促进意大利妇产医院母乳喂养：一项干预前研究。

Promotion of breastfeeding in Italian Maternity Hospitals: a pre-intervention study.

机构信息

Nutrition Research Centre, University of Insubria, Varese, Italy.

Neonatal Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

出版信息

Ital J Pediatr. 2024 Oct 25;50(1):219. doi: 10.1186/s13052-024-01793-9.

DOI:10.1186/s13052-024-01793-9

PMID:39456093

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11520110/

Abstract

BACKGROUND

In Italy, exclusive breastfeeding (EBF) rates at hospital discharge range unsatisfactorily between 20-97%.

METHODS

In 2023, the Project for Hospital Policy on Breastfeeding (HPB) has been launched to promote breastfeeding in Italian Maternity Hospitals (MHs) as a joint initiative of the Italian Scientific Societies involved in perinatal care together with the National Midwife (FNOPO) and Nurse (FNOPI) Boards and with Vivere Onlus, a family association. The HBP Project has been designed as an uncontrolled before-after study to increase EBF rate at hospital discharge in the population of healthy, term infant with a normal weight at birth following an intervention bundle comprising: 1) Establishment of a local hospital Working Group; 2) Adoption of a hospital policy; 3) Implementation of breastfeeding monitoring; 4) Training for perinatal care professionals; 5) Enhanced implementation of the practices of skin-to-skin contact (SSC) and mother-baby rooming-in; 6) Development/Improvement of perinatal care protocols.

RESULTS

We report the pre-intervention assessment of 89 out of the 111 enrolled MHs (80.2%) at the beginning of the Project (Time 1 or T1). Almost all MHs (96.6%) have a multi-professional Breastfeeding Working Group, while a hospital policy on breastfeeding is available only in 48.2%. Moreover, only 56.2% of the 9,777 perinatal health workers have been trained in breastfeeding. Over a 1-month period, SSC has been practiced in the delivery room by 76.9% of 6,304 term healthy newborn infants and rooming-in by 83.4% of 6,735 healthy term newborns of normal weight at birth. Over a 4-month period, 69.1% of 33,367 healthy term newborns of normal birth weight were exclusively breastfed at hospital discharge. Noticeably, EBF rate of MHs ranges from 4% up to 100%, the second quartile being 73%.

CONCLUSION

At T1 of the HPB Project, breastfeeding rates at hospital discharge for healthy, term infants with a normal weight at birth appear to be suboptimal among Italians MHs. Particularly, the range of EBF rates among participating centers is wide, with 50% of the MHs having EBF rate lower than 73%. Therefore, the ongoing HPB Project might represent not only an opportunity to increase the initiation of breastfeeding and to improve quality of health care in the whole study group of MHs, but possibly also to level differences between centers.

摘要

背景

在意大利，医院出院时的纯母乳喂养率（EBF）在 20-97%之间令人不满意。

方法

2023 年，启动了医院母乳喂养政策项目（HPB），以促进意大利产科医院（MHs）的母乳喂养，这是参与围产期护理的意大利科学协会的联合倡议，与国家助产士（FNOPO）和护士（FNOPI）委员会以及家庭协会 Vivere Onlus 一起。HPB 项目被设计为一项未经控制的前后研究，旨在通过包括以下内容的干预包来增加出生体重正常的健康足月婴儿出院时的 EBF 率：1）建立当地医院工作组；2）采用医院政策；3）实施母乳喂养监测；4）为围产期护理专业人员提供培训；5）增强皮肤接触（SSC）和母婴同室的实施；6）制定/改进围产期护理协议。

结果

我们报告了 89 个参与 MHs（80.2%）的干预前评估，这些 MHs 是在项目开始时（时间 1 或 T1）纳入的。几乎所有的 MHs（96.6%）都有一个多专业的母乳喂养工作组，而只有 48.2%的 MHs 有母乳喂养政策。此外，只有 56.2%的 9777 名围产期保健工作者接受过母乳喂养培训。在一个月的时间里，有 76.9%的 6304 名足月健康新生儿在产房进行了 SSC，有 83.4%的 6735 名出生体重正常的健康足月新生儿进行了母婴同室。在四个月的时间里，有 69.1%的 33367 名出生体重正常的健康足月新生儿在医院出院时进行了纯母乳喂养。值得注意的是，MHs 的 EBF 率从 4%到 100%不等，第二四分位数为 73%。

结论

在 HPB 项目的 T1 时，出生体重正常的健康足月婴儿在出院时的母乳喂养率似乎在意大利 MHs 中不理想。特别是，参与中心的 EBF 率范围很广，有 50%的 MHs 的 EBF 率低于 73%。因此，正在进行的 HPB 项目不仅可能是一个增加母乳喂养率和提高整个 MHs 研究组医疗保健质量的机会，而且可能是一个缩小中心之间差异的机会。