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

2004财政年度，专业助产士对新生儿重症监护室前低出生体重婴儿进行了家访，以继续上一年的目标，即建立一个系统，为婴儿成功的母乳喂养提供必要的支持。家访是应曾在“N”医疗中心就诊的25名母亲的要求进行的。除了提供必要的协助外，还进行了半结构化访谈，以评估母亲及其婴儿的身体状况、护理情况、母亲是否得到他人的支持以及母亲的担忧或焦虑。在这25名妇女中，20名是初产，5名是多产。有3例双胞胎，1例三胞胎。母亲的平均年龄为33.3岁，平均胎龄为29.7周，婴儿出院时平均体重为2452克。平均在出院后第24天进行访问。更多的妇女继续母乳喂养，要么直接（10例），要么通过直接哺乳和母乳喂养相结合。在12个案例中，丈夫独自分担照顾孩子的责任，在一个案例中，没有人分担母亲的负担。总的来说，母亲的情况是她们在照顾孩子方面得到的支持很少。这些访问使人们了解到有关儿童保育的背景和家庭问题。由于婴儿的身体机能发育不全、他们自己不确定会发生什么或得不到好的建议，这些受试者遭受了长期的照顾疲劳。由于在家庭环境中出现的具体问题得到解决，她们充分了解母乳喂养的好处，并得到乳房的直接护理等，这些访问为受试者提供了关键的心理安慰。然而，尽管有这些积极的影响，在只有丈夫提供帮助的情况下，多胞胎母亲仍在顽强地挣扎，例如，三胞胎母亲在她的孩子身上贴上胶带标签，以记录喂养的次数和消耗的牛奶量。随着时间的推移，疲劳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，包括由具有新生儿重症监护室经验的初级护士在婴儿离开医疗机构后立即开始进行访问。必须保证提供训练有素的专家，以满足对低出生体重婴儿进行持续护理的综合系统的需要。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