新生儿乳房爬行运动对阴道分娩初产妇母乳喂养和心理状态的影响

Influence of neonatal breast crawl on breastfeeding and psychological status of primipara in vaginal delivery

目的探讨新生儿乳房爬行运动对阴道分娩初产妇母乳喂养和心理状态的影响。方法采用便利抽样法,选取2019年1月至2020年1月盐城市第一人民医院经阴道分娩的正常足月儿及母亲86对作为研究对象,按照随机数字表法分为试验组和对照组各43对。对照组给予常规产后护理,试验组在常规产后护理基础上实施新生儿乳房爬行运动。比较2组产妇泌乳启动时间、首次母乳喂养成功率和首次母乳喂养测量工具(BAT)评分;分别于产后72 h和42 d比较2组纯母乳喂养率、母乳喂养自我效能简式量表(BSES-SF)评分和爱丁堡产后抑郁量表(EPDS)评分。结果试验组泌乳启动时间为(48.36±6.12)h,明显早于对照组的(52.86±7.29)h,差异有统计学意义(t=3.08,P<0.05);试验组首次母乳喂养成功率和BAT评分分别为88.1%(37/42)和(9.74±1.33)分,明显高于对照组的69.8%(30/43)和(8.84±1.60)分,差异有统计学意义(χ2=4.28,t=2.82,均P<0.05);产后72 h、42 d,试验组纯母乳喂养率分别为42.9%(18/42)和86.49%(32/37),明显高于对照组的20.9%(9/43)和60.00%(24/40),差异有统计学意义(χ2=4.71、3.93,均P<0.05)。产后72 h和42 d,试验组BSES-SF得分分别为(38.48±6.34)、(45.43±11.45)分,明显高于对照组的(35.21±4.87)、(40.10±10.82)分,差异有统计学意义(t=2.66、2.10,均P<0.05);试验组EPDS得分分别为(5.52±1.53)、(7.38±2.25)分,明显低于对照组的(6.26±1.63)、(8.73±2.39)分,差异有统计学意义(t=2.13、2.54,均P<0.05)。结论新生儿乳房爬行运动对阴道分娩初产妇母乳喂养有促进作用,并可提高初产妇母乳喂养自信心和缓解抑郁状态。

Objective To investigate the effect of neonatal breast crawling exercise on breastfeeding and psychological state of primiparas who delivered vaginally.Methods Using convenience sampling method,86 pairs of normal term infants and mothers who delivered vaginally in the First People′s Hospital of Yancheng from January 2019 to January 2020 were selected as the research objects,and divided into experimental group and control group according to the random number table method,there were 43 pairs in each group.The control group was given routine postpartum care,while the experimental group was given neonatal breast crawling exercise on the basis of routine postpartum care.The time of initiation of lactation,the success rate of first breastfeeding and the score of first Breastfeeding Assessment Tool(BAT)were compared between the two groups.The rates of exclusive breastfeeding,the scores of Breastfeeding Self-efficacy Scale Short Form(BSES-SF)and the scores of Edinburgh Postnatal Depression Scale(EPDS)were compared between the two groups at 72 h and 42 d after delivery respectively.Results The time of initiation of lactation was(48.36±6.12)h in the experimental group,which was significantly earlier than that in the control group(52.86±7.29)h,the difference was statistically significant(t=3.08,P<0.05).The success rate of first breastfeeding and the BAT scores of the experimental group were 88.1%(37/42)and(9.74±1.33),respectively,which were significantly higher than those in the control group 69.8%(30/43)and(8.84±1.60),the differences were statistically significant(χ2=4.28,t=2.82,both P<0.05).At 72 h and 42 d after delivery,the rate of exclusive breastfeeding were 42.9%(18/42)and 86.49%(32/37)in the experimental group,significantly higher than those in the control group 20.9%(9/43)and 60.00%(24/40),the differences were statistically significant(χ2=4.71,3.93,both P<0.05).At 72 h and 42 d after delivery,the BSES-SF scores were(38.48±6.34)and(45.43±11.45)in the experimental group,which were significantly higher than those in the control group(35.21±4.87)and(40.10±10.82),the differences were statistically significant(t=2.66,2.10,both P<0.05);the EPDS scores were(5.52±1.53)and(7.38±2.25)in the experimental group,which were significantly lower than those in the control group(6.26±1.63)and(8.73±2.39),the differences were statistically significant(t=2.13,2.54,both P<0.05).Conclusions Neonatal breast crawl is an effective way to promote the breastfeeding.It can also enhance maternal confidence and alleviate maternal psychological status.