乳頭混淆與母乳哺餵之相關文獻探討

Nipple Confusion and Breastfeeding: A Literature Review

WHO/UNICEF所提倡的成功哺餵母乳十步驟，其中步驟六及步驟九明確的陳述非醫療需要應避免配方奶的添加以及人工奶嘴的使用。而添加配方奶的後果除了影響泌乳機轉之外，若採取人工餵食，可能造成嬰兒的乳頭混淆。母嬰親善醫院建議使用杯子餵食、及避免奶嘴與奶瓶的使用，以防止嬰兒發生乳頭混淆，然而，乳頭混淆與母乳哺餵之間的關係仍未經證實。究竟乳頭混淆這個抽象的概念是否存在？本文章旨在藉由文獻查證，發展一理論架構，探索三種人工餵養方式，如：奶嘴、奶瓶餵食及杯子餵食與乳頭混淆的關係。希冀藉由本文章，提供臨床者照護此類案例時的參考，並刺激決策者及實務者共同思索此一議題。

Among the ten steps to successful breastfeeding advocated by the WHO and UNICEF, steps six and nine clearly state that formula supplementation and pacifier use, except when medically necessary, should be avoided. Early formula supplementation may not only interfere with the mother's lactation but also result in nipple confusion on the part of the baby. To avoid nipple confusion, the encouragement of cup feeding and the non-provision of pacifiers or bottles are required nursing practice in baby-friendly hospitals. However, the relationship between nipple confusion and the duration of breastfeeding has not been well examined. The purpose of this paper is to explore the relationships between three methods of feeding (i.e. pacifier, bottle feeding, and cup feeding), nipple confusion, and duration of breastfeeding. A hypothetical framework is proposed to explain these relationships on the basis of a review of the literature.