La Trobe University, Vic., Australia; Women and Infants Research Foundation, WA, Australia.
Midwifery. 2010 Feb;26(1):88-100. doi: 10.1016/j.midw.2008.03.001. Epub 2008 May 16.
to evaluate the effects of an extended midwifery support (EMS) programme on the proportion of women who breast feed fully to six months.
randomised controlled trial.
large public teaching hospital in Australia.
849 women who had given birth to a healthy, term, singleton baby and who wished to breast feed.
participants were allocated at random to EMS, in which they were offered a one-to-one postnatal educational session and weekly home visits with additional telephone contact by a midwife until their baby was six weeks old; or standard postnatal midwifery support (SMS). Participants were stratified for parity and tertiary education.
the main outcome measures were prevalence of full and any breast feeding at six months postpartum.
there was no difference between the groups at six months postpartum for either full breast feeding [EMS 43.3% versus SMS 42.5%, relative risk (RR) 1.02, 95% confidence interval (CI) 0.87-1.19] or any breast feeding (EMS 63.9% versus SMS 67.9%, RR 0.94, 95%CI 0.85-1.04).
the EMS programme did not succeed in improving breast-feeding rates in a setting where there was high initiation of breast feeding. Breast-feeding rates were high but still fell short of national goals.
continuing research of programmes designed to promote breast feeding is required in view of the advantages of breast feeding for all mothers and babies.
评估延长助产士支持（EMS）方案对完全母乳喂养至六个月的妇女比例的影响。
随机对照试验。
澳大利亚一家大型公立教学医院。
849 名分娩健康足月单胎婴儿并希望母乳喂养的妇女。
参与者被随机分配到 EMS 组，在该组中，她们接受了一对一的产后教育课程和每周家访，并通过一名助产士提供额外的电话联系，直到婴儿六周大；或接受标准的产后助产士支持（SMS）。参与者按产次和高等教育进行分层。
主要结局指标为产后六个月完全和任何母乳喂养的流行率。
两组在产后六个月时，完全母乳喂养率[EMS 为 43.3%，SMS 为 42.5%，相对风险（RR）为 1.02，95%置信区间（CI）为 0.87-1.19]或任何母乳喂养率[EMS 为 63.9%，SMS 为 67.9%，RR 为 0.94，95%CI 为 0.85-1.04]均无差异。
在母乳喂养初始率较高的情况下，EMS 方案未能成功提高母乳喂养率。母乳喂养率较高，但仍未达到国家目标。
鉴于母乳喂养对所有母亲和婴儿的益处，需要继续研究旨在促进母乳喂养的方案。
