Bebek dostu bir hastanede doğumu takiben formül süt desteği verilmesinde belirleyici faktörler

Yıl 2020, Cilt: 13 Sayı: 1, 81 - 90, 21.01.2020

Selma Aktas , Zeliha Özge Kuroğlu Ebru Kazancı Ayşe Korkmaz

https://doi.org/10.31362/patd.631449

Cited By: 1

Öz

Amaç: Hayatın ilk 6 ayında sadece anne sütü
önerilmesine rağmen, tüm dünyada hastanede formül süt desteği oldukça
yaygındır. Bu durumun anne sütü ile beslenme süresinin daha kısa olmasındaki en
güçlü belirleyici faktör olduğu farklı çalışmalarda gösterildi. Çalışmamızda
bebek-dostu hastanemizde doğum sonrası hastane takiplerinde formül süt desteği
gereksiniminin nedenlerini belirlemeyi amaçladık.

Gereç ve
Yöntemler: Bu retrospektif kohort
çalışmaya Ocak – Aralık 2018 tarihleri arasında doğum yapan 503 anne ve onların
bebekleri dahil edildi. Anne – bebek dosyalarından toplanan bilgiler hastanede
formül süt desteği ilişkili faktörleri belirlemek için analiz edildi.

Bulgular: Hastanede yenidoğanları %14,5’u formül süt
desteği aldı. En sık nedenler anne sütü eksikliği (%78) ve hipoglisemiydi
(%15). Formül süt en sık kadeh (%91,78) ile verildi. Düşük gestasyon haftası
(GH) ve doğum ağırlığı (DA), sezeryan doğum (C/S), in vitro fertilizasyon (IVF)
gebelik ve kardeşlerin emzirme süresinin daha kısa olması hastanede formül süt
desteği alanlarda anlamlı yüksekti. Univariate analizlerde hastanede formül süt
desteği ile ilişkili bulunan faktörler lojistik regresyon analizi ile
değerlendirildiğinde düşük DA, C/S doğum ve IVF gebeliğin anlamlılığını
sürdürdüğü görüldü.

Sonuç: Çalışmamızda hastanede formül süt destek
gereksinimini arttıran nedenler düşük DA, C/S ve IVF gebelik olarak belirlendi.
Doğum öncesi ve sonrasında sağlık profesyonellerinin öneri ve desteği, kurumun
yazılı emzirme politikası olması doğum sonrası hastane takipleri sırasında
tıbbi endikasyon dışında formül süt desteği verilmemesi düşük DA ve GH ile IVF gebeliğin olumsuz
etkilerini azaltabilir C/S ile doğum yapan annelerin emzirmeye başlaması ve
devamlılığının sağlanması için daha fazla destek gerekir.

Anahtar Kelimeler

Emzirme, anne sütü, hastanede formül süt desteği, formül süt

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Determinant factors in formula supplementation following delivery in a baby-friendly hospital.

Öz

Objectives:
Although exclusive breastfeeding is recommended for the first 6 months of life,
in-hospital formula supplementation is widespread all around the world and has
been demonstrated to be a strong determinant of shorter exclusive and any
breastfeeding. The aim of the study is to assess the reasons in which
in-hospital formula supplementation occurs in a baby-friendly hospital.

Methods:
This
retrospective cohort study was conducted among 503 mother-infant pairs from
January to December 2018. Data collected from mother-infant files were analysed
to identify factors associated with in-hospital supplementation.

Results: During
hospital stay 14.5% of the infants were received formula. The most common
reasons for supplementation were lack of human-milk  (78%) and hypoglycemia (15%). The most common
way for supplemantation was cup-feeding (91.78%).  Lower gestational week (GW) and birth weight
of the infant, cesarean delivery (C/S), in vitro fertilisation (IVF) pregnancy,
shorter breastfeeding duration of the siblings were significantly higher in
formula-supplemented group. The factors associated with in-hospital formula
supplementation in univariant analysis were assessed with Logistic regression;
lower birth weight, IVF pregnancy and C/S delivery were still significant in
formula-supplemented group.

Conclusion: Our
results identified several factors that enhance supplementation in hospital.
Healthcare profesional recommandations and support before and after delivery
may reduce the adverse effects of lower GW and birth weight and IVF pregnancy.
Special care is needed for mothers delivering by C/S to enable to initiate and
maintain breastfeeding.

