A randomized interventional study to promote milk secretion during mother–baby separation based on the health belief model: A consort compliant

• Published in: Medicine (Baltimore) Vol. 97; no. 42; p. e12921
• Main Authors: Liu, Yi, Yao, Jianrong, Liu, Xinghui, Luo, Biru, Zhao, Xiufang
• Format: Journal Article
• Language: English
• Published: United States the Author(s). Published by Wolters Kluwer Health, Inc 01-10-2018; Wolters Kluwer Health
• Subjects: Adult; Anxiety, Separation - physiopathology; Anxiety, Separation - psychology; Breast Feeding - psychology; Breast Feeding - statistics & numerical data; Cesarean Section; Clinical Trial/Experimental Study; Female; Humans; Infant, Newborn; Infant, Premature; Lactation - psychology; Male; Milk, Human - metabolism; Mother-Child Relations - psychology; Postpartum Period - psychology; Prospective Studies
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000012921

Breast milk is the most important nutrition for premature babies, but mothers of premature infants have difficulty in initiating and sustaining lactation. Breastfeeding infants who are separated with mothers have decreased morbidity. Nevertheless, such decrease is limited due to insufficient milk supply resulting from mother-baby separation during lac.
To evaluate the effect of intervention methods based on the health belief model on promoting the secretion of milk among mothers who were separated with their babies.
In this prospective, randomized controlled clinical trial, we enrolled 260 separation mothers between September 26, 2016 and March 7, 2017, in a 3rd-grade women and children hospital of Chengdu. The mothers all had cesarean delivery and were randomized into 2 groups: the intervention group (educated by investigators based on the health belief) and the control group (routinely educated by obstetric nurses). Data on the onset of lactation and the milk volume during 3 days postpartum were collected. The breast swelling rate within 3 days postpartum and the exclusive breastfeeding rate at 42 days postpartum were compared. The psychologic scores of separation maternal in both groups were assessed with State-Trait Anxiety Inventory at the 3rd day postpartum.
Compared with the control group, the intervention group had significantly earlier lactation time (P < .01), significantly larger milk volume (P < .01) during 24, 24 to 48, and 48 to 72 hours, and significantly lower psychologic scores (P < .01) at the 3rd-day postpartum.The onset of lactation among mothers who initiated milk expression within 1 hour after childbirth were earlier than those who initiated milk expression between 1 and 6 hours (P < .01); the milk volume within 24-hour postpartum did not differ significantly between the 2 groups (P > .05). However, the milk volume of the early-expression group (<1 hour) was significantly higher than that of the late-expression group (1-6 hours) during 24 to 48 and 48 to72 hours (P < .05).The breast swelling rate of separation mothers within 3 days postpartum in the intervention group was lower than that in the control group (P < .05). The exclusive breastfeeding rate of mothers in the intervention group was significantly higher than that in the control group (59% vs 35%; P < .01) at 42 days postpartum.
Nursing intervention based on the health belief model can stimulate milk secretion in mothers who were separated with their babies.