Bystrova K, Matthiesen A-S, Widström A-M, Ransjö-Arvidson A-B, Welles-Nyström B, Vorontsov I, Uvnäs-Moberg K
Department of Hospital Pediatrics, St. Petersburg State Pediatric Medical Academy, St. Petersburg, Russia.
Early Hum Dev. 2007 Jan;83(1):29-39. doi: 10.1016/j.earlhumdev.2006.03.016. Epub 2006 May 22.
Few investigations have considered evaluating the effects of certain combinations of ward routines like swaddling of the baby and separation of mother and baby on infant variables such as neonatal weight loss.
To study the effect of different ward routines in respect to proximity to mother and type of infant apparel, on breastfeeding parameters (amount of ingested milk, volume of supplements, number of breastfeeds, total duration of breastfeeding time) day 4 after birth as well as recovery from neonatal weight loss and infant's weight on day 5.
In a randomized trial with factorial design four treatment groups including 176 mother-infant dyads were studied 25-120 min after birth. Randomized treatments focused on care routines administered to the infants after delivery and later in the maternity ward as well as to the type of clothing the infants received. Group 1 infants were placed skin-to-skin with their mothers after delivery, and had rooming-in while in the maternity ward. Group 2 infants were dressed and placed in their mothers' arms after delivery, and roomed-in with mothers in the maternity ward. Group 3 infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group 4 infants were kept in the nursery after birth, but roomed-in with their mothers in the maternity ward. Equal numbers of infants were either swaddled or clothed in baby attire. Breastfeeding parameters were documented during day 4 after birth. Infant's weight was measured daily.
Babies who were kept in the nursery received significantly more formula and significantly less breast-milk, than did babies who roomed-in with their mothers. Swaddling did not influence the breastfeeding parameters measured. However, swaddled babies who had experienced a 2-h separation period after birth and then were reunited with their mothers tended to have a delayed recovery of weight loss compared to those infants who were exposed to the same treatment but dressed in clothes. Furthermore, swaddled babies who were kept in the nursery and received breast-milk supplements had a significantly delayed recovery of weight loss after birth when compared to those infants ingesting only breast-milk. On day 5, regression analyses of predicted weight gain in the exclusively breastfed infants indicated a significant increase per 100 ml breast-milk (59 g), compared to the predicted weight gain on day 5 per 100 ml supplements in the swaddled babies (14 g) (P=0.001).
Supplements given to the infants in the nursery had a negative influence on the amount of milk ingested. In addition, supplement feeding or a short separation after birth when combined with swaddling was shown to have a negative consequence to infant weight gain.
很少有研究考虑评估诸如包裹婴儿以及母婴分离等病房常规护理组合对新生儿体重减轻等婴儿变量的影响。
研究不同的病房常规护理（涉及与母亲的亲近程度和婴儿服装类型）对出生后第4天的母乳喂养参数（摄入的母乳量、补充奶量、母乳喂养次数、母乳喂养总时长）以及新生儿体重减轻的恢复情况和出生后第5天婴儿体重的影响。
在一项析因设计的随机试验中，对出生后25 - 120分钟的176对母婴二元组进行了四个治疗组的研究。随机治疗重点在于分娩后及之后在产科病房对婴儿实施的护理常规以及婴儿所穿衣物的类型。第1组婴儿在分娩后与母亲进行皮肤接触，并在产科病房实行母婴同室。第2组婴儿在分娩后穿上衣服并被放在母亲怀里，在产科病房与母亲同室。第3组婴儿在出生后及母亲在产科病房期间都被留在婴儿室。第4组婴儿出生后留在婴儿室，但在产科病房与母亲同室。数量相等的婴儿要么被包裹起来，要么穿着婴儿服装。在出生后第4天记录母乳喂养参数。每天测量婴儿体重。
与和母亲同室的婴儿相比，留在婴儿室的婴儿摄入的配方奶显著更多，母乳显著更少。包裹对所测量的母乳喂养参数没有影响。然而，与接受相同治疗但穿着衣服的婴儿相比，出生后经历2小时分离期然后与母亲团聚的被包裹婴儿体重减轻的恢复往往延迟。此外，与仅摄入母乳的婴儿相比，留在婴儿室并接受母乳补充的被包裹婴儿出生后体重减轻的恢复显著延迟。在第5天，对纯母乳喂养婴儿预测体重增加的回归分析表明，每100毫升母乳的体重增加显著增加（59克），相比之下，被包裹婴儿每100毫升补充奶在第5天的预测体重增加为14克（P = 0.001）。
在婴儿室给婴儿补充奶对摄入的母乳量有负面影响。此外表明，补充喂养或出生后短时间分离与包裹相结合对婴儿体重增加有负面后果。
