Jacobson Lisette T, Zackula Rosalee E, Lu Kelsey
Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS.
Office of Research, University of Kansas School of Medicine-Wichita, Wichita, KS.
Kans J Med. 2020 Sep 11;13:219-227. eCollection 2020.
Overweight and obesity during pregnancy are associated with adverse health outcomes leading to increased maternal and neonatal morbidity and mortality. Women with a high body mass index (BMI) also experience low breastfeeding rates. There is limited evidence of effective educational programs that aim to improve length of breastfeeding among this population. The main objective of this pilot educational intervention was to determine knowledge and skills retention at six weeks after completion of a breastfeeding class.
A two-hour breastfeeding class was offered during the second and third trimester of pregnancy targeting high BMI women. A longitudinal, survey study design was conducted using two data collection points. No comparator group was employed.
Baseline mean age of respondents was 26.6 years (SD = 5.7). Respondents who completed post-intervention surveys were largely white (69.2%) followed by Hispanic (15.4%) and non-Hispanic black (15.4%), some college (57.1%), earned less than $50,000/year (64.3%), had employer-provided insurance (53.8%), and did not receive WIC benefits (78.6%). Most respondents had a pre-pregnancy BMI category of overweight (28.6%) or obese (57.1%). The intervention appeared to have some impact on responses. The following were observed: an increased understanding that baby may be fussy in the evening hours and wants to nurse more often (p < 0.002), how to bring baby to the breast (p = 0.004), knowing what to do if breastfeeding hurts (p = 0.031), and knowing what to do when baby has trouble breastfeeding (p = 0.021).
Consistent with previous findings, all participants in our study reported increased knowledge to breastfeed. Thus, women's confidence to breastfeed their infant is enhanced through knowledge obtained from breastfeeding education. Additional studies are underway to assess breastfeeding behaviors.
孕期超重和肥胖与不良健康结局相关,会导致孕产妇和新生儿发病率及死亡率增加。体重指数(BMI)高的女性母乳喂养率也较低。旨在提高该人群母乳喂养时长的有效教育项目的证据有限。本次试点教育干预的主要目的是确定在完成母乳喂养课程六周后知识和技能的留存情况。
在孕期的第二和第三个月为高BMI女性提供为期两小时的母乳喂养课程。采用纵向调查研究设计,有两个数据收集点。未设对照组。
受访者的基线平均年龄为26.6岁(标准差=5.7)。完成干预后调查的受访者大多为白人(69.2%),其次是西班牙裔(15.4%)和非西班牙裔黑人(15.4%),部分上过大学(57.1%),年收入低于5万美元(64.3%),有雇主提供的保险(53.8%),未领取妇女、婴儿和儿童营养补充计划(WIC)福利(78.6%)。大多数受访者孕前BMI类别为超重(28.6%)或肥胖(57.1%)。干预似乎对回答有一定影响。观察到以下情况:对婴儿晚上可能烦躁不安且想更频繁吃奶的理解有所增加(p<0.002),如何让婴儿衔乳(p=0.004),知道母乳喂养疼痛时该怎么做(p=0.031),以及知道婴儿母乳喂养困难时该怎么做(p=0.021)。
与先前研究结果一致,我们研究中的所有参与者报告称母乳喂养知识有所增加。因此,通过从母乳喂养教育中获得的知识,女性母乳喂养婴儿的信心得到增强。正在进行更多研究以评估母乳喂养行为。