促进产后3 d纯母乳喂养的有效措施研究

Clinical research on effective measures to promote exclusive breastfeeding at 3 days after childbirth

目的规范母乳喂养操作流程,探索促进产后3d纯母乳喂养有效措施。方法经阴道分娩的足月健康新生儿及其母亲120对为研究对象,按随机数字表分为观察组和对照组,每组60对。对照组按常规进行母乳喂养操作,观察组在常规护理基础上,规范了母乳喂养实施的流程。包括加强医务人员母乳喂养相关知识和技能的培训、制定产后新生儿明确的喂养目标、做好第1次拥抱并成功吸吮、采用无需技巧的半躺式哺乳法和通俗易懂的含乳姿势、教会产妇正确评估新生儿等。记录2组新生儿产后3d内哺乳次数,产妇乳头疼痛、皲裂和乳胀发生率,婴儿含接姿势、母乳喂养信心和产后3d和产后42d纯母乳喂养率。对照数据进行整理分析,产后72h评价。结果观察组新生儿产后1、2、3d哺乳次数均在8~12次以上,较对照组产后1、2、3d喂奶次数差异有统计学意义(P<0.01);观察组婴儿吸吮姿势正确率高,产妇乳头疼痛、皲裂和乳胀发生率少,和对照组比较差异有统计学意义(P<0.01);观察组产妇母乳喂养信心、产后3d和产后42d纯母乳喂养率高,和对照组比较差异有统计学意义(P<0.01)。结论产后3d是实现母乳喂养的黄金时期,能否做到纯母乳喂养与母乳喂养的措施力度有关,规范后的母乳喂养流程是简单、明确、高效、可操作性强,值得临床推广。

Objective To normalize breastfeeding procedures and to explore effective measures to promote exclusive breastfeeding at 3 days after childbirth.Methods One hundred and twenty pairs of full-term healthy neonates delivered by vaginal delivery and their mothers were divided into observation group and control group according to a random number table,with 60 pairs in each group.Breastfeeding was initiated routinely in control group,whereas the breastfeeding procedure was standardized in observation group on the basis of routine nursing,including strengthening the training of medical personnel on breastfeeding-related knowledge and skills,developing clear feeding goals for the neonates,helping the parturients to complete the first hug and suck,adopting a semi-lying breast-feeding position that was not skillful and a plain posture for sucking milk,and informing the parturients of correct assessment of the neonates.The incidence of breastfeeding,maternal nipple pain,cracked nipple,and breast distention were recorded within 2 days after childbirth in the two groups.In addition,the infants’posture for sucking,breastfeeding confidence,and exclusive breastfeeding at 3 days and 42 days after childbirth were documented and analyzed.The data were statistically analyzed and evaluated at 72h after delivery.Results In observation group,the frequency of lactation at 1,2 and 3 days after childbirth was more than 8 to 12 times,which was significantly different from that in control group at 1,2 and 3 days after childbirth(P<0.01).The rate of correct posture for sucking was higher in observation group,and the incidence rates of nipple pain,cracked nipple,and breast distention were lower,there were significant differences between observation group and control group(P<0.01).The breatfeeding confidence of parturients and exclusive breastfeeding rate at 3 days and 42 days after childbirth in observation group were significantly higher than those in control group(P<0.01).Conclusion It is the golden period for breastfeeding at 3 days after childbirth.The exclusive breastfeeding is associated with breastfeeding measures.The standardized breastfeeding process is simple,clear and efficient,with strong operability,which is worthy of clinical promotion.