早產兒母奶哺餵及奶瓶餵食對生理指標及住院天數的影響

本研究目的旨在比較早產兒不同哺餵方式（直接哺餵、奶瓶餵食）對生理指標（心跳、呼吸、血氧）及住院天數的影響，作為早產兒哺餵方式建議。研究樣本為南部某醫學中心，出生妊娠週數小於37週、收案時矯正週數34週以上、無重大先天缺陷疾病之早產兒，且經母親同意並填妥同意書後收案，樣本共31位。採類實驗法的重複測量設計，每對母嬰觀察時段選擇在同一天12N-5pm未進行任何醫療措施的時段，依據評價設計介入餵食，每次觀察一對母嬰。前15位個案先直接母奶哺餵再奶瓶餵食，後16位個案先奶瓶餵食再直接母奶哺餵。觀察員依紀錄表紀錄早產兒在直接母奶哺餵及奶瓶餵食餵奶前、餵奶開始、餵奶中15分鐘、餵奶後、餵奶後30分鐘、60分鐘的生理監測器所監測得到的生理指標變化。資料以SPSS 17.0 版進行分析檢定。研究結果發現，心跳指標；在餵奶前、餵奶開始、餵奶中15分鐘、餵奶後、餵奶後30分鐘、60分鐘直接母奶哺餵及奶瓶餵食一樣穩定，惟呼吸指標；在餵奶開始，直接母奶哺餵較奶瓶餵食時更穩定，血氧指標；則在餵奶開始、餵奶中15分鐘直接母奶哺餵較奶瓶餵食更穩定，且直接母奶哺餵住院天數較奶瓶餵食住院天數短，故本研究建議早產兒如母親有哺餵母奶意願以直接母奶哺餵為宜。

關鍵字

早產兒；母奶哺餵；奶瓶餵食；生理指標；住院天數

並列摘要

The purpose of this study is to determine the impact of different feeding methods (direct breast feeding and bottle feeding) on physiological parameters (heart rate, respiration rate, blood oxygen saturation), and length of hospital stay among premature baby for future references when feeding premature babies. Case and data were collected from a medical center in Southern Taiwan. All premature babies meet the following criteria: 1. Gestational age below 37 weeks. 2. Corrected age above 34 weeks when case received. 3. No major congenital defect at birth. 4. Enrolled under written agreement by case’s mother. Case number came to a total of 31 cases. Experimental data were collected from a repeated observation and measure of all 31 cases on the same day during the 12-5pm period with no other medical intervention. Each case were observed and evaluated individually, where the first 15 cases will breast feed first and then bottle-feed, while the other 16 cases will bottle feed first and then breast feed. The observer will measure and record all physiological parameters changes at the following stages: before the feeding (by breast or bottle), during the feeding after 15mins, post feeding, 30 minutes post feeding and 60 minutes post feeding. The data was analyzed and tested with SPSS 17.0. The result showed no significant difference in terms of heart rates, where the heart rate measurements were similar and stable throughout the whole feeding process from before feeding till 60 minutes post feeding. However the respiration rate and blood oxygen saturation shows a relatively more stable measurement at beginning and after feeding 15 minutes (blood oxygen measurement only) with direct breast feeding when compared to bottle feeding. The length of hospital stay is also shorter for premature babies with direct breast-feeding. Therefore in conclusion of this study, breast-feeding is recommended for the mothers of premature babies.