Miller N H, Miller D J, Chism M
Department of Pediatrics, Baystate Medical Center, Springfield, Massachusetts 01199, USA.
Pediatrics. 1996 Sep;98(3 Pt 1):434-7.
To determine how employment as a resident physician (resident) affects breastfeeding practices and experiences.
Cross-sectional questionnaire survey.
US resident physicians in the second half of their postgraduate year three (PGY3).
1500 questionnaires were mailed at random to female 1990 graduates of American medical schools. After eliminating unusable surveys, an adjusted response rate of 45% produced 450 surveys; 60 delivered a child during residency.
None. MEASUREMENT/MAIN RESULTS: Forty-eight (80%) of 60 residents who delivered initiated breastfeeding, and continued for the duration of their maternity leave (mean, 7 weeks). With a return to residency half (24) of those who had initiated breastfeeding discontinued breastfeeding. The breastfeeding rate dropped to 15% (9/60) at 6 months. Residency work schedule was the most common reason (80%) for discontinuing breastfeeding. Of the 24 residents who continued breastfeeding while working, 83% pumped breast milk during their work shifts; 79% felt there was insufficient time during work, and 42% reported no appropriate place at work to express milk. Only 54% who continued felt supported by their attending physicians for their efforts to breastfeed; 67% felt colleagues were supportive.
The breastfeeding initiation rate for resident mothers was in compliance with the Healthy People 2000 guidelines, but the rate at infant age 6 months fell well below the goal of 50%. Modifiable factors in residents' work sites include both physical and emotional accommodations to encourage resident mothers to breastfeed.
确定住院医师的工作对母乳喂养行为及体验有何影响。
横断面问卷调查。
美国医学专业三年级后半段的住院医师。
随机向1990年毕业于美国医学院的女性邮寄1500份问卷。剔除无效问卷后,调整后的回复率为45%,共得到450份问卷;其中60人在住院医师培训期间生育。
无。
测量指标/主要结果:60名生育的住院医师中,48人(80%)开始母乳喂养,并在产假期间持续进行(平均7周)。恢复住院医师工作后,开始母乳喂养的人中一半(24人)停止了母乳喂养。6个月时,母乳喂养率降至15%(9/60)。住院医师的工作安排是停止母乳喂养最常见的原因(80%)。在工作期间继续母乳喂养的24名住院医师中,83%在工作班次期间挤奶;79%觉得工作时间不够,42%报告工作场所没有合适的挤奶地点。继续母乳喂养的人中只有54%觉得她们的主治医师支持她们母乳喂养的努力;67%觉得同事给予了支持。
住院医师母亲的母乳喂养启动率符合《2000年美国人健康指标》指南,但6个月婴儿的母乳喂养率远低于50%的目标。住院医师工作场所中可改变的因素包括提供物质和情感上的便利,以鼓励住院医师母亲进行母乳喂养。