School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2021 Sep;57(9):1473-1478. doi: 10.1111/jpc.15530. Epub 2021 May 27.
To investigate/evaluate the impact of hospital transfers on breastfeeding outcomes for infants requiring neonatal intensive care and to explore approaches to supporting lactation and breastfeeding.
A national study of two cohorts of infants admitted to the nine neonatal intensive care units (NICUs) in New South Wales (NSW) Australia using data sourced from a prospectively collected NICUS data collection.
A total of 7829 infants were admitted to the nine NICUs in NSW for two 18-month cohorts (2012/2013 and 2015/2016) and were included in the study. These infants experienced 17 238 transfers to 107 different hospitals during the study period. Multiple transfers and low gestational age were independently associated with lower breastfeeding rates at hospital discharge across both cohorts. Extremely preterm infants and those with the greatest number of hospital transfers are least likely to be breastfed at time of discharge. Breastfeeding rates remained unchanged over time. The level of lactation support varied across NICUs.
This study highlights the challenges of establishing and maintaining breastfeeding for infants requiring intensive care who have had multiple hospital transfers for continuing or specialist care. There is wide variation in lactation support across facilities. The importance of a consistent approach, education programmes and the provision of appropriate lactation support is emphasised.
调查/评估医院转院对需要新生儿重症监护的婴儿母乳喂养结果的影响，并探讨支持泌乳和母乳喂养的方法。
对澳大利亚新南威尔士州（NSW）9 个新生儿重症监护室（NICU）的两个队列的婴儿进行了一项全国性研究，使用了从前瞻性收集的 NICU 数据集中获取的数据。
共有 7829 名婴儿在 NSW 的 9 个 NICU 接受了两个 18 个月的队列（2012/2013 和 2015/2016）的治疗，并被纳入研究。在研究期间，这些婴儿经历了 17238 次转移到 107 家不同的医院。在两个队列中，多次转移和低胎龄与出院时母乳喂养率较低独立相关。极早产儿和接受医院转院次数最多的婴儿最不可能在出院时进行母乳喂养。母乳喂养率随时间保持不变。NICU 之间的泌乳支持水平存在差异。
本研究强调了为需要重症监护的婴儿建立和维持母乳喂养的挑战，这些婴儿因持续或专科护理而多次转院。各机构之间的哺乳支持存在很大差异。强调了采用一致的方法、教育计划和提供适当的哺乳支持的重要性。
