Breast-feeding initiation among post-Caesarean women of the Negev, Israel

The objectives of the study were to increase post-Caesarean breastfeeding rates and decrease timing of post-Caesarean breastfeeding initiation in multicultural populations following a post-Caesarean breastfeeding intervention. The study was a prospective population-based evaluation of a breastfeeding intervention for post-Caesarean women of different cultures at a southern Israeli hospital. The study population consisted of 570 Jewish and Muslim post-Caesarean women who had delivered healthy, term infants. The control group (n=264) received standard hospital care and the intervention group (n=306) received early, culturally sensitive, post-Caesarean breast-feeding guidance and education by trained professionals. Timing of post-Caesarean maternal-infant contact and breastfeeding initiation outcomes for the Jewish and Muslim women significantly improved following the intervention.     

系统化护理干预对改善产妇母乳喂养自信心效果的研究

目的：评价系统化护理干预对改善产妇母乳喂养自信心和纯母乳喂养率的效果。方法：选取在广州市3所三级甲等综合性医院妇产科住院分娩的313例产妇为研究对象,按住院顺序分为对照组148例,实验组165例。向对照组实施母乳喂养口头宣教,对实验组应用《实用母乳喂养手册》实施面对面、一对一的哺乳知识与技能指导并于产后5周、11周实施母乳喂养电话指导2次。比较两组产妇在产后3天、6周、3个月时的母乳喂养自信心量表（BSES）评分及纯母乳喂养率。结果：产后3天和6周时,实验组产妇的BSES评分高于对照组（P〈0.001）;产后3天、6周、3个月时,实验组的纯母乳喂养率高于对照组（P〈0.05）。结论：系统化护理干预能显著提高产妇的母乳喂养自信心和纯母乳喂养率。     

Evaluation of a lactation intervention program to encourage breastfeeding: a longitudinal study

The purpose of this study was to evaluate the implementation of a change to the breastfeeding policy in seven hospitals in accordance with the 'Ten Steps to Successful Breastfeeding' issued by the World Health Organization and the United Nations Children's Fund and to assess the impact of hospital practices on breastfeeding. A 3-year quasi-experimental pre-post test design was conducted in 12 hospitals. The subjects were composed of 4614 lactating women in both experimental and control groups. The research instruments included the Baby-Friendly hospital Initiative training programs and questionnaires on breastfeeding duration, knowledge, attitude, and demographic data. Breastfeeding rates (including exclusive breastfeeding, mixed breastfeeding, and overall breastfeeding rates) of the experimental and control groups were measured and compared at four different times, during the hospital stay and at 2 weeks, 1 and 2 months postpartum. The results indicated that the exclusive and overall breastfeeding rates of the experimental group were higher than those of the control group (p < 0.001); moreover, the breastfeeding rates generally exhibited an increasing trend year by year ((p < 0.001). The results also showed that the experimental group scored higher in breastfeeding knowledge than the control group as did positive attitudes toward breastfeeding (t > 1.96, p < 0.05) with scores increasing year by year. The results also showed that higher scores reflected better knowledge in breastfeeding, and, in turn, a longer duration of breastfeeding.     

系统化护理干预对产妇产后不同时期哺乳技能与纯母乳喂养的影响

[目的]探讨系统化护理干预对产妇产后不同时期哺乳技能与纯母乳喂养的影响。[方法]对照组接受现有常规护理,试验组接受以计划行为理论为指导的纯母乳喂养综合护理干预,分别于产后3d、6周、3个月各填写1次LATCHES母乳喂养技能量表。[结果]试验组产后6周、3个月的LATCHES母乳喂养技能评分分别为33．01分±2．38分、33．55分±2．39分,均高于同期对照组（31．00分±3．09分、3L．98分±4．29分）,差异均有统计学意义（均P〈0．001）;重复测量的双因素方差分析发现两组LATCHES评分在时间效应、组间效应、时间与组间的交互效应均有统计学意义（均P〈0．001）,两组LATCHES评分随时间变化均有增高趋势,但试验组增高幅度大于对照组;试验组产妇乳汁排空执行率为53．3％,高于对照组（26．4％）,差异有统计学意义（P〈0．001）;产后3d、6周、3个月试验组的纯母乳喂养率分别为31．5％、52．7％、59．4％,均高于同期对照组（20．9％、29．7％、29．1％）,差异均有统计学意义（P〈0．05或P〈0．001）。[结论]系统化护理干预能显著提高产妇的哺乳技能,作用持续到产后3个月;能显著提高产后3d、6周和3个月的纯母乳喂养率。     

