以嬰兒引導的母乳哺餵提升產後哺乳婦女哺餵舒適度之改善專案

Using the Baby-Led Breastfeeding Program to Improve the Comfort of Postpartum Breastfeeding Mothers

以嬰兒引導的母乳哺餵（baby-led breastfeeding）能讓母嬰有舒適的哺乳姿勢，幫助寶寶摸索學習吸乳，並能降低產婦哺乳時的不適及挫折感。本院護理師在協助產婦床邊哺乳時，發現媽媽常感緊張、不安，哺乳後也會抱怨疲累、腰痠背痛等不適。因此，本專案目的為評量以嬰兒引導的母乳哺餵提升哺乳婦女哺餵舒適度之成效。經觀察及問卷調查發現，造成哺乳婦女哺餵舒適度低的原因：護理人員哺乳技巧不足、哺乳擺位姿勢無法讓哺乳婦女身體放輕鬆、護理指導工具不足。經教育訓練、情境演練、及早執行以嬰兒引導的母乳哺餵、製作多媒體光碟、修訂產後護理指導手冊並製成CD-ROMs／QR codes及修訂母乳哺餵護理指導標準規範等改善策略後，哺乳婦女哺餵舒適度由改善前的59.9％提升到88.3％，效果顯著。此專案結果，可作為醫護單位促進婦女哺乳舒適度的參考。 The baby-led breastfeeding can help mothers and their babies to have a comfortable breastfeeding position and may have more time to learn, which can reduce discomfort and frustration during breastfeeding. We found that breastfeeding mothers often feel nervous, restless, fatigue, backache, and other discomforts. Therefore, the purpose of this project was to evaluate the effectiveness of infant-led breastfeeding to improve breastfeeding comfortably. After the observation, questionnaire survey and analysis, the affecting factors were (1) staff lacked related assistive skills; (2) women failed to take a relaxing breastfeeding position; (3) lack of appropriate breastfeeding instructional tools. Improvement approaches included education and training for improved baby-led breastfeeding related knowledge, situational drills for assistive skills practice, strategies of early initiation of infant-led breastfeeding, revision of the postnatal instruction manuals, production of the CD-ROMs and QR codes for instruction manuals, and revision of the breastfeeding guidelines. As a result, the breastfeeding comfort rate significant increased from 59.9% to 88.3%. The result of the project can be applied to clinical settings to improve breastfeeding comfortably.