早产儿母乳喂养现状的调查

目的了解早产儿住院期间母乳喂养状况及其影响因素,并针对影响因素提出干预对策。方法采用现场问卷调查方法对2013年6月-2014年6月自贡市妇幼保健院产科转入新生儿科的早产儿98例及其母亲进行调查,由2名产科责任护士专门负责,采用面对面询问母亲的方式并协助填写问卷,以便统一判断标准。结果住院期间早产儿母乳喂养率47.9%,其中混合喂养率30.6%,纯母乳喂养率仅为17.3%。影响早产儿母乳喂养的主要因素为母乳不足、母亲未掌握喂哺及挤奶技巧。结论早产儿纯母乳喂养率低,应加强医务人员指导,增强母亲喂哺信心,提高母亲喂哺技巧。     

母乳喂养心理准备的调查分析

为了更好地开展母乳喂养健康教育,我们采用问卷式调查卡,对本院产科1990年5月20日～6月20日期间,产后24小时内的产妇进行了调查。包括:对婴儿出生后6个月内喂养方式的选择和开奶时间的选择两方面的母乳喂养心理准备。结果与讨论喂养方式选择选择母乳喂养59人,占95.16％;选择人工喂养3人,占4.84％;无人选择混合喂养。通过对充分相信自己能用乳汁成功喂哺婴儿的47例分析表明:22例受科学育儿知识的影响;25例受当地母乳喂养习俗或有第一胎哺育经验教训的影响,此为影响其心理准备形成的重要因素。产妇生育时的年龄与接受科普教育的程度无明显影响。产妇文化程度的高低与接受科普教育的程度呈正相关(P<0.05)。产妇职业与接受科普教育的程度在工人与农民之间差异无显著性意义,但工农与干部之间差异有非常显著意义(P<0.001)。前者明显低于     

二胎新生儿纯母乳喂养情况及影响因素分析

目的 分析二胎新生儿纯母乳喂养情况及其相关影响因素。方法 选取2020年1月—2021年3月宁波市李惠利医院产后未出院二胎产妇90例作为研究对象,回顾性收集其一般资料,根据二胎新生儿纯母乳喂养情况分为纯母乳喂养组32例、非纯母乳喂养组58例,纯母乳喂养定义为分娩后6个月内婴儿在母乳喂养的基础上不接受任何配方奶喂养。分析二胎新生儿纯母乳喂养现状,通过单因素和多因素logistic回归分析法分析二胎新生儿非纯母乳喂养的危险因素。结果 90例二胎产妇纯母乳喂养32例,纯母乳喂养率为35.56%。多因素logistic分析结果显示,产妇乳头凹陷、两次分娩间隔>5年、一胎喂养方式为非纯母乳喂养、外祖母不支持母乳喂养、二胎新生儿分娩方式为剖宫产为二胎新生儿非纯母乳喂养的危险因素(P<0.05)。结论 二胎新生儿纯母乳喂养率不容乐观,二胎新生儿非纯母乳喂养与产妇乳头凹陷、两次分娩间隔>5年、一胎喂养方式为非纯母乳喂养、外祖母不支持母乳喂养、二胎新生儿分娩方式为剖宫产等因素息息相关,临床可根据以上因素对产妇进行健康宣教,提高产妇家庭支持,进而提高二胎纯母乳喂养率。     

剖宫产后产妇不同体位和不同喂养方法对母乳喂养的影响

目的:探讨剖宫产后产妇体位和采用不同喂养方法添加牛奶与提高母乳喂养率的关系。方法:剖宫产产妇120例,分为对照组、实验组各60例。对照组产妇术后常规去枕卧位6h后改为随意卧位,母乳不足时添加牛奶,用小勺喂哺;实验组产妇术后取垫枕卧位3h后改为随意卧位,母乳不足时添加牛奶,用简易哺乳辅助装置喂哺。结果:术后3天实验组有效吸吮次数比对照组多,母乳喂养率比对照组高。结论:剖宫产后产妇取垫枕卧位3h后改为随意卧位,母乳不足时,用简易哺乳辅助装置补充牛奶,能提高剖宫产产妇母乳喂养率。     

