世界衛生組織及國民健康局所提倡的成功哺餵母乳十步驟，其中步驟九提到「哺餵母乳之嬰兒，不給予人工乳頭或安撫奶嘴」，以免造成新生兒「乳頭混淆」。但是，吸吮安撫奶嘴是否真的會影響嬰兒建立正確的吸吮模式，而導致母乳哺餵失敗或提早中斷母乳哺餵期，目前仍然沒有定論。故本研究目的是在探討嬰兒使用安撫奶嘴的情形與母乳哺餵之關係以及在控制母乳哺餵自信心調節變項的影響後，嬰兒使用安撫奶嘴與母乳哺餵之關係。
本研究採縱貫式相關性研究設計，以結構式問卷調查161位台南市台灣籍育有正常足月新生兒之產婦，在住院期間、產後一個月、二個月及三個月其嬰兒使用安撫奶嘴的情形、哺餵狀況及母乳哺餵自信心。
研究結果發現，嬰兒有無使用安撫奶嘴與母乳哺餵有相關，有使用安撫奶嘴之嬰兒純母乳哺餵者比例較低；安撫奶嘴的使用頻率越高者者純完全母乳哺餵比例較低；安撫奶嘴的使用時間長短、使用類型與母乳哺餵的有顯著相關；第一次使用安撫奶嘴的時間則與母乳哺餵狀況無關；以邏輯斯迴歸控制母乳哺餵自信心之因素後發現，嬰兒使用安撫奶嘴與否、使用頻率、使用時間長度及使用類型並非純母乳哺餵與否之預測因子，母乳哺餵自信心才是重要因素。建議臨床對於嬰兒使用安撫奶嘴的政策可考慮更有彈性的使用，加強產婦之母乳哺餵自信心，才是促進母乳哺餵成功的關鍵。

Among the ten steps to successful breastfeeding advocated by the WHO, step nine clearly states that formula supplementation and pacifier use should be avoided to prevent nipple confusion. However, little evidences support the causal relationship between pacifiers used and breastfeeding. Purposes of this study were to explore (a) relationships between pacifiers used and breastfeeding of infants, and (b) whether these relationships were moderated by the factor of maternal breastfeeding self-efficacy.
One hundred and sixty-one healthy Taiwanese mothers and their full-term infants were studied. A structured questionnaire was used to obtain information of pacifiers used and breastfeeding. The Breastfeeding Self-Efficacy Scale (BSES) was used to measure maternal breastfeeding self-efficacy. Data was collected at periods of hospitalization, the first, second, and third months after discharge.
Results showed that pacifiers used of infants were significantly associated with breastfeeding. Lower exclusive breastfeeding rate was found in infants with pacifiers as compared to those without pacifiers. In infants who used pacifiers, the more often they used the lower exclusive breastfeeding rate. Duration and the type of pacifiers used were also significantly related to breastfeeding. There is no relationship between the first time that pacifiers used and breastfeeding. However, results of logistic regression analysis showed that after controlling for score of maternal BSES, whether a pacifier was used or not, frequency, duration, and types of pacifiers used were not predictors of exclusive breastfeeding rate. On the contrary, maternal breastfeeding efficacy was the significant predictor. Results of this study indicate that consideration of a flexible policy of pacifier used in infants is necessary. Strategies to enhance maternal breastfeeding efficacy are essential for successful breastfeeding .

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