经过培训的社区卫生工作者在产后早期进行家访能否改善新生儿的母乳喂养情况？
Can early postpartum home visits by trained community health workers improve breastfeeding of newborns?
作者信息
Mannan I, Rahman S M, Sania A, Seraji H R, Arifeen S E, Winch P J, Darmstadt G L, Baqui A
机构信息
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
出版信息
J Perinatol. 2008 Sep;28(9):632-40. doi: 10.1038/jp.2008.64. Epub 2008 Jul 3.
OBJECTIVE
Whether postpartum visits by trained community health workers (CHWs), reduce newborn breastfeeding problems.
METHOD
Community health workers made antenatal and postpartum home visits promoting newborn care practices including breastfeeding. CHWs assessed neonates for adequacy of breastfeeding and provided hands-on support to mothers to establish breastfeeding. History and observation data of 3495 neonates were analyzed to assess effects of CHW visitation on feeding problems.
RESULT
Inappropriate breastfeeding position and attachment were the predominant problems (12 to 15%). Only 6% of newborns who received home visit by CHWs within 3 days had feeding difficulties, compared to 34% of those who did not (odds ratio: 7.66, 95% confidence interval (CI): 6.03 to 9.71, P=0.00). Latter group was 11.4 times (95% CI: 6.7 to 19.3, P=0.00) more likely to have feeding problems as late as days 6 to 7, than the former.
CONCLUSION
Counseling and hands-on support on breastfeeding techniques by trained workers within first 3 days of birth, should be part of community-based postpartum interventions.
目的
受过培训的社区卫生工作者（CHW）进行产后家访是否能减少新生儿母乳喂养问题。
方法
社区卫生工作者进行产前和产后家访，推广包括母乳喂养在内的新生儿护理做法。CHW评估新生儿母乳喂养是否充足，并为母亲提供实际支持以建立母乳喂养。分析3495名新生儿的病史和观察数据，以评估CHW家访对喂养问题的影响。
结果
不适当的母乳喂养姿势和衔接是主要问题（12%至15%）。在出生3天内接受CHW家访的新生儿中，只有6%有喂养困难，而未接受家访的新生儿中这一比例为34%（比值比：7.66，95%置信区间（CI）：6.03至9.71，P = 0.00）。后一组在出生6至7天时出现喂养问题的可能性比前一组高11.4倍（95% CI：6.7至19.3，P = 0.00）。
结论
在出生后的前3天，由受过培训的工作人员提供关于母乳喂养技术的咨询和实际支持，应成为社区产后干预措施的一部分。
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