Anahtar Kelimeler

breastfeeding, human-milk, in-hospital formula supplementation, infant formula

Proje Numarası

yok

Kaynakça

• 1. Eidelman AI. Breastfeeding and the use of human milk: An analysis of the American Academy of Pediatrics 2012 Breastfeeding Policy Statement. Breastfeed Med 2012;7:323–324.
• 2. World Health Organization and UNICEF. Global Strategy for Infant and Young Child Fee-ding. Geneva, Switzerland:World Health Organization, 2003
• 3. Duijts L, Ramadhani MK, Moll HA Breastfeeding protects against infectious diseases during infancy in industrialized countries. A systematic review. Matern Child Nutr 2009; 5:199–210.
• 4.Dieterich CM, Felice JP, O’Sullivan E, Rasmussen KM. Breastfeeding and health outcomes for the mother-infant dyad. Pediatr Clin North Am 2013;60:31–48.
• 5. Tarrant M, Kwok MK, Lam TH, Leung GM, Schooling CM. Breast-feeding and childhood hospitalizations for infections. Epidemiology 2010;21:847–854. doi: 10.1097/EDE.0b013e3181f55803.
• 6. National Implementation of the Baby-friendly Hospital Initiative, 2017. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
• 7. Patil C. L, Turab A, Ambikapathi R et al. Early interruption of exclusive breastfeeding: Re-sults from the eight‐country MAL‐ED study. Journal of Health, Population and Nutrition, 2015; 34:10.
• 8. Tarrant M, Lok KY, Fong DY et al. Effect of a hospital policy of not accepting free infant formula on in-hospital formula supplementation rates and breast-feeding duration. Public He-alth Nutrition, 2015;18:2689-2699.
• 9. Chantry CJ, Dewey K G, Peerson, JM, Wagner EA, Nommsen-Rivers L A. In-hospital formula use increases early breastfeeding cessation among first-time mothers intending to exclusively breastfeed. The Journal of Pediatrics, 2014; 164: 1339-1345.
• 10. Castelli C, Perrin J, Thirion X, Comte F, Gamerre M, Courbiere B. Maternal Factors Influ-encing the Decision to Breastfeed Newborns Conceived with IVF. Breastfeed Med. 2015;10:26-30.
• 11. Türkiye Nüfus ve Sağlık Araştırması. (2013), http://www.hips.hacettepe.edu.tr/TNSA_2013_ana_rapor.pdf.
• 12. Nguyen T, Dennison BA, Fan W, Xu C, Birkhead GS. Variation in formula supplementation of breastfed newborn infants in New York hospitals. Pediatrics, 2017;140: e20170142.
• 13. Chen C, Yan Y, Gao X et al. Influences of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study.J Hum Lact. 2018;34:526-534.
• 14. Esteves TM, Daumas RP, Oliveira MI, Andrade CA, Leite IC. Factors associated to bre-astfeeding in the first hour of life: Systematic review. Revista de Saude Publica, 2014; 48:697-708.
• 15. Kalmakoff S, Gray A, Baddock S. Predictors of supplementation for breastfed babies in a Baby-Friendly hospital.Women Birth. 2018;31:202-209.
• 16. Parry JE, Ip DK, Chau PY, Wu KM, Tarrant M. Predictors and consequences of in-hospital formula supplementation for healthy breastfeeding newborns. J Hum Lact. 2013 ; 29:527-536.
• 17. Boban M, Zakarija-Grković . In-Hospital Formula Supplementation of Healthy Newborns: Practices, Reasons, and Their Medical Justification. Breastfeed Med. 2016 ;11:448-454.
• 18. Howard CR, Howard FM, Lanphear B et al. Randomized clinical trial of pacifier use and bottle-feeding or cupfeeding their effect on breastfeeding. Pediatrics 2003;111:511-518.
• 19. Donath SM, Amir LH. Effect of gestation on initiation and duration of breastfeeding. Arch Dis Child Fetal Neonatal Ed 2008;93:448–450.
• 20. Hackman N, Alligood-Peroco N, Martin A, Zhu J, Kjerulff K. Reduced breastfeeding rates in firstborn late preterm and early term infants. Breastfeed Med 2016;11:119–125.
• 21. Biro M, Sutherland G, Yelland J, Hardy P, Brown S. In-hospital formula supplementation of breastfed babies: a population-based survey. Birth 2011;38:302–310.
• 22. Taylor JS, Geller L, Risica PM, Kirtania U, Cabral HJ. Birth order and breastfeeding initiation: Results of a national survey. Breastfeed Med 2008;3:20–27.
• 23. Phillips G, Brett K, Mendola P. Previous breastfeeding practices and duration of exclusive breastfeeding in the United States. Matern Child Health J 2011;15:1210–1216.
• 24. Allen VM, Wilson RD, Cheung A. Pregnancy outcomes after assisted reproductive tech-nology. J Obstet Gynaecol Can 2006;28:220–233.
• 25. Fisher JRW, Rowe H, Hammarberg K. Admissions for early parenting difficulties among women with infants conceived by assisted reproductive technologies: A prospective cohort study. Fertil Steril 2012;97:1410–1416.
• 26. Monti F, Agostini F, Fagandini P, Paterlini M, La Sala GB, Blickstein I. Anxiety symptoms during late pregnancy and early parenthood following assisted reproductive technology. J Perinat Med 2008;36: 425–432.