Characteristics of biological mothers.

Despite consistent evidence highlighting the benefits of exclusive breastfeeding (EBF) for the first six months, EBF duration sometimes falls short of six months or exceeds it. This research seeks to explore factors influencing the practice of optimal duration of EBF and identify factors associated with suboptimal EBF durations. A cross-sectional survey was conducted in 16 districts across four Northern regions of Ghana with 2000 caregivers of children under five years old. The analysis specifically focused on a subset of 1761 biological mothers. Logistic regression was conducted to discern socio-demographic, care-seeking, and behavioral determinants influencing the practice of EBF for a six-month duration. Additionally, multinomial logistic regression was used to identify factors associated with suboptimal EBF durations, categorized as less than and beyond six months. All biological mothers breastfed their youngest child, varying in durations: 75% exclusively breastfed for six months, 19.2% for less than six months, and 5.9% for beyond six months. Several behavioral determinants influenced EBF for six months, with biological mothers ’ confidence in their ability to EBF (aOR: 6.8 95% CI, 4.13–11.33), willingness to recommend EBF practice to friends and family (aOR: 10.5 95% CI, 4.13–26.62) and perception of practicing EBF as normative in the community showing statistically significant associations (aOR: 6.3, 95% CI, 4.41–9.10). Education and religion of biological mothers were also significantly associated with EBF for six months. While there was overlap in behavioral factors associated with EBF for less than and beyond six months, the socio-demographic characteristics of biological mothers associated with these suboptimal durations of EBF differed. Among the factors included in this study, social norms, caregiver confidence, and approval of EBF were key factors influencing the recommended duration of EBF practices. These findings highlight the importance of community and cultural contexts in shaping biological mothers’ behavior and emphasize the need to address socio-cultural barriers and facilitators that influence EBF practices, as well as empower biological mothers to adopt and sustain these practices.尽管已有大量一致的研究证据证实，出生后前六个月纯母乳喂养（exclusive breastfeeding, EBF）对婴儿具有显著益处，但实际开展的纯母乳喂养时长有时会不足六个月，亦或超出这一周期。本研究旨在探究影响最优纯母乳喂养时长的相关因素，并明确与非最优纯母乳喂养时长相关的影响因子。本研究于加纳北部四个地区的16个行政区开展横断面调查，共纳入2000名五岁以下儿童的看护者，分析对象聚焦于其中1761名亲生母亲。研究采用逻辑回归分析，以识别影响六个月纯母乳喂养行为的社会人口学、求医行为及行为层面决定因素；同时运用多项逻辑回归模型，对被划分为“不足六个月”与“超出六个月”两类的非最优纯母乳喂养时长相关影响因子进行识别。所有受访亲生母亲均对其最小的孩子实施过母乳喂养，其母乳喂养时长分布如下：75%的母亲实现了六个月纯母乳喂养，19.2%的母亲纯母乳喂养时长不足六个月，另有5.9%的母亲纯母乳喂养时长超出六个月。多项行为层面决定因素与六个月纯母乳喂养行为存在显著关联，其中亲生母亲对自身纯母乳喂养能力的信心（调整后比值比（adjusted Odds Ratio, aOR）：6.8，95%置信区间（confidence interval, CI）：4.13~11.33）、愿意向亲友推荐纯母乳喂养行为（aOR：10.5，95%CI：4.13~26.62），以及认为纯母乳喂养在所在社区属于主流行为的认知，均呈现统计学意义上的显著关联（aOR：6.3，95%CI：4.41~9.10）。此外，亲生母亲的受教育程度与宗教信仰同样与六个月纯母乳喂养行为存在显著关联。尽管与“不足六个月”及“超出六个月”这两类非最优纯母乳喂养时长相关的行为影响因子存在部分重叠，但与这两类非最优纯母乳喂养时长相关的亲生母亲社会人口学特征存在明显差异。在本研究纳入的各类影响因子中，社会规范、看护者信心以及对纯母乳喂养的认可，是影响推荐纯母乳喂养时长的关键因素。本研究结果凸显了社区与文化语境在塑造亲生母亲喂养行为中的重要性，同时强调需针对性解决影响纯母乳喂养行为的社会文化障碍与促进因素，并赋能亲生母亲，使其能够采纳并坚持纯母乳喂养实践。