| Summary: | 碩士 === 長庚大學 === 護理學研究所 === 96 === Insufficiency of milk supply is the main reason for early breast feeding termination of breastfeeding, especially when milk supply insufficiency occurs during early postpartum. The aims of this study were to explore the relative factors that may influence a decrease in early milk secretion in post partum women and their perception of lactation onset. A study was carried out at a regional teaching hospital located in Northern Taiwan.
Two hundred and seventy-five healthy mothers and their full-term infants were eligible for enrollment. We used structured questionnaires, interviews and chart review to obtain the information during the women’s hospital stay. The information gathered included perception of lactation onset and the relative factors involving the amount of milk secreted. The SPSS/Windows 14.0 software was used to analyze the data. Logistic regression analysis was used to investigate the relative and prediction factors.
The results revealed that the mean hours for the perception of lactation onset were 78.98, and the average score for amount of milk secreted was 110.10. There was a significant correlation between the amount of milk secreted and the perception of lactation onset (r=-.186).
Parity and exclusive breastfeeding at 48 hours after giving birth, the significant explanatory factors identified in this study, explained 15.8% of the perception of lactation onset in postpartum women that delivered via vagina. The factors that predicted delay of lactation onset were parity, the period of stage II, and perineal wound pain. Infant birth weight, use of artificial feeding, breastfeeding frequency in the first 24 hours after giving birth, the perineal wound pain score at third day postpartum, and the use of epidural analgesia or pethidinde for pain control, were the five significant explanatory factors identified in this study. These factors explained 25.3% of the perception of lactation onset in postpartum women who delivered via vagina.
The time period for nothing by mouth post-operation, parity, the use of artificial feeding, breastfeeding frequency in the first 24 hours after giving birth, breastfeeding frequency at 49 to 72 hours postpartum, the significant explanatory factors identified in this study explained 26.5% of the perception of lactation onset in postpartum women who experienced scheduled cesarean delivery. The factors predicted to delay the onset of lactation in women who experienced scheduled cesarean delivery were parity, the frequency of artificial feeding on the first day postpartum and the breastfeeding frequency at the third day postpartum. The use of artificial feeding at 49 to 72 hours postpartum, the use of epidural analgesia or pethidinde for 3 days, the breastfeeding frequency in the first 24 hours postpartum and maternal nipple type were the significant explanatory factors identified in this study, and explained 33.7% of the perception of lactation onset in postpartum women who experienced scheduled cesarean delivery.
The study findings revealed that postpartum women’s instinct for breastfeeding would be restrained and further cause milk supply insufficiency syndrome if the hospital introduced an excess of medical practices. We hope these findings could help physicians’ to understand what factors would influence postpartum women’s lactation and promote them to screen the high risk population for insufficiency milk supply syndrome. Moreover, to arouse policy makers to face up to the problems in birthing practices and promote to creating a natural birthing environment.
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