Factors Related to Maternal Perception of Milk Supply While in the Hospital

產後住院期間母親乳汁分泌感知之相關因素探討

黃雅儀(Ya-Yi Huang)；李絳桃(Jian-Tao Lee)；黃久美(Chiu-Mieh Huang)；高美玲(Meei-Ling Gau)

母親主觀感知乳汁分泌 ； 住院期間 ； 母乳哺育 ； maternal perception of milk supply ； hospitalization ； breastfeeding

The Journal of Nursing Research

17卷3期（2009 / 09 / 01）

179 - 188

英文

背景　台灣產後婦女經常感到並擔憂乳汁分泌不足而停止哺乳。 目的　本研究旨在探索影響產婦乳汁分泌的相關因素。 方法　採橫斷面研究設計，於北部某醫學中心進行收案，共收案205名健康足月生產之母嬰，使用Hill及Humenick所發展乳汁分泌評估工具，於產婦住院期間蒐集哺乳資訊。 結果　產後住院期間母親乳汁分泌的預測因子有嬰兒的餵食方式、產婦的哺乳計畫、嬰兒吸吮行為、家人支持及嬰兒吸吮型態，共可解釋35.3%的變異量。 結論／臨床應用　臨床上要預防主觀性乳汁不足，除了鼓勵產婦儘可能的讓嬰兒直接的吸吮乳房、教導產婦哺乳姿勢技巧使嬰兒可達到正確含乳、安撫嬰兒的技巧之外，醫院的政策應避免直接給予嬰兒奶瓶餵食或是提供母親奶瓶的餵食工具，以避免干擾母親的乳汁分泌。

Background: Perceived insufficient milk supply is a frequent concern and reason for early weaning in Taiwanese mothers. Purpose: The purpose of this study was to explore the factors related to maternal milk supply. Methods: A cross-sectional study was carried out at a medical center in northern Taiwan. A total of 205 healthy mother-infant pairs were recruited. A tool to assess insufficient milk supply developed by P.D. Hill and S.S. Humenick (1996) was used to gather breastfeeding information during each participant's hospital stay. Results: Infant-feeding methods, planned breastfeeding duration, infant sucking behaviors, family support, and infant sucking patterns were found to explain 35.3% of variance in maternal perception of milk supply. Conclusions/Implications for Practice: Mothers in Taiwan are particularly sensitive to infant crying. To prevent mothers from perceiving inadequate milk supply, nurses should encourage postpartum mothers to suckle their infant on the breast and teach mothers breastfeeding skills and how to pacify crying babies. In addition, hospital managers should make policies to minimize bottle and supplementary formula feeding.

