營造新生兒中重度病房的親善哺乳環境

Creating Baby-Friendly Neonatal Intensive Care Units

迎接健康的新生命是大多數準父母的期待，如果新生兒需入住加護單位接受治療，對父母及其家庭成員都是重大衝擊。本文遵循世界衛生組織／聯合國兒童基金會2009年「愛嬰醫院」最新更正版本為核心架構，檢視中重度新生兒母乳哺育之相關實證研究，說明哺乳對中重度新生兒及其家庭的重要性；並提供建構新生兒中重度病房親善哺乳環境之建議，以及說明執行營造中重度新生兒病房親善哺乳環境之十措施三原則，尤其強調持續無限制的袋鼠式護理、家庭中心空間規劃、即時有效的擠奶與監測計畫、尊重女性個別需求的軟硬體環境建構。本文可作為國內建構新生兒中重度病房親善哺乳環境之實務建議的參考依據。

Most expectant parents anticipate giving birth to a healthy newborn. Admission of a neonate to a neonatal intensive care unit (NICU) is thus nearly always a significant and negative shock to parents and family members. We derived core concepts for this article from the World Health Organization/United Nations Children's Fund (WHO/UNICEF)'s Baby Friendly Hospital Initiative: Revised, updated, and expanded for integrated care (2009). This framework document advocates expanding to NICUs guidelines that were originally developed for maternity units. This paper reviews the importance of breastfeeding to the mother-baby dyad and family integration. We suggest how to build a breastfeeding-friendly environment within the NICU using 10 steps that adhere to the NEO-BFHI's three ”Guiding Principles”. The proposed environment gives special emphasis to providing continued and unlimited kangaroo care, creating a family-centered NICU design, implementing an effective milk expression and monitoring plan, and respecting mothers' individual needs. Suggestions are provided as a reference to government policymakers and medical centers to facilitate the creation of breastfeeding-friendly environments in NICUs.