花蓮地區母嬰親善措施與住院期間母乳哺育之關聯性研究

A Study of Relationship Between Mother-Baby Intimacy and Breastfeeding

推動母嬰親善醫院認證是衛生署國民健康局的重要工作項目，然而國內探討各項母嬰親善措施與母乳哺育之研究仍不多。本研究欲探討各項母嬰親善措施與住院期間母乳哺育之關聯性，並了解母嬰親善措施的預測能力。採描述關聯之研究，於花蓮某母嬰親善醫院進行問卷調查，共138位是月生產且無嚴重併發症之產婦，以SPSS14.0進行描述性統計、卡方檢定、獨立T檢定及Logistic迴歸等統計分析。結果發現全母乳哺育產婦哺乳知識分數顯著高於非全母乳哺育產婦，採行母嬰同室、依嬰兒需求哺乳產婦與全母乳哺育有顯著關聯性，產後半小時哺乳、不提供奶瓶或奶嘴與全母乳哺育無顯著關聯性，依Logistic迴歸模式進行分類預測，整體正確率為91.3%。為協助產婦哺餵母乳，護理人員應加強產婦在哺乳相關知識之衛教，教導產婦哺乳姿勢技巧，鼓勵採行母嬰同室，並教導產婦依嬰兒需求哺乳，雖然乳頭混淆與母乳哺餵之間的關係仍未經證實，但產婦仍應避免奶嘴與奶瓶的使用。

Promotion of mother-baby intimacy through breastfeeding for the accreditation of hospital is a major project to the National Bureau of Health. However, there were not many studies with statistical data about the relationship between mother-baby intimacy and breastfeeding at the hospitals in Taiwan. This study explored the relevance between the theoretical knowledge on breastfeeding and the measurement of mother-baby intimacy at the bedside of the hospital, thereafter, to understand the effects of the variables predicted by the authors on mother-baby intimacy. The study was by means of a survey and data analysis at a hospital providing care for mother-baby intimacy in Hualien, a city located in the eastern Taiwan. We recruited a total of 138 healthy postpartum mothers for data collection during each participant’s staying in the hospital. Data were analyzed via descriptive statistic, χ^2test, independent t-test and logistic regression using SPSS 14.0. The knowledge on breastfeeding in the group with exclusive breastfeeding was significantly higher than in the group with partial breastfeeding. Breastfeeding by baby's demand and a 24 hour rooming-in was significantly associated with the exclusive breastfeeding group. The group with table-feeding without provision of pacifiers or bottles was not significantly associated compared to the group with exclusive breastfeeding. Based on analysis of logistic regression, the correct percentage of classification was 91.3%. To assist postpartum mothers in breastfeeding, nurses should educate the mothers about knowledge and skills on breastfeeding, encourage the mothers to adopt 24 hour rooming-in and breastfeeding by baby's demand. However, the association between nipple confusion and breastfeeding has not been well examined. The mothers should avoid using pacifiers or bottles.