Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada.
Breastfeed Med. 2023 Feb;18(2):97-106. doi: 10.1089/bfm.2022.0151. Epub 2023 Jan 2.
While breast milk is widely accepted as the best source of nutrients for almost all newborns, breastfeeding can be especially challenging for preterm and low birth weight (LBW) infants. With increased risk of admission to neonatal intensive care units (NICUs) and separation from parents, this population experiences significant barriers to successful breastfeeding. Thus, it is crucial to identify interventions that can optimize breastfeeding for preterm and LBW infants that is continued from birth and admission, through to hospital discharge and beyond. To identify and analyze evidence-based interventions that promote any and exclusive breastfeeding among preterm and LBW neonates at discharge and/or postdischarge from hospital. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. Searches were performed in the following databases: MEDLINE Ovid, EMBASE, Web of Science, and Cumulative Index to Nursing and Allied Health (CINAHL). From the 42 studies included, 6 groups of intervention types were identified: educational and breastfeeding support programs, early discharge, oral stimulation, artificial teats and cups, kangaroo mother care (KMC), and supportive policies within NICUs. All groupings of interventions were associated with significantly increased rates of any breastfeeding at discharge. All types of interventions except artificial teats/cups and oral stimulation showed statistically significant increases in exclusive breastfeeding at discharge. KMC demonstrated the highest increased odds of breastfeeding at discharge among preterm and LBW infants. A variety of effective interventions exist to promote breastfeeding among hospitalized preterm and LBW infants. Hospital settings hold unique opportunities for successful breastfeeding promotion. PROSPERO registration: CRD42021252610.
虽然母乳被广泛认为是几乎所有新生儿的最佳营养来源，但母乳喂养对于早产儿和低出生体重儿（LBW）来说尤其具有挑战性。由于早产儿和 LBW 婴儿有更高的风险被送入新生儿重症监护病房（NICU）并与父母分离，他们在成功进行母乳喂养方面面临着重大障碍。因此，确定可以优化早产儿和 LBW 婴儿母乳喂养的干预措施至关重要，这些婴儿需要从出生到住院、出院以及出院后都能持续进行母乳喂养。
确定并分析在出院时和/或出院后促进早产儿和 LBW 新生儿进行任何形式和纯母乳喂养的基于证据的干预措施。根据系统评价和荟萃分析的首选报告项目（PRISMA）清单进行了系统评价。在以下数据库中进行了搜索：Ovid MEDLINE、EMBASE、Web of Science 和 Cumulative Index to Nursing and Allied Health（CINAHL）。
在纳入的 42 项研究中，确定了 6 组干预类型：教育和母乳喂养支持计划、提前出院、口腔刺激、人工奶嘴和杯子、袋鼠式护理（KMC）以及 NICU 内的支持政策。所有类型的干预措施都与出院时任何母乳喂养率的显著增加有关。除人工奶嘴/杯子和口腔刺激外，所有类型的干预措施均显示出院时纯母乳喂养率的统计学显著增加。KMC 显示早产儿和 LBW 婴儿出院时母乳喂养的可能性最高。
有多种有效的干预措施可促进住院早产儿和 LBW 婴儿进行母乳喂养。医院环境为成功促进母乳喂养提供了独特的机会。PROSPERO 注册号：CRD42021252610。