二次妊娠产妇纯母乳喂养状况及其影响因素调查

目的分析二次妊娠产妇纯母乳喂养状况,找出影响二次妊娠纯母乳喂养状况的影响因素,为提高纯母乳喂养率提供参考依据。方法采取分层抽样的方法选取2016年5月-2018年10月在该院成功分娩的二次妊娠产妇710例为研究对象,并对其进行长达6个月及以上的电话随访,根据随访结果将其中采取纯母乳喂养的350例产妇及其婴儿纳入纯母乳喂养组,将非纯母乳喂养的360例产妇及其婴儿纳入非纯母乳喂养组。通过统一的调查问卷,对二次妊娠产妇的相关资料进行调查,记录其一般人口学资料及纯母乳喂养状况,并分析纯母乳喂养情况的影响因素。结果单因素分析结果显示,第一胎喂养方式、二胎分娩方式及二胎是否在重症监护室、产妇是否有乳头凹陷、切口是否疼痛、子宫收缩痛、妊娠并发症、产前是否进行优生检查、开奶时间、初乳出现时间均与二次妊娠产妇纯母乳喂养情况有关(P<0.05)。多因素Logistic回归分析结果显示,第一胎喂养为人工喂养+混合喂养、二胎分娩方式为剖宫产及二胎在重症监护室、产妇乳头凹陷、切口疼痛、妊娠并发症、产前未进行优生检查、第一胎纯母乳喂养时间≤3月均是影响二次妊娠产妇纯母乳喂养的危险因素(OR>1,P<0.05)。结论全面二胎政策下的二次妊娠产妇纯母乳喂养状况处于中等水平,影响因素包括第一胎喂养方式、二胎分娩方式及二胎是否在重症监护室等,临床上应重视第一胎母乳喂养方式,社区应加强母乳喂养的宣教,降低剖宫产率,加强产前检查及宣教,以提高二次妊娠产妇纯母乳喂养率。     

穴位按摩加护理干预促进产妇母乳喂养的效果观察

目的:探讨中医穴位按摩及护理干预措施对促进母乳喂养成功的效果。方法:选取2018年5月—2019年5月在我院产科收治并实施剖宫产手术的产妇300例,按产妇意愿随机分为观察组和对照组:观察组150例,对照组150例。对照组按常规护理,观察组产妇在常规护理基础上给予中医穴位按摩及更积极的护理干预措施,分别观察两组产妇术后第4日纯母乳喂养、混合喂养及人工喂养例数及其比例。结果:术后第4日出院时,观察组:产妇乳汁充足,纯母乳喂养133例,纯母乳喂养率88.7%,乳汁中量17例,混合喂养率11.3%,无人工喂养;对照组:乳汁充足77例,纯母乳喂养率为51.3%,乳汁中量48例,混合喂养率为32%,乳汁极少25例,人工喂养率为16.7%。结论:剖宫产术后给予产妇中医穴位按摩及积极的护理干预措施可大大提高产后母乳喂养率。     

既往纯母乳喂养失败母亲再次分娩住院期间母乳喂养现状及影响因素分析

目的 分析既往纯母乳喂养失败母亲再次分娩住院期间母乳喂养现状及影响因素。方法 选取2020年7月-2021年6月在深圳市罗湖区妇幼保健院分娩的产妇150例作为研究对象。采用自行设计的调查问卷分析经产妇母乳喂养现状及影响因素。结果 纯母乳喂养组和非纯母乳喂养组在年龄、职业、教育程度、家庭月收入、分娩方式、孕期指导、并发症、主要照顾者、新生儿性别、新生儿出生体重、距上次分娩时间、疼痛、乳房条件、母乳喂养态度、技能维度评分上差异无统计学意义（P>0.05）。纯母乳喂养组的既往母乳喂哺时间为（8.89±2.85）个月,明显长于非纯母乳喂养组的（4.95±1.23）个月,乳汁不足比例为（7.78）%,显著低于非纯母乳喂养组的（46.67）%,母乳喂养自我效能、内心维度评分分别为（56.11±9.56）分、（20.12±3.73）分,明显高于非纯母乳喂养组的（50.75±7.82）分、（17.68±3.36）分,差异有统计学意义（P<0.05）。Logistic回归分析显示,影响经产妇母乳喂养的独立危险因素为既往母乳喂哺时间、乳汁分泌不足（P<0.05）。结论 既往纯母乳喂养失败...     

