Child care support to mothers of extremely low birth weight babies : Building a system of ongoing support for breast feeding

在2004财政年度，专业助产士对以前的低出生体重NICU婴儿进行了家访，延续了前一年的目标，即建立一个系统，为婴儿的成功母乳喂养提供必要的支持。这些家访是应曾在“N”医疗中心的25位母亲的要求进行的。除了提供必要的援助外，还进行了半结构化访谈，以评估母亲和她们的婴儿的身体状况、护理工作进行得如何、母亲是否得到他人的支持以及母亲的担忧或绝望。有三个双胞胎和一个三胞胎。母亲的平均年龄为33.3岁，平均孕周为29.7周，婴儿出院时的平均体重为2452克。平均而言，探视是在出院后第24天进行的。…的大部分更多的妇女继续母乳喂养，要么是直接喂养(10例)，要么是直接哺乳和喂养纯母乳的组合。在12个案例中，丈夫独自分担照顾孩子的责任，而在一个案例中，没有人分担母亲的负担。总体而言，这些母亲的情况是，她们在照顾儿童方面得到的支持很少。走访暴露了与儿童照顾有关的背景和家庭问题。受试者患有累积的照顾者疲劳，原因是他们的宝宝身体功能发育不充分，他们自己不确定应该期待什么，或者没有好的建议。这些探访为受试者提供了关键的精神安慰，因为他们解决了在家庭环境中出现的具体问题，使他们充分了解母乳喂养和直接照顾乳房的好处，等等。然而，尽管有这些积极的影响，只有她们的丈夫提供帮助，但多名母亲仍然顽强地挣扎着，例如，三胞胎母亲为她的婴儿贴上胶带标签，以记录喂奶的数量和牛奶的消耗量。随着时间的推移，疲惫的积累对这些母亲的健康构成了威胁。有必要建立以社区为基础的系统，为母乳喂养提供全面支持，包括具有NICU经验的初级护士的探视，在婴儿离开医疗设施后立即开始。必须保证提供训练有素的专家，以满足对持续照料低出生体重儿的全面系统的需要。较少

In FY2004 specialist midwives made home visits to former low birth weight NICU babies, in continuation of the previous year's objective of establishing a system for providing essential support for successful breast feeding of infants. The home visits were made at the request of 25 mothers who had been in the "N" Medical Center. In addition to providing the necessary assistance, semi-structured interviews were conducted to assess the physical conditions of the mothers and their babies, how well nursing was being conducted, whether or not the mothers were receiving support from others and the mothers' worries or annxieties.Of the 25 women,20 were primiparas and 5 were multiparas. There were three cases of twins and one of triplets. The aveage age of the mothers was 33.3,average gestational age was 29.7 weeks, and the babies' weights upon discharge from the center had an average weight of 2,452g. On average, the visits were made on the 24th day after discharge from the center. Most of the … More women were continuing to breast feed, either directly (in 10 cases) or by a combination of direct nursing and feeding expressed breast milk. In 12 cases, the husband alone was sharing in child care and no one shared the mother's burden in one case. Overall, the mothers' situations were that they received little support for child care.The visits brought to light background and family issues pertaining to child care. The subjects suffered from accumulated caregiver fatigue due to problems caused by their babies' insufficiently developed physical functions, their own uncertainties about what to expect or inavailability of good advice. The visits provided the subjects with critical mental reassurance as the result of having specific questions that had arisen in their home environments addressed, their gaining full understanding of the benefits of breast feeding and receiving direct care of their breasts, etc. These positive effects notwithstanding, however, with only their husbands to provide assistance, the multiple mothers were struggling valiently, the triplets mother, for example, affixing tape labels to her babies to keep track of numbers of feedings and amounts of milk consumed.Over time, fatigue build-up poses a danger to the health of these mothers. There is a need to establish community-based systems that provide full support for breast feeding, including visits by primary nurses with NICU experience that begin as soon as the infant leaves the medical facility. A supply of highly trained specialists must be assured in order to meet this need for a comprehensive system of ongoing caregiving to low birth weight babies. Less