Effect of early neonatal sucking guidance on breastfeeding behavior and breast complications

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

Abstract

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

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

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.

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.

References

[1] 杭琳,张洁苹,项丹玉,等.基于共同养育理论的母乳喂养支持方案在NICU早产儿医院-家庭过渡期中的应用[J].中华护理杂志,2023,58(12):1435-1441. DOI:10.3761/j.issn.0254-1769.2023.12.004.
[2] 董家男,李秀荣,王娟,等.短视频在父亲支持母乳喂养健康教育中的应用[J].护理学杂志,2023,38(2):69-72. DOI:10.3870/j.issn.1001-4152.2023.02.069.
[3] 赵海艳,杨敏,王献花.家属参与产后正念情绪-行为构建对初产妇母亲角色转换、母乳喂养成功率的影响[J].中国健康心理学杂志,2023,31(12):1768-1772. DOI:10.13342/j.cnki.cjhp.2023.12.002.
[4] 徐丽华,吴黎黎.母乳喂养指导在产科护理中的应用及对母乳喂养技巧掌握情况、产后开始泌乳时间的影响[J].国际护理学杂志,2022,41(6):1050-1053. DOI:10.3760/cma.j.cn221370-20201005-00272.
[5] 吴朝杏,陈惠丽,轩妍.新生儿早期吸吮健康教育对母乳喂养行为的影响研究[J].中国健康教育,2022,38(8):751-754,758. DOI:10.16168/j.cnki.issn.1002-9982.2022.08.017.
[6] 孙继伟.H2H院内营养指导下催乳术联合婴儿早吸吮对初产后乳汁分泌时间及母乳喂养情况的影响[J].中国医学创新,2020,17(14):110-113. DOI:10.3969/j.issn.1674-4985. 2020.14.027.
[7] 步玉辉,史立波,韩晓琳,等.冷敷联合布洛芬治疗哺乳期乳腺炎及对患者生活质量的影响[J].河北医药,2023,45(7):1061-1064. DOI:10.3969/j.issn.1002-7386.2023.07.023.
[8] Tomfohrde OJ, Reinke JS. Breastfeeding mothers' use of technology while breastfeeding[J]. Computers in Human Behavior, 2016, 64: 556-561. DOI:10.1016/j.chb.2016.07.057.
[9] 孙琳琳,王君芝,褚梁梁,等.基于三维质量结构模型构建母乳喂养护理质量评价指标体系[J].中国护理管理,2023,23(2):271-276. DOI:10.3969/j.issn.1672-1756.2023. 02.023.
[10] 刘可,邹丹.剖腹产术后母乳喂养侧卧位与坐位两种体位的对比分析[J].重庆医学,2016,45(3):429-430. DOI:10.3969/j.issn.1671-8348.2016.03.049.
[11] 苏燕燕,陈睿迪,张永花,等.兰州市城区102例乳母膳食营养状况及其与乳汁成分关系[J].华南预防医学,2021,47(9):1105-1108. DOI:10.12183/j.scjpm.2021.1105.
[12] 孙小嫡,李智慧,孔燕,等.基于助推理论的医院-社区-家庭三联动母乳喂养干预[J].护理学杂志,2023,38(9):81-84,90. DOI:10.3870/j.issn.1001-4152.2023.09.081.
[13] 郑佳颖,张静,李鹏,等.基于信息-动机-行为技巧的护理干预对早产儿父亲支持母乳喂养自我效能的影响[J].中华护理杂志,2023,58(12):1427-1434. DOI:10.3761/j.issn.0254- 1769.2023.12.003.
[14] 于蓉,杨富国,陈蕾,等.母亲声音联合非营养性吸吮在新生儿疼痛管理中的应用[J].国际护理学杂志,2020,39(8):1478-1481. DOI:10.3760/cma.j.cn221370-20181129- 00455.
[15] 裘梦凡,胡晓静.母乳亲喂婴儿吸吮-吞咽-呼吸机制的研究进展[J].四川大学学报(医学版),2023,54(6):1306-1311. DOI:10.12182/20231160503.
[16] 张甜甜,沈卫英,盛丹,等.助产士主导的群组孕期保健模式对初产妇分娩恐惧、新生儿Apgar评分及母乳喂养的影响[J].中国计划生育学杂志,2022,30(4):815-818. DOI:10.3969/j.issn.1004-8189.2022.04.019.
[17] 杨凡,武俊,孔超男,等.非营养性吸吮联合便利蜷曲减轻足月新生儿肌内注射疼痛[J].护理学杂志,2022,37(6):9-11. DOI:10.3870/j.issn.1001-4152.2022.06.009.
[18] 张小甜,张悦,孙瑾,等.母亲唾液催产素水平与喂养方式和抑郁情绪的相关性研究[J].中华行为医学与脑科学杂志,2023,32(8):694-699. DOI:10.3760/cma.j.cn371468- 20221115-00679.
[19] 初剑英,张磊,张雨健,等.剖宫产术后早期不同时段乳房按摩对产妇泌乳情况的影响[J].中华预防医学杂志,2017,51(11):1038-1040. DOI:10.3760/cma.j.issn.0253- 9624. 2017.11.016.
[20] 彭燕."赋能"式认知-行为教育对产后抑郁症患者心理状态及母乳喂养效能的影响[J].护理实践与研究,2023,20(5):728-732. DOI:10.3969/j.issn.1672-9676.2023.05.020.
[21] 梁全英,黎法文,宋思思,等.心理弹性支持结合助产士一体式全程护理对初产妇自然分娩结局及母乳喂养的影响[J].海南医学,2022,33(5):677-680. DOI:10.3969/j.issn.1003-6350.2022.05.036.
[22] 洪昭霞.助产引导新型群组孕期保健对首次分娩产妇妊娠结局母乳喂养率及心理状态的影响[J].中国妇幼保健,2021,36(10):2248-2250. DOI:10.19829/j.zgfybj.issn.1001-4411.2021.10.017.
[23] 顾建英,陈铭红,周莉.以助产士为主导的短期阶段式培训对初产妇角色适应、心理状态及母乳喂养成功率的影响[J].齐鲁护理杂志,2022,28(15):51-54. DOI:10.3969/j.issn.1006-7256.2022.15.016.
[24] 于红霞,曲慧丽,刘晓静.早期母婴皮肤接触联合延续性护理对产妇产后纯母乳喂养的影响[J].国际医药卫生导报,2019,25(4):656-659. DOI:10.3760/cma.j.issn.1007-1245. 2019.04.050.
[25] 周春秀,齐小红,徐倩倩.信息-动机-行为技巧模型的健康教育模式在剖宫产术后产妇中的应用[J].齐鲁护理杂志,2023,29(4):132-135. DOI:10.3969/j.issn.1006-7256. 2023.04.043.
[26] 肖媛媛.心理护理临床路径对妊娠高血压综合征患者心理状态、并发症及母乳喂养情况的影响分析[J].检验医学与临床,2020,17(7):926-929. DOI:10.3969/j.issn.1672- 9455.2020.07.017.