新生儿护士培训方案聚焦于 6 项母乳喂养支持性临床实践，可提高早产儿的纯母乳喂养率。
Improved exclusive breastfeeding rates in preterm infants after a neonatal nurse training program focusing on six breastfeeding-supportive clinical practices.
机构信息
Department of Neonatology, Knowledge Centre for Breastfeeding Infants with Special Needs, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Research Unit Women's and Children's Health, Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
出版信息
PLoS One. 2021 Feb 3;16(2):e0245273. doi: 10.1371/journal.pone.0245273. eCollection 2021.
BACKGROUND
Early breast milk expression, prolonged skin-to-skin contact, rooming-in, use of test-weighing and minimizing use of pacifiers are positively associated with exclusive breastfeeding of preterm infants, whereas use of nipple shields is negatively associated.
AIM
To test whether a training program for neonatal nurses with a focus on these six breastfeeding-supportive clinical practices affects the rate of preterm infants exclusively breastfed at discharge to home, the postmenstrual age at establishment of exclusive breastfeeding, and maternal self-reported use of the practice in the neonatal intensive care unit, the.
METHODS
A quasi-experimental multi-centre intervention study from 2016-2019 including a control group of 420 preterm mother-infant dyads, an intervention with a training program for neonatal nurses and implementation of weekly breastfeeding meetings for neonatal nurses, and an intervention group of 494 preterm mother-infant dyads.
RESULTS
Significantly more preterm infants in the intervention group were exclusively breastfed at discharge to home (66.6%) than in the control group (58.1%) p = 0.008. There was no significant difference in postmenstrual age at establishment of exclusive breastfeeding between control and intervention group (37.5 vs.37.8 weeks, p = 0.073). Compared to the control group the number of infants continuing daily skin-to-skin contact after incubator care increased (83.2% vs. 88.3%, p = 0.035), infants using a nipple shield decreased (61.8% vs. 54.2%, p = 0.029), and the number of mothers initiating breast milk expression before six hours post-partum increased (32.6% vs. 42.4%, p = 0.007). There was a significant correlation between percentage of neonatal nurses participating in the breastfeeding training program and changes in exclusive breastfeeding rates (Pearson Correlation 0.638, p = 0.047).
CONCLUSION
Exclusive breastfeeding rates in preterm infants and maternal self-reported use of breastfeeding-supportive practices increased by training neonatal nurses in the six clinical practices. It is important to include all nurses in the breastfeeding training program to ensure positive effect on exclusive breastfeeding rates.
背景
早期的母乳挤出、长时间的皮肤接触、母婴同室、使用测试称重和尽量减少使用奶嘴与早产儿的纯母乳喂养呈正相关，而使用奶嘴盾则呈负相关。
目的
测试一项以这六项支持母乳喂养的临床实践为重点的新生儿护士培训计划是否会影响早产儿出院时纯母乳喂养的比例、建立纯母乳喂养的胎龄和产妇在新生儿重症监护病房（NICU）中报告的使用这些实践的情况。
方法
一项 2016-2019 年的准实验性多中心干预研究，包括对照组 420 例早产儿母婴对和干预组 494 例早产儿母婴对，对照组为新生儿护士培训计划和每周新生儿护士母乳喂养会议的实施，干预组为新生儿护士培训计划和每周新生儿护士母乳喂养会议的实施。
结果
干预组中，出院时纯母乳喂养的早产儿比例显著高于对照组（66.6% vs. 58.1%，p = 0.008）。两组建立纯母乳喂养的胎龄无显著差异（对照组 37.5 周 vs. 干预组 37.8 周，p = 0.073）。与对照组相比，接受孵化器护理后继续每日皮肤接触的婴儿数量增加（83.2% vs. 88.3%，p = 0.035），使用奶嘴盾的婴儿数量减少（61.8% vs. 54.2%，p = 0.029），并且在产后 6 小时内开始挤奶的产妇数量增加（32.6% vs. 42.4%，p = 0.007）。新生儿护士参与母乳喂养培训计划的百分比与纯母乳喂养率的变化呈显著正相关（Pearson 相关系数 0.638，p = 0.047）。
结论
通过培训新生儿护士掌握这六项临床实践，早产儿的纯母乳喂养率和产妇自我报告的使用支持母乳喂养的实践有所增加。让所有护士都参与母乳喂养培训计划对于确保纯母乳喂养率的提高非常重要。
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