早期乳旁补奶诱导婴儿吸吮促进母乳分泌的临床研究

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[摘要] 目的 探讨早期乳旁补奶诱导婴儿吸吮促进母乳分泌的效果。 方法 选择2011年1月～2012年1月我院住院分娩的270例妊娠足月健康产妇及其新生儿，分为哺乳器组、小杯及小匙组、橡皮及奶瓶组，随机取不同分娩方式的总婴儿数的1/3入组，每组各90例。哺乳器组婴儿用一次性母乳喂养哺乳器固定于母亲旁诱导喂哺，小杯小匙组按常规给予早吸吮，加奶时用小杯小匙喂哺，橡皮奶瓶组按常规给予早吸吮，加奶时用橡皮、奶瓶喂哺，观察各组相关指标并进行比较分析。 结果 哺乳器组婴儿错觉率为1.11%，明显低于橡皮及奶瓶组（46.7%）和小杯及小匙组（61.1%）（χ2=32.6，P = 0；χ2=41.9，P = 0）；早吸吮成功率为81.1%，明显高于橡皮及奶瓶组（48.9%）和小杯及小匙组（33.3%）（χ2=4.4，P = 0.02；χ2=11.7，P = 0）；48 h PRL平均水平为（385.4±120.6）ng/L，明显高于橡皮及奶瓶组[（325.6±110.5）ng/L]和小杯及小匙组[（286.3±115.7）ng/L]（t = 2.243，P = 0；t = 2.942，P = 0）；产后开始泌乳时间为（23.6±8.2）h，明显短于橡皮及奶瓶组[（32.7±12.8）h]和小杯及小匙组[（38.3±10.6）h]（t = 1.163，P = 0；t = 1.754，P = 0）；母乳充盈平均时间为（38.3±11.5）h, 明显短于橡皮及奶瓶组[（54.3±12.2）h]和小杯及小匙组[（62.6±13.8）h]（t = 1.338，P = 0；t = 1.804，P = 0）；完全母乳喂养平均时间为（29.5±8.3）h, 明显短于橡皮及奶瓶组[（47.5±10.3）h]和小杯及小匙组[（56.4±9.6）h]（t = 1.480，P = 0；t = 1.675，P = 0）。 结论 婴儿早期放置母乳喂养哺乳器进行乳旁补奶诱导婴儿吸吮可降低婴儿错觉率，提高早吸吮的成功率，有效刺激催乳素的分泌，缩短母乳开始泌乳时间和母乳充盈时间，进而提高母乳喂养率，该法简便、卫生、安全，可代替目前常规的小勺、小匙喂哺。

[关键词] 母乳喂养；错觉；乳汁分娩；早吸吮；催乳素

[中图分类号] R473.71 [文献标识码] C [文章编号] 1673-7210（2012）08（c）-0133-03

Clinical research on promotion of breast milk secretion induced by baby sucking providing breast milk alongside in its early stage

TANG Wanqiu1 LAI Guifeng2 FANG Chenghua3

1.Nursing Unit, Department of Gynecology and Obstetrics, Guilin Women and Children Hospital, Guangxi Zhuang Autonomous Region, Guilin 541001, China; 2.Department of Gastroenterology, No. 1 People's Hospital of Nanning, Guangxi Zhuang Autonomous Region, Nanning 530000, China; 3.Department of Gynecology and Obstetrics, No. 1 People's Hospital of Nanning, Guangxi Zhuang Autonomous Region, Nanning 530000, China.

[Abstract] Objective To explore the effect of promoting breast milk secretion induced by baby sucking providing breast milk alongside in its early stage. Methods 270 healthy puerperae and neonates delivered in our hospital from January 2011 to January 2012 were divided into three groups: breast pump group, cup or spoon group and rubber nipple or feeding-bottle group. One third of each group's babies were selected as participants in random. In breast pump group, babies were fed with disposable breast pumps fixed near to mothers' nipple. In cup or spoon group, babies were conventionally offered with early suck and fed by small cup or spoon when adding human milk. In rubber nipple or feeding-bottle group, babies were conventionally provided with early suck and fed by rubber nipple or feeding-bottle when adding human milk. Some relevant indexes from each group were compared and analyzed. Results Nipple illusion rate in breast pump group was 1.11%, which was lower than that of rubber nipple or feeding-bottle group (46.7%) and small cup or spoon group (61.1%) (χ2=32.6, P = 0; χ2=41.9, P = 0). Early suck success rate in breast pump group was 81.1%, which was higher than that of rubber nipple or feeding-bottle group (48.9%) and small cup or spoon group (33.3%) (χ2=4.4, P = 0.02; χ2=11.7, P = 0). Average level of prolactin secretion within 48 hours in breast pump group reached (385.4±120.6) ng/L. The average value was remarkably higher than that of rubber nipple or feeding-bottle group [(325.6±110.5) ng/L] and small cup or spoon group [(286.3±115.7) ng/L] (t = 2.243, P = 0; t = 2.942, P = 0). Postpartum lactating time in breast pump group was (23.6±8.2) h, which was shorter than that of rubber nipple or feeding-bottle group [(32.7±12.8) h] and small cup or spoon group [(38.3±10.6) h] (t = 1.163, P = 0; t = 1.754, P = 0). Mean time for breast milk refilling was (38.3±11.5) h, which was greatly shorter than that of rubber nipple or feeding-bottle group [(54.3±12.2) h] and small cup or spoon group [(62.6±13.8) h] (t = 1.338, P = 0; t = 1.804, P = 0). Completely breast feeding time in average in breast pump group only took (29.5±8.3) h, which was shorter than that of rubber nipple or feeding-bottle group [(47.5±10.3) h] and small cup or spoon group [(56.4±9.6) h] (t = 1.480, P = 0; t = 1.675, P = 0). Conclusion Early placed breast pump near to mother's nipples for infantile breastfeeding guiding baby suck can reduce infant's nipple illusion rate, improve successful possibility for early suck, effectively stimulate prolactin secretion, shorten postpartum initial lactating time and breast milk refilling period, and finally increase breastfeeding rate. It is very simple, hygienic, and safe, which can replace conventional small cup or spoon feeding approach.