Department of Women's and Children's Health, University Children's Hospital, Uppsala, Sweden.
J Hum Lact. 2013 Aug;29(3):300-9. doi: 10.1177/0890334413489775. Epub 2013 May 31.
In the World Health Organization/United Nations Children's Fund document Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, neonatal care is mentioned as 1 area that would benefit from expansion of the original Ten Steps to Successful Breastfeeding. The different situations faced by preterm and sick infants and their mothers, compared to healthy infants and their mothers, necessitate a specific breastfeeding policy for neonatal intensive care and require that health care professionals have knowledge and skills in lactation and breastfeeding support, including provision of antenatal information, that are specific to neonatal care. Facilitation of early, continuous, and prolonged skin-to-skin contact (kangaroo mother care), early initiation of breastfeeding, and mothers' access to breastfeeding support during the infants' whole hospital stay are important. Mother's own milk or donor milk (when available) is the optimal nutrition. Efforts should be made to minimize parent-infant separation and facilitate parents' unrestricted presence with their infants. The initiation and continuation of breastfeeding should be guided only by infant competence and stability, using a semi-demand feeding regimen during the transition to exclusive breastfeeding. Pacifiers are appropriate during tube-feeding, for pain relief, and for calming infants. Nipple shields can be used for facilitating establishment of breastfeeding, but only after qualified support and attempts at the breast. Alternatives to bottles should be used until breastfeeding is well established. The discharge program should include adequate preparation of parents, information about access to lactation and breastfeeding support, both professional and peer support, and a plan for continued follow-up.
在世界卫生组织/联合国儿童基金会的《婴儿友好医院倡议：修订、更新和扩展综合护理》文件中，新生儿护理被提及为受益于扩大最初的成功母乳喂养十项措施的 1 个领域。与健康婴儿及其母亲相比，早产儿和患病婴儿及其母亲面临的情况不同，需要为新生儿重症监护制定专门的母乳喂养政策，并要求医护人员具备特定于新生儿护理的哺乳和母乳喂养支持方面的知识和技能，包括提供产前信息。促进早期、持续和长时间的皮肤接触（袋鼠式护理）、尽早开始母乳喂养以及母亲在婴儿整个住院期间获得母乳喂养支持非常重要。母亲自己的母乳或捐赠母乳（如有）是最佳营养。应努力尽量减少母婴分离，并促进父母与婴儿的无限制接触。母乳喂养的开始和持续应仅根据婴儿的能力和稳定性来指导，在过渡到纯母乳喂养期间采用半按需喂养方案。在进行管饲喂养、缓解疼痛和安抚婴儿时，可以使用奶嘴。乳头保护罩可用于促进母乳喂养的建立，但仅在经过合格的支持和尝试母乳喂养之后使用。应使用奶瓶替代品，直到母乳喂养得到良好建立。出院计划应包括对父母进行充分准备、有关获得哺乳和母乳喂养支持的信息，包括专业和同伴支持，以及继续随访的计划。
