母子分離状態における母親の搾乳回数・搾乳量と産後1ヵ月の児の栄養法との関連  [in Japanese] Relationships between mothers' expressing breast-milk for babies in NICU and nutrition at one month after delivery  [in Japanese]

出生児がNICUに入院し,母子分離となった場合,母乳分泌のために搾乳が必要になる。本研究は搾乳回数,搾乳量と産後1ヵ月の栄養法との関連を検討し,直接授乳できない母親の母乳分泌維持のためのケアを見出すことを目的とした。NICUに入院した児の母親26名を対象とし,分娩後3日目,5日目,7日目,14日目,21日目の5時点における搾乳回数,搾乳量,搾乳1回あたりの搾乳量を収集し,各データの時系列変化と産後1ヵ月時点の栄養法との関連を反復測定による分散分析を用いて検討した。その結果,産後1ヵ月時点の母乳栄養群は16名(61.5%),混合栄養群は10名(38.5%)であった。分散分析の結果,有意な交互作用がみられた組み合わせは,「栄養法」×「搾乳回数」,「栄養法」×「搾乳量」,「栄養法」×「1回あたりの搾乳量」であった。交互作用について検討したところ,母乳栄養群における搾乳回数,搾乳量,および搾乳1回あたりの搾乳量は,分娩後3〜21日目まで線形増加を示した。一方,混合栄養群では,分娩後7日目からプラトーを示した。また,母乳栄養法の主効果を検討したところ,「搾乳回数」「搾乳量」において有意差がみられた。母乳栄養群の数値は,混合栄養群よりも高い傾向がみられた。母乳分泌維持のためには,5回より多い搾乳回数を維持し,産後21日目までは搾乳量が増加するようにケアを行っていく必要性が示唆された。

The purpose of this research was to study correlations between mothers' expressing breast-milk for babies in NICU and the method of nutritional supply at one month after delivery. From 26 mothers whose babies were in NICU, we obtained the frequency of their milk expression per day and the volume of their expressed breast-milk at the 3rd, 5th, 7th, 14th, and 21st days after delivery. One-way repeated ANOVA was used to examine the relationships between the time series data and the method of nutritional supply at one month after delivery. The breastfeeding group at the point of one-month after delivery consisted of 16 mothers (61.5%) and the mixed breastfeeding group consisted of 10 mothers (38.5%). Statistically significant interactions were observed between the total volume of expressed breast-milk per day and method of nutritional supply at the time of one-month after delivery and between the volume of expressed breast-milk per expression and method of nutritional supply at the time of one-month after delivery. In the breastfeeding group, the volume of breast-milk per expression demonstrated a linear increase from the days from 3rd to 21st after the delivery. In the mixed breastfeeding group, the volume of breast-milk per expression reached plateau on the 7th day. Significant main determinant for nutrition at one month after delivery were observed in the frequencies of expression and in the volume of expressed breast-milk per day. Both frequencies and volume of expression for breast-milk were higher in the breastfeeding group than in the mixed-feeding group.