| Objective:To investigate the current status of breastfeeding for premature infants at 1 week of birth(during NICU hospitalization)and 3 months of birth(after discharge from hospital),and to analyze the influencing factors,so as to provide theoretical basis for early clinical intervention,in order to improve the rate of breast-feeding premature infants and prolong the maintenance of breast-feeding time.Methods:Using longitudinal study design,premature infants and their mothers hospitalized in neonatal intensive care unit(NICU)of three tertiary hospitals in Fuzhou from October 2019 to October 2020 were included.The survey which included general information,breastfeeding knowledge questionnaire,breastfeeding self-efficacy scale and Edinburgh Postpartum Depression Scale,was investigated at the 1st week and 3th months after birth.SPSS 22.0 software was used to analysis the data.Chi square、rank sum test and t test were used for univariate analysis of the influencing factors between breastfeeding group and non breastfeeding group.The influencing factors with significant differences(P < 0.05)were included in binary logistic regression to analyze the influencing factors of breastfeeding in different periods of premature infants.Results:1.Follow-up completion: A total of 422 pairs of premature infants and their mothers were included.There were 418 valid questionnaires were included in the analysis.In the second survey,4 pairs of premature infants and their mothers loss to follow-up,a total of 414 valid questionnaires were included in the second analysis.The drop rate of follow-up was 1.90%.2.Results of breastfeeding of premature infants.(1)Survey results at 1 week after birth(during NICU hospitalization): Among the 418 valid questionnaires,34 cases were breastfeeding,including 30 cases of exclusive breastfeeding,4 cases of intensive breastfeeding,and the breastfeeding rate was 8.13%;206 cases were mixed feeding,accounting for 49.28%;178 cases were artificial feeding,accounting for 42.59%.(2)Survey results at 3 months after birth(after discharge): Among the 414 valid questionnaires,151 cases were exclusive breastfeeding,the rate of exclusive breastfeeding was 36.47%;139 cases were mixed feeding,accounting for 33.58%;124cases were artificial feeding,accounting for 29.95%.3.Analysis of influencing factors of breastfeeding:(1)Factors influencing breastfeeding of preterm infants at 1 week of birth:univariate analysis results that,Mother’s residence,education level,occupation,family income,breast massage in the early postnatal,whether the breast is blocked,whether to promote lactation,the amount of breast milk,whether to send breast milk,and mother’s depression(incidence is 59.01%)all affected the breastfeeding rate,and the differences were statistically significant(all P < 0.05).Binary logistic regression analysis showed that breast massage in the early postnatal(OR = 0.13,95% CI = 0.022-0.767)and sufficient breast milk(OR = 0.055,95% CI = 0.018-0.174)were favorable factors for breastfeeding.(2)Factors influencing breastfeeding of preterm infants at 3 months of birth:univariate analysis results that,Mother’s age,parity,residence,education level,occupation,mastitis,lactation,maternity leave,breastfeeding self-efficacy,depression(incidence is37.2%)and hospitalization time of premature infants all affected the breastfeeding rate,and the differences were statistically significant(all P < 0.05).Binary logistic regression analysis showed that high breastfeeding self-efficacy(OR =0.233,95% CI = 0.115-0.471)and breastfeeding during hospitalization(OR = 0.105,95%CI = 0.027-0.414)were favorable factors for breastfeeding,while maternal depression(OR = 5.118,95% CI = 2.278-11.499)was a disadvantageous factor for breastfeeding.Conclusion:The rate of breastfeeding for premature infants 1 week and 3 months after birth were both lower than the goal of 50 percent or more breastfeeding rate set in China’s Program for the Development of Children 2011-2020.Adequate amount of breast milk and breast massage in early postnatal are favorable factors for breastfeeding rate for preterm infants at 1 week after birth.The maternal self-efficacy of breastfeeding and the implementation of breastfeeding during the NICU hospitalization of premature infants were the favorable factors for breastfeeding rate at 3 months after birth,while the maternal depression was the unfavorable factors.Therefore,measures should be taken actively during early postnatal to promote favorable factors and reduce unfavorable factors,so as to improve the breastfeeding rate for premature infants at 1 week after birth and promote the breastfeeding of premature infants at 3 months after birth. |
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