新生儿科探视制度改进对母婴分离产妇的影响

目的了解母婴接触机会增加对母婴分离产妇心理和母乳喂养方式的影响。方法将母婴分离产妇249例分为实验组124例和对照组125例,对照组执行新生儿科常规探视制度,实验组产妇增加母婴接触机会并允许其直接哺喂新生儿,进行两组产妇住院期间抑郁心理和产后30天母乳喂养情况的调查。结果与对照组相比,实验组产妇抑郁情绪减轻（P〈0.01）,母乳喂养率提高（P〈0.05）。结论母婴接触机会增加能对母婴分离产妇起到安抚作用,并能为母乳喂养的顺利实施提供保证。     

母婴分离产妇发生产后抑郁现状调查

目的 了解母婴分离产妇住院期间产后抑郁发生的基本情况,探讨导致母婴分离产妇发生产后抑郁的影响因素.方法 对144例健康儿母婴同室(母婴同室组)和117例疾患儿母婴分离(分离组)初产妇应用爱丁堡产后抑郁量表(EPDS)、简易应对方式问卷(SCSQ)、社会支持评定量表(SSRS)以及自行设计一般情况调查表进行问卷调查.结果 母婴分离产妇住院期间产后抑郁的检出率较母婴同室产妇高(P<0.05);母婴分离产妇发生产后抑郁社会支持较差,其中以缺乏社会客观支持为主(P<0.01);照顾喂养新生儿信心缺乏(P<0.05)、产妇认为自身与新生儿患病有关(P<0.01) 及生女婴(P<0.05)是产后抑郁的诱发因素.结论 对母婴分离产妇要给予更多关注,引导其客观认识新生儿的病因,帮助其树立新生儿喂养信心,同时教育产妇和家人要转变重男轻女的思想.     

早期护理干预对母婴分离产妇母乳喂养的影响

目的:探讨早期护理干预对母婴分离产妇心理状况以及母乳喂养的作用和影响。方法:选择我院2017年1~10月收治的母婴分离产妇100例,均在常规护理的基础上予以早期护理干预,观察并分析产妇的心理状况以及母乳喂养情况。结果:接受干预后,产妇产后第3,5天的焦虑(SAS)、抑郁(SDS)评分低于产后第1天,产妇产后泌乳时间为(35.6±7.2)h,其泌乳量充足时间为(41.8±5.7)h,产妇母乳喂养率高达92.00%。结论:积极实施早期护理干预,可以有效改善母婴分离产妇的心理状况,促进其初乳分泌,有助于提升母乳喂养率,对于确保母婴健康具有重要意义,值得临床推广应用。     

基于新生儿吸吮特点构建母婴分离产妇乳房护理新模式及其效果分析

目的构建基于新生儿吸吮特点的母婴分离产妇乳房护理模式,评价其临床实践的效果。方法选取2018年8月至12月在广西中医药大学第一附属医院产科分娩的正常足月新生儿100例,观察其吸吮母乳的特点,统计吸吮的时间、频次、间隔时间、24 h母乳喂养次数等,构建新型护理模式。选取2019年1月至5月在广西中医药大学第一附属医院产科住院分娩的母婴分离产妇100例,根据随机数字表法分为观察组和对照组,各50例,对照组采用常规护理模式,观察组在对照组的基础上采用基于新生儿吸吮特点构建的母婴分离产妇乳房护理新模式。观察两组产妇乳汁分泌、母乳喂养、产后抑郁等情况。结果构建母婴分离产妇乳房护理新模式;与对照组相比,观察组乳汁分泌较早,泌乳量及产后42 d纯母乳喂养率较高,产后抑郁发生率较低(均P<0.05),差异有统计学意义。结论通过构建与实施基于新生儿吸吮特点的母婴分离乳房护理模式,为乳房护理提供依据,促进母婴分离产妇乳汁的提早分泌与量的增加,提高纯母乳喂养率,有效减少产后抑郁的发生。     

