Moe Amanda M, Brockway Meredith L, McNeil Deborah A, Afzal Arfan R, Benzies Karen M
Faculty of Nursing, University of Calgary, Canada.
Department of Paediatrics, Cumming School of Medicine, University of Calgary, Canada.
PEC Innov. 2024 Sep 19;5:100345. doi: 10.1016/j.pecinn.2024.100345. eCollection 2024 Dec 15.
Human milk (HM) is the optimal nutrition for infants; preterm infants demonstrate shorter HM feeding duration. Care interventions may increase HM feeding among preterm infants after NICU discharge. We compared Alberta Family Integrated Care (FICare) versus Standard Care on HM feeding in preterm infants at age 2 months.
We conducted a follow-up of a cluster randomized controlled trial of 455 infants and their mothers with data linked to the infant's 2-month public health visit. We used partial proportional odds to model group differences and factors associated with feeding type: exclusive HM (EHM), Non-EHM, or no HM (NHM).
Compared to Standard Care, mothers in Alberta FICare were less likely to provide EHM versus NHM. There was no group difference between EHM and Non-EHM. Mothers with higher education who were on maternity leave or employed were more likely to provide EHM. Infants who received EHM at discharge were more likely to continue at age 2 months. Higher maternal breastfeeding self-efficacy at discharge was associated with a greater likelihood of EHM.
Alberta FICare was not associated with EHM feeding at age 2 months.
Different factors predicted the three HM feeding categories, suggesting the need to individualize feeding supports.Trial Registration.ClinicalTrials.gov Identifier NCT02879799, retrospectively registered August 26, 2016.
母乳是婴儿的最佳营养来源；早产儿的母乳喂养持续时间较短。护理干预可能会增加早产儿在新生儿重症监护病房（NICU）出院后的母乳喂养量。我们比较了艾伯塔省家庭综合护理（FICare）与标准护理对2个月大早产儿母乳喂养的影响。
我们对一项包含455名婴儿及其母亲的整群随机对照试验进行了随访，数据与婴儿2个月时的公共卫生访视相关。我们使用部分比例优势模型来分析组间差异以及与喂养类型相关的因素：纯母乳喂养（EHM）、非纯母乳喂养（Non-EHM）或无母乳喂养（NHM）。
与标准护理相比，艾伯塔省FICare模式下的母亲提供纯母乳喂养而非无母乳喂养的可能性较小。纯母乳喂养和非纯母乳喂养之间没有组间差异。休产假或就业的高学历母亲更有可能提供纯母乳喂养。出院时接受纯母乳喂养的婴儿在2个月大时更有可能继续纯母乳喂养。出院时母亲更高的母乳喂养自我效能感与纯母乳喂养的可能性更大相关。
艾伯塔省FICare模式与2个月大时的纯母乳喂养无关。
不同因素预测了三种母乳喂养类别，这表明需要个性化的喂养支持。试验注册。ClinicalTrials.gov标识符NCT02879799，于2016年8月26日追溯注册。
