影响新生儿重症监护病房母乳供应促进因素及障碍的家长报告的因素

Factors Influencing Parent Reports of Facilitators and Barriers to Human Milk Supply in Neonatal Intensive Care Units.

作者信息

Alves Elisabete, Magano Raquel, Amorim Mariana, Nogueira Conceição, Silva Susana

机构信息

1 ISPUP-EPIUnit, Universidade do Porto, Rua das Taipas, no. 135, 4050-600 Porto, Portugal.

2 Faculdade de Medicina, Universidade do Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal.

出版信息

J Hum Lact. 2016 Nov;32(4):695-703. doi: 10.1177/0890334416664071. Epub 2016 Sep 26.

DOI:10.1177/0890334416664071

PMID:27563012

Abstract

BACKGROUND

Successful human milk supply in neonatal intensive care units (NICUs) requires the development of family-centered services.

OBJECTIVE

This study aimed to assess parent perceptions of factors that help or hinder providing human milk to very preterm infants (VPI) in the NICU according to sociodemographic, reproductive, and obstetric characteristics.

METHODS

This cross-sectional quantitative study included 120 mothers and 91 fathers of VPI hospitalized in a level 3 NICU located in the Northern Health Region of Portugal (July 2013-June 2014). Interviewers administered structured questionnaires regarding parent characteristics and the provision and perception of factors that help or hinder human milk supply in the NICU, 15 to 22 days after birth.

RESULTS

The main facilitators of human milk supply were its contribution to infant growth and well-being (51.4%) and parents' knowledge of breastfeeding benefits (27.6%). The main barriers were worries related to inadequate milk supply (35.7%), difficulties with expressing breast milk (24.8%), and physical separation from infants (24.3%). Fathers referred less frequently to the contribution of human milk to infant growth and well-being (odds ratio [OR] = 0.57; 95% confidence interval [CI], 0.32-1.00) but more frequently to knowledge of breastfeeding benefits as facilitators (OR = 2.31; 95% CI, 1.23-4.32). Participants with > 12 years of education (OR = 1.91; 95% CI, 1.05-3.47) and those with an extremely low birth weight infant (OR = 1.90; 95% CI, 1.02-3.54) highlighted worries related to inadequate milk supply. Fathers (OR = 2.16; 95% CI, 1.11-4.19) and participants with ≤ 12 years of education (OR = 0.25; 95% CI, 0.11-0.57) more frequently reported difficulties with expressing as the main barrier.

CONCLUSION

The parent's gender and education and the infant's birth weight are crucial considerations for establishing optimal practices for supporting breastfeeding.

摘要

背景

新生儿重症监护病房（NICU）要成功实现母乳供应，需要发展以家庭为中心的服务。

目的

本研究旨在根据社会人口学、生殖和产科特征，评估父母对新生儿重症监护病房中有助于或阻碍为极早产儿（VPI）提供母乳的因素的看法。

方法

这项横断面定量研究纳入了葡萄牙北部卫生区域一家三级新生儿重症监护病房（2013年7月至2014年6月）收治的120名极早产儿的母亲和91名父亲。访谈者在婴儿出生15至22天后，就父母特征以及新生儿重症监护病房中有助于或阻碍母乳供应的因素的提供情况和看法，发放结构化问卷。

结果

母乳供应的主要促进因素是其对婴儿生长和健康的贡献（51.4%）以及父母对母乳喂养益处的了解（27.6%）。主要障碍是对母乳供应不足的担忧（35.7%）、挤奶困难（24.8%）以及与婴儿的身体分离（24.3%）。父亲提及母乳对婴儿生长和健康的贡献的频率较低（优势比[OR]=0.57；95%置信区间[CI]，0.32 - 1.00），但提及对母乳喂养益处的了解作为促进因素的频率较高（OR = 2.31；95% CI，1.23 - 4.32）。受教育年限超过12年的参与者（OR = 1.91；95% CI，1.05 - 3.47）以及出生体重极低的婴儿的父母（OR = 1.90；95% CI，1.02 - 3.54）强调了对母乳供应不足的担忧。父亲（OR = 2.16；95% CI，1.11 - 4.19）以及受教育年限≤12年的参与者（OR = 0.25；95% CI，0.11 - 0.57）更频繁地报告挤奶困难是主要障碍。