品管圈改进策略对母婴分离新生儿纯母乳喂养率及泌乳量的影响

目的探讨品管圈改进策略对母婴分离新生儿纯母乳喂养率及产妇泌乳量的影响。方法选取2020年4~10月于我科住院分娩的母婴分离新生儿产妇50例为研究对象。对所有产妇展开问卷调查,分析影响母婴分离产妇泌乳量的原因,根据原因实施品管圈改进策略,对比品管圈改进前后24 h、48 h、72 h、1周的母婴分离产妇泌乳量及品管圈改进策略对母婴分离新生儿纯母乳喂养率的影响。结果影响母婴分离产妇泌乳量的原因:产妇缺乏挤奶技巧占22.00%,产妇缺乏母乳喂养亲喂知识占22.00%,产妇发生产后焦虑或抑郁占14.00%,产妇乳头条件差占12.00%;品管圈改进后24 h、48 h、1周产妇泌乳量均多于改进前,差异有统计学意义(P<0.05);改进后的纯母乳喂养率为82%,高于改进前的64%,差异有统计学意义(P<0.05)。结论影响母婴分离产妇泌乳量的原因包括产妇缺乏挤奶技巧、母乳喂养亲喂知识、产妇发生产后焦虑或抑郁、产妇乳头条件差,实施品管圈改进策略可有效提高母婴分离新生儿产妇泌乳量,提高纯母乳喂养率,值得临床推广应用。     

影响母乳喂养的开奶行为分析

本文调查分析了略阳县医院和略阳铁路医院430名住院分娩产妇的开奶行为及其与新生儿期母乳喂养的关系.调查结果,产后24小时内开奶率为14.4%,平均开奶时间为52.8±24.6小时;婴儿开奶前喂养率为69.3%,奶瓶使用率为73.9%,奶瓶喂养率为57.7%.新生儿期母乳喂养与产后开奶时间、婴儿开奶前喂养及奶瓶喂哺等因素有明显相关(P＜0.01).提出在具备住院分娩母婴同室的地区,仍应积极开展母乳喂养健康教育.     

合肥市6月龄婴儿纯母乳喂养现状及影响因素研究

目的 调查合肥市6月龄婴儿喂养现状并研究纯乳母喂养影响因素,为提高纯母乳喂养行为提供科学依据。方法 以2020年1—10月在合肥某医院产科分娩的单胎活产儿及其母亲为研究对象,在婴儿出生后满6个月时通过医院分娩记录获取其母亲/父亲联系方式对婴儿母亲进行6月龄婴儿喂养现状及影响因素调查,采用描述性流行病学分析方法对6月龄婴儿喂养现状进行分析,并采用单、多因素分析方法对纯母乳喂养影响因素进行分析。结果 共2 537名婴儿纳入研究,纯母乳喂养724例,占28.54%,优势母乳喂养298例,占11.75%,补充喂养356例,占14.03%,母乳喂养819例,占32.28%,奶瓶喂养340例,占13.40%。多因素Logistic回归分析结果显示婴儿母亲年龄越大（OR=0.441）、婴儿母亲乳头凹陷/扁平（OR=0.360）、婴儿母亲开奶时间≥30 min（OR=0.431）的6月龄婴儿纯母乳喂养可能性较小,婴儿母亲学历越高（OR=2.499）、职业为事业单位工作人员（OR=1.806）、个体经营者（OR=1.730）、农民/无业者（OR=2.018）、婴儿父母支持母乳喂养（OR=2.392）的6月龄婴儿纯母乳喂养可能性较大。结论 合肥市6月龄婴儿纯母乳喂养率低,其受到母亲年龄、学历、职业、乳头凹陷/扁平、开奶时间以及父亲是否支持母乳喂养等多种因素影响,应当针对现状及影响因素加强纯母乳喂养知识宣教及干预措施,改善该地区婴儿母乳喂养情况。     

Premature complementary feeding is associated with poorer growth of vietnamese children

