Bremer Madeleine Jade, Knippen Kerri Lynn
Food Service Director and Community Nutrition Educator, Camp Beechpoint 3212 125th Ave, Allegan, Michigan, USA.
Department of Public & Allied Health, Bowling Green State University, 122 Health & Human Services Building, Bowling Green, OH, USA.
Matern Child Health J. 2023 Apr;27(4):747-756. doi: 10.1007/s10995-022-03497-0. Epub 2022 Aug 10.
Evidence of opioid use at hospital delivery has increased over the past two decades, increasing risk of neonatal withdrawal. Breastfeeding may improve infant outcomes, but little is known about breastfeeding experiences of women who have a history of opioid use prior to or during pregnancy. This study aimed to determine if self-reported opioid use prior to or during pregnancy impacted breastfeeding, specifically attempt to breastfeed, duration of breastfeeding, assessment of prenatal breastfeeding intention, source of breastfeeding information, and early hospital experiences.
Data from ten states (n = 10,550) that evaluated opioid use in the 2016 Pregnancy Risk Assessment Monitoring System survey were included. Weighted univariate and multivariate linear and logistic regression were calculated. The multivariate regression also included adjustment for covariates.
Among the overall sample, 939 participants reported opioid exposure before or during pregnancy. We found no significant difference in breastfeeding attempt. Breastfeeding for at least 6, 10, or 20 weeks was significantly less likely in participants reporting opioid exposure. Exposure correlated with lower odds of skin-to-skin contact, infant being fed in the first hour, exclusive breastfeeding in the hospital, and feeding on demand. Hospital pacifier use was associated with opioid exposure.
While we found no difference in breastfeeding attempt, we did observe significant differences in breastfeeding duration and early hospital experiences which may represent modifiable gaps in clinical practice. Future work should focus on optimizing early hospital experiences and support when breastfeeding is clinically indicated.
在过去二十年中，医院分娩时使用阿片类药物的证据有所增加，这增加了新生儿戒断的风险。母乳喂养可能会改善婴儿的结局，但对于在怀孕前或怀孕期间有阿片类药物使用史的女性的母乳喂养经历知之甚少。本研究旨在确定自我报告的怀孕前或怀孕期间使用阿片类药物是否会影响母乳喂养，特别是母乳喂养的尝试、母乳喂养的持续时间、产前母乳喂养意愿的评估、母乳喂养信息的来源以及早期住院经历。
纳入了来自十个州（n = 10,550）的数据，这些数据来自2016年妊娠风险评估监测系统调查中对阿片类药物使用情况的评估。计算了加权单变量和多变量线性及逻辑回归。多变量回归还包括对协变量的调整。
在整个样本中，939名参与者报告在怀孕前或怀孕期间接触过阿片类药物。我们发现母乳喂养尝试方面没有显著差异。报告接触阿片类药物的参与者中，母乳喂养至少6周、10周或20周的可能性显著降低。接触阿片类药物与皮肤接触、婴儿在出生后第一小时内喂奶、在医院进行纯母乳喂养以及按需喂养的几率较低相关。在医院使用安抚奶嘴与阿片类药物接触有关。
虽然我们发现母乳喂养尝试方面没有差异，但我们确实观察到母乳喂养持续时间和早期住院经历存在显著差异，这可能代表临床实践中可改变的差距。未来的工作应侧重于在临床建议母乳喂养时优化早期住院经历并提供支持。
