哺乳顾问提供的母乳养支持:系统审查和元分析
Curtis J D'Hollander1,2,3, Victoria A McCredie4,5,6, Elizabeth M Uleryk7
1Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
JAMA pediatrics
|March 3, 2025
概括
哺乳顾问 (LC) 的干预显著降低了停止纯母乳养和任何母乳养的风险. 高强度的LC干预和早期产后测量提高了有效性,支持高收入国家的母乳养.
科学领域:
- 公共卫生 公共卫生
- 孕产妇和儿童的健康
- 基于证据的实践.
背景情况:
- 母乳提供了重要的健康益处,但高收入国家的母乳养率仍未达到建议.
- 低的母乳养率凸显了需要有效的干预措施来支持母亲.
研究的目的:
- 评估哺乳顾问 (LC) 干预措施对母乳养时间,母亲的自我有效性和婴儿成长的影响,与通常护理相比.
- 综合来自高收入环境中LC干预的随机临床试验的证据.
主要方法:
- 1985年至2024年间发表的随机临床试验的系统综述和元分析.
- 搜索了多个数据库,包括Cochrane,MEDLINE,Embase,CINAHL,Scopus和科学网络.
- 利用三级相关和层次效应模型进行数据合成和特征分析的元回归.
主要成果:
- 包括40项涉及8582名参与者的研究. 乳腺癌干预降低了停止纯母乳养 (RR,0.96) 和任何母乳养 (RR,0.92) 的风险.
- 随着LC干预,任何母乳养时间都增加了3.63周. 增加纯母乳养时间和母亲自我有效性的证据很弱.
- 早期产后测量和更高强度 (更多的LC访问) 的干预效果更大.
结论:
- 哺乳顾问的干预表明,在高收入国家改善专属母乳养和任何母乳养率是有前途的.
- 生命线干预的时间和强度是影响其成功的关键因素.
- 这些发现支持整合LC支持,以提高母乳养结果.
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