Meyer N, Spegel H, Hendrowarsito L, Schwegler U, Fromme H, Bolte G
Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Sachbereich Arbeits- und Umweltepidemiologie, München.
Gesundheitswesen. 2012 Jan;74(1):34-41. doi: 10.1055/s-0030-1268510. Epub 2010 Dec 15.
The health-promoting short- and long-term effects of breast-feeding are supported by a vast scientific literature. The Bavarian prospective cohort study 2005/2006 showed regional variations of breast-feeding rates. Furthermore, improvement in counselling mothers, particularly with regard to prevention and handling of breast-feeding problems, has a great potential for health promotion. The objective of this study is to promote breast-feeding in maternity clinics by improving the surrounding conditions.
A clinic-based and community-related intervention trial was carried out in Lower Bavaria as a model region with below average breast-feeding rates. (1) INTERVENTION: an advanced training of maternity ward professionals of 10 hospitals and after-care midwives was performed from May until December 2008. The training programme was based on the WHO/UNICEF criteria of the "Ten Steps to Successful Breastfeeding" to deepen the breast-feeding knowledge and to improve the breast-feeding management. (2) EVALUATION: A singular assessment of the advanced training programme was undertaken concerning an increase of knowledge and the practicability in clinical everyday life by participants; improvements of the maternity wards were assessed via structural interviews with maternity ward staff before and after intervention.
Approximately 85% (n=378) of the staff of the 10 maternity clinics attended the training course. The survey after the training programme (response rate 83%) indicated that more than 80% of the participants stated to have learned something new and to be able to use the knowledge acquired for their own practice. Results of the clinic interviews showed a transfer of training contents into clinical work routines. Improvements at interview date were shown best for bonding (all 10 maternity clinics), for additional feeding (8 maternity clinics) as well as for 24-h rooming-in and mother counselling (7 maternal clinics each).
Training of maternity ward professionals accounts for baby-friendly conditions in maternity clinics. Most willingness for improvements was shown by maternity ward staff particularly for bonding between mother and child as well as for additional feeding. Considerable differences between the hospitals were observed for the promotion of infant formulas before and after the intervention.
大量科学文献支持母乳喂养对健康的短期和长期促进作用。2005/2006年巴伐利亚前瞻性队列研究显示了母乳喂养率的地区差异。此外，改善对母亲的咨询，特别是在母乳喂养问题的预防和处理方面，对促进健康具有巨大潜力。本研究的目的是通过改善周边条件来促进产科诊所的母乳喂养。
在母乳喂养率低于平均水平的下巴伐利亚作为示范地区开展了一项基于诊所和社区的干预试验。（1）干预：2008年5月至12月对10家医院的产科病房专业人员和产后护理助产士进行了高级培训。培训计划基于世界卫生组织/联合国儿童基金会的“成功母乳喂养十步骤”标准，以加深母乳喂养知识并改善母乳喂养管理。（2）评估：对高级培训计划进行了单项评估，内容涉及参与者知识的增加以及在临床日常生活中的实用性；通过在干预前后对产科病房工作人员进行结构化访谈来评估产科病房的改善情况。
10家产科诊所约85%（n = 378）的工作人员参加了培训课程。培训计划后的调查（回复率83%）表明，超过80%的参与者表示学到了新东西，并能够将所学知识应用于自己的实践。诊所访谈结果显示培训内容已转化为临床工作常规。在访谈时，母婴亲密接触（所有10家产科诊所）、补充喂养（8家产科诊所）以及24小时母婴同室和母亲咨询（各7家产科诊所）方面的改善最为明显。
对产科病房专业人员的培训有助于产科诊所营造爱婴环境。产科病房工作人员表现出最强烈的改善意愿，特别是在母婴亲密接触和补充喂养方面。干预前后在婴儿配方奶粉推广方面观察到医院之间存在显著差异。
