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产前小组教学对产后乳头疼痛、乳头损伤及母乳喂养率的积极影响。

Positive effects of an antenatal group teaching session on postnatal nipple pain, nipple trauma and breast feeding rates.

作者信息

Duffy E P, Percival P, Kershaw E

机构信息

School of Nursing, Edith Cowan University, Churchlands, Western Australia.

出版信息

Midwifery. 1997 Dec;13(4):189-96. doi: 10.1016/s0266-6138(97)80005-8.

DOI:10.1016/s0266-6138(97)80005-8
PMID:9511686
Abstract

OBJECTIVE

To assess whether an antenatal teaching session on position and attachment of the baby on the breast had an effect on postnatal nipple pain, nipple trauma and breast feeding duration. The study was planned as a pilot study to allow an adequate sample size to be calculated for a larger study.

DESIGN

An observer blind experimental design was used. Women were randomly assigned to either the experimental group teaching session or the control group.

SETTING

One public hospital in Western Australia.

PARTICIPANTS

70 primiparae who intended to breast feed their baby were recruited from the antenatal clinic of the study hospital at 36 weeks' gestation.

INTERVENTION

Antenatal group sessions on position and attachment of the baby on the breast were conducted by a lactation consultant.

MEASUREMENTS AND FINDINGS

During the first four postnatal days, position and attachment was measured by LATCH (Latch on, Audible swallow, Type of nipple, Comfort and Help) (Jensen et al 1994), nipple pain was measured by the Visual Analogue Scale (VAS) and nipple trauma was measured by the Nipple Trauma Index (NTI). The analysis of variance (ANOVA) results indicated that the women in the experimental group were better able to attach the baby on the breast and had significantly less nipple pain and trauma than the control group. At six weeks postnatally, 31 of the 35 women in the experimental group were breast feeding compared to 10 of the 35 in the control group.

CONCLUSIONS AND IMPLICATIONS

These initial findings suggest that midwives can make the best use of decreasing resources by using practical 'hands on' antenatal group teaching as an effective strategy to increase breast feeding rates.

摘要

目的

评估关于婴儿在乳房上的姿势和含接的产前教学课程是否对产后乳头疼痛、乳头损伤及母乳喂养持续时间有影响。该研究计划作为一项试点研究,以便为更大规模的研究计算出足够的样本量。

设计

采用观察者盲法实验设计。女性被随机分配到实验组教学课程组或对照组。

地点

西澳大利亚的一家公立医院。

参与者

从研究医院的产前诊所招募了70名打算母乳喂养的初产妇,孕周为36周。

干预措施

由一名泌乳顾问开展关于婴儿在乳房上的姿势和含接的产前小组课程。

测量与结果

在产后的头四天,通过LATCH(含接、可闻吞咽声、乳头类型、舒适度和帮助程度)(詹森等人,1994年)测量姿势和含接情况,通过视觉模拟评分法(VAS)测量乳头疼痛,通过乳头损伤指数(NTI)测量乳头损伤。方差分析(ANOVA)结果表明,实验组的女性在让婴儿含接乳房方面表现更好,与对照组相比,乳头疼痛和损伤明显更少。产后六周时,实验组35名女性中有31名仍在进行母乳喂养,而对照组35名女性中只有10名。

结论与启示

这些初步研究结果表明,助产士可以通过开展实用的“动手操作”产前小组教学,充分利用日益减少的资源,作为提高母乳喂养率的有效策略。

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