Randomised trial comparing hand expression with breast pumping for mothers of term newborns feeding poorly.
Randomised trial comparing hand expression with breast pumping for mothers of term newborns feeding poorly.
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DOI：
10.1136/adc.2010.209213
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发表时间：
2012-01
期刊：
影响因子：
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通讯作者：
Newman TB
中科院分区：
文献类型：
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作者：
Flaherman VJ;Gay B;Scott C;Avins A;Lee KA;Newman TB
当新生儿吸乳或吸吮不良时，可建议吸乳或用手表达。最近的一项试验发现，在产后早期使用吸奶器的母亲效果更差。本研究的目的是比较出生后12-36小时喂养不良的健康足月婴儿母亲的双侧电动吸乳和手部表达。随机对照试验。良好的婴儿护理和产后单位。68例12-36 h新生儿吸吮或闭锁不良的母亲被随机分配到15分钟的双侧电抽或15分钟的手部表情组。干预后即刻的泌乳量、产妇疼痛、母乳喂养信心和母乳表达体验（BMEE），以及出生后2个月的母乳喂养率。中位泌乳量（范围）为0.5 (0-5)ml，手乳母亲为1 (0-40)ml （p=0.07）。产妇疼痛、母乳喂养信心和BMEE在干预中没有差异。在2个月时，手部表情组的母亲更有可能母乳喂养（96.1%），而吸吮组的母亲（72.7%）（p=0.02）。与吸乳相比，产后早期的手部表情似乎可以提高出生后2个月的最终母乳喂养率，但需要进一步的研究来证实这一点。然而，在12-36小时喂养不良的健康足月婴儿适宜抽吸或用手表达的情况下，提供者应考虑推荐用手表达。
Breast pumping or hand expression may be recommended when newborns latch or suck poorly. A recent trial found worse outcomes among mothers who used a breast pump in the early postpartum period. The objective of this study was to compare bilateral electric breast pumping to hand expression among mothers of healthy term infants feeding poorly at 12–36 h after birth. Randomised controlled trial. Well-baby nursery and postpartum unit. 68 mothers of newborns 12–36 h old who were latching or sucking poorly were randomly assigned to either 15 min of bilateral electric pumping or 15 min of hand expression. Milk transfer, maternal pain, breastfeeding confidence and breast milk expression experience (BMEE) immediately after the intervention, and breastfeeding rates at 2 months after birth. The median volume of expressed milk (range) was 0.5 (0–5) ml for hand expressing mothers and 1 (0–40) ml for pumping mothers (p=0.07). Maternal pain, breastfeeding confidence and BMEE did not differ by intervention. At 2 months, mothers assigned to hand expression were more likely to be breastfeeding (96.1%) than mothers assigned to breast pumping (72.7%) (p=0.02). Hand expression in the early postpartum period appears to improve eventual breastfeeding rates at 2 months after birth compared with breast pumping, but further research is needed to confirm this. However, in circumstances where either pumping or hand expression would be appropriate for healthy term infants 12–36 h old feeding poorly, providers should consider recommending hand expression.