Slusher Tina, Slusher Ida L, Biomdo Margaret, Bode-Thomas Fidelia, Curtis Beverly A, Meier Paula
Department of Pediatrics, University of Louisville, Louisville, KY, USA.
J Trop Pediatr. 2007 Apr;53(2):125-30. doi: 10.1093/tropej/fml066.
Health experts worldwide recognize breastmilk as the superior infant food. Recommendations from the American Academy of Pediatrics and the World Health Organization (WHO) identify exclusive breastfeeding for the first half-year of life and continuation of breastfeeding into toddlerhood as offering maximum protection from illness, providing a substrate for immunological protection. Data from developed countries identify increasing morbidity and mortality rates for infants who have never received breastmilk in life and demonstrate that infants benefit from exclusive breastfeeding, especially, in areas of severe poverty. Preterm infants, most at risk for morbidity and mortality in developing countries, are identified as needing their own mother's milk for survival. Exclusive feeding of own mothers' milk (OMM) is associated with improved infant survival; however, inadequate maternal milk volume (MMV) often necessitates adding artificial feedings or exogenous substances to OMM. The objective of this study was to compare mean daily MMV for mothers of premature or sick infants in special care nurseries (SCN) using one of three methods of OMM expression: electric breast pump, non-electric pedal breast pump, and hand (manual) expression. We studied 65 mothers whose infants were cared for in two SCN in Africa (Kenya and Nigeria) and were unable to feed directly at the breast. In this randomized trial, mothers were randomly assigned to one of three milk expression groups at birth. MMV, the dependent variable, was measured for an average of 8.7 days. MMV for the electric and pedal pump and hand milk expression was 578 +/- 228 ml (n = 22), 463 +/- 302 ml (n = 24) and 323 +/- 199 ml (n = 19), respectively. Data were evaluated using a one-way ANOVA (p = 0.014). The Tukey revealed significant differences (p < 0.01) between electric breast pump expression and hand expression but not between the electric and pedal pump or the pedal pump and hand expression. Findings revealed greater MMV with electric breast pumps than hand-expression for mothers of infants in African nurseries. This data has important implications for international policy if exclusive OMM feeding is to be achieved for the vulnerable infant. Funded by West Virginia University Department of Research and Graduate Studies HSC Grant # 2U023U; Non-monetary donations of breast pumps and breast pump kits were made by Medela (Medela, Inc., McHenry, IL, USA).
全球健康专家都认为母乳是最适合婴儿的食物。美国儿科学会和世界卫生组织（WHO）的建议指出，婴儿在出生后的前半年进行纯母乳喂养，并持续母乳喂养至幼儿期，能最大程度地预防疾病，为免疫保护提供基础。发达国家的数据表明，从未接受过母乳喂养的婴儿的发病率和死亡率不断上升，且证明婴儿从纯母乳喂养中受益，尤其是在极端贫困地区。早产儿是发展中国家发病和死亡风险最高的群体，他们需要自己母亲的乳汁才能存活。纯母乳喂养自己母亲的乳汁（OMM）与提高婴儿存活率相关；然而，母乳量不足（MMV）往往需要在OMM中添加人工喂养或外源物质。本研究的目的是比较在特殊护理病房（SCN）中，早产或患病婴儿的母亲使用三种OMM挤出方法之一时的平均每日MMV：电动吸奶器、非电动脚踏吸奶器和手挤（手动）。我们研究了65位母亲，她们的婴儿在非洲（肯尼亚和尼日利亚）的两个SCN接受护理，无法直接进行母乳喂养。在这项随机试验中，母亲们在婴儿出生时被随机分配到三个乳汁挤出组之一。作为因变量的MMV平均测量了8.7天。电动吸奶器、脚踏吸奶器和手挤乳汁的MMV分别为578 +/- 228毫升（n = 22）、463 +/- 302毫升（n = 24）和323 +/- 199毫升（n = 19）。使用单因素方差分析（p = 0.014）对数据进行评估。Tukey检验显示电动吸奶器挤出和手挤之间存在显著差异（p < 0.01），但电动吸奶器和脚踏吸奶器之间或脚踏吸奶器和手挤之间没有显著差异。研究结果表明，对于非洲托儿所中婴儿的母亲来说，电动吸奶器挤出的母乳量比手挤的更多。如果要为脆弱的婴儿实现纯OMM喂养，这些数据对国际政策具有重要意义。由西弗吉尼亚大学研究与研究生部HSC资助 # 2U023U；美德乐公司（美国伊利诺伊州麦克亨利市美德乐公司）提供了吸奶器和吸奶器套件的非货币捐赠。
