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与极低出生体重婴儿的母亲在 6 周内停止哺乳相关的人口统计学、社会和个人因素。

Demographic, Social, and Personal Factors Associated With Lactation Cessation by 6 Weeks in Mothers of Very Low Birth Weight Infants.

机构信息

3463 University of Florida, USA.

50546 Medical University of South Carolina, Charleston, USA.

出版信息

J Hum Lact. 2021 Aug;37(3):511-520. doi: 10.1177/0890334420940239. Epub 2020 Oct 8.

Abstract

BACKGROUND

Although mother's own milk decreases prematurity-associated morbidities, mothers of infants born preterm and very low birth weight experience a significantly shorter lactation duration. Little is known regarding factors associated with lactation cessation during the hospitalization of a very low birth weight infant.

RESEARCH AIM

To determine demographic, social, and personal factors associated with lactation cessation by 6-weeks postpartum in mothers delivering very low birth weight infants.

METHODS

We used a retrospective, longitudinal, two-group comparison design using data from a randomized control study. Mothers of very low birth weight infants ( = 142) were enrolled from a labor and delivery unit associated with a Level 4 neonatal intensive care unit. Demographic, social, and health information was obtained from the medical records. Participants were surveyed regarding lactation goals, experience, and reason(s) for cessation.

RESULTS

Participants who did not continue lactating for more than 6 weeks were more likely to be unemployed ( = .019), Medicaid eligible ( = .009), less educated ( < .031), smoke ( = .002), provide less skin-to-skin care ( = .007), and to delay the decision to provide their milk to their infant ( = .007). After Bonferroni adjustment, only minutes of skin-to-skin care remained statistically significant. Insufficient maternal milk production was the most common reason for lactation cessation.

CONCLUSION

While the etiology of lactation cessation is often non-modifiable, strategies aimed at maintaining mother's own milk production, smoking cessation, increasing skin-to-skin care, and promoting an earlier decision to lactate, may prolong lactation duration in this vulnerable population.This RCT was registered (2012-00071) with ClinicalTrials.com on 6/28/2013.

摘要

背景

尽管母乳喂养可降低早产儿相关疾病的发病率,但早产儿和极低出生体重儿的母亲母乳喂养时间明显更短。对于极低出生体重儿住院期间与停止母乳喂养相关的因素知之甚少。

目的

确定与极低出生体重儿母亲在产后 6 周内停止母乳喂养相关的人口统计学、社会和个人因素。

方法

我们使用回顾性、纵向、两组比较设计,使用一项随机对照研究的数据。从一家与四级新生儿重症监护病房相关的产房和分娩病房招募极低出生体重儿的母亲(n=142)。从病历中获取人口统计学、社会和健康信息。调查参与者关于母乳喂养目标、经验和停止母乳喂养的原因。

结果

持续母乳喂养超过 6 周的参与者更有可能失业(p=0.019)、有资格获得医疗补助(p=0.009)、受教育程度较低(p<0.031)、吸烟(p=0.002)、提供较少的皮肤接触(p=0.007),并且延迟决定将自己的奶提供给婴儿(p=0.007)。在进行 Bonferroni 调整后,只有皮肤接触时间仍具有统计学意义。母乳不足是停止母乳喂养的最常见原因。

结论

虽然停止母乳喂养的病因通常是不可改变的,但旨在维持母乳产量、戒烟、增加皮肤接触和促进更早开始哺乳的策略,可能会延长这个脆弱人群的母乳喂养时间。这项 RCT 于 2013 年 6 月 28 日在 ClinicalTrials.com 上注册(注册号:2012-00071)。

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