ABSTRACT
Objective:To analyze the influence of epidural labor analgesia on neonatal breast-seeking behavior and first breastfeeding.Methods:This study was an observational study. According to the cross-sectional study formula and inclusion and exclusion criteria, 150 cases of puerperas and their full-term infants who underwent vaginal delivery in the Affiliated Hospital of Southwest Medical University from March to September 2020 were included as the research objects, and the time of breast searching behavior in newborn crawling was observed and recorded. According to whether epidural analgesia was used or not, the patients were divided into analgesic group and non-analgesic group (the specific names of the two groups), and the outcome variables were analyzed.Results:There were 81 cases of successful breast crawl, 69 cases of failure, including 94 cases of epidural analgesia, 56 cases of non-epidural analgesia. Epidural analgesia had no effect on breast crawl and the time of breast searching behavior ( P>0.05). For puerperas with epidural analgesia, the total score of Breastfeeding Assessment Tool (IBFAT) and the scores of its four dimensions such as feeding time, foraging, sucking and nipple holding behavior were 9(7, 10), 3(2, 3), 2(2, 3), 2(1, 2), 2(1, 2), which lower than those non-epidural analgesia puerperas, which were 10(8, 10), 3(3, 3), 3(2, 3), 2(2, 2), 2(1, 2), the differences were statistically significant ( Z values were -6.36- -4.32, all P<0.05). Conclusions:When epidural analgesia is used clinically, medical staff need to seize the best time of drug use, pay attention to continuous monitoring of drug use duration and dosage, while exerting drug analgesia effect, it is also necessary to minimize adverse outcomes and reduce the impact of analgesics on breastfeeding.
ABSTRACT
Objective:To investigate the effect of neonatal breast crawling exercise on breastfeeding and psychological state of primiparas who delivered vaginally.Methods:Using convenience sampling method, 86 pairs of normal term infants and mothers who delivered vaginally in the First People′s Hospital of Yancheng from January 2019 to January 2020 were selected as the research objects, and divided into experimental group and control group according to the random number table method, there were 43 pairs in each group. The control group was given routine postpartum care, while the experimental group was given neonatal breast crawling exercise on the basis of routine postpartum care. The time of initiation of lactation, the success rate of first breastfeeding and the score of first Breastfeeding Assessment Tool (BAT) were compared between the two groups. The rates of exclusive breastfeeding, the scores of Breastfeeding Self-efficacy Scale Short Form (BSES-SF) and the scores of Edinburgh Postnatal Depression Scale (EPDS) were compared between the two groups at 72 h and 42 d after delivery respectively.Results:The time of initiation of lactation was (48.36 ± 6.12) h in the experimental group, which was significantly earlier than that in the control group(52.86 ± 7.29) h, the difference was statistically significant (t=3.08, P<0.05). The success rate of first breastfeeding and the BAT scores of the experimental group were 88.1% (37/42) and (9.74 ± 1.33), respectively, which were significantly higher than those in the control group 69.8% (30/43) and (8.84 ± 1.60), the differences were statistically significant (χ 2=4.28, t=2.82, both P<0.05). At 72 h and 42 d after delivery, the rate of exclusive breastfeeding were 42.9%(18/42) and 86.49%(32/37) in the experimental group, significantly higher than those in the control group 20.9% (9/43) and 60.00% (24/40), the differences were statistically significant (χ 2=4.71, 3.93, both P<0.05). At 72 h and 42 d after delivery, the BSES-SF scores were (38.48 ± 6.34) and (45.43 ± 11.45) in the experimental group, which were significantly higher than those in the control group (35.21 ± 4.87) and (40.10 ± 10.82), the differences were statistically significant (t=2.66, 2.10, both P<0.05); the EPDS scores were (5.52 ± 1.53) and (7.38 ± 2.25) in the experimental group, which were significantly lower than those in the control group (6.26 ± 1.63) and (8.73 ± 2.39), the differences were statistically significant (t=2.13, 2.54, both P<0.05). Conclusions:Neonatal breast crawl is an effective way to promote the breastfeeding. It can also enhance maternal confidence and alleviate maternal psychological status.