Martino Kimberly, Wagner Meg, Froh Elizabeth B, Hanlon Alexandra L, Spatz Diane L
J Obstet Gynecol Neonatal Nurs. 2015 May-Jun;44(3):450-7. doi: 10.1111/1552-6909.12568. Epub 2015 Apr 9.
To examine the duration and exclusivity of breastfeeding and provision of human milk among infants with complex anomalies that require surgery postdischarge from a neonatal intensive care unit (NICU).
Prospective cohort study.
A tertiary care children's hospital with a fetal diagnostic and treatment center, special delivery unit, and NICU.
Mothers who had delivered infants with complex anomalies that require surgery between 2009 and 2012 (N = 165).
Phone interviews were used for data collection and were analyzed using descriptive statistics methods.
The average duration of breastfeeding/provision of human milk was 8 months. The percentage of infants who received human milk at 6 months was 60.1% (n = 98/163,; p = .0063) and at 12 months was 34.5% (n = 57/165, p = .023). Of infants in this cohort, the percentage of those infants exclusively receiving human milk was 54.3% (n = 89/164, p = .0004) at 3 months of age and 35.6% (n = 58/163, p < .0001) at age 6 months. Another clinically important finding is that 30.7% of the cohort required gavage feeds postdischarge from the NICU.
Even for the most surgically complex infant/mother dyads, breastfeeding outcomes can improve significantly with a strong prenatal lactation program, nursing staff with specific breastfeeding education, and a hospital culture that values and supports breastfeeding and the provision of human milk. These findings support the use of hospital-grade electric breast pumps postdischarge for families of infants with complex anomalies that require surgery, as approximately one third of the cohort went home on tube feeds and their mothers continued to pump their breast milk at home.
研究新生儿重症监护病房（NICU）出院后需要手术治疗的复杂畸形婴儿的母乳喂养时长、纯母乳喂养情况及母乳提供情况。
前瞻性队列研究。
一家设有胎儿诊断与治疗中心、特殊分娩单元及NICU的三级儿童专科医院。
2009年至2012年间分娩出需要手术治疗的复杂畸形婴儿的母亲（N = 165）。
通过电话访谈收集数据，并采用描述性统计方法进行分析。
母乳喂养/提供母乳的平均时长为8个月。6个月时接受母乳的婴儿比例为60.1%（n = 98/163；p = 0.0063），12个月时为34.5%（n = 57/165，p = 0.023）。在该队列婴儿中，3个月时纯母乳喂养的婴儿比例为54.3%（n = 89/164，p = 0.0004），6个月时为35.6%（n = 58/163，p < 0.0001）。另一个重要的临床发现是，30.7%的队列婴儿在NICU出院后需要鼻饲喂养。
即使对于手术最复杂的母婴组合，通过强有力的产前泌乳计划、接受过特定母乳喂养教育的护理人员以及重视并支持母乳喂养和母乳提供的医院文化，母乳喂养效果也能显著改善。这些发现支持出院后为需要手术治疗的复杂畸形婴儿家庭提供医院级电动吸奶器，因为约三分之一的队列婴儿回家时仍需管饲喂养，而他们的母亲继续在家中泵奶。
