目的 分析产后母婴皮肤接触时间对出院时、产后1月、产后3月母乳喂养情况的影响。方法 选择2018年12月-2019年12月贵州省人民医院符合标准的产妇368例,按实际母婴皮肤接触时间分为<30 min(n=49)、30~<60 min(n=59)、60~<90 min(n=54)、≥90 min(n=206)4组,了解4组纯母乳喂养率、母乳喂养困难情况及远期母乳喂养风险。结果 4组产妇出院时纯母乳喂养率差异无统计学意义(χ2=2.026,P＞0.05),但在产后1月母婴皮肤接触时间≥90 min纯母乳喂养率高于其他3组(χ2=8.755,P＜0.05),产后3月显著升高(χ2=53.000,P＜0.001)。随着母婴皮肤接触时间的延长,中重度母乳喂养困难发生情况显著下降,轻度或无困难比率增加(χ2=19.627,P＜0.05)。产后3月,产妇满意度、婴儿满意度、生活方式持续母乳喂养总分随皮肤接触时间延长得分均增加(F=9.758、15.201、9.025、16.360,P＜0.001)。结论 延长产后母婴皮肤接触时间有助于提高产后纯母乳喂养率及远期母乳喂养结局。
Abstract
Objective To explore the influence of mother-infant skin-contact time on breastfeeding at discharge, 1 month or 3 months after delivery, in order to facilitate implementation of newborn safety project in pilot hospitals in Guizhou. Methods A total of 368 pregnant women were selected from pilot hospitals in the designated areas (Guizhou Province) of WHO/China CDC newborn safety project, and were divided into four groups according to mother-infant skin-contact time[＜30 min(n=49), 30-<60 min(n=59), 60-<90 min(n=54), ≥90 min(n=206)].The exclusive breastfeeding rate, difficulty of breastfeeding and long-term breastfeeding risk of the four groups were analyzed. Results There was no statistical difference in the exclusive breastfeeding rate among the four groups (χ2=2.026, P>0.05),but the rate of exclusive breastfeeding in the group of mother-infant skin-contact time ≥90 min was significantly higher than that in the three groups in the first month after delivery(χ2=8.755, P＜0.05).With the increasing time of mother-infant skin-contact time, the rate of moderate/severe difficulty of breastfeeding was significantly reduced, while the mild difficulty of breastfeeding significantly increased(χ2=19.627, P＜0.001) .In 3 months after birth, with the increasing of mother-infant skin-contact time, the scores of maternal and infant satisfaction and lifestyle, as well as the total score of Maternal Breastfeeding Evaluation Scale(MBFES) significantly increased(F=9.758,15.201,9.025,16.360, P<0.001). Conclusion Prolonging mother-infant skin-contact time is helpful to improve the key link of breastfeeding, the rate of exclusive breastfeeding and the long-term outcome of breastfeeding.
关键词
母婴皮肤接触 /
母乳喂养 /
新生儿安全项目 /
健康扶贫
Key words
mother-infant skin contact /
breastfeeding /
newborn safety project /
health poverty alleviation
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参考文献
[1] 叶芳,林荭,刘芳,等.母乳喂养评价量表介绍[J].中华围产医学杂志,2019,22(7):479-484.
[2] Smith JW.Breastfeeding and Human Lactation, 3rd Edition[J].The Journal of Midwifery and Women's Health,2005,50(3):253-254.
[3] Parker LA,Sullivan S,Krueger C,et al.Strategies to increase milk volume in mother of VLBW infant[J].MCN Am J Matern Child Nurs,2013,38(6):385-390.
[4] Leff EW, Jefferis SC, Gagne MP.The development of the Maternal Breastfeeding Evaluation Scale[J].J Hum Lact, 1994, 10(2):105-111.
[5] Cooke M, Schmied V, Sheehan A.An exploration of the relationship between postnatal distress and maternal role attainment, breast feeding problems and breast feeding cessation in Australia[J].Midwifery, 2007,23(1):66-76
[6] Riordan JM, Woodley G, Heaton K, et al.Testing validity and reliability of an instrument which mesures maternal breastfeeding evaluation scale[J].J Hum Lcat,1994,10(4):105-111.
[7] Cooke M, Sheehan A, Schmied V.A description of the relationship between breastfeeding experiences, breastfeeding satisfaction, and weaning in the first 3 months after birth[J].J Hum Lcat,2003,19 (2):145-156.
[8] Bramson L,Lee JW,Moore E,et al.Effect of early skin- to-skin mother-infant contact during the first 3 hours following birth on exclusive breastfeeding during the maternity hospital stay[J].J Hum Lact,2010,26(2):130-137.
[9] 翟聪利, 孙慧娜, 毛竹香,等.母婴皮肤接触持续时间对新生儿影响的研究[J].中华护理杂志 2018,53(12),1419-1423.
[10] Carfoot S,Williamson P,Dickson R.A randomized controlled trial in the north of England examining the effects of skin-to-skin eare in breast feeding[J].Midwifery,2005,21(1):71-79.
[11] 侯燕文,黄蓉,李艳,等.产后母婴皮肤接触时间对初产妇住院期间母乳喂养的影响[J].解放军护理杂志,2016,33(23):6-10.
[12] 叶芳,林荭,陈杰,等.0~5 月龄婴儿母乳喂养困难调查及影响因素研究[J].中国儿童保健杂志,2018,26(3):290-293.
[13] Lutter CK, Lutter R.Fetal and early childhood undernutrition, mortality, and lifelong health[J].Science,2012,337(6101):1495-1499.
[14] 周海侠.社会支持对高龄经产妇生活质量、母乳喂养、产后抑郁的影响[D].济南:山东大学,2018.
[15] Pang WW,Tan PT,Cai S,Nutrients or nursing? Understanding how breast milk feeding affects child cognition[J].Eur J Nutr,2020,59(2):609-619.
基金
2019年贵州省卫生健康委科学技术基金项目(gzwjkj2019-1-015)
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