Cicely Saunders Institute, King's College London, London, United Kingdom (Dr Kim); Neonatal Intensive Care Unit, Samsung Medical Center, Gangnam-Gu, Seoul, South Korea (Dr Kim and Ms Min, Ji Yeon Lee, and Ji Yoon Lee); and Graduate School of Clinical Nursing Science, Sungkyunkwan University, Gangnam-gu, Seoul, South Korea (Dr Yi).
J Perinat Neonatal Nurs. 2024;38(1):73-87. doi: 10.1097/JPN.0000000000000791. Epub 2024 Jan 10.
This study aimed to develop a direct breastfeeding protocol for premature infants admitted to neonatal intensive care units (NICUs) and investigate its efficacy.
Direct breastfeeding increases the amount and duration of breastfeeding. However, NICUs have low direct feeding rates owing to medical staff anxiety, lack of knowledge and experience, and fear of overwork. Accordingly, this study developed a protocol for direct breastfeeding in the NICU and evaluated its effect.
The protocol was developed through a literature review, expert validation, and preliminary investigation. Its application effects were identified using a nonexperimental, evidence-based research design targeting premature infants, their mothers, and NICU nurses.
The protocol comprised 5 areas and 23 items. Application of the protocol resulted in continuous weight gain of the infants and increased self-efficacy in the mothers' direct breastfeeding ( t = 3.219, P = .004). Significant increases were noted in NICU nurses' direct breastfeeding activities ( t = 3.93, P < .001), breastfeeding rates in the NICU ( P = .037), and direct breastfeeding rates ( P = .007).
Results underscore the value of an evidence-based protocol for improving breastfeeding rates in premature infants. This study highlights the need for continuous nursing education on protocol applications and human resource support.
本研究旨在为新生儿重症监护病房（NICU）中收治的早产儿制定直接母乳喂养方案，并对其疗效进行研究。
直接母乳喂养可增加母乳喂养的量和时长。然而，由于医务人员的焦虑、缺乏知识和经验，以及担心过度劳累，NICU 的直接喂养率较低。因此，本研究制定了 NICU 中直接母乳喂养的方案，并评估了其效果。
该方案通过文献回顾、专家验证和初步调查制定。采用非实验性、基于证据的研究设计，针对早产儿、其母亲和 NICU 护士，确定该方案的应用效果。
该方案包括 5 个方面和 23 个项目。应用该方案后，婴儿的体重持续增加，母亲对直接母乳喂养的自我效能感增强（ t = 3.219，P =.004）。NICU 护士的直接母乳喂养活动（ t = 3.93，P <.001）、NICU 中的母乳喂养率（ P =.037）和直接母乳喂养率（ P =.007）均显著提高。
研究结果强调了制定基于证据的方案对提高早产儿母乳喂养率的重要性。本研究突出了对方案应用的持续护理教育和人力资源支持的必要性。
