Rosetti Leah, Elliott Stacy, Lee Amanda H X, McCracken Laura A, Hocaloski Shea, Hodge Karen, Zobina Ineta, Rapidi Christina-Anastasia, Manthos Prokopios, Galata Aggeliki, Miller Tiev, Chung Raymond C K, Krassioukov Andrei V
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
International Collaboration on Repair Discoveries (ICORD), Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Spinal Cord. 2022 Sep;60(9):837-842. doi: 10.1038/s41393-022-00805-x. Epub 2022 Apr 22.
Narrative review.
To evaluate the availability and quality of breastfeeding guidelines for women with spinal cord injury (SCI).
International Collaboration on Repair Discoveries (ICORD), Department of Medicine, Vancouver, BC.
An environmental scan restricted to English language literature was performed to identify existing postpartum and breastfeeding guidelines. Guidelines were evaluated using a structured, validated tool (AGREE II) by 13 appraisers [medical/research experts (n = 10) and those with lived experience (n = 3)] from Vancouver and two international sites. Seven guidelines were evaluated across Domain 1 of the AGREE II tool to determine if they were applicable to mothers with SCI/physical disabilities. Domains 2 to 7 were evaluated if the guideline made mention of the SCI population.
Of the seven guidelines evaluated, only one mentioned SCI (Postpartum Care in SCI from BC Women's Hospital). Other guidelines were excluded from further evaluation as they did not address the issue of breastfeeding in women with SCI. The overall scaled score for this guideline was 34.5%. There was significant variability between domains but no AGREE II domain scored greater than 50%, indicating substantial limitations.
Current breastfeeding guidelines are not targeted to persons with SCI. The one guideline that made mention of women with SCI had significant global deficits. This highlights the importance of developing guidelines for health care providers focused specifically on women with SCI to support and optimize breastfeeding in this unique population for the benefit of mother and infant across the lifespan.
叙述性综述。
评估针对脊髓损伤（SCI）女性的母乳喂养指南的可用性和质量。
不列颠哥伦比亚省温哥华市医学系修复发现国际协作组织（ICORD）。
进行一项仅限于英文文献的环境扫描，以识别现有的产后和母乳喂养指南。13名评估人员[医学/研究专家（n = 10）和有实际经验者（n = 3）]来自温哥华和另外两个国际地点，使用经过验证的结构化工具（AGREE II）对指南进行评估。对七项指南在AGREE II工具的第1领域进行评估，以确定它们是否适用于患有SCI/身体残疾的母亲。如果指南提及了SCI人群，则对第2至7领域进行评估。
在评估的七项指南中，只有一项提到了SCI（不列颠哥伦比亚妇女医院的SCI产后护理）。其他指南因未涉及SCI女性的母乳喂养问题而被排除在进一步评估之外。该指南的总体量表得分是34.5%。各领域之间存在显著差异，但AGREE II的任何一个领域得分均未超过50%，表明存在重大局限性。
当前的母乳喂养指南并非针对SCI患者。唯一提到SCI女性的指南存在重大的整体缺陷。这凸显了为医疗保健提供者制定专门针对SCI女性的指南的重要性，以支持和优化这一特殊人群的母乳喂养，从而在整个生命周期中使母婴受益。
