新生儿早期基本保健对初产妇泌乳启动的影响

目的 研究新生儿早期基本保健(EENC)技术对初产妇母乳喂养得分、泌乳启动时间及产后前72 h纯母乳喂养率的影响。方法 2018年6-7月随机选取潍坊医学院附属医院自然分娩的89对初产妇及新生儿,分为干预组(n=45)及对照组(n=44)。干预组新生儿实施EENC,对照组进行常规护理。采用母乳喂养测量工具(BAT)进行母乳喂养评分,并在产后24、48、72 h随访记录产妇泌乳启动时间及纯母乳喂养情况。结果 干预组首次母乳喂养评分为(10.84±1.36)分,对照组为(10.23±1.43)分,差异有统计学意义(t=-2.085,P=0.040);干预组产妇泌乳启动时间(48.51±10.71)h] 早于对照组(53.66±10.99)h] ,差异有统计学意义(t=2.238,P=0.028);干预组产后24、48、72 h的纯母乳喂养率(33.3%、51.1%、71.1%)均高于对照组(13.6%、29.5%、50.0%),差异有统计学差异(χ²=4.788,4.295,4.155,P<0.05)。但两组首次母乳喂养或成功率和泌乳启动率间差异均无统计学意义(P>0.05)。结论 新生儿早期基本保健对母乳喂养评分及产妇泌乳启动有促进作用,能够提高早期纯母乳喂养率,值得推广。

Effects of early essential newborn care on the onset of lactogenesis among primiparaes

Objective To study the effect of early essential newborn care(EENC) after birth on neonatal first breastfeeding success rate,maternal onset of lactogenesis and exclusive breastfeeding rate during 72 h postpartum. Methods A total of 89 primiparas mother-infant pairs were recruited from a tertiary hospital in Shandong from June to July 2018,and were randomly divided into intervention group(n=45) and control group(n=44). The intervention group received the EENC,while the control group was given routine care. The neonatal first breastfeeding was scored after the postpartum by the Breastfeeding Measurement Tool(BAT).The onset time for maternal lactogenesis and the exclusive breastfeeding rate per 24 hours were recorded during the follow-up. Results The first breastfeeding score in intervention group(10.84±1.36) was significantly higher than that in control group(10.23±1.43)(t=-2.085,P=0.040). The onset time for lactogenesis of the intervention group(48.51±10.71) h] was significantly earlier than that of the control group(53.66±10.99) h] (t=2.238,P=0.028). Moreover,the exclusive breastfeeding rates in 24 hours(33.3% vs.13.6%),48 hours(51.1% vs. 29.5%) and 72 hours(71.1% vs. 50.0%) after delivery in intervention group were significantly higher than those in control group(χ²=4.788,4.295,4.155,P<0.05),but the differences on the successful rate of breastfeeding,and the onset rate of lactogenesis between the two groups were not significant(P＞0.05). Conclusion Early essential newborn care can promote the first breastfeeding score and maternal lactation,and effectively increase the early exclusive breastfeeding rate,which is worthy of widely use.