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分娩镇痛对母乳喂养成功的影响。

Effect of labor analgesia on breastfeeding success.

作者信息

Halpern S H, Levine T, Wilson D B, MacDonell J, Katsiris S E, Leighton B L

机构信息

Department of Anesthesia, University of Toronto, Women's College Hospital, Ontario, Canada.

出版信息

Birth. 1999 Jun;26(2):83-8. doi: 10.1046/j.1523-536x.1999.00083.x.

Abstract

BACKGROUND

The effect of labor analgesia on breastfeeding success is not well defined. Some authors have hypothesized that labor analgesia may affect lactation success. The purpose of this observational study was to determine if intrapartum analgesia influenced breastfeeding success at 6 weeks postpartum in a setting that strongly supported breastfeeding.

METHODS

Healthy women with uncomplicated term pregnancies who planned to breastfeed consented to a telephone interview. We recorded demographic data, labor induction status, delivery mode, and analgesic medications. At between 6 and 8 weeks postpartum, patients were asked to describe breastfeeding use, problems encountered, solutions derived, sources of support and information, and satisfaction. We created a logistic regression model using intrapartum analgesia information and controlling for demographic factors previously correlated with lactation success.

RESULTS

We enrolled 189 women, contacted 177 women postpartum, and obtained complete data on 171 women. Of these, 59 percent received epidural analgesia, 72 percent breastfed fully, and 20 percent breastfed partially (> 50% of infant nutrition) at 6 weeks postpartum. After controlling for demographics and labor outcome, we could not demonstrate a correlation between breastfeeding success at 6 to 8 weeks and labor analgesia.

CONCLUSIONS

In a hospital that strongly promotes breastfeeding, epidural labor analgesia with local anesthetics and opioids does not impede breastfeeding success. We recommend that hospitals that find decreased lactation success in parturients receiving epidural analgesia reexamine their postdelivery care policies.

摘要

背景

分娩镇痛对母乳喂养成功的影响尚不明确。一些作者推测分娩镇痛可能会影响泌乳成功。这项观察性研究的目的是确定在一个大力支持母乳喂养的环境中,产时镇痛是否会影响产后6周时的母乳喂养成功情况。

方法

计划进行母乳喂养的健康足月妊娠且无并发症的女性同意接受电话访谈。我们记录了人口统计学数据、引产情况、分娩方式和镇痛药物。在产后6至8周时,询问患者描述母乳喂养情况、遇到的问题、解决方法、支持和信息来源以及满意度。我们使用产时镇痛信息创建了一个逻辑回归模型,并对先前与泌乳成功相关的人口统计学因素进行了控制。

结果

我们招募了189名女性,产后联系了177名女性,并获得了171名女性的完整数据。其中,59%接受了硬膜外镇痛,72%在产后6周时进行了全母乳喂养,20%进行了部分母乳喂养(婴儿营养的>50%)。在控制了人口统计学和分娩结局后,我们未能证明产后6至8周时的母乳喂养成功与产时镇痛之间存在相关性。

结论

在一家大力推广母乳喂养的医院中,使用局部麻醉剂和阿片类药物的硬膜外分娩镇痛不会阻碍母乳喂养成功。我们建议那些发现接受硬膜外镇痛的产妇泌乳成功率降低的医院重新审视其产后护理政策。

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