Herzhaft-Le Roy Juliette, Xhignesse Marianne, Gaboury Isabelle
1 Entraide Naturo-Lait, Québec, Canada.
2 Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada.
J Hum Lact. 2017 Feb;33(1):165-172. doi: 10.1177/0890334416679620. Epub 2016 Dec 27.
Despite well-known recommendations from national and international bodies including the World Health Organization, few mothers achieve the goal of breastfeeding exclusively for 6 months. Half of mothers stop breastfeeding due to biomechanical issues in the first month, despite increasing support from lactation consultants. Osteopaths worldwide work with these babies, but there is little empirical evidence for this type of treatment. Research aim: This study aimed to determine the efficacy of an osteopathic treatment coupled with usual lactation consultations on infants' ability to latch. Secondary objectives included assessment of nipple pain and mothers' perceptions of the effect of treatment.
We conducted a single blind, randomized controlled trial at a mother-to-mother support group between January and December 2015. Data were collected at four different times over a 10-day period (T0-T10) from 97 mother-infant dyads using the LATCH assessment tool, a visual analog scale (VAS) to document mothers' nipple pain, and a de novo questionnaire for breastfeeding management and potential treatment side effects.
There were consistent statistical and clinical differences in the mean LATCH scores between the treatment and the control groups ( p < .001). However, no significant differences in the VAS scores were reported over time ( p = .713). Mothers reported no serious or unexpected side effects during the follow-up period.
This study is one of the first to bring together lactation consultants and osteopaths to address infants with biomechanical sucking difficulties. Findings support the hypothesis that the addition of osteopathy to regular lactation consultations is beneficial and safe.
尽管包括世界卫生组织在内的国家和国际机构都给出了广为人知的建议，但很少有母亲能实现纯母乳喂养6个月的目标。尽管泌乳顾问提供的支持不断增加，但仍有一半的母亲在第一个月就因生物力学问题而停止母乳喂养。世界各地的整骨疗法师都在治疗这些婴儿，但几乎没有这类治疗的实证证据。研究目的：本研究旨在确定整骨疗法结合常规泌乳咨询对婴儿吸吮能力的疗效。次要目标包括评估乳头疼痛以及母亲对治疗效果的看法。
2015年1月至12月，我们在一个母婴互助小组中进行了一项单盲随机对照试验。在10天内的四个不同时间点（T0 - T10），使用LATCH评估工具、视觉模拟量表（VAS）记录母亲的乳头疼痛情况，并使用一份全新的关于母乳喂养管理和潜在治疗副作用的问卷，从97对母婴中收集数据。
治疗组和对照组的平均LATCH评分在统计学和临床上存在持续差异（p < .001）。然而，随着时间推移，VAS评分未报告有显著差异（p = .713）。母亲们在随访期间未报告有严重或意外的副作用。
本研究是首批将泌乳顾问和整骨疗法师联合起来治疗有生物力学吸吮困难婴儿的研究之一。研究结果支持这样的假设，即在常规泌乳咨询中增加整骨疗法是有益且安全的。
