Humenick S S, Hill P D, Thompson J, Hart A M
School of Nursing, University of Wyoming, Laramie, USA.
Can J Nurs Res. 1998 Fall;30(3):67-81.
This study partially replicates and extends a study reporting that elevated breast-milk sodium BM [Na+] during early lactogenesis was predictive of poor breastfeeding outcomes. The present study used 6-day postpartum breast milk. Consistent with the findings of the earlier study, 80% of those with a BM [Na+] of 16 mmol/L or lower at day 6 sustained a high level of breastfeeding at week 4, compared to only 50% of those with an elevated BM [Na+] (chi 2 = 4.05, df = 1, p = .04). This difference was even greater in a subgroup of mothers predicted to be at high risk for insufficient milk supply on the basis of support density and self-perception variables. Of the latter group, 75% with low BM [Na+] sustained a high level of breastfeeding at 4 weeks postpartum, compared to only 22% with an elevated BM [Na+] (chi 2 = .65, df = 1, p = .01). In contrast, among the low-risk mothers BM [Na+] levels were not associated with any difference in breast-milk sustainment (89% and 82% sustainment for low- and high-sodium groups, respectively). Thus a normal drop in BM [Na+] is predictive of higher sustainment of breastfeeding. However, the predictive validity of this marker appears to be enhanced by combining it with the psychosocial variables of support density and self-perception of breastfeeding by the mother.
本研究部分重复并扩展了一项研究，该研究报告称，在泌乳早期母乳钠含量（BM[Na+]）升高预示着母乳喂养结局不佳。本研究使用产后6天的母乳。与早期研究结果一致，产后第6天BM[Na+]为16 mmol/L或更低的母亲中，80%在第4周维持了高水平的母乳喂养，而BM[Na+]升高的母亲中这一比例仅为50%（χ2 = 4.05，自由度 = 1，p = 0.04）。在根据支持密度和自我认知变量预测为乳汁供应不足高风险的母亲亚组中，这种差异更大。在后一组中，产后4周时BM[Na+]低的母亲中有75%维持了高水平的母乳喂养，而BM[Na+]升高的母亲中这一比例仅为22%（χ2 = 6.65，自由度 = 1，p = 0.01）。相比之下，在低风险母亲中，BM[Na+]水平与母乳维持情况的差异无关（低钠组和高钠组的维持率分别为89%和82%）。因此，BM[Na+]正常下降预示着母乳喂养的更高维持率。然而，将该指标与母亲的支持密度和母乳喂养自我认知等社会心理变量相结合，似乎可以提高该指标的预测效度。
