目的探讨母乳喂养门诊的延续性指导对婴幼儿生长发育及产妇出院后母乳喂养状况的影响。方法选取2018年1—12月于南京市妇幼保健院儿童保健门诊就诊的1月龄内婴儿及其母亲240例,随机分为干预组与对照组。对照组婴儿只接受儿童保健门诊常规体检,干预组在对照组基础上继续转入母乳喂养门诊,并由国际认证泌乳顾问(IBCLC)对产妇母乳喂养给予延续性的指导干预。对比两组产妇产后1、3、6和12个月母乳喂养情况及两组婴儿的健康状况。结果两组产妇产后1个月时纯母乳喂养率对比差异无统计学意义(P> 0.05);干预组产后3、6个月的纯母乳喂养率和12个月的母乳喂养率高于对照组,母乳喂养持续时间长于对照组,差异均有统计学意义(P<0.05);干预组婴儿3、6月龄时的身高、体重和BMI均高于对照组,差异有统计学意义(P<0.05);干预组产妇产后3个月时的自我效能在技巧维度和内在思考维度得分均高于对照组,产后6个月时技巧维度得分高于对照组,差异均有统计学意义(P<0.05)。结论母乳喂养门诊开展延续性指导可明显提高产妇出院后纯母乳喂养率,增强产妇自我效能,并延长母乳喂养持续时间。

Objective To explore the influence of continuous guidance of breastfeeding on infant growth and development and breastfeeding status after discharge.Methods 240 cases one month old infants who were treated at the Children's Health Clinic of Nanjing Maternal and Child Health care Hospital from January 2018 to December 2018 and their mothers were randomly divided into intervention group and control group. The infants in the control group only received routine physical examination, while the intervention group received routine physical examinations and continuous breastfeeding instructions provided by IBCLC( International Certified Lactation Consultant). The breastfeeding situation of the two groups at 1, 3, 6 and 12 months after delivery and the health status of the infants in the two groups were compared.Results There was no significant difference between the two groups in the rate of exclusive breastfeeding at 1 month after delivery(P> 0. 05). The exclusive breastfeeding rates at 3,6 months and the breastfeeding rate at 12 months in the intervention group were higher than those in the control group(P< 0. 05). The duration of breastfeeding in the intervention group was longer than that in the control group(P< 0. 05). The height, weight and BMI of infants in the intervention group at 3 and 6 months were higher than those in the control group(P< 0. 05). The scores of self-efficacy of the mothers in the intervention group were higher than those of the control group in terms of skills and internal thinking at 3 months postpartum(P<0. 05), and the scores of skill dimensions at 6 months postpartum were higher than those of the control group(P< 0. 05).Conclusion Continued guidance in breastfeeding clinics can significantly increase the rate of exclusive breastfeeding after discharge from hospital, enhance maternal self-efficacy, and extend the duration of breastfeeding.