Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel; Department of Neonatology, Meir Medical Center, Kfar-Saba, Israel.
Faculty of Medicine, Occupational Therapy Department, School of Health Professions, Tel-Aviv University, Ramat Aviv, Tel Aviv, Israel.
Womens Health Issues. 2024 Jan-Feb;34(1):80-89. doi: 10.1016/j.whi.2023.09.004. Epub 2023 Nov 6.
Exclusive breastfeeding (EBF) is recommended for the first 6 months of life, yet EBF rates at 6 months (T3) in most developed countries are low. Painful and nonpainful sensory stimuli processing is linked, and while pain has been suggested to restrict breastfeeding, its coupling with sensory over-responsiveness (SOR) in relation to breastfeeding has not yet been reported.
We aimed to explore whether breastfeeding-related pain, SOR, and general pain sensitivity predict nonexclusive breastfeeding (NEBF) at T3.
In this prospective study, participants were recruited at 2 days postpartum (enrollment). For the assessment of breastfeeding-related pain, participants completed the visual analogue scale and the Short-Form McGill Pain Questionnaire at enrollment, and at 6 weeks after birth. At T3, they completed the Pain Sensitivity Questionnaire and the Sensory Responsiveness Questionnaire-Intensity Scale and then provided information about their breastfeeding status. Participants were divided into two groups accordingly: EBF and NEBF.
A total of 164 participants were reached at T3: EBF (n = 105) and NEBF (n = 59). The incidence of SOR was significantly higher among NEBF compared with EBF participants (25.4% vs. 11.4%; p = .020). Between enrollment and 6 weeks after birth, 72.3% of the EBF participants had reported a ≥30% pain reduction, compared with 44.8% of the NEBF participants (p = .001). Logistic regression modeling revealed that both breastfeeding-related pain reduction and SOR predicted NEBF at T3 (p < .001), indicating a 3.2 times (p = .001) and 2.5 times (p = .041) odds ratio for NEBF, respectively.
SOR and sustained breastfeeding-related pain predict NEBF at T3 and may emerge as substantial breastfeeding barriers.
建议在生命的头 6 个月内进行纯母乳喂养（EBF），但在大多数发达国家，6 个月时的 EBF 率较低。有研究表明，痛苦和非痛苦感觉刺激处理是相互关联的，虽然疼痛被认为会限制母乳喂养，但它与母乳喂养相关的感觉过度反应（SOR）之间的联系尚未被报道。
我们旨在探讨与母乳喂养相关的疼痛、SOR 和一般疼痛敏感性是否可以预测 6 个月时的非纯母乳喂养（NEBF）。
在这项前瞻性研究中，参与者在产后 2 天（入组）时被招募。为了评估与母乳喂养相关的疼痛，参与者在入组时和产后 6 周时完成了视觉模拟量表和短式麦吉尔疼痛问卷。在 T3 时，他们完成了疼痛敏感性问卷和感觉反应性问卷-强度量表，然后提供了他们的母乳喂养状况信息。参与者根据情况分为两组：EBF 和 NEBF。
共有 164 名参与者在 T3 时达到：EBF（n=105）和 NEBF（n=59）。与 EBF 参与者相比，NEBF 参与者的 SOR 发生率明显更高（25.4% vs. 11.4%；p=0.020）。在入组和产后 6 周之间，72.3%的 EBF 参与者报告疼痛减轻≥30%，而 NEBF 参与者中只有 44.8%（p=0.001）。Logistic 回归模型显示，与母乳喂养相关的疼痛减轻和 SOR 都可以预测 T3 时的 NEBF（p<0.001），表明 NEBF 的风险分别增加了 3.2 倍（p=0.001）和 2.5 倍（p=0.041）。
SOR 和持续的与母乳喂养相关的疼痛预测 T3 时的 NEBF，可能成为母乳喂养的重要障碍。
