生產醫療措施與計畫剖腹生產產婦泌乳起始時間之相關研究

本研究旨在探討生產醫療措施與計畫剖腹生產產婦泌乳起始時間之相關性研究。採描述相關研究，以方便取樣方式於北部某區域教學醫院，針對計畫剖腹生產產婦進行收案，共收案116名無任何合併症之產後婦女。研究工具包括人口學屬性及產科學調查表，生產醫療措施調查表、語言疼痛評估量表、以及自覺泌乳起始時問訪談表。研究結果發現：(1)泌乳起始時間的平均值爲757±168小時（範圍40至117小時）；(2)產婦自覺延遲泌乳的發生機率爲500%(n=58)，其中延遲泌乳的初產婦有27位，佔所有初產婦(n=42)的64.3%，延遲泌乳的經產婦有31位，佔所有經產婦(n=74)的41.9%，經產婦發生延遲泌乳的機率較低；(3)產次、術後禁食時間以及配方乳使用，是泌乳起始時間的重要預測因子，共可解釋計畫剖腹產婦泌乳起始時間總變異數的22.5%。醫護人員應該鼓勵產婦以純母乳餵養嬰兒，以及縮短術後禁食時間，提早讓產婦進食，以減少延遲泌乳的發生機會，進而促進產婦成功哺乳。

關鍵字

母乳哺餵；生產醫療措施；計畫剖腹生產；泌乳起始時間

並列摘要

This study explored the relationship between birth practices and onset of lactation during hospital stay in women undergoing planned cesarean. The study design was descriptive correlation. A convenience sample of 116 healthy mothers was recruited from a Northern Taiwan regional teaching hospital. The study instruments included: demographic and obstetrical data, childbirth health care environment inventory, and verbal pain rating scales. An interview guide entitled, ”Maternal Perception of the Onset of Lactation” was also used to obtain milk secretion data. The analytical results revealed a mean onset of lactation of 75.7±16.8 hours (range=40 to 117). The prevalence of delayed lactation onset was 50.5% (n=58); 64.3% (n=42) were primiparous, and 41.9% (n=74) were multiparous. Parity, hours of withholding oral intake post-operation, and use of formula were significant predictors of perceived lactation onset. These factors explained 22.5% of perceived lactation onset in postpartum women who planned cesarean section. To increase milk secretion and to promote breastfeeding, medical personnel should encourage mothers to breastfeed exclusively in order to minimize the duration of restriction oral intake post-operation.