Schreck Paula K, Solem Krista, Wright Tamika, Schulte Colleen, Ronnisch Kimberly J, Szpunar Susan
St. John Hospital and Medical Center , Detroit, Michigan.
Breastfeed Med. 2017 Apr;12:142-148. doi: 10.1089/bfm.2016.0131. Epub 2017 Feb 16.
Breastfeeding provides many health benefits for mothers and their infants that span their life course. Despite this, national breastfeeding rates are below benchmarks set by the CDC (Centers for Disease Control and Prevention). Breastfeeding rates in the Detroit low-income population are particularly low.
To measure the effect of hospital-based prenatal and postnatal breastfeeding interventions on breastfeeding initiation and continuation rates in a low-income population. The interventions implemented were a prenatal breastfeeding education curriculum and a hospital-based breastfeeding support group.
A total of 650 women were tracked via chart review and telephone survey after delivery to assess breastfeeding initiation, continuation, and goal achievement. The baseline group (n = 330) received care in the hospital-associated prenatal clinic before intervention implementation; the postintervention group (n = 320) received breastfeeding education and had a hospital-based breastfeeding support group made available to them, in which some participated. Data were analyzed using the chi-squared test and the Student's t-test.
Breastfeeding initiation rates were greater in the postintervention group (p < 0.0001). The breastfeeding continuation rate at or beyond 6 months did not differ among baseline and postintervention groups (p = 0.5), but was greater among women who also participated in the breastfeeding support group compared with women who participated in the prenatal intervention alone. Participation in interventions did not affect the rate, at which women reported meeting their breastfeeding goals.
Both prenatal education and ongoing postdischarge support are needed to improve breastfeeding continuation.
母乳喂养对母亲及其婴儿一生都有诸多健康益处。尽管如此，全国母乳喂养率仍低于美国疾病控制与预防中心（CDC）设定的基准。底特律低收入人群的母乳喂养率尤其低。
衡量基于医院的产前和产后母乳喂养干预措施对低收入人群母乳喂养启动率和持续率的影响。实施的干预措施包括产前母乳喂养教育课程和基于医院的母乳喂养支持小组。
通过病历审查和产后电话调查对650名妇女进行跟踪，以评估母乳喂养的启动、持续情况及目标达成情况。基线组（n = 330）在干预措施实施前在医院附属的产前诊所接受护理；干预后组（n = 320）接受母乳喂养教育，并可参加基于医院的母乳喂养支持小组，其中一些人参加了该小组。数据采用卡方检验和学生t检验进行分析。
干预后组的母乳喂养启动率更高（p < 0.0001）。基线组和干预后组在6个月及以后的母乳喂养持续率没有差异（p = 0.5），但与仅参加产前干预的妇女相比，参加母乳喂养支持小组的妇女的母乳喂养持续率更高。参与干预措施并未影响妇女报告达到母乳喂养目标的比例。
需要产前教育和出院后持续支持来提高母乳喂养的持续率。
