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足月婴儿的日常皮肤接触和母乳喂养:一项随机对照试验的次要结局。

Daily skin-to-skin contact in full-term infants and breastfeeding: Secondary outcomes from a randomized controlled trial.

机构信息

Department of Developmental Psychology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.

Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.

出版信息

Matern Child Nutr. 2022 Jan;18(1):e13241. doi: 10.1111/mcn.13241. Epub 2021 Jul 8.

Abstract

This randomized controlled trial evaluated the effect of a 5-week daily skin-to-skin contact (SSC) intervention between mothers and their full-term infants, compared with care-as-usual, on exclusive and continued breastfeeding duration during the first post-natal year. Healthy pregnant women (n = 116) from a community sample were enrolled and randomly allocated to the SSC or care-as-usual condition. SSC mothers were requested to provide one daily hour of SSC for the first five post-natal weeks. Twelve months post-partum, mothers indicated the number of exclusive and continued breastfeeding months. Multiple regression analyses were conducted using intention-to-treat, per-protocol and exploratory dose-response frameworks. In intention-to-treat analyses, exclusive and continued breastfeeding duration was not different between groups (exclusive: 3.61 ± 1.99 vs. 3.16 ± 1.77 months; adjusted mean difference 0.28, 95% confidence interval [CI] -0.33 to 0.89; p = 0.36; continued: 7.98 ± 4.20 vs. 6.75 ± 4.06 months; adjusted mean difference 0.81, 95% CI -0.46 to 2.08; p = 0.21). In per-protocol analyses, exclusive and continued breastfeeding duration was longer for SSC than care-as-usual dyads (exclusive: 4.89 ± 1.26 vs. 3.25 ± 1.80 months; adjusted mean difference 1.28, 95% CI 0.31-2.24; p = 0.01; continued: 10.81 ± 1.97 vs. 6.98 ± 4.08 months; adjusted mean difference 2.33, 95% CI 0.13-4.54; p = 0.04). Exploratory dose-response effects indicated that more SSC hours predicted longer exclusive and continued breastfeeding duration. This study demonstrates that for the total group, the 5-week daily SSC intervention did not extend exclusive and continued breastfeeding duration. However, for mothers performing a regular daily hour of SSC, this simple and accessible intervention may extend exclusive and continued breastfeeding duration by months. Future studies are required to confirm these promising findings. Trial registration: Netherlands Trial Register (NTR5697).

摘要

这项随机对照试验评估了母亲与足月婴儿进行为期 5 周的每日皮肤接触(SSC)干预与常规护理相比,对婴儿在产后第一年中纯母乳喂养和持续母乳喂养的影响。从社区样本中招募了 116 名健康孕妇,并将其随机分配到 SSC 或常规护理条件组。SSC 母亲被要求在前 5 个产后周内每天提供 1 小时的 SSC。产后 12 个月,母亲报告了纯母乳喂养和持续母乳喂养的月数。采用意向治疗、方案和探索性剂量反应框架进行多变量回归分析。在意向治疗分析中,两组的纯母乳喂养和持续母乳喂养时间没有差异(纯母乳喂养:3.61±1.99 个月 vs. 3.16±1.77 个月;调整后的平均差异 0.28,95%置信区间 [CI] -0.33 至 0.89;p=0.36;持续母乳喂养:7.98±4.20 个月 vs. 6.75±4.06 个月;调整后的平均差异 0.81,95% CI -0.46 至 2.08;p=0.21)。在方案分析中,SSC 组的纯母乳喂养和持续母乳喂养时间长于常规护理组(纯母乳喂养:4.89±1.26 个月 vs. 3.25±1.80 个月;调整后的平均差异 1.28,95% CI 0.31-2.24;p=0.01;持续母乳喂养:10.81±1.97 个月 vs. 6.98±4.08 个月;调整后的平均差异 2.33,95% CI 0.13-4.54;p=0.04)。探索性剂量反应效应表明,SSC 时间越多,纯母乳喂养和持续母乳喂养时间越长。这项研究表明,对于整个群体,为期 5 周的每日 SSC 干预并没有延长纯母乳喂养和持续母乳喂养的时间。然而,对于每天定期进行 1 小时 SSC 的母亲来说,这种简单易行的干预措施可能会使纯母乳喂养和持续母乳喂养的时间延长几个月。需要进一步的研究来证实这些有希望的发现。试验注册:荷兰试验注册(NTR5697)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bbb/8710110/6f3a55fc6356/MCN-18-e13241-g002.jpg

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