The objective of this longitudinal study was to investigate the association between the premature initiation of complementary feeding and physical growth of children. Four cohorts of newborn children were included, consisting of 90 infants born in 1981, 90 in 1982, 60 infants in 1983 and 60 in 1984. The weights and heights of children were measured monthly up to 1 y, then every 3 mo for y 2 and 3, and once every 6 mo in y 4. Information on feeding practices and diseases of the children was obtained by interviewing the mothers at each home visit. All but three children (98.6%) were breast-fed. Although 87.1% of the mothers breast-fed their children for at least 1 y, only 3.3% of the infants were breast-fed exclusively at the age of 4 mo. In the analyses of growth, care was taken to address the biases of reverse causality, regression to the mean and confounding. There was little association between feeding pattern at 15 d and growth in length in mo 1. However, partially breast-fed and weaned infants gained weight more slowly than those exclusively or predominantly breast-fed. From 1 to 3 mo, exclusively breast-fed infants grew more quickly in both weight and length, followed by predominantly breast-fed infants. From 3 to 6 mo, exclusively breast-fed infants gained more weight compared with the other groups, but there was a slight difference (P = 0.047) in length gain only between exclusively and partially breast-fed infants. In the older period (6-12 mo), exclusively and predominantly breast-fed infants grew in length more quickly than partially breast-fed and weaned groups. However, there was no difference in weight gain among groups. Morbidity from diarrhea and acute respiratory infections was significantly lower for the >/=3 mo exclusively breast-fed group (chi(2) and Fisher-Exact Test). Over nearly the whole age range from 1 mo to 4 y, Z-scores for all indices (weight-for-age, height-for-age and weight-for-height) of the children who received complementary food were significantly lower than those of children who were exclusively breast-fed for at least 3 mo (repeated measures ANOVA, adjusted for sex, family size, maternal education and family income). These results show a long-term deterioration of physical growth in infants who received premature complementary feeding and confirm the importance of exclusive breast-feeding for infants for at least 3 mo.     

Proposed vitamin a fortification levels

Fortified complementary foods could be effective in preventing and controlling vitamin A and other common nutritional deficiencies in young children. Milk from well-nourished women is an excellent source of vitamin A. However, in Latin America many children are weaned prematurely and must receive the entire requirement of vitamin A from food. This paper proposes vitamin A fortification levels for foods targeted for children aged 6-23 mo to meet the existing intake gap among both breast-fed and weaned infants and young children. Estimates assume a nonsignificant contribution of common complementary foods and average levels of human milk intake by breast-fed infants and children. The estimated vitamin A gap for breast-fed infants aged 6-11 mo amounts to 63-92 microg RE [16-23% of recommended daily intake (RDI)] and for breast-fed children reaches 125 microg RE (31% of RDI). Weaned infants and children would have to fully meet the RDI (400 microg RE) from complementary foods. A fortified complementary food with 500 mg RE/100 g of dry product provided daily in a single ration of 40 g would meet 50% of the gap for weaned infants aged 6-11 mo and would raise the total intake above RDI for breast-fed infants aged 6-8 mo (125%) and 9-11 mo (127%). The same fortified food given in a daily ration of 60 mg would meet most of the gap (75%) for weaned children aged 12-23 mo and would increase total intake of breast-fed children aged 12-23 mo well above the RDI (144%), with no risk of exceeding established upper tolerable intake levels.     

Infant feeding and HIV

Mother-to-child HIV transmission is the main cause of HIV infection in children. About two thirds of children infected vertically are infected during pregnancy and around the time of delivery, while the remainder are infected during breast-feeding. Although breast-feeding tends to be the best way to feed infants, substituting breast-feeding can reduce the risk of mother-to-child HIV transmission when mothers are HIV-seropositive. However, when breast milk substitutes are used, infants are 5 times more likely to have bacterial infections than are breast-fed infants, even in the context of good hygiene. Where hygiene is poor, artificially fed infants may be 20 times more likely to die from diarrhea than are breast-fed infants. HIV-positive women need information on the risks and benefits of breast-feeding and of the various alternatives, and support in deciding which method is best. Infant feeding options are discussed.     