对剖宫产后纯母乳喂养护理干预的效果观察

目的探讨合理的护理干预对剖宫产手术后纯母乳喂养率的影响。方法选择剖宫产产妇160例,随机分为试验组和对照组,每组各80例。对照组给予产科常规护理,试验组配备专职护士有针对性地进行行为干预和心理疏导,比较2组纯母乳喂养率。结果试验组产妇手术后24、48、72h纯母乳喂养率明显高于对照组;住院期间纯母乳喂养率试验组为86.3%,对照组为60.0%,差异有统计学意义（P〈0.02）。结论合理的护理干预能有效提高剖宫产手术后纯母乳喂养率。     

How does postpartum depression affect breastfeeding?

PURPOSE: To examine patterns of exclusive breastfeeding, combination feeding, and exclusive bottle-feeding among a sample of women identified at 2-4 weeks postpartum with positive PPD symptoms. STUDY DESIGN AND METHODS: The sample included 122 women who were part of a larger study testing an intervention for promoting maternal-infant interaction among women with elevated PPD symptoms. Data were collected during three postpartum home visits. Demographic and feeding pattern data were described. Variables related to and predictors of feeding pattern were analyzed. The sample was compared to a random sample of postpartum women in New England. RESULTS: Severity of depression was not significantly related to breastfeeding. Older maternal age, living with a partner, and higher income were positively related to breastfeeding. Compared to a random sample, the level of exclusive breastfeeding was significantly lower in this sample than the level of combination feeding. CLINICAL IMPLICATIONS: Nurses should be involved in screening all prenatal and postpartum women for PPD symptoms, particularly when they present with breastfeeding difficulties, and refer for treatment when appropriate. For breastfeeding mothers, PPD treatment must include consideration of therapeutic options as well as implications for the breastfeeding relationship. When appropriate treatment for PPD is being considered, thought should be given to the importance and value of breastfeeding to the mother.     

Getting it right: Australian primiparas' views about breastfeeding: A quasi-experimental study

BACKGROUND: The study documented Australian primigravidas' perceptions about breastfeeding. OBJECTIVES: To examine women's perspectives of their breastfeeding experiences during the first 12 weeks postpartum. DESIGN: A Journal was introduced to an intervention group (n=149) attending prenatal classes at a private hospital at 36 antenatal weeks. Using quantitative data at two days and 12 weeks postpartum, the intervention group was compared with a control group (n=154) that delivered at the same hospital. Qualitative data were also collected about the women's perceptions about breastfeeding to further illuminate their experience. Qualitative data from 203 women at two days postpartum and 252 women at 12 weeks postpartum represented the combined comments from the intervention and control groups. PARTICIPANTS: Participants were recruited as part of a randomised controlled trial of the effects of a Breastfeeding Journal on breastfeeding prevalence, self-efficacy, support, and influence from conflicting advice. The convenience sample of middle class, well-educated primiparous women from a Western Australian hospital had given birth to a singleton infant that was greater than 34 weeks gestation. METHODS: An open-ended question on a questionnaire sought mothers' comments about their breastfeeding experiences. Data were analysed using inductive content analysis. FINDINGS: These mothers described trying to 'get breastfeeding right'. Getting it right included enhancing factors, factors with mixed effect, and negative factors. CONCLUSIONS: Middle class mothers share breastfeeding perceptions with women in more vulnerable groups, including encountering conflicting and unhelpful advice and feeding pressures from health care professionals, family, and community members.     

基于网络即时通讯工具的延续护理在提高产妇产后纯母乳喂养以及生活质量中的应用价值分析

目的：探讨基于网络即时通讯工具的延续护理在提高产后纯母乳喂养和生活质量中的应用价值。方法：选择2019年4月-2019年10月我院收治的184例产妇。采用随机数字表法将患者分为对照组和观察组,每组各92例。对照组行常规延续性护理,观察组在此基础上加以微信、公众号等网络即时通讯工具的延续性护理。对比两组产妇母乳喂养率、母乳喂养态度、母乳喂养质量、纯母乳喂养总时间、产后抑郁情况。结果：两组产妇3个月纯母乳喂养率对比差异无统计学意义(P > 0.05)；观察组产妇6个月纯母乳喂养率显著高于对照组S(P < 0.05),观察组纯母乳喂养总时间显著高于对照组(P 相似文献   

Evaluating effects of a prenatal breastfeeding education programme on women with caesarean delivery in Taiwan

