母婴喂养互动与依恋关系建立的队列研究  

A Cohort Study of Maternal-Infant Feeding Interaction and the Establishment of Attachment

作　　者：王琼瑶 严双琴 翁婷婷 蔡智玲 赵蓉蓉 张悦[2] WANG Qiong-yao;YAN Shuang-qin;WENG Ting-ting;CAI Zhi-ling;ZHAO Rong-rong;ZHANG Yue

机构地区：[1]马鞍山市妇幼保健院,马鞍山243011 [2]中国疾病预防控制中心妇幼保健中心,北京100081

出　　处：《中国听力语言康复科学杂志》2022年第5期341-343,348,共4页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：中国疾病预防控制中心青年基金(2018A202)。

摘　　要：目的 观察分析3月龄婴儿及其母亲在哺喂过程中的互动行为表现,探讨母婴喂养互动行为质量与婴儿依恋水平之间的关系。方法 选取2018年6月~9月马鞍山市妇幼保健院儿童保健科健康检查的3月龄婴儿及其母亲102例(纯母乳喂养组52例,人工喂养组50例),在儿童保健门诊行为观察室中采集喂养过程视频,依据互动评估量表(interaction rating scale,IRS)建立行为观察模型,通过视频行为编码,评价母亲及婴儿在喂养过程中的互动行为表现,描述母婴喂养行为,并随访至婴儿1周岁,评估婴儿依恋水平。结果 纯母乳喂养组婴儿互动高分组婴儿依恋水平高分人数多于婴儿互动低分组(χ^(2)=7.485,P=0.020),调整相关混杂因素后发现,二元Logistic回归模型结果显示,婴儿早期高互动水平导致12月龄婴儿依恋水平高分的可能性增加(OR=5.255,95%CI:1.243-22.227),母亲互动评分分类与婴儿依恋水平之间关系无显著差异(P>0.05)。结论 纯母乳喂养可促进母婴互动行为,良好的母婴互动可促进婴儿依恋水平发展。Objective To investigate the relationship between the quality of mother-infant interaction and motherinfant attachment by observing and analyzing the interactive behaviors of 3-month-old infants and their mothers during breastfeeding. Method In this study, 3-month-old infants and their mothers(52 cases in the exclusive breastfeeding group and 50 cases in the artificial feeding group) who underwent health checkups in the child health department of Maanshan Maternal and Child Health Hospital from June 2018 to September 2018 were selected, and videos of the feeding process were collected in the behavioral observation room of the child health clinic, based on Field’s Interaction Rating Scale. The video was used to establish a behavioral observation model to evaluate the interactive behavioral performance of mothers and infants during feeding by video behavioral coding, to describe mother-infant feeding behavior, and to follow up the infants untill they were 1 year old to assess infant attachment. Results The number of high infant attachment scores was more in the high infant interaction group than in the low infant interaction group in the exclusive breastfeeding group(χ^(2)=7.485 P=0.020), and after adjusting for relevant confounders, the results of a binary logistic regression model revealed that high levels of early infant interaction lead to an increased likelihood of high attachment level scores in 12-month-old infants,(OR=5.255, 95% CI: 1.243-22.227), and the relationship between maternal interaction score classification and infant attachment level was not statistically significant(P>0.05). Conclusion Exclusive breastfeeding promotes mother-infant interactive behaviors and good infant interaction promotes mother-infant attachment development.

关 键 词：喂养 亲子互动 婴儿依恋水平 

分 类 号：R174.4[医药卫生—妇幼卫生保健]