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【目的】探讨不同分娩方式对分娩后及产褥期母乳喂养的影响,促进母乳喂养。【方法】自2004年6月起收集北京大学第一医院分娩新生儿802例,在生后2~5 d时、42 d回访时追踪其母乳喂养情况。【结果】分娩后婴儿早接触早吸吮的时间剖宫产、自然产、助产三组分别为(32.80±35.70)、(20.00±32.32)(、25.40±35.27)h,剖宫产组和阴道自然产组间差别有统计学意义(F=22.626,P=0.000)。剖宫产、自然产、助产三组分别有9 6.8%、9 7.0%、93.8%的母亲在分娩前希望母乳喂养,比较两两差异无统计学意义;但生后2~5 d时三组纯母乳喂养率分别为37.6%、45.0%3、8.5%,42 d时分别为35.2%、44.6%、40.0%;而未母乳喂养的主要原因,都是奶水不足或未下奶;对两个时期的母乳喂养情况进行比较,剖宫产和阴道自然产两组间母乳喂养差别有统计学意义,阴道自然产婴儿的全母乳喂养率高于剖宫产组,其他组间差别无统计学意义。多变量因素分析中发现母亲年龄越小、早接触时间越早、住房面积越小及孕期有母乳喂养愿望的母亲其生后2~5 d时4、2 d时的母乳喂养率越高。【结论】严格剖宫产指征,加强孕期母乳喂养的健康教育,宣传适龄生育的好处,鼓励及促进自然分娩。
【Objective】 To investigate the effects of different modes of delivery on postpartum and postpartum breastfeeding and to promote breastfeeding. 【Methods】 From June 2004, 802 newborns delivered at Peking University First Hospital were collected and their breastfeeding status was tracked at 42 days after birth at 2-5 days. 【Results】 The results of cesarean section, spontaneous delivery and midwifery were (32.80 ± 35.70), (20.00 ± 32.32) (25.40 ± 35.27) h, Natural production group differences were statistically significant (F = 22.626, P = 0.000). Cesarean section, natural production, midwifery, respectively, 9 6.8%, 9 7.0%, 93.8% of mothers want to breastfeed before delivery, no significant difference between the two pairs of contrast; but after birth 2 ~ 5 d three The rates of exclusive breastfeeding were 37.6%, 45.0%, 3 and 8.5%, respectively, which were 35.2%, 44.6% and 40.0% respectively at 42 days. The main reasons for not being breast-fed were insufficient milk or no milk; A period of breastfeeding were compared, cesarean section and vaginal natural production of breastfeeding between the two groups were statistically significant, vaginal birth of natural breastfeeding rate was higher than the cesarean section, the other groups, the difference was not statistically significant significance. In the multivariate analysis, the mothers’ breastfeeding rate was found to be higher at 2 and 5 days after birth at 4 and 2 days after the mothers were younger, the earliest contact time was earlier, the housing area was smaller and the desire for breastfeeding was during pregnancy. [Conclusion] Strict indications of cesarean section, to strengthen health education during breastfeeding during pregnancy to promote the benefits of childbearing age, to encourage and promote natural childbirth.