Nurs Res. 2021;70(3):193-199. doi: 10.1097/NNR.0000000000000502.
Mother's own milk (MOM) is well known to decrease prematurity-related morbidities, yet mothers delivering preterm infants often produce insufficient quantities of milk to provide these benefits. Although a critical need exists for research to support lactation success in this vulnerable population, development and investigation of interventions to increase available MOM for infant consumption requires consistent, valid, and reliable measures of lactation outcomes.
The aim of this study was to compare and contrast methods of measuring lactation outcomes in mothers of preterm infants and evaluate their advantages and disadvantages.
Measures of lactation outcomes were reviewed and synthesized. Insights on best practices and future research directions are provided.
Volume of MOM produced, lactation duration, and time to onset of secretory activation are important measures of lactation success. The most valid and reliable measure of milk production is likely weighing each vial of expressed milk combined with test weighing when infants breastfeed. Measures of lactation duration should include actual days mothers lactated rather than limiting to infant consumption of MOM as a proxy for duration and include not only whether mothers are lactating at infant discharge but whether they are also lactating at other health-relevant time points during hospitalization. Although time to onset of secretory activation is an important lactation outcome, information regarding valid and reliable indicators of onset in women delivering preterm infants is limited, and investigation of such indicators is a research priority. Variables that may affect lactation outcomes, including time to initiation of expression following delivery, duration of expression sessions, expression method, time spent in skin-to-skin care, maternal demographics and comorbidities, as well as maternal intent to lactate, must be considered when researchers investigate lactation outcomes in mothers of very low birth weight infants.
Consistent and valid measures of lactation outcomes are required to produce reliable results from which evidence-based practice recommendations can be developed in order to improve lactation success in this vulnerable population.
众所周知，母乳（MOM）可降低与早产相关的发病率，但早产儿的母亲往往产奶量不足，无法带来这些益处。尽管迫切需要研究来支持这一脆弱人群的母乳喂养成功，但要增加婴儿可摄入的母乳量并开发和研究干预措施，就需要使用一致、有效和可靠的哺乳结果衡量标准。
本研究旨在比较和对比早产儿母亲哺乳结果的衡量方法，并评估其优缺点。
对哺乳结果衡量标准进行了回顾和综合。提供了关于最佳实践和未来研究方向的见解。
母乳产量、哺乳持续时间和分泌启动时间是衡量哺乳成功的重要指标。衡量产奶量最有效和最可靠的方法可能是将每瓶挤出的母乳称重，并在婴儿母乳喂养时进行测试称重。哺乳持续时间的衡量标准应包括母亲实际哺乳的天数，而不是将婴儿摄入 MOM 的时间作为哺乳持续时间的替代指标，并不仅包括母亲在婴儿出院时是否在哺乳，还包括在住院期间其他与健康相关的时间点是否在哺乳。虽然分泌启动时间是一个重要的哺乳结果，但关于早产儿母亲中有效和可靠的启动指标的信息有限，因此研究这些指标是一个研究重点。在研究极低出生体重儿母亲的哺乳结果时，必须考虑可能影响哺乳结果的变量，包括分娩后开始挤奶的时间、挤奶时间、挤奶方法、皮肤接触时间、产妇人口统计学和合并症以及母乳喂养意愿等。
为了从可靠的结果中制定基于证据的实践建议，以改善这一脆弱人群的母乳喂养成功率，需要使用一致和有效的哺乳结果衡量标准。
