照護一位剖腹產初產婦成功以母乳哺餵高膽紅素血症嬰兒之護理經驗

The Nursing Experience in a Caesarean Section Primiparous Mother who Successfully Breastfeed Her Hyperbilirubinemia Infant

本報告描述一位剖腹產初產婦及高膽紅素血症新生兒家庭成功哺餵母乳的經驗。藉由觀察、身體評估及會談等方式收集資料，並運用Gordon十一項健康功能模式，評估產婦的主要護理問題包括：急性疼痛、焦慮、及無效性母乳哺餵等。產後初期，產婦因傷口疼痛、管路留置，且新生兒需照光治療，一度想放棄哺餵母乳。藉由照護團隊從旁協助、促進舒適，主動提供哺乳資訊、給予支持，持續激勵哺乳意願。同時，協助父親分擔照護產婦及新生兒的責任，強化父職角色，並在返家後持續提供關懷。最終，產婦成功克服哺乳初期的難題，成功以母乳哺餵新生兒。希望藉由照護此產婦的經驗，與相同領域的護理同仁分享，儘早提供欲哺餵母乳的媽媽們完善的照護及協助。This case report described the nursing experience of a first-time mother who gave birth to an infant with hyperbilirubinemia undergoing phototherapy and her family members. As a consequence of hospitalization for phototherapy, the woman interrupted the process of breastfeeding.Based on the Gorden's eleven-functional health pattern assessments, health problems including acute pain, anxiety and interrupted breastfeeding were identified through observation, physical assessment and interviews. In view of the above-mentioned health problems, the author provided direct nursing care to relieve acute pain, such as providing information about breastfeeding of hyperbilirubinemia infants, sharing experience, and giving support. At the same time, the primary nurse assisted the father to share the responsibility of maternal and newborn care to strengthen the role of being a fatherhood. The results of the nursing care helped the mother and her family overcome the physical and psychological barriers, and successfully breastfeed their baby.In this case report, the author shared positive experiences in helping the mother who was willing to breastfeed her hyperbilirubinemia infant. Caring, emotional support, teaching and providing bedside assistance as soon as possible could be key elements of successful breastfeeding.