新生儿黄疸是否影响台湾地区母乳喂养的专一性和时长？

Does Jaundice in Newborn Infants Affect Exclusivity and Duration of Breastfeeding in Taiwan?

机构信息

PhD, RN, Assistant Professor, Department of Nursing, Ching Kuo Institute of Management and Health, Taiwan, ROC.

MD, Attending Physician, Department of Obstetrics and Gynecology, Cardinal Tien Hospital-Hsintien, and Assistant Professor, School of Medicine, College of Medicine, Fu Jen Catholic University, Taiwan, ROC.

出版信息

J Nurs Res. 2021 Jan 29;29(2):e145. doi: 10.1097/jnr.0000000000000420.

DOI:10.1097/jnr.0000000000000420

PMID:33534355

Abstract

BACKGROUND

Cases of breastfeeding- and breast-milk-related jaundice tend to increase with increased rates of breastfeeding. Diagnoses of jaundice often lead mothers to discontinue breastfeeding because of assumptions that breastfeeding may exacerbate neonatal jaundice and lengthen the duration of phototherapy treatment.

PURPOSE

This study was designed to explore the effect of neonatal jaundice on breastfeeding duration and exclusivity during the first 4 months postpartum.

METHODS

This study applied a two-group comparative and follow-up design. The two groups comprised 135 and 160 mothers of infants, respectively, with and without neonatal jaundice. All of the participants were recruited from three certified baby-friendly hospitals in northern Taiwan. Follow-up was conducted by telephone at 1 and 4 months postpartum.

RESULTS

Mean breastfeeding duration was longer in the group of participants whose infants had neonatal jaundice (group with neonatal jaundice) than in the group whose infants did not have this condition (group without neonatal jaundice; 102.00 vs. 89.85 days, p = .007). The degree of breastfeeding was higher in the group with neonatal jaundice, although the difference was significant only at 1 month postpartum and not during hospitalization or at 4 months postpartum. The results of a Cox regression model showed that the group without neonatal jaundice was more likely to discontinue breastfeeding (adjusted hazard ratio = 1.68, 95% CI [1.08, 2.62]). A generalized estimating equation model suggests that infants with neonatal jaundice had a higher likelihood of being breastfed for at least half of their feedings (adjusted OR = 1.53, 95% CI [1.04, 2.25]).

CONCLUSIONS

On the basis of the results of this study, neonatal jaundice is not an obstacle to breastfeeding in pro-breastfeeding hospital environments. Participants whose infants developed neonatal jaundice were found in this study to breastfeed more often, which promotes breastfeeding success.

摘要

背景

随着母乳喂养率的提高，与母乳喂养和母乳相关的黄疸病例往往会增加。黄疸的诊断往往导致母亲停止母乳喂养，因为她们认为母乳喂养可能会加重新生儿黄疸，并延长光疗治疗时间。

目的

本研究旨在探讨新生儿黄疸对产后前 4 个月母乳喂养持续时间和排他性的影响。

方法

本研究采用了两组比较和随访设计。两组分别由 135 名和 160 名患有和不患有新生儿黄疸的婴儿的母亲组成。所有参与者均来自台湾北部的三家认证的爱婴医院。在产后 1 个月和 4 个月通过电话进行随访。

结果

患有新生儿黄疸的婴儿的母亲（新生儿黄疸组）的母乳喂养持续时间长于没有新生儿黄疸的婴儿的母亲（无新生儿黄疸组）（102.00 天 vs. 89.85 天，p=0.007）。新生儿黄疸组的母乳喂养程度更高，尽管仅在产后 1 个月且不在住院期间或产后 4 个月时差异有统计学意义。Cox 回归模型的结果表明，无新生儿黄疸组更有可能停止母乳喂养（调整后的危险比=1.68，95%置信区间[1.08，2.62]）。广义估计方程模型表明，患有新生儿黄疸的婴儿更有可能至少有一半的喂养是母乳喂养（调整后的优势比=1.53，95%置信区间[1.04，2.25]）。