Bicalho-Mancini Paula G, Velásquez-Meléndez Gustavo
Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
J Pediatr (Rio J). 2004 May-Jun;80(3):241-8.
To study the rate of exclusive breastfeeding at the moment of hospital discharge of newborns admitted to a neonatal Intensive Care Unit and to analyze potential risk factors.
Four hundred and ninety-five medical records were studied, pertaining to neonates born between 1998 and 1999, admitted to a neonatal intensive care unit, before and after the implementation of the Baby Friendly Hospital Initiative policies. Babies born during the Baby Friendly Hospital Initiative transition period and outside the Maternity ward were excluded from the study, as were children or mothers who were transferred from the institution, abandoned children and also mothers unfit to breastfeed. Risk factors for non-exclusive breast-feeding at discharge were studied. Odds ratio and 95% confidence intervals were calculated using multivariate logistic regression.
The exclusive breastfeeding rate increased from 36% at discharge (before the Baby Friendly Hospital Initiative) to 54.7% (after BFHI). The independent risk factors associated with non-exclusive breastfeeding were the use of enteral feeding (OR = 3.01), ante-natal consultations < 6 (OR = 2.75), relactation use (OR = 2.66), birth weight < 2,500 g (OR = 2.64) and being born during the period before Baby Friendly policies were implemented (OR = 2.75).
This research shows the potential efficiency of adopting Baby Friendly policies to increase the chance of successful breastfeeding at the point of discharge for high-risk newborns.
研究入住新生儿重症监护病房的新生儿出院时的纯母乳喂养率,并分析潜在风险因素。
研究了495份病历,这些病历涉及1998年至1999年出生、在实施爱婴医院倡议政策前后入住新生儿重症监护病房的新生儿。爱婴医院倡议过渡期间在产房外出生的婴儿,以及从该机构转来的儿童或母亲、弃婴和不适合母乳喂养的母亲被排除在研究之外。研究了出院时非纯母乳喂养的风险因素。使用多变量逻辑回归计算比值比和95%置信区间。
纯母乳喂养率从出院时(爱婴医院倡议之前)的36%升至(爱婴医院倡议之后)的54.7%。与非纯母乳喂养相关的独立风险因素包括使用肠内喂养(比值比=3.01)、产前检查次数<6次(比值比=2.75)、采用再泌乳法(比值比=2.66)、出生体重<2500克(比值比=2.64)以及在爱婴医院政策实施前出生(比值比=2.75)。
本研究表明,采用爱婴医院政策对于提高高危新生儿出院时成功母乳喂养的几率具有潜在效果。