UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Trials. 2020 Apr 7;21(1):318. doi: 10.1186/s13063-020-4225-3.
Late preterm infants suffer from more complications and are less likely to be breastfed compared to term infants and their mothers experience higher levels of stress than mothers with term infants. The physiological or hormonal responses that influence milk ejection, milk production, and/or maternal behaviour are possible mechanisms by which maternal distress could negatively influence breastfeeding success. Maternal mood might also affect infant behaviour (feeding, sleeping, and crying) through changes in milk volume and composition, and consequently breastfeeding success and infant growth. Previous research, using relaxation therapy in 64 Malaysian first-time mothers breastfeeding their full-term infants, demonstrated that the therapy was effective in reducing maternal stress and improving infant growth. We hypothesise that expected benefits are even greater in a more vulnerable population where additional breastfeeding support is especially needed, such as in mothers of late preterm infants.
METHODS/DESIGN: This protocol describes our randomised controlled trial that tests whether a breastfeeding meditation audio reduces maternal stress in mothers of late preterm infants in London. Home visits will be conducted at 2-3 and 6-8 weeks post-delivery. Participants will be randomised to a control group or an intervention group, where mothers will be asked to listen to a meditation tape on a daily basis while breastfeeding. The main outcomes of the intervention will be maternal stress markers and infant weight Z-score. Potential mediators will be the secondary outcomes and include breast milk macronutrient and hormone levels (ghrelin, leptin, cortisol, and adiponectin), milk volume assessed by 48-h test-weighing, and maternal engagement with the infant. Infant behaviour, including crying and sleeping, and infant appetite will be evaluated. Data about other mediators such as maternal perception of milk supply and salivary oxytocin will be collected.
We hypothesise that the use of the breastfeeding meditation will reduce maternal stress and consequently improve infant growth mediated by changes in milk composition and volume and maternal behaviour. This study will allow us to understand the mother-infant factors that influence breastfeeding in late preterm infants and potentially identify a method that could improve mother, infant, and breastfeeding outcomes.
ClinicalTrials.gov, NCT03791749. Registered 1 January 2019.
与足月婴儿相比，晚期早产儿并发症更多，母乳喂养的可能性更小，其母亲所承受的压力也高于足月婴儿的母亲。影响奶汁喷射、乳汁分泌和/或母亲行为的生理或激素反应可能是母亲焦虑通过何种机制对母乳喂养成功产生负面影响的机制。母亲的情绪也可能通过乳汁量和成分的变化影响婴儿的行为（喂养、睡眠和哭泣），从而影响母乳喂养的成功和婴儿的生长。先前的研究使用放松疗法对 64 名马来西亚初产妇进行了母乳喂养足月婴儿，结果表明该疗法可有效降低母亲的压力并改善婴儿的生长。我们假设，在更脆弱的人群中，预期的益处更大，在这些人群中，特别需要额外的母乳喂养支持，例如晚期早产儿的母亲。
方法/设计：本方案描述了我们的随机对照试验，该试验测试在伦敦的晚期早产儿母亲中，母乳喂养冥想音频是否可以降低母亲的压力。分娩后 2-3 周和 6-8 周将进行家访。参与者将被随机分配到对照组或干预组，母亲将被要求在母乳喂养时每天听冥想带。干预的主要结果将是母亲的压力指标和婴儿体重 Z 分数。潜在的中介因素将是次要结果，包括母乳宏量营养素和激素水平（ghrelin、leptin、cortisol 和 adiponectin）、通过 48 小时测试称重评估的乳汁量以及母亲与婴儿的互动。将评估婴儿的行为，包括哭泣和睡眠，以及婴儿的食欲。将收集有关其他中介因素的数据，例如母亲对乳汁供应的感知和唾液催产素。
我们假设使用母乳喂养冥想将减轻母亲的压力，从而通过改变乳汁成分和量以及母亲的行为来改善婴儿的生长。这项研究将使我们能够了解影响晚期早产儿母乳喂养的母婴因素，并有可能确定一种可以改善母婴和母乳喂养结果的方法。
ClinicalTrials.gov，NCT03791749。2019 年 1 月 1 日注册。
