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住院期间经巴氏消毒的捐赠人母乳或配方奶补充喂养的足月双胎的临床特征和母乳喂养结局。

Clinical Characteristics and Breastfeeding Outcomes in Term Dyads Following In-Hospital Supplementation with Pasteurized Donor Human Milk or Formula.

机构信息

Department of Nursing, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

出版信息

Breastfeed Med. 2021 Sep;16(9):717-724. doi: 10.1089/bfm.2020.0337. Epub 2021 Apr 19.

Abstract

Pasteurized donor human milk (PDHM) supplementation for healthy infants is an emerging practice. Little is known about demographics or breastfeeding outcomes for dyads whose mothers choose PDHM versus formula. To identify relationships between in-hospital supplementation choice and (1) dyad characteristics and breastfeeding intent, and (2) breastfeeding outcomes at 1 month. This exploratory prospective cohort study surveyed healthy dyads requiring medically indicated supplementation. Participants completed questionnaires including demographics, breastfeeding intent, and self-efficacy during hospitalization, and self-efficacy and lactation outcomes at 1 month. Of 39 participants, 24 (62%) supplemented with formula and 15 (38%) with PDHM. Formula dyads were more likely than PDHM dyads to have a delivery body mass index (BMI) ≥30 kg/m (58% versus 20%,  = 0.02), and less likely to have attained greater than a college degree (33% versus 7%,  = 0.02); formula dyads also reported lower breastfeeding intent scores (12.0 versus 15.5,  = 0.002). Breastfeeding self-efficacy scores were similar but decreased for both groups over 1 month. At 1 month, mothers who chose formula were more likely to continue to provide breast milk to their infants (84% versus 72%). Direct breastfeeding rates were similar (72% versus 68%); of participants directly breastfeeding at 1 month, PDHM dyads were 1.5 times more likely to provide maternal expressed milk. Differences in maternal education, BMI, and breastfeeding intent were found between feeding groups. Results suggest an association between PDHM choice and initial breastfeeding intent and breastfeeding self-efficacy and provision of maternal expressed milk at 1 month.

摘要

经巴氏消毒的捐赠人母乳(PDHM)补充剂用于健康婴儿是一种新兴做法。对于选择 PDHM 与配方奶的母亲及其婴儿的人口统计学或母乳喂养结果知之甚少。本研究旨在确定住院期间补充选择与(1)母婴特征和母乳喂养意向,以及(2)1 个月时母乳喂养结果之间的关系。本探索性前瞻性队列研究调查了需要医学指征补充的健康母婴对。参与者在住院期间完成了问卷调查,包括人口统计学、母乳喂养意向和自我效能感,以及 1 个月时的自我效能感和哺乳结果。在 39 名参与者中,有 24 名(62%)用配方奶补充,15 名(38%)用 PDHM 补充。与 PDHM 母婴对相比,配方奶母婴对的分娩体重指数(BMI)≥30kg/m²的可能性更高(58%对 20%, = 0.02),且获得大学以上学历的可能性更低(33%对 7%, = 0.02);配方奶母婴对的母乳喂养意向评分也较低(12.0 对 15.5, = 0.002)。1 个月后,两组的母乳喂养自我效能评分相似,但均下降。1 个月时,选择配方奶的母亲更有可能继续给婴儿提供母乳(84%对 72%)。直接母乳喂养率相似(72%对 68%);在 1 个月时直接母乳喂养的参与者中,PDHM 母婴对提供母亲表达奶的可能性是配方奶母婴对的 1.5 倍。在喂养组之间发现了母亲教育、BMI 和母乳喂养意向的差异。结果表明,PDHM 选择与初始母乳喂养意向和母乳喂养自我效能感以及 1 个月时提供母亲表达奶之间存在关联。

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