综合护理干预对母婴分离产妇母乳喂养的效果研究

目的 分析综合护理干预对母婴分离产妇母乳喂养的效果。方法 选取 2021 年 1 月至 2021 年 11 月本院接诊的 120 例母婴 分离产妇,随机分为对照组和观察组。对照组采用常规护理,观察组实施综合护理。观察和比较两组的心理状态、母乳喂养情 况和护理满意度。结果 观察组抑郁自评量表评分、焦虑自评量表评分、泌乳量充足时间、产后泌乳时间、母乳喂养率和护理 满意度方面优于对照组（P<0.05）。结论 母婴分离产妇实施综合护理,能够提高母乳喂养率,改善产妇不良情绪,缩短产后泌 乳时间。     

预见性护理在促进母婴分离产妇母乳喂养中的应用

[目的]探讨预见性护理对母婴分离产妇母乳喂养的影响,为今后护理工作提供指导。[方法]选取2017年1月—2017年7月来我院门诊产检并在我院住院分娩母婴分离产妇200例,随机分为对照组和观察组,每组100例。对照组采用产科促进母乳喂养的常规护理;观察组在常规护理基础上采用预见性护理干预措施,比较两组产后泌乳始动时间、奶胀发生率和产后42d纯母乳喂养成功率。[结果]观察组泌乳始动时间明显短于对照组(P0.05),观察组发生奶胀55例(55.0%),对照组发生奶胀76例(76.0%),观察组奶胀发生率低于对照组,差异有统计学意义(P0.01);观察组产妇42d产后母乳喂养率为73%,对照组产妇42d产后母乳喂养率为30%,观察组产后42d母乳喂养率明显高于对照组(P0.01)。[结论]对母婴分离产妇采取早评估、早预防、早发现、早处理的预见性护理措施能提早泌乳始动时间,降低产后奶胀发生率,提高产后42d纯母乳喂养成功率。     

护理干预对母婴分离糖尿病产妇的效果分析

目的减少糖尿病产妇产后5天内乳房肿胀发生率，提高母乳喂养率。方法2004年5月—2005年5月根据母婴分离后糖尿病产妇特殊的身心变化，采取支持——指导——教育的方法，即给予心理支持、早期乳房护理和科学的健康宣教。结果通过实施护理干预，产后5天内乳房肿胀发生率由原来的42％下降到12％，产后42天母乳喂养率由原来的70％上升到89％，提升了对护理工作的满意度。结论对糖尿病产妇护理干预的实施，解决了母婴护理中的实际问题，增加了产妇对护士的信任感。     

护理综合护理干预缓解母婴分离产妇焦虑情绪的效果

目的 观察综合护理干预对缓解母婴分离产妇焦虑情绪的影响。方法 选取收治的分娩产后分离的产妇180例,以随机数字表法分为观察组和对照组各90例,对照组给予常规护理干预,观察组给予综合护理干预,对比两组护理后产妇焦虑、抑郁情绪改变与护理满意度、母乳喂养成功率。结果 两组焦虑与抑郁情绪改变情况、护理满意度与母乳喂养成功率比较,观察组均明显高于对照组(P0.05)。结论 综合护理干预不仅可以改善产妇焦虑、抑郁等不良情绪,同时还有利于提升产妇护理满意度,提高母乳喂养成功率。     

护理干预对母婴分离产妇的影响探讨

目的探讨护理干预对母婴分离产妇的影响。方法将200例住院的母婴分离产妇分为两组,对照组采用传统的产后护理方法,实验组则实施护理干预。结果实验组产妇的焦虑情绪、产后出血的发生率低于对照组,母乳喂养、婴儿护理知识及技能掌握率、对婴儿疾病恢复有信心率、对护理服务的满意率均比对照组有大幅上升。结论护理干预对产科母婴分离产妇是十分重要的,能有效地满足产科母婴分离产妇对高质量护理服务的需求。     