Infant feeding practices of urban low income group in Ibadan

The feeding pattern of 915 children from the low income areas of Ibadan were determined with the aid of a questionnaire administered on their mothers. All the 915 infants were breast-fed for varying periods starting from birth. About 80% of the infants were breast-fed within 48 hours of delivery but most of the mothers in all areas claimed to have discarded the colostrum produced in the first 24 hours postpartum. Infants not breast-fed until a few days postpartum were fed on glucose water or herbal preparations. Culture played no significant role in infant feeding practices.     

Evaluation of the impact of weaning food messages on infant feeding practices and child growth in rural Bangladesh.

In rural Bangladesh, a community-based weaning intervention used volunteers to teach complementary feeding to families of 62 breast-fed infants aged 6-12 mo. Over 5 mo, treatment children gained on average 0.46 SD (approximately 460 g) more in weight-for-age (WAZ) than the 55 control subjects, and were approximately 0.5 kg heavier at the final measure. The differences were statistically significant (P < 0.001). The percent median weight-for-age (WAPM) of treatment children held steady at 76% of the National Center for Health Statistics' reference, whereas the WAPM of control subjects dropped from 78% to 72%. The increase in percentage points of severe malnutrition (below -3 WAZ) was only 5% in the treatment group compared with 26% in the control subjects. Treatment children consumed a significantly greater percent of their energy and protein requirements from complementary foods than did control subjects. The affordable complementary foods consisted mainly of cereal porridge with oil and brown sugar. These findings suggest that educational interventions teaching families to feed hygienic, simple, cheap, energy-enriched complementary foods to breast-fed infants after 5-6 mo can improve child growth, even under impoverished conditions.     

The relationship between breast and bottle feeding and respiratory illness in the first year of life.

The relationship between breast or bottle feeding and the incidence of bronchitis and pneumonia in the first year of life was examined in a birth cohort of nearly 2000 children born in Harrow, England, in 1963--65. Fewer episodes of acute bronchitis and pneumonia were reported in children who were breast-fed than in children who were bottle-fed. Firstborn children were more likely to be breast-fed than subsequent children. Mothers who smoked were less likely to breast-feed their babies. Although birth order and parental smoking have been shown to be associated with bronchitis and pneumonia in the same cohort, the association between feeding pattern and respiratory illness history persisted when these and other important factors were taken into account.     

Independent protective effect of lactation against breast cancer: a case-control study in Japan.

A case-control study was carried out to assess the risk of breast cancer associated with breast feeding in Japan. The data were obtained in a hospital-based case-control study of 521 women with breast cancer and 521 controls from January 1988 to December 1989. Statistical adjustment for potential confounders as well as a likelihood ratio test for linear trend was done by unconditional logistic regression. Compared with parous women who had never breast-fed, women with a positive history of breast feeding had an odds ratio of breast cancer of 0.62 (95% confidence interval 0.37-1.04). The trend of decreasing risk with increasing average months of breast feeding was statistically significant (chi 2 trend = 4.5, p less than 0.05), while it was was nonsignificant for the number of breast-fed children borne. Among premenopausal women, a significant linear relation with a log-transformed term of average months of breast feeding was noted, regardless of the age of the woman at first full-term pregnancy and parity (chi 2 trend = 5.3, p less than 0.05). The risk was the lowest among premenopausal women who had ever lactated for 7-9 months (adjusted odds ratio = 0.39, 95% confidence interval 0.15-0.97). These findings suggest that lactation has an independent protective effect against breast cancer in Japanese women.     

The association between cesarean delivery and breast-feeding outcomes among Mexican women.

OBJECTIVES: This study examined the impact of cesarean section delivery on the initiation and duration of breast-feeding in the 1987 Mexican Demographic and Health Survey. METHODS: The subsample (n = 2517) was restricted to women whose delivery of their last-born children (aged 5 years and younger) was attended by a physician. Multivariate logistic regression was used to examine the association between cesarean section and likelihood of either not initiating breast-feeding or doing so for less than 1 month. Among women who breast-fed for 1 month or more, multivariate survival analysis was used to examine the relationship between cesarean section and breast-feeding duration. RESULTS: Cesarean section was a risk factor for not initiating breast-feeding (odds ratio [OR] = 0.64, 95% confidence interval [CI] = 0.50, 0.82) and for breast feeding for less than 1 month (OR = 0.58, 95% CI = 0.37, 0.91) but was unrelated to breast-feeding duration among women who breast-fed for 1 month or more (OR = 0.97, 95% CI = 0.86, 1.11). CONCLUSIONS: It is desirable to provide additional breast-feeding support during the early postpartum period to women who deliver via cesarean sections.     