Aims. The aims of this study were: (1) to evaluate the effectiveness of a prenatal breastfeeding education programme for primigravida women who have elected caesarean section as a model of delivery and (2) to evaluate its effectiveness for encouraging a positive attitude to breastfeeding and rooming‐in and to increase exclusive breastfeeding rates within hospital and at one month postpartum. Background. Prenatal preparation for pregnant women about breastfeeding enhances their practical knowledge and skills about breastfeeding techniques, which prepares them when encountering possible difficulties. Design. A quasi‐experimental design was used. Methods. The targeted population was primigravidas at 36–39 weeks and who had chosen to deliver by caesarean section. The study consisted of approximately 100 individuals; the control group consisted of 46 subjects and the following 54 made up the experimental group. The study was conducted at a hospital in Taiwan. Results. The results of the study show that the subjects of the experimental group exhibited a more positive breastfeeding attitude (88·9 vs. 79·8, t = 7·40, p < 0·001), a higher 24 hours rooming‐in rate (87% vs. 63%, χ² = 16·06, p < 0·001) and a higher exclusive breastfeeding rate (79·6% vs. 52·2%, χ² = 8·38, p = 0·004) during hospital stays and a higher exclusive breastfeeding rate (75·9% vs. 34·7%, χ² = 16·98, p < 0·001) for the one month postpartum period. Conclusion. Results suggest that providing education booklets, videos and telephone interview on breastfeeding prior to a caesarean delivery may contribute to breastfeeding attitude and improved rooming‐in and exclusive breastfeeding rates. Relevance to clinical practice. This breastfeeding education programme has proven to be successful in aiding women breastfeeding after a caesarean delivery and provides health care professionals with an evidence‐based intervention.     

Prevalence, self-efficacy and perceptions of conflicting advice and self-management: effects of a breastfeeding journal

AIM: This paper reports an assessment of the effects of a breastfeeding journal on breastfeeding prevalence and perceptions of conflicting advice, self-management and self-efficacy. BACKGROUND: Breastfeeding prevalence rates in most developed countries are not meeting recommendations. Women's concerns about inconsistent advice, limited involvement in decision-making, accessibility of information and inappropriate follow-up have been recognized. Research on evaluation of interventions addressing these concerns and including antenatal and early postnatal periods is required. Method. An intervention study was conducted from July 2003 to April 2004, with control and intervention groups recruited sequentially. The intervention group received a breastfeeding journal at 36 weeks antenatally in breastfeeding classes that were attended at different times by intervention and control group members. The intervention and control groups were compared during postpartum hospitalization and 12 weeks for breastfeeding prevalence and perceptions of self-efficacy, conflicting advice and self-management. FINDINGS: No statistically significant differences were noted between the intervention and control groups in breastfeeding prevalence at 12 weeks or self-efficacy during hospitalization. There was a statistically significant difference between groups in conflicting advice at both times. Although conflicting advice continues to present a dilemma for women, levels of conflicting advice did not explain breastfeeding self-efficacy. Breastfeeding self-management was a statistically significant contributor to breastfeeding prevalence prior to the addition of breastfeeding self-efficacy. CONCLUSIONS: Women's perceptions of their ability to manage and be actively involved in decision-making explained breastfeeding prevalence at 12-week postpartum. Efforts to encourage women's involvement in decision-making about breastfeeding are a useful strategy to promote breastfeeding.     

The reliability and validity of the Polish version of the Breastfeeding Self-Efficacy Scale-Short Form: translation and psychometric assessment

BACKGROUND: The majority of women discontinue breastfeeding before the recommended 6 months postpartum. If health professionals are to improve low breastfeeding duration and exclusivity rates, they need to reliably assess high-risk women and identify predisposing factors that are amenable to intervention. One possible modifiable variable is breastfeeding confidence. The Breastfeeding Self-Efficacy Scale Short Form (BSES-SF) is a 14-item measure designed to assess a mother's confidence in her ability to breastfeed her baby. OBJECTIVES: To translate the BSES-SF into Polish and assess its psychometric properties among breastfeeding mothers. DESIGN: Methodological study. SETTING: Five hospitals in Lodz Poland. PARTICIPANTS: Using convenience sampling, 105 in-hospital breastfeeding mothers were recruited. METHODS: Following back-translation procedures, mothers completed questionnaires in-hospital and at 8 and 16 weeks postpartum. RESULTS: The Cronbach's alpha coefficient for internal consistency was 0.89. In-hospital BSES-SF scores significantly predicted breastfeeding duration and exclusivity at 8 and 16 weeks postpartum. Demographic response patterns suggested the BSES-SF is a unique tool to identify breastfeeding mothers at risk of prematurely discontinuing. CONCLUSIONS: This study provides evidence that the translated version of the BSES-SF may be a valid and reliable measure of breastfeeding self-efficacy among a sample of mothers in Lodz Poland.     

