Hicks Jennifer, Morse Elizabeth, Wyant David K
1 Tennessee Department of Health, Rutherford County Health Department , Murfreesboro, Tennessee.
2 College of Health Sciences, Belmont University , Nashville, Tennessee.
Breastfeed Med. 2018 May;13(4):259-265. doi: 10.1089/bfm.2017.0130. Epub 2018 Mar 29.
This study utilized a cross-sectional qualitative and quantitative interview-based survey to capture the infant feeding practices and barriers to exclusive breastfeeding for women in methadone maintenance therapy. Participants were recruited from an opioid dependence treatment center in an urban setting in the Southeastern United States.
A convenience sample of women in treatment (n = 30) were interviewed using an adapted instrument designed to capture decisions and intentions to formula feed or breastfeed; support from friends and family; hospital experience; support from healthcare personnel; and maternal knowledge of breastfeeding while taking methadone.
The majority of women in the sample initiated breastfeeding, but only 10% continued for >1 month. Challenges related to infant hospital stay posed a significant barrier. Two-thirds of infants remained hospitalized after the mother was discharged. Out of the 24 women who initiated breastfeeding, 11 reported that they discontinued because of issues related to infant's neonatal intensive care unit (NICU) stay. Eleven women reported that their healthcare providers did not discuss breastfeeding with them. Women who were encouraged to breastfeed by healthcare staff were more likely to breastfeed for longer durations.
Women in treatment for opioid dependence both desire and attempt to establish breastfeeding, but encounter significant challenges, including long NICU stays and lack of support and education, that compromise their success. These findings should inform the development of future programs or interventions geared toward increasing breastfeeding initiation, support, and duration among women who give birth to babies while in treatment for opioid addiction.
本研究采用了基于访谈的横断面定性和定量调查，以了解接受美沙酮维持治疗的女性的婴儿喂养方式及纯母乳喂养的障碍。参与者从美国东南部城市环境中的一家阿片类药物依赖治疗中心招募。
采用便利抽样法，对30名接受治疗的女性进行访谈，使用一种经过改编的工具来获取配方奶喂养或母乳喂养的决定和意图；来自朋友和家人的支持；住院经历；来自医护人员的支持；以及母亲在服用美沙酮期间对母乳喂养的了解。
样本中的大多数女性开始进行母乳喂养，但只有10%的女性持续母乳喂养超过1个月。与婴儿住院相关的挑战构成了重大障碍。母亲出院后，三分之二的婴儿仍住院。在开始母乳喂养的24名女性中，11名报告称她们因与婴儿新生儿重症监护病房（NICU）住院相关的问题而停止母乳喂养。11名女性报告称她们的医护人员未与她们讨论母乳喂养问题。受到医护人员鼓励进行母乳喂养的女性更有可能持续较长时间的母乳喂养。
接受阿片类药物依赖治疗的女性既渴望也尝试进行母乳喂养，但面临重大挑战，包括长时间入住NICU以及缺乏支持和教育，这影响了她们母乳喂养的成功。这些发现应为未来旨在增加阿片类药物成瘾治疗期间分娩女性的母乳喂养启动率、支持率和持续时间的项目或干预措施的制定提供参考。
