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芬兰爱婴医院倡议第四步的实施——母亲和助产士视角下的纯母乳喂养与母婴皮肤接触

The realization of BFHI Step 4 in Finland - Initial breastfeeding and skin-to-skin contact according to mothers and midwives.

作者信息

Hakala Mervi, Kaakinen Pirjo, Kääriäinen Maria, Bloigu Risto, Hannula Leena, Elo Satu

机构信息

Northern Ostrobothnia Hospital District, Oulaskangas Hospital, Finland.

Research Unit of Nursing Science and Health Management, University of Oulu, Finland; Medical Research Center (MRC) Oulu, Finland.

出版信息

Midwifery. 2017 Jul;50:27-35. doi: 10.1016/j.midw.2017.03.010. Epub 2017 Mar 22.

Abstract

BACKGROUND

Breastfeeding and skin-to-skin contact are the best start for infant life. Breastfeeding ensures the best trajectory for development and growth while preventing many diseases later in life. It is recommended that initial breastfeeding occur during the first hour and that generally exclusive breastfeeding is adopted during the first six months.

OBJECTIVE

The aim of this study is to describe how initial breastfeeding and skin-to-skin contact (Step 4 of the BFHI) is implemented in Finnish maternity hospitals as well as to explain the factors connected to it. The information can be used to develop maternity care during the immediate postpartum period.

DESIGN

Cross-sectional study.

METHODS

The data were collected from mothers who had given birth as well as their midwives via questionnaire during the spring of 2014 during one week at eight maternity hospitals in Finland. The response rate was 59% for the new mothers (n=111), while it was 57% for the midwives (n=272). The data were analysed statistically and the open-ended questions in the questionnaire using content specifications.

FINDINGS

On the basis of the results, initial breastfeeding succeeded well after vaginal birth. Initial breastfeeding began, on average, at 41minutes of age and lasted for 51minutes. Of mothers, 87% regarded it a very positive experience. Initial breastfeeding was delayed mainly because of caesarean section and for reasons related to an infant's condition. Many background factors such as midwives' age, mothers' parity and the mode of childbirth were statistically significant in respect to the success of initial breastfeeding.

CONCLUSIONS

More attention should be placed on the initial breastfeeding of infants born by caesarean section and primiparous mothers.

摘要

背景

母乳喂养和肌肤接触是婴儿生命的最佳开端。母乳喂养确保了发育和成长的最佳轨迹,同时预防日后的多种疾病。建议在出生后第一小时内开始首次母乳喂养,并且通常在头六个月采用纯母乳喂养。

目的

本研究的目的是描述芬兰妇产医院如何实施首次母乳喂养和肌肤接触(爱婴医院倡议的第四步),并解释与之相关的因素。这些信息可用于改善产后即时阶段的产妇护理。

设计

横断面研究。

方法

2014年春季,在芬兰八家妇产医院,通过问卷收集了产妇及其助产士的数据。新妈妈的回复率为59%(n = 111),助产士的回复率为57%(n = 272)。对数据进行了统计分析,并使用内容规范对问卷中的开放式问题进行了分析。

结果

根据结果,顺产之后首次母乳喂养情况良好。首次母乳喂养平均在出生后41分钟开始,持续51分钟。87%的母亲认为这是一次非常积极的体验。首次母乳喂养延迟主要是因为剖宫产以及与婴儿状况相关的原因。许多背景因素,如助产士年龄、母亲的胎次和分娩方式,在首次母乳喂养成功方面具有统计学意义。

结论

应更加关注剖宫产出生的婴儿和初产妇的首次母乳喂养。

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