一次哺乳母乳摄入量与吸吮时间相关性及其他影响因素的研究

Relationships of breast milk intake during one breastfeeding session with sucking time and other determinants

摘要

目的 研究一次哺乳母乳摄入量与吸吮时间的相关性,并探讨其他相关的影响因素。方法 2015年6月至7月在深圳市罗湖区妇幼保健院儿童保健门诊开展母乳喂养摄入量横断面调查,招募足够1~12月龄婴儿及其母亲,观察一次正常哺乳过程,并进行问卷调查.严格定义并记录哺乳时婴儿吸吮时间,使用称重法获得一次哺乳母乳摄入量,采用问卷调查母子健康信息和喂养情况.使用多元线性逐步回归法建立包括吸吮时间等因素影响一次哺乳母乳摄入量和摄入平均速率的模型,并进行统计分析。结果 经筛选共纳入150对研究对象进行分析.一次哺乳母乳摄入量与吸吮时间呈直线相关(r=0.57,P<0.05).单因素分析结果显示,所有因素的组间吸吮时间差异均无统计学意义(P>0.05),右侧哺乳乳房的一次哺乳母乳摄入量明显高于左侧[(61.14±32.14)g vs.(49.88±29.35)g,t=2.24,P<0.05];右侧哺乳乳房的母乳摄入平均速率明显高于左侧[(8.12±4.48)g/min vs.(6.66±3.38)g/min,t=2.67,P<0.05),母亲为家庭主妇/休产假的母乳摄入平均速率明显高于有工作者[(8.02±4.22)g/min vs.(6.60±3.65)g/min,t=-2.17,P<0.05],5~12月龄婴儿的母乳摄入平均速率明显高于1~4月龄婴儿[(8.15±4.25)g/min vs.(6.67±3.70)g/min,t=-2.27,P<0.05].多因素分析结果显示,在1~4月龄婴儿中,吸吮时间、婴儿体重和母亲右侧乳房哺乳与一次哺乳母乳摄入量均呈正相关(R值分别为0.61、0.22、0.36,P<0.05),婴儿体重和母亲右侧乳房哺乳与母乳摄入平均速率均呈正相关(R值分别为0.22、0.27,P<0.05);在5~12月龄婴儿中,吸吮时间与一次哺乳母乳摄入量呈正相关(R=0.61,P<0.05),婴儿体重与母乳摄入平均速率呈正相关(R=0.26,P<0.05).婴儿性别、婴儿年龄、婴儿出生体重,以及24h母乳喂养频率、母亲体质量指数、产次、母亲年龄、母亲职业均对两个年龄组一次哺乳母乳摄入量和母乳摄入平均速率均无显著性影响(P>0.05)。结论 影响一次哺乳母乳摄入量的显著性因素为吸吮时间和婴儿体重,在小年龄段婴儿中还包括哺乳乳房侧.需要进一步研究影响母乳摄入量的其他因素,如母乳喂养类型和哺乳间隔等.

Abstract

Objective To explore relationships of one-time breast milk intake with sucking time during one breastfeeding session, and to identify other determinants that influence breast milk removal of the infant. Methods A cross-sectional survey was conducted in Child Health Care Clinic of Luohu District Maternity and Child Health Hospital of Shenzhen City from June to July, 2015. Infants aged from full 1 month to 12 months and their mothers were recruited. A breastfeeding process of each participating mother was observed. Sucking time was strictly defined and recorded. Breast milk intake volume of the infants was measured in test-weighing method. Information on maternal and infant health and infant's feeding practice were collected by a self-designed questionnaire. Multiple linear stepwise regression was used to establish a model to estimate volume and average velocity of breast milk intake in a breast milk feeding process. The data were analyzed statistically. Results A total of 150 dyads were included in the study. There was a significant linear correlation between sucking time and breast milk intake during one breastfeeding session (r=0.57, P<0.05). Univariate analysis shown that there was no significant difference in sucking time among all factors groups (P>0.05). The infants' breast milk intake from right side of breast during one breastfeeding session was significantly higher than that from left breast (61.14±32.14g vs. 49.88±29.35g, t=2.24, P<0.05). And the average velocity of breast milk intake during one breastfeeding session was significantly higher than the left side of breast (8.12±4.48g/min vs. 6.66±3.38g/min, t=2.67, P<0.05). Furthermore, the average velocity of breast milk intake of the infants during one breastfeeding session from those full-time housewife/in materning leave mothers was significantly higher than those mothers as working (career) women (8.02±4.22g/min vs. 6.60±3.65g/min, t=-2.17, P<0.05). And the average velocity of breast milk intake of the those infants aged 5-12 moths during one breastfeeding session was significantly higher than those infants aged 1-4 months (8.15±4.25g/min vs. 6.67±3.70g/min, t=-2.27, P<0.05). Multi-factor analysis shown that among 1-4-month infants, the sucking time, infant present body weight and right breastfeeding were positively correlated with breast milk intake during one breastfeeding session (R=0.61, 0.22 and 0.36 respectively, all P<0.05). And the infants' present body weight and right breastfeeding were positively correlated with the average velocity of breast milk intake of the infants (R=0.22 and 0.27 respectively, both P<0.05). Among 5-12-month infants, the sucking time was positively correlated to breast milk intake during one breastfeeding session (R=0.61, P<0.05), also, the infants' present body weight was positively correlated with the average velocity of breast milk intake during one breastfeeding session (R=0.26, P<0.05). While the infant's gender, age, birth weight and breastfeeding frequency per day, maternal body mass index (BMI), parity, maternal age and maternal occupation did not significantly influence the breast milk intake and the average velocity of breast milk intake of the infants during one breastfeeding session in both two age groups (all P>0.05). Conclusions Sucking time, infant present body weight and breastfeeding side of breast had significant impacts on breast milk intake during one breastfeeding session. Other influencing factors such as feeding style and breastfeeding intervals should be confirmed in further study.

关键词

母乳喂养 / 吸吮时间 / 母乳摄入量 / 婴儿体重 / 乳房侧

Key words

breastfeeding / sucking time / breast milk intake / infant weight / breast side

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