School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
School of Nursing, North Sichuan Medical College, Nanchong, Sichuan, China.
BMC Pregnancy Childbirth. 2021 Mar 24;21(1):248. doi: 10.1186/s12884-021-03714-8.
The importance of breastfeeding for maternal and child health is agreed upon worldwide. However, lactation-related nipple problems are common and are important factors affecting breastfeeding. Multiple studies recommended laid-back breastfeeding, but they are of various levels of quality, and the results are inconclusive.
We systematically searched the following twelve databases from inception to January 28,2020: Cochrane Library, EMBASE, Medline, Ovid, PubMed, Web of Science, CINAHL, Scopus, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), WanFang, and VIP. All studies regarding laid-back breastfeeding or biological nurturing were considered, regardless of whether they were randomized controlled trials. Two trained investigators independently evaluated the quality of the selected articles and screened the data. All the data were analysed separately using Review Manager Version 5.3 and STATA/SE Version 15.1.
A total of 12 studies involving 1936 groups of postpartum women and their newborns were included. The results of the meta-analysis showed that nipple pain (RR = 0.24; 95% CI 0.14, 0.40; p < 0.00001), nipple trauma (RR = 0.47; 95% CI 0.29, 0.75; p = 0.002) and correct latching position (RR = 1.22; 95% CI 1.11, 1.33; p < 0.0001) in the experimental groups were all better than those of the control groups, and the differences were statistically significant (p < 0.05), which indicates that the laid-back position has a positive effect on maternal breastfeeding. However, the results of position comfort showed that there was no statistical significance between the two groups (ES = 0.09; 95% CI -0.63, 0.81; p = 0.798).
Compared with traditional breastfeeding positions, the laid-back position has been proven to be related to a decreased incidence of nipple pain and nipple trauma and is seemingly conducive to the use of the correct latching position. It is suggested that the laid-back position is helpful in solving lactation-related nipple problems and can be recommended as a position for breastfeeding. However, no significant difference in position comfort was found between the two groups based on the current evidence, and further studies are still needed to validate these results due to the limitations of the included studies.
母乳喂养对母婴健康的重要性已得到全球认可。然而，与哺乳相关的乳头问题很常见，是影响母乳喂养的重要因素。多项研究推荐采用侧卧式哺乳，但这些研究质量参差不齐，结果也不一致。
我们系统地检索了以下 12 个数据库，从建库到 2020 年 1 月 28 日：Cochrane 图书馆、EMBASE、Medline、Ovid、PubMed、Web of Science、CINAHL、Scopus、中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方和维普。纳入所有关于侧卧式哺乳或生物养育的研究，无论其是否为随机对照试验。两名经过培训的调查员独立评估入选文章的质量并筛选数据。所有数据均使用 Review Manager Version 5.3 和 STATA/SE Version 15.1 分别进行分析。
共纳入 12 项研究，涉及 1936 组产后妇女及其新生儿。荟萃分析结果显示，实验组乳头疼痛（RR=0.24；95%CI 0.14，0.40；p<0.00001）、乳头创伤（RR=0.47；95%CI 0.29，0.75；p=0.002）和正确的衔乳位置（RR=1.22；95%CI 1.11，1.33；p<0.0001）均优于对照组，差异有统计学意义（p<0.05），提示侧卧式有利于产妇母乳喂养。然而，两组的体位舒适度结果无统计学差异（ES=0.09；95%CI -0.63，0.81；p=0.798）。
与传统的哺乳姿势相比，侧卧式哺乳已被证明与降低乳头疼痛和乳头创伤的发生率有关，并且似乎有利于采用正确的衔乳位置。建议采用侧卧式有助于解决与哺乳相关的乳头问题，可以推荐作为一种哺乳姿势。但是，基于目前的证据，两组之间在体位舒适度方面没有发现显著差异，由于纳入研究的局限性，还需要进一步的研究来验证这些结果。
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