產後初期母親哺餵母乳自覺成效之相關因素探討

Factors Related to Mothers' Perception on Breastfeeding Effectiveness during Early Postpartum Period

背景：產後初期有許多問題導致母親早期停止哺餵母乳，母親自覺哺餵母乳的有效性能幫助提升其育兒的信心。而醫護人員早期評估、提供有效的支持，是幫助母親成功及持續哺餵母乳的重要關鍵。目的：探討產後初期母親哺餵母乳自覺成效之影響因素。方法：應用中文版「產後初期哺餵母乳調查（The Beginning Breastfeeding Survey, BBS）量表」，於台灣某醫學中心產後病房共收案440位健康產婦，有效樣本420人。結果：研究結果發現：（1）產後初期母親感受到哺餵母乳自覺成效屬中上程度，母親能感覺到嬰兒吸吮是強而有力，經由哺餵母乳時之互動能與寶寶產生良好的親密感，但母親仍感到乳頭疼痛（86.43%）。（2）產後初期母親哺餵母乳感受到的社會支持程度屬於中上程度，社會支持程度以來自護理人員的平均得分最高，其次依序則為先生、醫師、母親、朋友、婆婆、親戚。（3）產後初期母親哺餵母乳的社會支持與哺餵母乳自覺成效呈正相關。（4）產後初期母親自覺感受到中上程度之產後疲倦，而剖腹生產之產婦其產後疲倦程度高於以陰道生產者。（5）產後初期母親之產後疲倦與母親哺餵母乳自覺成效呈負相關。結論／實務應用：本研究結果可提供護理人員進行臨床教育及作為哺餵母乳推動政策之參考。

Background: During early postpartum period, various factors cause women to early cessation of breastfeeding, one of which is perception of breastfeeding ineffectiveness. To provide early assessment and support by medical staffs is the key to sustaining breastfeeding. Purpose: To explore influencing factors of mothers' breastfeeding effectiveness during early postpartum period. Methods: This study enrolled 440 healthy mothers hospitalized in the postpartum ward in a medical center in the central Taiwan. The effective sample size was estimated to be 420. During postpartum period, the Chinese version of the Beginning Breastfeeding Survey (BBS) was applied. Results: The main findings included: (1) Mothers felt upper moderate levels of breastfeeding effectiveness. Mothers can sense strong suckling of the infants and feel the intimacy due to interaction on breastfeeding, despite feeling pain on nipples (86.43%). (2) Mothers felt upper moderate levels of social support for breastfeeding. Social support came from, in descending order of mean scores, nursing staffs, husbands, doctors, mothers, friends, mother-in-law and other relatives. (3) The levels of social support were positively correlated with maternal perceptions of breastfeeding effectiveness. (4) Mothers felt upper moderate levels of fatigue. The levels of postpartum fatigue were greater among those choosing Caesarean section than vaginal delivery. (5) The levels of postpartum fatigue were negatively correlated with maternal perceptions of breastfeeding effectiveness. Conclusions/Implications for Practice: Our results are useful for education on nursing staffs and policymaking on breastfeeding promotion.