Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss
Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss
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DOI：
10.1542/peds.112.3.607
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发表时间：
2003-09-01
期刊：
影响因子：
8
通讯作者：
Cohen, RJ
中科院分区：
文献类型：
--
作者：
Dewey, KG;Nommsen-Rivers, LA;Cohen, RJ
客观的。即使在高度动力母乳喂养的情况下，一些母亲也很难发起泌乳。这项研究的目的是确定次优婴儿母乳喂养行为（SIBB）的发生率和危险因素，哺乳的发作延迟以及母亲对母亲的新生儿体重减轻过多，具有较高的教育水平和动力的母乳喂养。所有居住在加利福尼亚州戴维斯的母亲在1999年10个月的招聘期内，在5个地区医院中有一个健康的单身婴儿在5个地区的1个婴儿中生下了他们，如果他们愿意尝试独家母乳喂养至少1个月，则邀请他们参加。提供了哺乳引导，并在医院（第0天）和第3、5、7和14天收集了数据。婴儿母乳喂养行为是通过使用婴儿母乳喂养评估工具的训练哺乳顾问评估的。哺乳的发作是根据母亲的乳房饱满变化的报告定义的。如果婴儿的体重减轻大于或等于第3天的出生体重的10％，则认为体重减轻过大。在328位合格的母亲中，有280名（85％）参加了这项研究。 SIBB的患病率第0天为49％，第3天为22％，在第7天为14％。SIBB与初学者（第0和第3天），剖宫产区（在Multiparas，第0天，第0天），nipples nipples或Biverate nortant，Birty Brest ii（第0和第3天使用），第3天（第3天）（第3天（第3天）（第3天，第3天（第3天），3和78小时（第3天）（第3天）（第3天，第3天，第3天，第3天，第3天，） > 1小时（第7天），孕产妇体重指数> 27 kg/m（2）（第7天）和出生体重72小时）发生在22％的女性中，与初学性，剖宫产，II期劳动> 1小时有关，产妇体重指数> 27 kg/m（2），平坦或倒乳头或倒乳头和出生体重> 3600 g（in prim> 3600 g）。多余的体重减轻发生在12％的婴儿中，并且与初学，长期劳动持续时间，使用劳动药（以多种为单位）以及出生时的婴儿身份有关。如果母亲延迟泌乳发作，那么婴儿体重减轻过剩的风险要高7.1倍，如果婴儿在第0天患有SIBB，则高2.6倍。早期哺乳的成功受到平等的强烈影响，但也可能受到可能修改的因素的影响，例如分娩方式，劳动持续时间，劳动力药物，非乳房牛奶液和/或奶嘴的使用以及孕产妇增持。所有母乳喂养的母亲对，应在产后72至96小时的时间进行评估。
Objective. Some mothers have difficulty initiating lactation even when highly motivated to breastfeed. The purpose of this study was to determine the incidence of and risk factors for suboptimal infant breastfeeding behavior (SIBB), delayed onset of lactation, and excess neonatal weight loss among mother-infant pairs in a population with high educational levels and motivation to breastfeed.Methods. All mothers residing in Davis, California, who gave birth to a healthy, single, term infant at 1 of 5 area hospitals during the 10-month recruitment period in 1999 were invited to participate if they were willing to attempt to breastfeed exclusively for at least 1 month. Lactation guidance was provided and data were collected in the hospital (day 0) and on days 3, 5, 7, and 14. Infant breastfeeding behavior was evaluated by trained lactation consultants using the Infant Breastfeeding Assessment Tool. Onset of lactation was defined based on maternal report of changes in breast fullness. Infant weight loss was considered excessive if it was greater than or equal to10% of birth weight by day 3.Results. Of the 328 eligible mothers, 280 (85%) participated in the study. The prevalence of SIBB was 49% on day 0, 22% on day 3, and 14% on day 7. SIBB was significantly associated with primiparity (days 0 and 3), cesarean section (in multiparas, day 0), flat or inverted nipples, infant status at birth (days 0 and 3), use of nonbreast milk fluids in the first 48 hours (days 3 and 7), pacifier use (day 3), stage II labor >1 hour (day 7), maternal body mass index >27 kg/m(2) (day 7) and birth weight 72 hours) occurred in 22% of women and was associated with primiparity, cesarean section, stage II labor > 1 hour, maternal body mass index > 27 kg/m(2), flat or inverted nipples, and birth weight > 3600 g (in primiparas). Excess weight loss occurred in 12% of infants and was associated with primiparity, long duration of labor, use of labor medications (in multiparas), and infant status at birth. The risk of excess infant weight loss was 7.1 times greater if the mother had delayed onset of lactation, and 2.6 times greater if the infant had SIBB on day 0.Conclusions. Early lactation success is strongly influenced by parity, but may also be affected by potentially modifiable factors such as delivery mode, duration of labor, labor medications, use of nonbreast milk fluids and/or pacifiers, and maternal overweight. All breastfeeding mother-infant pairs should be evaluated at 72 to 96 hours' postpartum.