Fard Razieh Khalooei, Tabassi Zohre, Qorbani Mostafa, Hosseini Saeed
a School of Nutritional Sciences and Dietetics , Tehran University of Medical Sciences , Tehran , Iran.
b Department Obstetrics and Gynecology , Kashan University of Medical Science , Kashan , Iran.
J Diet Suppl. 2018 Jul 4;15(4):445-451. doi: 10.1080/19390211.2017.1353566. Epub 2017 Sep 22.
Delay in the initiation of breastfeeding is one of the problems of cesarean section. Its causes are insulin resistance, pain, anxiety, stress, thirst, hunger, and so on. Preoperative oral carbohydrate (OCH) reduces postoperative insulin resistance and improves postoperative recovery. The present study was conducted to evaluate the effect of preoperative oral carbohydrate on breastfeeding after cesarean section. In this double-blind randomized clinical trial, 91 pregnant women who underwent elective cesarean section were randomly assigned to preoperative OCH (Nutricia Preop; n = 45) or control group (water flavored with lemon; n = 46). The patients ingested 800 ml + 400 ml of liquid before the surgery. The time to first breastfeeding after surgery (min), the duration of breastfeeding (min), and breastfeeding frequency were measured using a questionnaire for up to 36 h after the surgery. Time to first breastfeeding after surgery was significantly shorter in the OCH group than in the control group (27.47 ± 11.51 vs. 51.96 ± 20.20 min, p< .001). The mean frequency of breastfeeding (6.14 ± 0.55 vs. 4.82 ± 0.46, p < .001) was significantly higher and the mean duration of breastfeeding (116.48 ± 19.68 vs. 82.13 ± 12.40 min, p < .001) was significantly longer in the OCH group compared with the control group in the first 36 h after the surgery. Preoperative oral carbohydrate improves breastfeeding after surgery (time to first breastfeeding, breastfeeding frequency, and breastfeeding duration). Further clinical trials and precise measurement tools are needed to assess breastfeeding to confirm these effects. The study was registered at http://www.IRCT.ir (IRCT2016072629082N1).
剖宫产术后开始母乳喂养延迟是其中一个问题。其原因包括胰岛素抵抗、疼痛、焦虑、压力、口渴、饥饿等。术前口服碳水化合物（OCH）可降低术后胰岛素抵抗并改善术后恢复情况。本研究旨在评估术前口服碳水化合物对剖宫产术后母乳喂养的影响。在这项双盲随机临床试验中，91例行择期剖宫产的孕妇被随机分为术前口服碳水化合物组（纽迪希亚术前营养补充剂；n = 45）或对照组（柠檬味水；n = 46）。患者在手术前摄入800毫升 + 400毫升液体。术后使用问卷测量至首次母乳喂养的时间（分钟）、母乳喂养持续时间（分钟）以及母乳喂养频率，最长至术后36小时。口服碳水化合物组术后至首次母乳喂养的时间明显短于对照组（27.47±11.51对51.96±20.20分钟，p <.001）。术后前36小时，口服碳水化合物组的平均母乳喂养频率（6.14±0.55对4.82±0.46，p <.001）明显更高，平均母乳喂养持续时间（116.48±19.68对82.13±12.40分钟，p <.001）明显更长。术前口服碳水化合物可改善术后母乳喂养情况（至首次母乳喂养的时间、母乳喂养频率和母乳喂养持续时间）。需要进一步的临床试验和精确的测量工具来评估母乳喂养情况以证实这些效果。该研究已在http://www.IRCT.ir（IRCT2016072629082N1）注册。