Effectiveness of a prenatal education programme on breastfeeding outcomes in Taiwan

Aims. The objectives of this study were to design a structured prenatal education programme on breastfeeding and to evaluate the effectiveness of the programme. Indicators of effectiveness were selected based on Kirkpatrick's Training Evaluation Model, including satisfaction with the programme, breastfeeding knowledge, breastfeeding attitude, breastfeeding satisfaction, breastfeeding problems and rate of exclusive breastfeeding. Methods. This study applied a quasi‐experimental design. The experimental group included 46 women who received a 90‐minute group educational programme on breastfeeding during their 20th–36th week of pregnancy. Each experimental subject was matched by a control subject according to age, educational level, work status and pregnancy gestational age. Control subjects did not receive any intervention. Data were collected through self‐administered questionnaires at preintervention, postintervention, three days postpartum and one month postpartum. Results. Satisfaction with the programme was high. The experimental group had higher scores in breastfeeding knowledge and breastfeeding attitude at three days postpartum. The experimental group showed higher breastfeeding satisfaction at three days and one month postpartum. There were no significant differences in experiencing breastfeeding problems. The rate of exclusive breastfeeding was higher for the experimental group at three days and one month postpartum, but the differences were not statistically significant. Conclusion. This study demonstrated the effectiveness of a prenatal education programme on maternal knowledge, attitude and satisfaction toward breastfeeding. Relevance to clinical practice. Other hospitals could apply this model to plan and evaluate their prenatal education programme on breastfeeding.     

Comparison of Different Virtual Follow-ups on Mother’s Lactation

This study compared the effect of telephone and social messaging application follow-up on mothers’ self-efficacy, perceived social support, and duration of exclusive breastfeeding. Participants were randomized into 3 groups. The control group received the breastfeeding education during hospitalization, and the 2 intervention groups received education sustained postdischarge follow-up via telephone or by a social messaging application. Both intervention groups had significant differences in breastfeeding self-efficacy, perceived social support, and the duration of EBF compared with the control group, but the intervention groups were similar in these regardes. The telephone and social messaging application follow-up both promote EBF duration.     

基于共同养育理论的母乳喂养干预方案在初产妇早期母乳喂养中的应用效果

目的探究基于共同养育理论的母乳喂养干预方案对初产妇母乳喂养情况的影响。方法采用便利抽样法,选取2019年在北京市丰台区妇幼保健院产科门诊进行产前检查的67名初产妇及其配偶67名为研究对象,以预产期在2019年10—11月的35名初产妇及其35名配偶为对照组,预产期在2019年12月—2020年1月的32名初产妇及其32名配偶为试验组。对照组通过微信群给予母乳喂养知识宣教和答疑,试验组在对照组的基础上接受基于共同养育理论的母乳喂养干预方案。比较两组初产妇产后6周的纯母乳喂养率、简体中文版母乳喂养自我效能简式量表(BSES-SF)得分、简易共同养育关系量表(Brief CRS)得分及其配偶的中文版婴儿喂养态度量表(IIFAS)得分。结果试验组产后6周纯母乳喂养率为87.5%(28/32),高于对照组的77.1%(27/35),差异无统计学意义(χ2=0.432,P>0.05)。试验组初产妇的简体中文版BSES-SF内心活动维度得分为(20.78±5.05)分、Brief CRS总分为(71.84±8.60)分、产妇配偶的中文版IIFAS总分为(63.38±7.25)分,高于对照组的(16.94±4.78)、(67.00±10.94)、(59.89±5.92)分,差异均有统计学意义(t值分别为3.196、2.002、2.166;P<0.05)。结论基于共同养育理论的母乳喂养干预方案可以提高产妇配偶的婴儿喂养态度、初产妇的共同养育感知程度,对提高纯母乳喂养率和母乳喂养自我效能的干预效果还有待进一步验证。     

Predictors of the duration of exclusive breastfeeding among first-time mothers

Few women currently meet revised WHO recommendations to breastfeed exclusively for 6 months postpartum. In this prospective study we aimed to determine the influence of socio-demographic, psychosocial, and perinatal factors on the length of exclusive breastfeeding among 189 Canadian primiparous mothers. A majority of the participants did not meet their exclusive breastfeeding goals, and only 5% breastfed exclusively for a full 6 months. Breastfeeding self-efficacy, in-hospital formula supplementation, prenatal class attendance, and type of delivery independently predicted exclusive breastfeeding duration. Findings underscore the complex interplay of factors influencing breastfeeding, highlight the early postpartum weeks as a critical period for the establishment of exclusive breastfeeding, and suggest the need for a continuum of pre- and postnatal strategies for prolonging the exclusive breastfeeding period.     

