胎兒死亡婦女的非藥物退奶照護

Nursing Care of Non-pharmacologic Lactation Suppression for Women with Fetal Death

蘇鈺婷(Yu-Ting Su) ； 陳馥萱(Fu-Hsuan Chen)

《弘光學報》 83期 (2019/03) Pp. 39-49

https://doi.org/10.6615/HAR.201903_(83).0003

摘要

胎兒死亡婦女的哀傷雖漸漸受到重視，但懷孕16週以上婦女常須面對的產後退奶問題仍未被關注；退奶的方式包括藥物及非藥物，一般而言藥物退奶的效果較佳，但胎兒死亡婦女常認為自己的身體狀況不佳是胎兒死亡的肇因，也害怕藥物對身體有害，因此坐月子期間的台灣產婦較易選擇非藥物方式的「自然退奶」，可是坐月子的本質強調避「寒」趨「熱」、且以食補為主，不能用冰或用冷，這些都可能影響自然退奶，由於實證性的自然退奶文獻甚少且過舊，我國的護理人員僅能以教科書中的內容，建議產婦減少進補及水分攝取、食用生麥芽水及韭菜等膳食退奶，但對細節不清楚，這些建議應用在產婦身上的成效也不清楚，由於脹奶的處理攸關著胎兒死亡產婦的哀傷調適，產科護理人員需要更了解非藥物退奶之照護，才能縮短脹奶不適所引發的哀傷，本文擬整理現有的非藥物退奶文獻，並據以提出對胎兒死亡婦女的非藥物退奶照護與研究建議，以提升胎兒死亡產婦的身心照護品質。

關鍵字

乳房充盈 ； 非藥物退奶 ； 刮痧 ； 胎兒死亡

並列摘要

Grieving mothers who experience perinatal loss is getting more and more attention recently. However, lactation suppression in the women had not been paid attention yet. Lactation suppression could be pharmacologic or non-pharmacologic, and postpartum women in Taiwan prefer non-pharmacologic ways or natural ways for health. However, ＂doing-the-month＂ emphasizes food supplement and avoiding ＂coldness＂ and tends to be ＂hot＂. Due to the paucity of empirical studies in natural lactation suppression, and the mechanism is not clear enough, the accurate instructions are unclear either, nursing staff can only advise women with traditional way, such as decrease fluid intake, take raw malt water and leeks etc. Because breast engorgement will impact the psychological adaptation of those mothers, nursing staffs need to know more about non-pharmacologic lactation suppressions. This article tries to explore the current non-pharmacologic methods for suppress lactation, and provide advice for caring perinatal loss, hoping to enhance the quality of physical and psychological care of women with perinatal loss.

並列關鍵字

engorgement ； Gua-Sha ； fetal death ； nonpharmacologic lactation suppression

參考文獻

林素瑛、高美玲、李佳琳、李絳桃(2008)‧陰道生產之產婦首次泌乳時間及其相關因素‧實證護理，4(4)，257-266。doi: 10.6225/JEBN.4.4.257

張玉欣(1997)‧產後退乳回奶的食療偏方‧中國飲食文化基金會會訊, 3(4)，9-10。doi:10.6644/qfcdcb.1997.03.04.03

鄭兆君(2015)‧坐月子期間飲食與中藥材之應用‧長庚科技學刊，22， 33-40。doi:10.6192/cgust.2015.6.22.4

AlSaad, D., Awaisu, A., Elsalem, S., Abdulrouf, P. V., Thomas, B., & AlHail, M. (2017). Is pyridoxine effective and safe for post-partum lactation inhibition? A systematic review. Journal of Clinical Pharmacy and Therapeutics, 42(4), 373-382. doi:10.1111/jcpt.12526

Bernard, N., Jantzem, H., Becker, M., Pecriaux, C., Bénard-Laribière, A., Montastruc, J. L.,…Vial, T. (2015). Severe adverse effects of bromocriptine in lactation inhibition: A pharmacovigilance survey. BJOG : An International Journal of Obstetrics and Gynaecology. 122(9). 1244-1251. doi: 10.1111/1471-0528.13352.