硬膜外镇痛分娩与母乳喂养

Labor epidural analgesia and breastfeeding

硬膜外分娩镇痛技术作为有效减轻分娩疼痛的适宜技术日益受到公众关注。国家卫生健康委员会将在全国范围内开展此项技术的试点工作,旨在提高分娩服务质量,保障母婴安全。母乳喂养是促进母婴近期和远期健康的重要公共卫生措施,然而实施硬膜外分娩镇痛是否会对母乳喂养产生负面影响仍缺乏一致的研究证据。在此现状下,所有为产科患者提供医疗服务的医护人员都应努力成为母乳喂养文化的支持者。我国2016年引入的世界卫生组织新生儿早期基本保健技术特别强调在分娩过程关注新生儿的健康需求,建议新生儿出生后立即进行持续的母婴皮肤接触至少90分钟、帮助母婴尽早完成第一次母乳喂养,以及出院后支持母婴6个月内纯母乳喂养等。这些措施作为操作简单、经济高效的适宜技术,已被纳入《健康儿童行动计划(2018-2020)》,也将逐步在全国推广。

Epidural analgesia as an effective treatment for labor pain has been receiving increasing public attention. The Chinese National Health Committee will carry out pilot programs on epidural analgesia to improve childbirth health care services and ensure the safety of mothers and newborns. Breastfeeding is an important public health concern to promote short and long term health of mothers and children. However,there has been conflicting evidence regarding the potential influence of labor epidural analgesia on breastfeeding success. Under this situation,all health workers who provide care for obstetric patients should do well to be champions for a culture that supports breastfeeding. Since 2016,China has introduced from WHO the guideline on Early Essential Newborn Care ( EENC) ,which emphasize the medical needs of newborn during childbirth practice. The key recommended interventions of EENC include continuous and prolonged skin-to-skin contact of the mother and newborn as soon as after delivery,support the mother and newborn for the first breastfeeding in delivery room,and exclusive breastfeeding for 6 months etc. These simple and cost-effective interventions have been included in the newly issued Healthy Children Action Plan ( 2018 -2020) and will be scaled up nationwide in the future.