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

目的探讨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。方法选取2016年4月至2019年4月该院收治的79例妊娠高血压综合征患者为研究对象,根据入院日期单双号,将研究对象分为对照组40例及研究组39例。对照组患者接受传统产科护理,研究组在对照组的基础上采用心理护理临床路径进行护理。比较干预前后两组患者的治疗依从性、心理状态、母乳喂养自信心以及产后并发症发生率、泌乳始动时间、母乳喂养情况以及护理满意度。结果与干预前相比,干预后两组患者的治疗依从性和母乳喂养自我效能量表(BSES)评分均明显升高(P<0.05);两组患者的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分明显降低(P<0.05),且研究组显著优于对照组(P<0.05)。与对照组相比,研究组患者产后并发症发生率更低(P<0.05),泌乳始动时间显著缩短(P<0.05),护理总满意度更高(P<0.05)。产后随访1个月,研究组纯母乳喂养率显著高于对照组(P<0.05)。结论心理护理临床路径可有效改善患者的心理状态,提高治疗依从性及母乳喂养自信心,促进乳汁分泌,减少产后并发症,对提高纯母乳喂养率、促进母婴健康具有积极意义。     

Promoting exclusive breastfeeding for Hispanic women

This article focuses on assisting nurses with the promotion of exclusive breastfeeding in Hispanic women through the understanding of their heritage, cultural traditions, and acculturation. Nurses can incorporate these traditions into daily nursing practice in order to enhance the breastfeeding experience of Hispanic mothers. Because exclusive breastfeeding is low in minority groups in the United States, it is essential that nurses use the initial postpartum period to help educate women about exclusive breastfeeding. In order to accomplish this, nurses need culturally specific information, which promotes cultural traditions and also encourages breastfeeding.     

连续护理对妊娠期糖尿病患者妊娠结局的干预效果研究

目的探讨连续护理对妊娠期糖尿病（GDM）患者妊娠结局的干预效果。方法选取在产科门诊经OGTT试验确诊为GDM,并在我院产检、分娩的患者160例,分为干预组和对照组,每组各80例。对照组采用传统护理;干预组在传统护理的基础上采用个体化连续护理干预方案,合理应用教育指导、饮食疗法、适度运动锻炼、血糖监测和用药指导等干预,并对出院后的患者进行全程管理。统计两组孕妇孕期及产后并发症和新生儿并发症的发生率以及产后42d血糖控制情况,作为评价GDM患者妊娠结局的观察指标。在完成全程管理、结束本次连续护理的研究计划时,让患者自行填写糖尿病患者生存质量特异性量表（DQOL）。结果两组孕妇孕期及产后并发症和新生儿并发症发生率、血糖控制情况以及DQOL结果显示,干预组均显著优于对照组。结论连续护理应用于GDM患者,可有效提高妊娠质量,改善妊娠结局。     

剖宫产术后6小时内母乳喂养体位的探讨

目的：探讨剖宫产术后6小时内母乳喂养体位以提高母乳喂养率。 方法：选择160例剖宫产产妇,随机分成观察组和对照组各80例,对照组产妇剖宫产术后常规处理行早接触、早吸吮1小时后于按传统体位进行按需哺乳,观察组产妇剖宫产术后常规处理行早接触、早吸吮1小时后由护理人员协助新生儿采取横俯趴式体位进行按需哺乳,观察两组产妇48小时泌乳量、乳房充盈时间、新生儿含接姿势正确率、产妇哺乳体位舒适度、产妇对纯母乳喂养的信心以及纯母乳喂养情况。 结果：观察组产妇乳房充盈时间早于对照组,而产后48小时泌乳量、新生儿含接姿势正确率、产妇哺乳体位舒适度、产妇对纯母乳喂养的信心以及纯母乳喂养情况均显著高于对照组（P＜0.05）。 结论：剖宫产术后6小时内予以横俯趴式体位干预,可以有效增加早接触时间并提高早期吸吮的时间和频率,可以增加产妇哺乳体位的舒适度,有效增加泌乳量,促进了产妇对纯母乳喂养的信心,有效提高了纯母乳喂养率。