Nursing Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, No 2699, West Gaoke Road, Pudong New Area, Shanghai, 200092, China.
Int Breastfeed J. 2022 May 2;17(1):34. doi: 10.1186/s13006-022-00472-x.
Breastfeeding is crucial for the preterm infants. Breast milk is not only food but also medicine. Few studies have focused on the longitudinal effects of exclusive breastfeeding outcome of preterm infants separated from their mothers after discharge, especially in Shanghai. We aimed to examine the exclusive breastfeeding rate and duration amongst first time mothers of preterm infants after discharge and its determinants.
Analyses were based on 500 preterm infants separated from their mothers in a tertiary maternity and infant-specialized hospital in Shanghai from September 2018 to September 2019.The Socio-demographic characteristics, breastfeeding knowledge questionnaire, breastfeeding self-efficacy short form scale, Edinburgh postpartum depression scale and breastfeeding family support scale were used for the investigation and the exclusive breastfeeding rate of premature infants was followed up on 1 month, 3 months and 6 months after discharge. The changing trend of breastfeeding knowledge, breastfeeding self-efficacy, postpartum depression and family support were measured by ANOVA at different stages. Using the chi-square test and multiple logistic regression, factors impacting the breastfeeding rate of preterm infants at three time intervals after discharge were investigated. The Kaplan Meier survival curve and cox regression model were used to analyze the determinants of exclusive breastfeeding duration of premature infants after discharge.
Exclusive breastfeeding rates were 19.0, 17.2 and 10.4% at 1 month, 3 months and 6 months after discharge of preterm infants, respectively. The average length of exclusive breastfeeding duration was(3.69 ± 1.80)months. Finally, type of delivery (adjusted odds ratio [AOR] 1.564; 95% confidence interval [CI] 0.513,3.116), gestational age(AOR 0.612, 95% CI 0.236, 3.418), maternal family support (AOR 6.125,95% CI 6.359, 98.452) were discovered to be independent predictors on the exclusive breastfeeding rate at 6 months after preterm infants were discharged. Through the cox regression model, we found that a maternal planned pregnancy (HR 0.681, 95%CI 0.531,0.873), delivering breast milk during hospitalization (HR 0.797, 95%CI 0.412,2.288), NICU feeding mode during hospitalization (HR 1.221, 95%CI 0.128,1.381) and family support (HR 0.561, 95%CI 0.004,2.428) were significantly associated with the exclusive breastfeeding duration after discharge.
The exclusive breastfeeding outcome of premature infants was affected by many factors, so we should focus on the three levels of individual, family, society and design targeted intervention measures to increase the exclusive breastfeeding rate and prolong exclusive breastfeeding duration.
母乳喂养对早产儿至关重要。母乳不仅是食物，也是药物。很少有研究关注早产儿出院后与母亲分离后的纯母乳喂养结果，特别是在上海。我们旨在检验首次分娩的早产儿母亲出院后纯母乳喂养的比例及其决定因素。
分析基于 2018 年 9 月至 2019 年 9 月期间，在上海一家三级妇产专科医院与母亲分离的 500 名早产儿。采用社会人口学特征、母乳喂养知识问卷、母乳喂养自我效能简短量表、爱丁堡产后抑郁量表和母乳喂养家庭支持量表进行调查，并在出院后 1 个月、3 个月和 6 个月时对早产儿的纯母乳喂养率进行随访。在不同阶段通过 ANOVA 测量母乳喂养知识、母乳喂养自我效能、产后抑郁和家庭支持的变化趋势。使用卡方检验和多因素逻辑回归分析，调查出院后三个时间间隔早产儿母乳喂养率的影响因素。使用 Kaplan-Meier 生存曲线和 Cox 回归模型分析出院后早产儿纯母乳喂养持续时间的决定因素。
早产儿出院后 1 个月、3 个月和 6 个月的纯母乳喂养率分别为 19.0%、17.2%和 10.4%。纯母乳喂养持续时间的平均长度为(3.69±1.80)个月。最终，分娩方式（调整后的优势比 [AOR] 1.564；95%置信区间 [CI] 0.513，3.116）、胎龄（AOR 0.612，95%CI 0.236，3.418）、母亲家庭支持（AOR 6.125，95%CI 6.359，98.452）被发现是早产儿出院后 6 个月纯母乳喂养率的独立预测因素。通过 Cox 回归模型，我们发现，母亲计划妊娠（HR 0.681，95%CI 0.531，0.873）、住院期间挤奶（HR 0.797，95%CI 0.412，2.288）、住院期间 NICU 喂养模式（HR 1.221，95%CI 0.128，1.381）和家庭支持（HR 0.561，95%CI 0.004，2.428）与出院后的纯母乳喂养时间显著相关。
早产儿的纯母乳喂养结果受多种因素影响，因此应关注个体、家庭、社会三个层面，设计有针对性的干预措施，提高纯母乳喂养率，延长纯母乳喂养时间。
