Ruth Lucas, PhD, RNC, CLC, is Assistant Professor, University of Connecticut School of Nursing, Storrs. Yiming Zhang, MS, is Graduate Student, University of Connecticut Department of Statistics, University of Connecticut School of Nursing, Storrs. Stephen J. Walsh, ScD, is Associate Professor, University of Connecticut School of Nursing, Storrs. Heather Evans, PhD, is Assistant Professor, School of Interdisciplinary Health & Science, Department of Nursing, University of Saint Joseph, West Hartford, Connecticut. Erin Young, PhD, is Assistant Professor, University of Connecticut School of Nursing, Storrs. Angela Starkweather, PhD, ACNP-BC, FAAN, is Professor, University of Connecticut School of Nursing, Storrs.
Nurs Res. 2019 Mar/Apr;68(2):E1-E10. doi: 10.1097/NNR.0000000000000336.
Over 90% of women experience pain during breastfeeding initiation and lack strategies to self-manage breast and nipple pain. Guided by the Individual and Family Self-Management Theory, a breastfeeding self-management (BSM) intervention targeted women's knowledge, beliefs, and social facilitation to manage their breast and nipple pain and achieve their breastfeeding goals.
The purpose of this longitudinal pilot randomized control trial (RCT) was to test the preliminary efficacy of the BSM intervention on general and specific pain related to breastfeeding.
Sixty women intending to breastfeed were approached within 48 hours of delivery to participate in this pilot RCT (30 randomized to the BSM intervention and 30 randomized to the control group). All participants provided baseline data before discharge and pain and breastfeeding measures at 1, 2, and 6 weeks. Participants in the BSM intervention group received educational modules addressing breast and nipple pain and biweekly, text-based nurse coaching and completed a daily breastfeeding journal.
Women in the BSM intervention group reported significantly less breast and nipple pain at 1 and 2 weeks using a visual analog scale (p < .014 and p < .006) and at 2 weeks using the Brief Pain Inventory intensity scale (p < .029), but no difference in breastfeeding duration.
The BSM intervention pilot demonstrates a positive effect on breastfeeding specific and overall generalized pain. Future investigation is needed to identify at-risk women of ongoing breastfeeding pain and develop precision interventions to sustain this beneficial health behavior for mothers and infants.
超过 90%的女性在开始母乳喂养时会感到疼痛，并且缺乏自我管理乳房和乳头疼痛的策略。本研究以个体和家庭自我管理理论为指导，针对女性管理乳房和乳头疼痛及实现母乳喂养目标的知识、信念和社会促进因素，制定了母乳喂养自我管理（BSM）干预措施。
本纵向前瞻性随机对照试验（RCT）的目的是检验 BSM 干预措施对与母乳喂养相关的一般和特定疼痛的初步疗效。
在分娩后 48 小时内，共招募了 60 名计划母乳喂养的女性参与本研究的前瞻性 RCT（30 名随机分配至 BSM 干预组，30 名随机分配至对照组）。所有参与者在出院前提供基线数据，并在 1、2 和 6 周时提供疼痛和母乳喂养测量数据。BSM 干预组的参与者接受了关于乳房和乳头疼痛的教育模块，以及每两周一次的基于文本的护士辅导，并完成了每日母乳喂养日记。
BSM 干预组女性在 1 周和 2 周时使用视觉模拟评分（VAS）报告的乳房和乳头疼痛显著减少（p <.014 和 p <.006），在 2 周时使用Brief 疼痛量表（BPI）强度量表报告的疼痛也显著减少（p <.029），但母乳喂养持续时间无差异。
BSM 干预试验初步显示出对母乳喂养特异性和总体一般性疼痛的积极影响。未来需要进一步研究以确定持续母乳喂养疼痛的高危女性，并开发精准干预措施，以维持这种对母婴有益的健康行为。
