[[alternative]]Onset of Lactation in Vaginal Delivery Women and Related Factors

[[abstract]]本研究旨在探討陰道生產之產婦首次泌乳時間及其相關因素。採描述相關研究，以方便取樣方式於北部某區域教學醫院，針對陰道生產產婦進行收案，共收案133名無任何合併症之產後婦女。研究工具包括醫療環境調查表、語言疼痛評估量表、生產史及人口學屬性調查表以及自覺首次泌乳時間訪談表。研究結果發現：(1)首次泌乳時間的平均值為78.2±18.7小時（範圍42至121小時）；(2)產婦自覺延遲泌乳的發生機率為43.6%(n=58)，其中初產婦佔56.9%(n=33)，經產婦佔43.1%(n=25)；(3)產次、第二產程時間、第二產程時間大於一小時、第一到第三天會陰傷口疼痛分數，是延遲首次泌乳時間的重要預測因子。醫護人員應該鼓勵母親執行增加乳汁分泌的方法，並運用護理措施縮短第二產程時間以及避免會陰切開，以減少延遲泌乳的發生機會，進而促進產婦成功哺乳。[[abstract]]The purpose of this study was to explore the onset of lactation of vaginal delivery women and related factors. Using a descriptive correlation research design, a convenience sample of 133 healthy mothers was recruited from a regional teaching hospital in Northern Taiwan. Tools included a Health Care Environment Inventory, Verbal Pain Rating Scales, Obstetrical Inventory, and Demographic Inventory. An interview guide, entitled "Maternal Perception of the Onset of Lactation", was also used to obtain milk secretion data. Results found a mean onset of lactation of 78.2±18.7 hours (range=42 to 121 hours). The prevalence of delayed lactation onset was 43.6% (n=58). Slighly over half of participants (56.9%, n=33) were primiparous. Parity, total second stage of labor duration, duration of second labor stage beyond one hour, and perinea wound pain were the most significant predictors of delayed lactation onset. To increase milk secretion, medical personnel should promote proper breastfeeding practices among new mothers and use nursing interventions to shorten the length of the second stage of labor and prevent episiotomy