探討母乳哺餵持續的脈絡─以母乳支持團體的觀點分析

Exploring the Continuum of Breastfeeding Experience: From Participating of Breastfeeding Support Peer Group

黃齡儀(Ling-Yi Huang)

指導教授 ： 官晨怡

國立臺灣大學/公共衛生學院/公共衛生碩士學位學程/碩士(2020年)

https://doi.org/10.6342/NTU202002680

摘要

世界衛生組織建議母乳哺餵應維持至出生後六個月並配合補充食物超過兩年(WHO, 2002)，2001年政府依據世界衛生組織與聯合國兒童基金會（WHO／UNICEF）提出的成功哺餵母乳十大措施標準，開始推動母嬰親善醫療院所認證。成功哺餵母乳十大措施中，第十項為幫助建立哺育母乳支持團體，並於母親出院後轉介至該團體，近年來母乳支持團體迅速增加，顯見以母乳支持團體協助產婦哺乳已成為趨勢。當政府、醫療、民間同在母乳支持團體經營母乳議題，團體性質看似類似，卻因發展脈絡、立場不同而有不同樣態，且一般母乳哺育衛教著重於產後住院期間與月子期間，對於第一線衛生單位持續推廣方面較少著墨，故想了解第一線衛生單位對於母乳哺育之推廣經驗。
研究者以健康服務中心辦理之母乳支持團體作為田野，透過參與觀察的方式了解母乳支持團體講座中的運作過程，以延伸本臺灣本土母乳支持團體實務面相關資訊，作為調整深度訪談細項的參考。研究以半結構式的訪談，訪談對象為健康服務中心母乳支持團體的參與者。訪談參與者自懷孕、生產至今有關母乳哺育的艱困歷程與其中感受到的家庭與社會中不到位的支持經驗，與參與母乳支持團體的過程，從不同角度中了解母乳支持團體的重要性以提供衛生單位辦理母乳支持團體的建議，研究中發現母乳支持團體雖然可以給予哺乳婦女同儕的幫助，甚至形成一個新的小型支持團體於生活中提供支持，進而持續哺乳，衛生單位辦理母乳支持團體需要與過去不同的資源整合策略，如結合國際母乳協會等民間團體，此外，也指出成功的母乳哺餵需要整體社會的努力，需改善整體社會民眾對母乳哺餵認知不足的現狀，並持續調整既有母乳哺餵政策，使其更貼近母乳哺餵媽媽的需求。

關鍵字

母乳哺育 ； 母乳支持團體 ； 健康服務中心

並列摘要

The World Health Organization recommends breastfeeding to be maintained up to six months after birth and with supplementary food for more than two years (WHO, 2002). In 2001, the Taiwanese government started the certification for mother-baby friendly care hospitals based on the top 10 measures for successful breastfeeding recommended by the World Health Organization and the United Nations Children's Fund (WHO/UNICEF). The tenth is to help form a breastfeeding peer support group and refer it to a mother after being discharged from a hospital. In recent years, breastfeeding peer support groups have increased rapidly and significantly helped women to breastfeed successfully. Health units, medical systems, and local groups all devote to improve breastfeeding time in the form of "Mom Helps Mother." The government, medical care, and private support groups all hold their breastfeeding peer support groups. But the nature of the group varies with the specific contexts and standpoints of the host organizations.
Moreover, most breastfeeding education focuses on postpartum hospitalization and the first month of the baby's birth. The experiences in continuous promotion breastfeeding in health units, such as the District health center, receives little attention. This research attempts to explore the breastfeeding promotion experiences in health units. The researcher conducts participant observation in the breastfeeding peer support groups, and in-depth interviews to understand the women's experiences in the groups. This research aims to provide suggestions to the health units, which can then maximize the effects of breastfeeding promotion under limited resources, improve maternal and child health, and create a friendly environment for mother and baby.

並列關鍵字

Breastfeeding ； breastfeeding peer support group ； District health center

參考文獻

Barclay, L., Lupton, D. (1999). The experiences of new fatherhood: a socio‐cultural analysis. Journal of advanced nursing, 29(4), 1013-1020.

Chuang, C.-H., Chang, P.-J., Chen, Y.-C., Hsieh, W.-S., Hurng, B.-S., Lin, S.-J., Chen, P.-C. (2010). Maternal return to work and breastfeeding: a population-based cohort study. International journal of nursing studies, 47(4), 461-474.

Corbin, J., Strauss, A. (2014). Basics of qualitative research: Techniques and procedures for developing grounded theory: Sage publications.

Corbin, J. M. (1990). Basics of qualitative research: Grounded theory procedures and techniques: Sage.

Dennis, C.-L., Hodnett, E., Gallop, R., Chalmers, B. (2002). The effect of peer support on breast-feeding duration among primiparous women: a randomized controlled trial. Cmaj, 166(1), 21-28.