Best practices in breastfeeding are often not followed despite appropriate levels of knowledge and positive attitudes regarding the benefits of human milk. For many reasons, some women do not initiate breastfeeding, suspend breastfeeding early, or initiate complementary feeding earlier than recommended. Usual measurement methods use large sample surveys at a national scale, which are not well suited for monitoring sub-national differences. In order to understand how local infant feeding practices could influence policy and promotion practices, we apply data pooling methodology to analyse breastfeeding patterns in different Ecuadorian settings: Cumbayá parish, located near Quito, the Ecuadorian capital; the city of Macas and rural surroundings in the Amazon basin province of Morona Santiago; and the province of Galapagos. Surveys were conducted independently between August 2017 and August 2018; while they are representative of each respective setting, sampling designs and survey methods differ, but the same demographic information and data based on standard breastfeeding indicators established by the World Health Organization (WHO) were collected. In order to account for differences in the different settings, the design effect of each survey was considered in the analysis. Significant differences were found in breastfeeding practices between the suburban Cumbayá parish near Quito and Galapagos on one hand, and urban and rural parts of Morona Santiago, on the other. The rates of early breastfeeding initiation and age-appropriate breastfeeding are significantly higher in urban and rural Morona Santiago then in Cumbayá or Galapagos, while the rate of exclusive breastfeeding is highest in rural parts of Morona Santiago. No significant differences were found in complementary feeding practices between Cumbayá and Galapagos, but there are with urban and rural Morona Santiago. Initiation of breastfeeding in the first hour after birth occurs in only 36.2% of cases in Cumbayá but in 75.4% of cases in urban Morona. Differences among regions reflect specific opportunities and barriers to practices related to promoting optimal infant health and nutrition. Consequently, regional or local conditions that often are not apparent in national-level data should orient policies and promotion activities in specific populations.

中文翻译：

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厄瓜多尔的母乳喂养做法和补充喂养：对本地化政策应用和母乳喂养推广的影响：汇总分析。

尽管对母乳的益处有适当的了解和积极的态度，但母乳喂养的最佳做法往往没有得到遵循。出于多种原因，一些女性没有开始母乳喂养、提前暂停母乳喂养或比建议的时间更早开始添加辅食。通常的测量方法在全国范围内使用大样本调查，这不太适合监测次国家差异。为了了解当地婴儿喂养实践如何影响政策和推广实践，我们应用数据汇集方法来分析厄瓜多尔不同环境中的母乳喂养模式：位于厄瓜多尔首都基多附近的 Cumbayá 教区；亚马逊河流域莫罗纳圣地亚哥省的马卡斯市和农村环境；和加拉帕戈斯省。调查是在 2017 年 8 月至 2018 年 8 月期间独立进行的；虽然它们代表了各自的环境，但抽样设计和调查方法不同，但收集了基于世界卫生组织 (WHO) 制定的标准母乳喂养指标的相同人口统计信息和数据。为了说明不同环境下的差异，分析中考虑了每次调查的设计效果。一方面，基多和加拉帕戈斯附近的郊区 Cumbayá 教区与莫罗纳圣地亚哥的城市和农村地区之间的母乳喂养实践存在显着差异。Morona Santiago 城市和农村的早期母乳喂养率和适龄母乳喂养率明显高于 Cumbayá 或 Galapagos，而纯母乳喂养率在 Morona Santiago 的农村地区最高。在 Cumbayá 和 Galapagos 之间的补充喂养实践中没有发现显着差异，但在城市和农村 Morona Santiago 之间存在显着差异。在 Cumbayá 的病例中只有 36.2% 的病例在出生后的第一个小时内开始母乳喂养，但在城市 Morona 的病例中这一比例为 75.4%。地区之间的差异反映了与促进最佳婴儿健康和营养相关的实践的具体机会和障碍。因此，通常在国家级数据中不明显的区域或地方条件应针对特定人群的政策和促进活动。但有城市和农村的莫罗纳圣地亚哥。在 Cumbayá 的病例中只有 36.2% 的病例在出生后的第一个小时内开始母乳喂养，但在城市 Morona 的病例中这一比例为 75.4%。地区之间的差异反映了与促进最佳婴儿健康和营养相关的实践的具体机会和障碍。因此，通常在国家级数据中不明显的区域或地方条件应针对特定人群的政策和促进活动。但有城市和农村的莫罗纳圣地亚哥。在 Cumbayá 的病例中只有 36.2% 的病例在出生后的第一个小时内开始母乳喂养，但在城市 Morona 的病例中这一比例为 75.4%。地区之间的差异反映了与促进最佳婴儿健康和营养相关的实践的具体机会和障碍。因此，通常在国家级数据中不明显的区域或地方条件应该针对特定人群的政策和促进活动。