主动预控技术在母婴分离产妇母乳喂养管理中的应用

目的:探讨主动预控技术在母婴分离产妇母乳喂养管理中的应用效果。方法:将2018年1月1日～10月31日在围产门诊建档且分娩的产妇60例作为对照组,采用常规母乳喂养管理;将2018年11月1日～2019年8月31日在围产门诊建档且分娩的产妇60例作为实验组,接受有利于母乳喂养行为的主动预控技术干预。比较两组泌乳始动时间、乳房肿胀情况、产后42 d内纯母乳喂养率。结果:实验组泌乳始动时间短于对照组(P0.05),乳房中重度肿胀率低于对照组(P0.05),产后42 d内纯母乳喂养率高于对照组(P0.05)。结论:采用主动预控技术对母婴分离产妇施以母乳喂养管理,可明显缩短泌乳始动时间,降低乳房肿胀度,提高产后42 d内纯母乳喂养率。     

Breast feeding in Cambridge, England: factors affecting the mother''s milk supply

Mothers breast feeding 2 weeks after delivery were studied. One group (106 mothers) were advised to 'eat for two' during lactation to sustain their milk supply. They were compared at 3 months with a control group of 152 mothers. At 3 months only half as many advised group mothers had weaned their babies due to insufficient milk as control mothers. The numbers weaning for other reasons were similar in both groups. More breast feeding mothers reported an increased appetite during lactation than did mothers who had changed to artificial feeding. Smokers were more likely to have given up breast feeding between 2 weeks and 3 months than non-smokers but smoking was not associated with any particular weaning reason. Women taking a contraceptive pill during lactation more often experienced a diminution of milk supply than non-pill-takers. Sustained lactation benefits the mother since those who were still breast feeding were less likely to suffer from depression or fatigue at 3 months, and were more likely to have lost weight. The early introduction of solids was less frequent among infants being breast fed at 3 months.     

NICU出院早产儿母亲角色适应的心理体验

目的 了解NICU出院早产儿母亲在新生儿出院早期的心理体验,探讨母婴分离后早产儿母亲的角色适应问题,为制订有效的NICU护理提供依据.方法 采用质性研究法,对18例NICU早产儿母亲在早产儿出院后1周内进行深度访谈,访谈内容根据Colaizzi的现象学分析法进行整理.结果 母亲在早产儿出院早期表现出“积极接纳”与“消极否定”的互相矛盾的复杂心境.“积极接纳”主要表现为喜悦、幸福、安心,“消极否定”主要表现为恐惧与震惊、怀疑、陌生、无奈,以及担忧.结论 母婴分离早产儿母亲面临着角色转换的困惑,这种困惑可能导致母婴感情建立延迟,影响母亲的育儿行为,针对早产儿母亲的积极的NICU护理介入应引起重视.     

口服当归补血汤加味中药促进剖宫产产妇泌乳及母乳喂养的效果观察

目的探讨口服当归补血汤加味中药对剖宫产产妇泌乳及母乳喂养的效果。方法选取2007年1-12月住院行剖宫产的产妇160例，按分娩时间先后顺序分为试验组及对照组各80例。对照组给予常规的健康教育和母乳喂养指导；试验组在对照组的基础上，遵医嘱于产后6h给予产妇口服当归补血汤加味中药，每日服2次，每次1130ml，连服3d。观察丽组产妇产后24h、48h、72h泌乳情况，比较两组产后第4天的乳房结块发生率及产后42d纯母乳喂养率。结果两组产妇产后24h、48h、72h泌乳情况比较，差异均有统计学意义（P〈0．01），试验组产妇产后24h、48h、72h泌乳量中等和多的人数明显多于对照组；产后第4天试验组乳房结块发生率低于对照组（P〈0．01）；试验组产后42d纯母乳喂养率高于对照组（P＜0．05）。结论剖宫产产妇口服当归补血汤加味中药能促进泌乳，增加乳汁量，降低乳房结块发生率，提高母乳喂养率。     