Growth of breastfed and bottle-fed infants up to 2 years of age: CLACYD (Lactation, Alimentation, Growth and Development) study 1993-1995]

Studies done in various countries show important differences in the growth of breastfed and bottle-fed children. In addition, it has been found that breast-fed children grow more slowly beginning at the age of 2 or 3 months in comparison with the reference pattern of the U.S. National Center for Health Statistics (NCHS) and the World Health Organization (WHO). These results cast doubt on whether maximum growth is the same as optimal growth. The objective of this study was to compare the growth in weight and length, from birth to 24 months, for a group of children who were breast-fed with that of a group who were bottle-fed. The study was also intended to describe the growth of the breastfed group in relation to the NCHS/WHO norms and a WHO "12-month breast-fed pooled data set." For this research, data were analyzed from the "Cordoba: lactation, feeding, growth, and development" study (or CLACYD study, for its Spanish-language acronym). That study looked at a representative cohort, stratified by social class, of children born in 1993 in the city of Cordoba, Argentina. The researchers analyzed anthropometric data on 74 children who were breast-fed during the first year of life and on 108 bottle-fed children. The data had been recorded, using standardized techniques, at birth and at 6, 12, and 24 months of age. Both groups were homogenous with respect to the age and schooling of the parents, social stratum, birth order, maternal height, and child's weight and length at birth. The living conditions (housing construction and availability of water and sewer services) were better among the group that was bottle-fed (P = 0.04). The breast-fed children had a lower weight and a shorter length at 6, 12, and 24 months than did the bottle-fed children. The breast-fed children also showed a slowing in growth with respect to the NCHS/WHO guidelines beginning in the second semester. This indicates that the NCHS/WHO norms are not totally adequate for evaluating the growth of breast-fed children in Cordoba, Argentina. In the high and middle social strata, the values for the breast-fed group resembled those for the WHO "pooled data set," both in weight and length. In the low and very low social strata, weight values were satisfactory, but the figures for length were less than those of the "pooled data set." The gap in length found among the low and very low social strata does not reduce the validity of the WHO "pooled data set" reference, but rather indicates the influence of living conditions on linear growth.     

Breast-feeding and cognitive development: a meta-analysis.

BACKGROUND: Although the results of many clinical studies suggest that breast-fed children score higher on tests of cognitive function than do formula-fed children, some investigators have suggested that these differences are related to confounding covariables such as socioeconomic status or maternal education. OBJECTIVE: Our objective was to conduct a meta-analysis of observed differences in cognitive development between breast-fed and formula-fed children. DESIGN: In this meta-analysis we defined the effect estimate as the mean difference in cognitive function between breast-fed and formula-fed groups and calculated average effects using fixed-effects and random-effects models. RESULTS: Of 20 studies meeting initial inclusion criteria, 11 studies controlled for >/=5 covariates and presented unadjusted and adjusted results. An unadjusted benefit of 5.32 (95% CI: 4.51, 6.14) points in cognitive function was observed for breast-fed compared with formula-fed children. After adjustment for covariates, the increment in cognitive function was 3.16 (95% CI: 2.35, 3.98) points. This adjusted difference was significant and homogeneous. Significantly higher levels of cognitive function were seen in breast-fed than in formula-fed children at 6-23 mo of age and these differences were stable across successive ages. Low-birth-weight infants showed larger differences (5.18 points; 95% CI: 3.59, 6.77) than did normal-birth-weight infants (2.66 points; 95% CI: 2.15, 3.17) suggesting that premature infants derive more benefits in cognitive development from breast milk than do full-term infants. Finally, the cognitive developmental benefits of breast-feeding increased with duration. CONCLUSION: This meta-analysis indicated that, after adjustment for appropriate key cofactors, breast-feeding was associated with significantly higher scores for cognitive development than was formula feeding.