新生儿早期吸吮指导对母乳喂养行为及乳房并发症的影响

doi:10.3760/cma.j.issn.1007-1245.2024.20.025

摘要/Abstract

摘要：

目的　探讨新生儿早期吸吮指导对母乳喂养行为及乳房并发症的影响。方法　前瞻性选取2022年1月至2023年1月于西北妇女儿童医院顺利分娩并进行母乳喂养的产妇194例作为研究对象，通过随机数字表法分为对照组（97例）和观察组（97例）。对照组产妇年龄（29.82±2.56）岁，孕周（39.66±0.47）周，初产妇74例，经产妇23例；观察组产妇年龄（30.20±2.78）岁，孕周（39.15±0.52）周，初产妇61例，经产妇36例。对照组产妇实施常规护理，观察组产妇在对照组基础上由助产士实施新生儿早期吸吮指导。两组均干预至产妇出院，并随访至产后6个月。比较两组产妇泌乳情况（首次泌乳时间、出院前乳汁充足情况）、母乳喂养率、母乳喂养效能［母乳喂养自我效能测量简表（Breastfeeding Self-Efficacy Scale-Short Form，BSES-SF）］及产后6个月内乳房并发症（乳腺炎、涨乳、乳头损伤）。统计学方法采用t检验、χ²检验。结果　观察组产妇首次泌乳时间短于对照组［（1.22±0.31）d比（2.43±0.78）d］，乳汁充足率高于对照组［91.75%（89/97）比79.38%（77/97）］，两组比较差异均有统计学意义（均P<0.05）；观察组产妇产后1个月、2个月、4个月、6个月母乳喂养率分别为93.81%（91/97）、88.66%（86/97）、84.54%（82/97）、78.35%（76/97），均高于对照组［81.44%（79/97）、73.20%（71/97）、64.95%（63/97）、56.70%（55/97）］，两组比较差异均有统计学意义（均P<0.05）；观察组产妇产后1个月的母乳喂养效能中技能、内心活动维度评分分别为（33.37±3.88）分、（26.63±2.43）分，高于对照组的（29.60±2.46）分、（21.10±2.51）分，两组比较差异均有统计学意义（均P<0.05）；观察组乳房并发症发生率低于对照组［9.28%（9/97）比21.65%（21/97）］，两组比较差异有统计学意义（P<0.05）。结论　新生儿早期吸吮指导能缩短产妇首次泌乳时间并增加泌乳量，有助于提高产妇的母乳喂养率，增强产妇母乳喂养自我效能，同时降低乳房并发症发生率。

关键词:

母乳喂养, 早期吸吮指导, 泌乳情况, 自我效能, 并发症

Abstract:

Objective　To investigate the effect of early neonatal sucking guidance on breastfeeding behavior and breast complications. Methods　A total of 194 pregnant women with successful delivery and breastfeeding enrolled in Northwest Women's and Children's Hospital from January 2022 to January 2023 were prospectively selected as the research objects, and were divided into a control group (97 cases) and an observation group (97 cases) by the random number table method. In the control group, the age of the pregnant women was (29.82±2.56) years old, and the gestational age was (39.66±0.47) weeks, including 74 primiparas and 23 multiparas. In the observation group, the age of the pregnant women was (30.20±2.78) years old, and the gestational age was (39.15±0.52) weeks, including 61primiparas and 36 multiparas. The control group received routine nursing, and the observation group received early neonatal sucking guidance from midwives on the basis of the control group. Both groups were intervened until the pregnant women were discharged from hospital and were followed up until 6 months after delivery. The breastfeeding status (initiation time of lactation and adequacy of milk supply before discharge), breastfeeding rate, and breastfeeding efficacy [Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF)], and breast complications (mastitis, hypergalactosis, and nipple injury) within 6 months after delivery were compared between the two groups. Statistical methods used were t test and χ² test. Results　The initiation time of lactation in the observation group was shorter than that in the control group [(1.22±0.31) d vs. (2.43±0.78) d], and the adequacy rate of milk supply was higher than that in the control group [91.75% (89/97) vs. 79.38% (77/97)], with statistically significant differences between the two groups (both P<0.05). The breastfeeding rates at postpartum 1 month, 2 months, 4 months, and 6 months in the observation group were 93.81% (91/97), 88.66% (86/97), 84.54% (82/97), and 78.35% (76/97), which were higher than those in the control group [81.44% (79/97), 73.20% (71/97), 64.95% (63/97), and 56.70% (55/97)], with statistically significant differences between the two groups (all P<0.05). The scores of skills and inner activity of the breastfeeding efficacy in the observation group were (33.37±3.88) points and (26.63±2.43) points, which were higher than those in the control group [(29.60±2.46) points and (21.10±2.51) points], with statistically significant differences between the two groups (both P<0.05). The incidence of breast complications in the observation group was lower than that in the control group [9.28% (9/97) vs. 21.65% (21/97)], with a statistically significant difference between the two groups (P<0.05). Conclusion　Early neonatal sucking guidance can shorten the initiation time of lactation and increase the lactation volume, helps to improve the maternal breastfeeding rate, enhance the maternal breastfeeding self-efficacy, and reduce the incidence of breast complications.

Key words:

Breastfeeding, Early sucking instruction, Lactation, Self-efficacy, Complications

刘静刘晶张静侯丹丹刘英洁王艳霞.

新生儿早期吸吮指导对母乳喂养行为及乳房并发症的影响 [J]. 国际医药卫生导报, 2024, 30(20): 3471-3475.

Liu Jing, Liu Jing, Zhang Jing, Hou Dandan, Liu Yingjie, Wang Yanxia.

Effect of early neonatal sucking guidance on breastfeeding behavior and breast complications [J]. International Medicine and Health Guidance News, 2024, 30(20): 3471-3475.

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