早産児の母乳育児における電動搾乳器の有効性 <原著>

目的: 本研究の目的は, 早産児の母親退院後から直母開始までの期間における, 電動搾乳器の有効性を, 搾乳量と搾乳時間, 搾乳に伴う痛みと疲労の観点から明らかにすることとした.

対象と方法: 本研究デザインは準実験研究とした. 対象者は, 3次レベルの公立総合病院のNICUにおいて, 単胎, 在胎27～32週で出産した母親とした. データ収集内容は, 母親退院翌日から直母開始日までにおける, 搾乳回数・時間・量, 直母開始日の1回哺乳量, 搾乳に伴う痛み(手指, 腕, 乳頭)と疲労感とした. 母親退院後の搾乳方法は, 母親の希望をとりいれ, 電動搾乳器(Symphony®)をダブルポンプで毎日使用する母親(E群)と, 用手搾乳または手動搾乳器を使用する母親(C群)に割り付けた. 分析は, 母親退院後1週間と直母開始日において, 対象者別に記述的分析を行った後, 2群問の差をMann-WhitneyのU検定を用いて検討した。, 結果: 対象者はE群6人, C群4人であった. 母親退院後1週間, 直母開始日ともに, 搾乳回数は, 搾乳方法による違いはなかったが, E群のほうが, 1日の搾乳時間は有意に短く(p<0.05), 搾乳量(1回量, 1日量)は多い傾向であった. 母親退院後1週間において, E群のほうが, 手指と腕の痛み, 疲労感は有意に低く(すべてp<0.05), 乳頭の痛みは低い傾向であった. 直母開始日では, E群のほうが手指, 腕, 乳頭の痛みは有意に低かった(すべてp<0.05).

結論: 電動搾乳器による搾乳は用手搾乳法に比べ, より短時間で, より痛みや疲労感を感じることなく, より多くの母乳を搾ることができた.

Purpose: The purpose of this study was to compare the effectiveness of an electric breast pump to hands or a hand pump for expression time, milk volume, feeling of pain, and fatigue, in mothers of preterm infants at discharge from the hospital until they start breastfeeding.

Methods: This study was a quasi-experimental design. Participants at 1 NICU were mothers who delivered a singleton at 27 to 32 weeks of gestation. The data contained the number of expression times, expression time, milk volume, feeling of pain (fingers, arms, and nipples), and fatigue in mothers at discharge from the hospital until they start breastfeeding. After discharge from hospital, experimental group used an electric breast pump (Symphony®) simultaneously and comparison group expressed by hands or used a hand pump. Mothers chose the method of expression. Data were analyzed descriptively, and then analyzed using Mann-Whitney test about one week after discharge and the day of first breastfeeding.

Results: Experimental group was six and comparison group was four mothers. One week after discharge and at the day of first breastfeeding, expression times showed no difference. Total expression time per day was significantly shorter for the experimental group (p<0.05). Milk volumes (one expression, and day expression) were larger for the experimental group, but not significantly. One week after discharge, finger-pain, arm-pain, and fatigue were significantly lower than for the comparison group (all p<0.05). Painful nipples were lower for experimental group, but not significantly. At the day of first breastfeeding, finger, arm and nipples pain was significantly lower than for the comparison group (all p<0.05).

Conclusion: Using an electric breast pump, mothers of preterm infants after discharge from the hospital are able to express with shorter time, feel less pain and fatigue, and express more breast milk.