School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada.
Department of Pediatrics, Queen's University, Kingston, ON, Canada.
Breastfeed Med. 2024 Oct;19(10):768-778. doi: 10.1089/bfm.2023.0158. Epub 2024 Aug 21.
It is well accepted that lactation consultant (LC) services can enhance the breastfeeding success in mother-infant dyads. However, despite such advantages, not all neonatal intensive care units (NICUs) offer LC services. The objective of this systematic review was to assess the available evidence on the effect of LC service on breastfeeding outcomes for mothers whose infants are in the NICU. The PRISMA Extension for Systematic Reviews were used to conduct this systematic review. The following databases: Embase, Medline, CINAHL, and Cochrane library were searched. An initial 464 studies were obtained. Duplicates and studies that did not fit the inclusion criteria were removed, leaving 30 full-text articles to review. Nineteen were further excluded after full-text review. A total of 11 studies were included. Due to the heterogeneity of the included studies, a meta-analysis could not be performed, instead a qualitative numerical summary was conducted. Overall, 10/11 (90%) of studies observed a 6-31% increase in the number of infants who received mother's own milk, and 11-27% in the number of infants who received direct breastfeeds associated with the implementation of LC services in the NICU. The two most common types of LC services studied included: i) multidisciplinary lactation support-described as a team-based approach that includes at least one LC and ii) designation of LC formal role in the NICU. This review highlights that having LC services in the NICU is vital for meeting the unique needs and enhancing breastfeeding outcomes for mothers whose infants are in the NICU.
人们普遍认为，哺乳顾问（LC）服务可以提高母婴二人组的母乳喂养成功率。然而，尽管有这些优势，并非所有新生儿重症监护病房（NICU）都提供 LC 服务。本系统评价的目的是评估 LC 服务对在 NICU 中的婴儿的母亲的母乳喂养结果的可用证据。本系统评价使用 PRISMA 扩展进行。检索了以下数据库：Embase、Medline、CINAHL 和 Cochrane 图书馆。最初获得了 464 项研究。删除了重复项和不符合纳入标准的研究，留下 30 篇全文文章进行审查。在全文审查后，又有 19 篇被排除在外。共有 11 项研究被纳入。由于纳入研究的异质性，无法进行荟萃分析，而是进行了定性数值总结。总体而言，10/11（90%）项研究观察到接受母亲自己的奶的婴儿数量增加了 6-31%，接受直接母乳喂养的婴儿数量增加了 11-27%，这与在 NICU 中实施 LC 服务有关。研究中最常见的两种 LC 服务类型包括：i）多学科哺乳支持——描述为一种包括至少一名 LC 的团队方法，以及 ii）在 NICU 中指定 LC 的正式角色。本综述强调，NICU 中的 LC 服务对于满足在 NICU 中的婴儿的母亲的独特需求和提高母乳喂养结果至关重要。
