| Summary: | 碩士 === 國立陽明大學 === 臨床暨社區護理研究所 === 102 === Motivation: The “Global Strategy for Infant and Young Infant Feeding “proposed by WHO recommended that infants needs to be fed with exclusive breastfeeding until they reach 6 months old, at which point complementary foods should be provided. For the past years, the exclusive breastfeeding rates in many countries have raised significantly. Yet, in the regard to complementary foods for infants, the recommend introduction time are varied around the world, which lead to the problem of early or delayed complementary foods feeding. In recent years the exclusive breastfeeding rate in Taiwan has soared, and at the same time the introduction time of complementary foods is delayed. It is unclear if it is due to the policy of exclusive breastfeeding promotion, since there are few empirical studies investigating the issue of breastfeeding versus complementary foods feeding with national survey and long-term samples.
Purpose: Through the analysis of the national data of Taiwan from year 2004 to 2011, the study tends to describe the relation between whether the introduction time of complementary foods, the types of complementary foods for the first time is appropriate or not, the duration of exclusive breastfeeding, the way to feeding, giving-birth in the Baby-Friendly Hospital or not, and the medical facilities provide health guidance, so as to review and forecast the feedings of infants in Taiwan.
Method: The study adopts secondary database for analysis, using the samples from the 5 national surveys conducted by Ministry of Health and Welfare from year 2004 to 2011. The subjects are females 4 months to 3 years after giving birth. The number of subjects are varied from 1,458 to 12,455 in each year, and the feedback were collected with structured questionnaire through phone interview. The study uses Chi-square Test, Multinominal Logistic Regression, as well as Binary Logistic Regression for analysis.
Results: The primary result of this study reveals that early introduction time of complementary foods is less than 1%, while the delayed introduction is nearly 20%. As such, there is a tendency that the delay of complementary foods introduces may as late as 6-month old. The inappropriateness rate of first-time complementary foods items is around 60%, most of which are allergen and processed items. The multinominal regression analysis of introduction time of complementary foods shows females from Southeast Asia and those have no college degree are easily early and delayed, females from mainland China and those with smoking habit are tend to be early introduce, birth age over 35 years old are easily delay introduce. Also, the non-premature and giving birth in the Baby-Friendly Hospital tends to introduce complementary foods during 4-6 months. After controlling the basic variables above, it shows that no matter the duration of exclusive breastfeeding is, the introduction of complementary foods begins at where breastfeeding ends; as such, the duration time of feeding may lead to early or delayed introduction of complementary foods. And while those have received guidance from medical facilities tends to introduce to infants at 4-month to 6-month old. As for the result from the binary regression analysis of the appropriateness of first-time complementary food items, it shows the related variants of inappropriateness are subjects from foreign countries, living in rural areas, high school as educational level, with smoking habit, birth age ranged from 20 to 24, premature, cesarean section, non-giving-birth in the Baby-Friendly Hospital. If we controlled the variables above, the inappropriateness variables are subjects who giving exclusive breastfeeding less 4 months, giving infant formula or mix feeding when 4 and 6 months, those didn’t receive guidance from medical facilities.
Conclusion: The tendency for the introduction time of complementary foods in Taiwan may as late as 6-month old. Yet, the inappropriateness rate of first-time complementary foods feeding is high in percentage. The introduction time of complementary foods is significantly correlated to the duration of exclusive breastfeeding. Therefore, we should enhance the health education on complementary foods feeding guidance for those early and delayed breastfeeding. The mothers who have received guidance from medical facilities or who gave birth in Baby-Friendly Hospital are more appropriately giving the first-time feeding of complementary foods. Therefore, we should strengthen our promotion on the prevention of inappropriate allergen and processed items, so as to lower the inappropriateness rate. Thus, we should provide a more cultural-appropriate guidance for foreign spouses, and keep track the factors resulting in the stop of exclusive breastfeeding in rural areas. Finally, it is suggested that we should provide a more appropriate feeding guidance and assessment to mothers with lower educational level, old maternal age、premature and cesarean section, so as to elevate the health of infants.
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