Maternal aspects of home based newborn care (HBNC) practices in rural areas of Uttarakhand,India: A cross-sectional study

Background and objectivesAround 2.6 million infants die within the first one month of life every year and India alone accounts for about one-fifth of global live births and one-fourth of neonatal deaths. Uttarakhand being a rural predominant state of India has neonatal mortality rate of 31 per 1000 live births in 2018 that is much higher than the targeted 12 deaths per 1000 live births by 2030 as per Sustainable Developmental Goal-3. The present study is being undertaken to examine Home Based Newborn Care practices of mothers in rural areas of Uttarakhand, India.MethodsA community based cross-sectional study was conducted on 205 postnatal mothers who were within 42 days of delivery in Doiwala, Uttarakhand using total enumeration technique. Data were collected using reliable, structured and pretested tools comprising various aspects of home based newborn care practices. The data were analyzed using SPSS version 21.ResultsDelivery of most of the mothers (94.15%) took place in health centers though they never consulted obstetricians during pregnancy. While the remaining 5.85% of mothers gave birth at home with the help of local Dais and family members. Most of the babies (95.12%) were born full-term and about half of them (47.40%) were immunized with BCG, OPV and HEP-B vaccines. About 78.05% of mothers initiated breast feeding within the first hour of delivery and 88.29% of the mothers reported exclusive breastfeeding. However, the remaining 11.71% of mothers provided water, gripe water or ghutti to their babies as pre-lacteal feeds. 72.68% of mothers delayed the first bath of their baby for at least 48 h post-delivery and Kangaroo Mother Care (KMC) was practiced by 74.63% of mothers. Most of the participants (93.66%) were aware of keeping umbilical cords clean and dry, however, the remaining 6.34% of the mothers still practiced traditional methods of applying turmeric powder and ghee to the cord.ConclusionMost of the mothers were aware of hygiene maintenance and thermal protection for babies during the post-natal period. Some of the major challenges experienced by the mothers include early bathing of newborns, delayed initiation of breast feeding, cord care, avoidance of KMC, providing pre-lacteal feeds to newborns, as well as others.     

The contraceptive effects of lactation. Failure to appreciate these effects resulted in unnecessary stress for a couple

Lactational infertility is being investigated in mothers who delivered in the Simpson Memorial Maternity Pavilion in Edinburgh, Scotland. A group of breast feeding and a group of bottle feeding mothers were monitored. Weekly urinary total estrogen, pregnanediol excretion, and fortnightly plasma gonadotropins and prolactin concentrations were measured to determine the relationship between the resumption of menstruation and 1st postpartum ovulation. A research sister visited each mother at home every 2 weeks to collect a 10 ml sample of venous blood and to check on the progress of breast feeding. Although lactation is not a totally reliable contraceptive method, a mother is very unlikely to ovulate when she is fully breast feeding in the early weeks after delivery and particularly if she is giving night-time feeds. When the timing of 1st ovulation was compared in 7 bottle feeding mothers and 10 breast feeding mothers, ovulation was delayed in all lacting women and returned only when the mother started to wean her baby. A case history is reported of 1 patient who highlights the need for a deeper understanding of this natural contraceptive mechanism. The patient was Roman Catholic, mother of 4 children, and she and her husband wanted to practice only natural methods of contraception. She was informed that her weekly urinary steroid levels showed no evidence of ovulation, but she remained unconvinced and requested information and guidance on cervical mucus assessment. By choosing to stop breast feeding to return to a familiar contraceptive method, the patient increased the risk of unwanted conception. A prolonged period of lactation may be an effective method for couples who want to space their children, and this option should be explained to couples.     

