Furman Lydia, Minich Nori, Hack Maureen
Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA.
Pediatrics. 2002 Apr;109(4):e57. doi: 10.1542/peds.109.4.e57.
We sought to determine the correlates of intent to breastfeed and of successful lactation and nursing at the breast in mothers of very low birth weight (VLBW; <1.5 kg) infants.
We conducted a prospective observational study of 119 mothers of singleton VLBW infants (mean birth weight: 1056 g; mean gestational age: 28 weeks), 87 (73%) of whom intended to breastfeed. Mothers completed questionnaires at 3 weeks' postnatal age and at 35 and 40 weeks' (term) and 4 months' corrected ages (CAs).
Of the 87 mothers who intended to breastfeed, 30 mothers (34%) continued lactation beyond 40 weeks' CA (postmenstrual plus postnatal age). Compared with mothers who discontinued lactation before this time, those who continued were older (31 vs 26 years), more were married (80% vs 39%), they had more than a high school education (70% vs 42%), and they were white (63% vs 35%). There were no significant differences in their infants' birth data or rates of neonatal morbidity. Significant correlates of lactation beyond 40 weeks' CA included beginning milk expression before 6 hours postdelivery, expressing milk > or =5 times per day, and kangaroo care. These correlates remained significant after controlling for maternal age, race, marital status, and education beyond high school. At 4 months' CA, 14 mothers (16%) were still lactating, 12 of whom were nursing at the breast.
Increased maternal support specifically directed toward behavioral factors, including early and more frequent milk expression and kangaroo care, may improve the rates of successful lactation among mothers of VLBW infants who choose to breastfeed.
我们试图确定极低出生体重（VLBW；<1.5kg）婴儿母亲的母乳喂养意愿以及成功泌乳和进行亲喂的相关因素。
我们对119名单胎VLBW婴儿的母亲进行了一项前瞻性观察研究（平均出生体重：1056g；平均胎龄：28周），其中87名（73%）母亲打算母乳喂养。母亲们在产后3周、35周、40周（足月）以及4个月矫正年龄（CA）时完成问卷调查。
在87名打算母乳喂养的母亲中，30名母亲（34%）在矫正年龄40周（月经龄加出生后年龄）后仍持续泌乳。与在此之前停止泌乳的母亲相比，持续泌乳的母亲年龄更大（31岁对26岁），更多为已婚（80%对39%），接受过高中以上教育的比例更高（70%对42%），且为白人的比例更高（63%对35%）。她们婴儿的出生数据或新生儿发病率无显著差异。矫正年龄40周后仍持续泌乳的显著相关因素包括产后6小时内开始挤奶、每天挤奶≥5次以及袋鼠式护理。在控制了母亲年龄、种族、婚姻状况和高中以上教育程度后，这些相关因素仍然显著。在矫正年龄4个月时，14名母亲（16%）仍在泌乳，其中12名进行亲喂。
针对行为因素，特别是早期和更频繁的挤奶以及袋鼠式护理等方面增加母亲支持，可能会提高选择母乳喂养的极低出生体重婴儿母亲的成功泌乳率。
