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The Effect of Labor Epidural Analgesia on Breastfeeding Outcomes: A Prospective Observational Cohort Study in a Mixed-Parity Cohort.分娩硬膜外镇痛对母乳喂养结局的影响:混合多产队列的前瞻性观察性队列研究。
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1月龄时母乳喂养率的相关因素:聚焦于日本一家妇产医院的新生儿喂养行为

Factors associated with breastfeeding rates at 1 month of age: Focusing on newborn feeding behaviours in a Japanese maternity hospital.

作者信息

Tomita Aya, Tahara-Sasagawa Emi, Yonezawa Kaori, Usui Yuriko, Haruna Megumi

机构信息

Division of Health Sciences and Nursing, Department of Midwifery and Women's Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

J Paediatr Child Health. 2024 Dec;60(12):852-858. doi: 10.1111/jpc.16691. Epub 2024 Oct 14.

DOI:10.1111/jpc.16691
PMID:39400378
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11616249/
Abstract

AIM

This study investigated the relationship between newborn feeding behaviour and feeding type among month-old babies and explored maternal and neonatal factors associated with breastfeeding rates at 1 month of age.

METHODS

This observational study was conducted in Japan with healthy mothers and full-term newborns. Newborn feeding behaviours were assessed using the Japanese Infant Breastfeeding Assessment Tool (IBFAT) within approximately 1 day of birth. Obstetric and newborn characteristics, including newborn feeding behaviours, were investigated in relation feeding type (breast milk or mixed milk) at 1 month of age.

RESULTS

This study included 176 mother-newborn pairs. IBFAT scores were significantly higher in the breast-milk group (Median (M) = 10.5, Interquartile Ranges (IQR): 9.0-11.0) than in the mixed-milk group (M = 10.0, IQR: 7.5-11.0) (P = 0.046). Additionally, the sucking pattern of breastfeeding was showing a greater distribution of higher scores in the breast-milk group (M = 2.0, IQR: 2.0-2.5) than in the mixed-milk group (M = 2.0, IQR: 1.5-2.5) (P = 0.015). Compared to mothers who received epidural analgesia or synthetic oxytocin, primiparas who did not receive them were more likely to breastfeed (epidural analgesia: (33.3% vs. 65.8%, P = 0.004); synthetic oxytocin: (42.0% vs. 78.6%, P = 0.018)). For multiparas, Apgar and IBFAT scores were associated with feeding type at 1 month of age.

CONCLUSIONS

This study found that newborns' effective and sustained sucking within 1 day of birth is an important factor for breastfeeding at 1 month of age. When assessing feeding type, maternal factors such as epidural analgesia should be the focus for primiparas, while neonatal factors such as feeding behaviour should be prioritised for multiparas.

摘要

目的

本研究调查了月龄婴儿的新生儿喂养行为与喂养方式之间的关系,并探讨了与1月龄时母乳喂养率相关的母婴因素。

方法

本观察性研究在日本对健康母亲和足月儿进行。在出生后约1天内使用日本婴儿母乳喂养评估工具(IBFAT)评估新生儿喂养行为。调查了产科和新生儿特征,包括新生儿喂养行为,与1月龄时的喂养方式(母乳或混合奶)的关系。

结果

本研究纳入了176对母婴。母乳组的IBFAT评分(中位数(M)=10.5,四分位数间距(IQR):9.0 - 11.0)显著高于混合奶组(M = 10.0,IQR:7.5 - 11.0)(P = 0.046)。此外,母乳喂养的吸吮模式在母乳组(M = 2.0,IQR:2.0 - 2.5)中高分分布比混合奶组(M = 2.0,IQR:1.5 - 2.5)更广泛(P = 0.015)。与接受硬膜外镇痛或合成缩宫素的母亲相比,未接受这些的初产妇更有可能进行母乳喂养(硬膜外镇痛:(33.3%对65.8%,P = 0.004);合成缩宫素:(42.0%对78.6%,P = 0.018))。对于经产妇,阿氏评分和IBFAT评分与1月龄时的喂养方式相关。

结论

本研究发现出生后1天内新生儿有效且持续的吸吮是1月龄时母乳喂养的重要因素。在评估喂养方式时,对于初产妇,应关注硬膜外镇痛等母亲因素,而对于经产妇,应优先考虑喂养行为等新生儿因素。