早期混合喂养对预防剖宫产新生儿高胆红素血症的效果观察

目的探讨早期混合喂养对剖宫产术后新生儿血清总胆红素的影响。方法选择我院120例剖宫产分娩的正常新生儿,随机分成两组各60例,观察组早期混合喂养,对照组母乳喂养。观察两组产妇泌乳时间、新生儿排便时间、生后4～5d血清胆红素。结果观察组与对照组乳汁分泌时间差异无显著性(P>0.05),观察组新生儿排便时间、出生后4～5d血清总胆红素浓度与对照组比较差异有显著性(P<0.01)。结论剖宫产新生儿早期混合喂养可以预防高胆红素血症。     

Breastfeeding in neonatal intensive care: description of a change

The results of a program to promote breast feeding in a neonatal intensive unit are presented. Data on all newborns admitted during the first three days of life in a neonatal intensive unit in the first semester of 1998 and 2000 were collected. Of the 100 newborns admitted in 1998 data were collected on 76 and on 50/61 admitted in 2000. Information on breast feeding practices at home were collected by phone interview to the mothers. The support program offered consisted in a room for breast milk collection with professional electric breast pump; a short information sheet on how to collect breast milk; cushions and armchairs to improve mothers comfort; an educational course for nurses on how to promote breastfeeding; and the availability of professional consultants before admission and after discharge. The newborns were comparable for the main characteristics. The number of mothers that collected the milk in the first three days did not change (from 72 to 80%). An increase was observed in the number of milk collections a day: 62% of the mothers collected the milk more than 4 times a day (compared to less than 35% in 1998) and the length of duration of milk collection increased from 21+/-24 days in 1998 to 42+/-44 in 2000 (p=0.01). Also the number of newborns breast feed increased from 21.2% in 1998 to 64% in 2000 (p=0.001). The change observed is encouraging, although not optimal. Further efforts need to be implemented with different strategies (information sheets, and the promotion of new milk collection techniques) to improve the results.     

促进母婴分离产妇母乳采集的循证实践

目的 实施母婴分离产妇母乳采集的循证实践并探索其对泌乳的影响。方法 应用循证护理的方法获取最佳证据,以基于证据的持续质量改进模式为理论框架,于2018年5月—12月,按照证据获取、现状审查、证据引入和效果评价4个阶段将循证实践应用于母婴分离产妇,比较循证实践应用前后产妇母乳采集的依从性和泌乳量等指标的变化。结果 循证实践应用了12条证据。循证实践后,产妇母乳采集的依从性提高,送母乳至新生儿科的产妇人数比例提高,产妇开始送母乳时间提前,产后1周内产妇泌乳总量增加。结论 通过循证护理对母婴分离产妇进行管理,可有效规范产妇母乳采集行为,促进成功泌乳及提高泌乳量,可为母婴分离状态下母乳喂养的管理提供参考。     

围产期新生儿高胆红素血症及其危险因素分析

【目的】分析围产期新生儿高胆红素血症（NHB）及其影响因素,为防治NHB提供依据。【方法】回顾分析2005年1月至2007年12月住院1872例新生儿临床资料。记录新生儿的性别、胎次、胎龄、分娩方式、出生时评分、出生体重及头3d胆红素监测情况、合并症、母乳喂养及孕母情况。【结果】引起围产期NHB的危险因素包括剖宫产、母乳缺乏、出生后头3d体重下降、围产窒息、吸入综合征、宫内窘迫、高龄初产、胎龄、感染。其中剖宫产组与非剖宫产组NHB发生率分别为41．0％、33．2％,两组差异有显著性（P〈0．01）;同时剖宫产组合并窒息、呼吸窘迫综合征（RDS）、暂时性呼吸困难（TTN）发生率明显高于非剖宫产组,差异有显著性（P〈O．05）;剖宫产组中母亲有妊娠合并症者NHB发生率为44．0％,略高于母亲无妊娠合并症者NHB发生率（40．2％）,两者差异无显著性（P〉0．05）。【结论】剖宫产分娩、母乳缺乏同样要作为NHB围产因素并引起重视,进行早期干预。