significant differences of pregnancy assessment rates before the second pregnancy among different gestational ages (x2 =7.816,P ＜ 0.01).The consistency in feeding patterns of different fetal times was poor (Kappa =0.292,P ＜ 0.01),while there were statistically significant differences of feeding patterns in two fetal times (W =24.997,P =0.035).Exclusive breastfeeding duration and the whole breastfeeding duration of the second fetal time were longer than the first fetal time (P ＜ 0.05).The consistency in breastfeeding difficulties of different fetal times was general (Kappa =0.499,P ＜ 0.01) with statistical differences (x2 =4.45,P =0.034).'Experienced relatives or friends' and'searching by myself'were the two most effective ways for help when meeting breastfeeding difficulties.The participation rates of pregnancy schools were about 50.0％ in two fetal times with general consistency (Kappa =0.502,P ＜ 0.01) and no significant difference was found (W =1.097,P =0.778).There were 81 (48.2％) multiparas required the educations and instructions about breastfeeding skills after the second delivery.The consistency in postpartum visit situations was general in two fetal times (Kappa =0.431,P ＜0.01) with statistically significant differences (W =18.964,P ＜ 0.01).Conclusion The exclusive breastfeeding rate is raised in the second fetal time and the whole breastfeeding duration of the second fetal time is longer than the first fetal time.The participation rates of pregnancy schools in two fetal times are lower than 50.0％.There are gaps of times and contents of postpartum visit between the implementation and national requirements.General practitioners could offer relevant guidance to the elderly residents who take care of babies within general practitioners contract system in order to promote the breastfeeding situation.关键词
二孩政策/经产妇/胎次/母乳喂养/母婴保健Key words
Two-child policy/Multiparas/Fetal times/Breastfeeding/Maternal and infant health care分类
医药卫生
