Ahmed Azza H, Sands Laura P
School of Nursing, Purdue University, West Lafayette, IN..
School of Nursing and director of the Regenstrief Center for Health Care Engineering at Purdue University, West Lafayette, IN.
J Obstet Gynecol Neonatal Nurs. 2010 Jan-Feb;39(1):53-63. doi: 10.1111/j.1552-6909.2009.01088.x.
To investigate the effect of pre- and postdischarge interventions on breastfeeding outcomes and weight gain among preterm infants.
PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) database were searched for study selection using MeSH terms infant/premature, breastfeeding, weight gain, patient discharge, postnatal care, and counseling.
Inclusion criteria included studies that involved preterm infants who were born less than or equal to 37 weeks of gestation, randomized controlled trials that were in English, conducted in developed countries, and had breastfeeding and weight gain outcomes. A total of 8 articles met inclusion criteria.
All data related to breastfeeding outcomes including duration, exclusivity, maternal satisfaction, and weight gain were extracted from the randomized controlled trials for the purpose of data synthesis.
A total of 310 studies were reviewed. Eight randomized controlled trials met the inclusion criteria. Gestational age of the infants in the studies ranged from 26 to 37 weeks. The results revealed that kangaroo care, peer counseling, in-home breast milk intake measurement, and postdischarge lactation support improved breastfeeding outcomes among preterm infants, and that maternal satisfaction improved with postdischarge interventions. No significant evidence of pre- and postdischarge interventions on weight gain was found.
Pre- and postdischarge interventions were effective in promoting breastfeeding exclusivity, duration, and maternal satisfaction among mothers of preterm infants. These findings have important clinical implications that support the need for evidence-based breastfeeding interventions for preterm infants before discharge and vigilant postdischarge support. Research to determine more effective interventions to promote exclusive and long-term breastfeeding among preterm infants is required.
探讨出院前和出院后干预措施对早产儿母乳喂养结局及体重增加的影响。
使用医学主题词“婴儿/早产”“母乳喂养”“体重增加”“患者出院”“产后护理”和“咨询”在PubMed和护理及相关健康文献累积索引（CINAHL）数据库中检索以选择研究。
纳入标准包括涉及孕周小于或等于37周的早产儿的研究、以英文发表的随机对照试验、在发达国家开展且有母乳喂养和体重增加结局的研究。共有8篇文章符合纳入标准。
为进行数据综合，从随机对照试验中提取所有与母乳喂养结局相关的数据，包括持续时间、纯母乳喂养情况、母亲满意度和体重增加情况。
共审查了310项研究。8项随机对照试验符合纳入标准。研究中婴儿的孕周为26至37周。结果显示，袋鼠式护理、同伴咨询、家庭内母乳摄入量测量以及出院后泌乳支持可改善早产儿的母乳喂养结局，且出院后干预措施可提高母亲满意度。未发现出院前和出院后干预措施对体重增加有显著影响的证据。
出院前和出院后干预措施在促进早产儿母亲的纯母乳喂养、喂养持续时间及母亲满意度方面有效。这些发现具有重要的临床意义，支持在早产儿出院前进行基于证据的母乳喂养干预以及出院后进行密切支持的必要性。需要开展研究以确定更有效的干预措施来促进早产儿的纯母乳喂养和长期母乳喂养。