1. American Academy of Pediatrics.(2005).Policy statement: Breastfeeding and the use of human milk.Pediatrics,115(2),496-506.
2. Berens, P. D.(2004).Applied physiology in the peripartum management of lactation.Clinical Obstetrics & Gynecology,47(3),643-655.
3. Survey of breastfeeding in Taiwan
4. Chatterton, R. T.,Hill, P. D.,Aldag, J. C.,Hodges, K. R.,Belknap, S. M.,Zinaman, M. J.(2000).Relation of plasma oxytocin and prolatin concentrations to milk production in mothers of preterm infant: Influence of stress.The Journal of Clinical Endocrinology and Metabolism,85(10),3661-3668.
5. Dewey, K. G.,Nommsen-Rivers, L. A.,Heinig, M. J.,Cohen, R. J.(2003).Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss.Pediatrics,112(3),607-619.
6. F. S. King (Ed.)(2001).Helping mothers to breastfeed.Nairobi, Kenya:African Medical and Research Foundation.
7. Furman, L.,Minich, N. M.(2006).Evaluation of breastfeeding of very low birth weight infants: Can we use the Infant Breastfeeding Assessment Tool?.Journal of Human Lactation,22(2),175-181.
8. Gau, M. L.(2004).Evaluation of a lactation intervention program to encourage breastfeeding: A longitudinal study.International Journal of Nursing Studies,41(4),425-435.
9. Hildebrandt, H. M.(1999).Maternal perception of lactogenesis time: A clinical report.Journal of Human Lactation,15(4),317-323.
10. Hill, P. D.,Aldag, J. C.(1991).Potential indications of insufficient milk supply syndrome.Research in Nursing & Health,14,11-19.
11. Hill, P. D.,Humenick, S. S.(1996).Development of the H&H Lactation Scale.Nursing Research,45(3),136-140.
12. Hill, P. D.,Humenick, S. S.(1989).Insufficient milk supply.Image: The Journal of Nursing Scholarship,21,145-148.
13. Howard, C. R.,Howard, F. M.,Lanphear, B.,deBlieck, E. A.,Eberly, S.,Lawrence, R. A.(1999).The effects of early pacifier use on breastfeeding duration.Pediatrics,103(3),33.
14. Huang, M. S.(1998).Taipei, ROC.,National Taiwan University.
15. Iewallen, L. P.,Dick, M. J.,Flowers, J.,Powell, W.,Zicke, K. T.,Wall, Y. G.(2006).Breast feeding support and early cessation.Journal of Obstetric, Gynecologic, and Neonatal Nursing,35(2),166-172.
16. Johnson, T. S.,Mulder, P. J.,Strube, K.(2007).Mother-infant breastfeeding progress tool: A guide for education and support of the breastfeeding dyad.Journal of Obstetric, Gynecologic, and Neonatal Nursing,36(4),319-327.
17. Manganaro, R.,Mami, C.,Marrone, T.,Marseglia, L.,Gemelli, M.(2001).Incidence of dehydration and hypernatremia in exclusively breast-fed infants.Journal of Pediatrics,139(5),673-675.
18. Matthews, M. K.(1988).Developing an instrument to assess infant breastfeeding behaviour in the early neonatal period.Midwifery,4(4),154-165.
19. Mizuno, K.,Fujimaki, K.,Sawada, M.(2004).Sucking behavior at breast during the early newborn period affects laterbreast-feeding rate and duration of breast-feeding.Pediatrics International,46(1),15-20.
20. Neifert, M.(1996).Early assessment of the breastfeeding infant.Contemporary Pediatrics,13(10),142-166.
21. Neville, M. C.,Morton, J.(2001).Physiology and endocrine changes underlying human lactogenesis II.Journal of Nutrition,131,3005-3008.
22. Breastfeeding-Starting out right
23. Lactation aid
24. Otsuka, K.,Dennis, C.,Tatsuoka, H.,Jimba, M.(2008).The relationship between breastfeeding self-efficacy and perceived insufficient milk among Japanese mothers.Journal of Obstetric, Gynecologic, and Neonatal Nursing,37(5),546-555.
25. Righard, L.(1998).Are breastfeeding problems related to incorrect breastfeeding technique and the use of pacifiers and bottles?.Birth,25(1),40-44.
26. Sacco, L. M.,Caulfield, L. E.,Gittelsohn, J.,Martinez, H.(2006).The conceptualization of perceived insufficient milk among Mexican mothers.Journal of Human Lactation,22(3),277-286.
27. Sharma, V.,Corpse, C. S.(2008).Case study revisiting the association between breastfeeding and postpartum depression.Journal of Human Lactation,24(1),77-79.
28. Stainton, C.,I. M. Bobak (Eds.),M. D. Jensen (Eds.)(1991).Essentials of maternity nursing.New York:Mosby.
29. Stewart-Knox, B.,Gardiner, K.,Wright, M.(2003).What is the problem with breast-feeding? A qualitative analysis of infant feeding perception.Journal of Human Nutrition and Dietetics,16(4),265-273.
30. Taiwan Joint Commission on Hospital Accreditation.(2008).Report of baby-friendly hospital initiations in Taiwan in 2008.Taipei:Taiwan Joint Commission on Hospital Accreditation.
31. Teng, S. W.,Su, T. J.,Yang, Y. L.,Chang, G. L.(1995).The impact of rooming-in care on the breast-feeding mother's emotional disturbance and feeding method one month after delivery.Nursing Research (Taiwan),3(2),181-194.
32. Victora, C.G.,Behague, D. P.,Barros, F. C.,Anselmo Olinto, M. T.,Weiderpass, E.(1997).Pacifier use and short breastfeeding duration: Cause, consequence, or coincidence?.Pediatrics,99(3),445-453.