Su Lin-Lin, Chong Yap-Seng, Chan Yiong-Huak, Chan Yah-Shih, Fok Doris, Tun Kay-Thwe, Ng Faith S P, Rauff Mary
Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074.
BMJ. 2007 Sep 22;335(7620):596. doi: 10.1136/bmj.39279.656343.55. Epub 2007 Aug 1.
To investigate whether antenatal breast feeding education alone or postnatal lactation support alone improves rates of exclusive breast feeding compared with routine hospital care.
Randomised controlled trial.
A tertiary hospital in Singapore.
450 women with uncomplicated pregnancies.
Primary outcomes were rates of exclusive breast feeding at discharge from hospital and two weeks, six weeks, three months, and six months after delivery. Secondary outcomes were rates of any breast feeding.
Compared with women who received routine care, women in the postnatal support group were more likely to breastfeed exclusively at two weeks (relative risk 1.82, 95% confidence interval 1.14 to 2.90), six weeks (1.85, 1.11 to 3.09), three months (1.87, 1.03 to 3.41), and six months (2.12, 1.03 to 4.37) postnatally. Women receiving antenatal education were more likely to breast feed exclusively at six weeks (1.73, 1.04 to 2.90), three months (1.92, 1.07 to 3.48), and six months (2.16, 1.05 to 4.43) postnatally. The numbers needed to treat to achieve one woman exclusively breast feeding at six months were 11 (6 to 80) for postnatal support and 10 (6 to 60) for antenatal education. Women who received postnatal support were more likely to exclusively or predominantly breast feed two weeks after delivery compared with women who received antenatal education (1.53, 1.01 to 2.31). The rate of any breastfeeding six weeks after delivery was also higher in the postnatal support group compared with women who received routine care (1.16, 1.02 to 1.31).
Antenatal breast feeding education and postnatal lactation support, as single interventions based in hospital both significantly improve rates of exclusive breast feeding up to six months after delivery. Postnatal support was marginally more effective than antenatal education.
Clinical Trials NCT00270920 [ClinicalTrials.gov].
探讨单独的产前母乳喂养教育或单独的产后泌乳支持与常规医院护理相比，是否能提高纯母乳喂养率。
随机对照试验。
新加坡的一家三级医院。
450例无并发症妊娠的妇女。
主要结局是出院时及产后两周、六周、三个月和六个月时的纯母乳喂养率。次要结局是任何形式母乳喂养的比率。
与接受常规护理的妇女相比，产后支持组的妇女在产后两周（相对危险度1.82，95%置信区间1.14至2.90）、六周（1.85，1.11至3.09）、三个月（1.87，1.03至3.41）和六个月（2.12，1.03至4.37）时更有可能进行纯母乳喂养。接受产前教育的妇女在产后六周（1.73，1.04至2.90）、三个月（1.92，1.07至3.48）和六个月（2.16，1.05至4.43）时更有可能进行纯母乳喂养。在六个月时实现一名妇女纯母乳喂养所需治疗的人数，产后支持组为11（6至80），产前教育组为10（6至60）。与接受产前教育的妇女相比，接受产后支持的妇女在产后两周更有可能纯母乳喂养或主要进行母乳喂养（1.53，1.01至2.31）。与接受常规护理的妇女相比，产后支持组在产后六周时任何形式母乳喂养的比率也更高（1.16，1.02至1.31）。
作为基于医院的单一干预措施，产前母乳喂养教育和产后泌乳支持均能显著提高产后六个月内的纯母乳喂养率。产后支持比产前教育的效果略好。
临床试验NCT00270920 [ClinicalTrials.gov]
