如何協助哺乳母親維持泌乳

How to Support Lactating Mothers in Maintaining Milk Production

母乳哺育被視為嬰幼兒營養的黃金標準與基本人權，對母嬰雙方的短期與長期健康皆具深遠影響。世界衛生組織與聯合國兒童基金會強烈建議嬰兒出生後應純母乳哺育6個月，並在添加副食品的情況下持續哺育至兩歲或以上。然而，在臨床實務中，母嬰分離、早產、新生兒或母親疾病住院、乳暈水腫或泌乳延遲等挑戰，常導致母親面臨奶水不足的困境，進而提早中斷母乳哺育。護理人員在支持與衛教母親維持泌乳上扮演著不可或缺的關鍵角色。本文旨在探討維持泌乳的核心生理機轉，並基於最新實證醫學文獻，系統性地統整早期肌膚接觸的成效、手擠乳與吸乳器的最佳應用時機與技巧、反向施壓按摩法、放鬆療法與排乳反射的刺激，以及催乳藥物的使用規範與母乳儲存之實證指引。期能提供臨床護理人員全面且具實證基礎的參考，以制定個別化的護理計畫，協助母親成功克服泌乳障礙。

Breastfeeding is considered the gold standard for infant nutrition and a basic human right, with profound impacts on the short- and long-term health of both mother and infant. The World Health Organization (WHO) and UNICEF strongly recommend exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with the addition of complementary foods for up to two years or beyond. However, in clinical practice, challenges such as mother-infant separation, premature birth, hospitalization of the newborn or mother, areolar edema, or delayed lactogenesis often lead mothers to face the dilemma of insufficient milk supply, subsequently resulting in early cessation of breastfeeding. Nursing professionals play an indispensable and critical role in supporting and educating mothers to maintain lactation. This article aims to explore the core physiological mechanisms of maintaining lactation and, based on the latest evidence-based medical literature, systematically synthesize the effectiveness of early skin-to-skin contact, the optimal timing and techniques for hand expression and breast pump usage, Reverse Pressure Softening, relaxation therapies, and stimulation of the let-down reflex, as well as guidelines for the use of galactogogues and evidence-based guidelines for breast milk storage. It is hoped to provide clinical nursing professionals with a comprehensive and evidence-based reference to develop individualized nursing care plans and assist mothers in successfully overcoming lactation barriers.