Bristol ve LATCH Emzirme Değerlendirme Ölçeklerinin karşılaştırılması
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Tarih
2025
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Alanya Alaaddin Keykubat Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
ÖZET Bristol ve LATCH Emzirme Değerlendirme Ölçeklerinin Karşılaştırılması, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Tıpta Uzmanlık Tezi Anne sütü, bebeklerin büyüme ve gelişimi için temel besin kaynağıdır. Emzirme başarısını değerlendirmek, desteğe ihtiyaç duyan anneleri belirlemek ve emzirme oranlarını artırmak için objektif ölçüm araçlarına ihtiyaç vardır. Bristol Emzirme Değerlendirme Ölçeği (BEDÖ) ve LATCH ölçekleri bu amaçla yaygın kullanılmaktadır. Çalışmamız Eylül 2024 ile Mart 2025 tarihleri arasında Alaaddin Keykubat Üniversitesi Tıp Fakültesi Alanya Eğitim Araştırma Hastanesi'nde miadında doğum yapan sağlıklı 157 anne ve bebeğin katılımı ile prospektif ve kesitsel şekilde yürütülmüştür. Katılımcılara doğum sonrası ilk 24 saatte ve taburculuk sonrası ilk hafta poliklinik başvurusu sırasında BEDÖ ve LATCH ölçekleri uygulanmıştır. Bebeklerin beslenme durumu 14. ve 40. günlerde telefonla takip edilmiştir. Annelerin yaş ortalaması 29,02 ± 6,29 yıl (min:18, maks:45) olup, %58,0'ı (n=91) emzirme eğitimi almıştır. Planlanan emzirme süresi 21,70 ± 5,37 ay (min:2, maks:48), planlanan yalnızca anne sütü ile beslenme süresi ise 6,80 ± 3,56 ay (min:2, maks:24) olarak bildirildi. Emzirme skorları, ilk 24 saatte BEDÖ için 6,37 ± 1,92 ve LATCH için 8,03 ± 1,79 iken; ilk haftada BEDÖ için 7,48 ± 1,10 ve LATCH için 9,10 ± 1,33 olarak bulundu. Her iki ölçekte de 7. gün skorlarının ilk gün skorlarına göre anlamlı düzeyde yüksek olduğu saptandı (p<0,001). Yalnızca anne sütü ile beslenme oranı, ilk 24 saatte %83,4 (n=132) iken; 7. günde %68,8 (n=108), 14. günde %71,9 (n=113) ve 40. günde %68,8 (n=108) olarak saptandı. Korelasyon analizlerinde ilk 24 saat ve ilk hafta BEDÖ ve LATCH skorları arasında güçlü pozitif korelasyon (r=0,783, r=0,719, p<0,001) olduğu görüldü. Lojistik regresyon analizinde; ilk 24 saatte sadece anne sütü ile beslenme olasılığını anne yaşındaki bir yıllık artışın %13,5 azalttığı (OR:0,865, p=0,010); LATCH skorundaki bir puanlık artışın ise 2,8 kat artırdığı (OR:2,783, p<0,001) saptandı. Postnatal 40. Günde sadece anne sütü ile beslenme olasılığını annede sağlık sorunu olmamasının 4,6 kat (OR:4,606, p=0,007), çekirdek ailede yaşamanın 23 kat (OR:22,985, p=0,002); ilk 24 saat LATCH skorundaki bir puanlık artışın 1,6 kat (OR:1,619, p=0,001), ilk hafta BEDÖ skorundaki bir puanlık artışın 1,8 kat (OR:1,782, p=0,018) artırdığı, annenin emzirme eğitimi almamış olmasının ise aynı olasılığı %93,5 azalttığı (OR:0,065, p=0,004) saptandı. ROC analizi sonuçlarında ise postnatal 40. günde sadece AS ile beslenmeyi öngörmede ilk 24 saat BEDÖ?6, LATCH?7; ilk hafta BEDÖ?7, LATCH?8 olarak birlikte değerlendirildiğinde bu kesim değerleri anlamlı bulundu. [AUC=0,695 (%95 GA:0,602-0,789; p<0,001) (sensitivite: %88, Spesifite: %47)] Klinik sonuçlarda ise sadece anne sütü ile beslenen bebeklerin doğum ağırlığını 6,44 ± 2,17 günde, formül mama kullanan bebeklerin ise 7,98 ± 2,91 günde (p<0,001) yakaladığı, sadece anne sütü ile beslenenlerde yenidoğan yoğun bakım yatış oranının anlamlı düzeyde düşük olduğu görüldü (p=0,020). BEDÖ ve LATCH ölçekleri emzirme başarısının erken dönem değerlendirilmesinde ve uzun dönem emzirme devamlılığının öngörülmesinde güvenilir ve birbirinin alternatifi olarak kullanılabilecek araçlardır. Emzirme eğitimi, aile yapısı ve erken dönem emzirme skorları, 40. günde sadece anne sütü ile beslenmenin en güçlü belirleyicileri olarak saptanmıştır. Bu çalışmanın sonuçları risk altındaki anne ve bebeklerin erken tanınması ve desteklenmesi için objektif değerlendirme araçlarının önemini vurgulamaktadır. Anahtar Kelimeler: Anne sütü, emzirme, LATCH, Bristol Emzirme Değerlendirme Ölçeği.
ABSTRACT Comparison of Bristol and LATCH Breastfeeding Assessment Tools, Department of Child Health and Diseases, Medical Specialization Thesis Breast milk is the primary source of nutrition for infant growth and development. Objective assessment tools are needed to evaluate breastfeeding success, identify mothers requiring support, and increase breastfeeding rates. The Bristol Breastfeeding Assessment Tool (BBAT) and the LATCH score are widely used for this purpose. This study was conducted prospectively and cross-sectionally between September 2024 and March 2025 at Alanya Alaaddin Keykubat University Faculty of Medicine, Alanya Training and Research Hospital, with the participation of 157 healthy mothers and their term infants. The BBAT and LATCH scores were administered to the participants within the first 24 hours postpartum and during the first-week outpatient visit after discharge. Infant feeding status was monitored by telephone on the 14th and 40th days. The mean age of the mothers was 29.02 ± 6.29 years (min: 18, max: 45), and 58.0% (n=91) had received breastfeeding education. The planned duration of breastfeeding was reported as 21.70 ± 5.37 months (min: 2, max: 48), and the planned duration of exclusive breastfeeding as 6.80 ± 3.56 months (min: 2, max: 24). Breastfeeding scores at 24 hours were 6.37 ± 1.92 for BBAT and 8.03 ± 1.79 for LATCH; at the first week, 7.48 ± 1.10 for BBAT and 9.10 ± 1.33 for LATCH. Both scales showed significantly higher scores at day 7 compared to day 1 (p<0.001). The exclusive breastfeeding rate was 83.4% (n=132) at 24 hours, 68.8% (n=108) at day 7, 71.9% (n=113) at day 14, and 68.8% (n=108) at day 40. Correlation analyses revealed a strong positive correlation between BBAT and LATCH scores at both 24 hours and the first week (r=0.783, r=0.719, p<0.001). Logistic regression analysis demonstrated that, within the first 24 hours, each one-year increase in maternal age reduced the likelihood of exclusive breastfeeding by 13.5% (OR: 0.865, p=0.010), whereas each one-point increase in LATCH score increased it 2.8-fold (OR: 2.783, p<0.001). At day 40 postpartum, the likelihood of exclusive breastfeeding was increased 4.6- fold by the absence of maternal health problems (OR: 4.606, p=0.007), 23-fold by living in a nuclear family (OR: 22.985, p=0.002), 1.6-fold by each one-point increase in the initial 24-hour LATCH score (OR: 1.619, p=0.001), and 1.8-fold by each one-point increase in the first-week BBAT score (OR: 1.782, p=0.018). Conversely, lack of breastfeeding education reduced the likelihood of exclusive breastfeeding at day 40 by 93.5% (OR: 0.065, p=0.004). In ROC analysis, the cut-off values for predicting exclusive breastfeeding at day 40 were determined as BBAT ?6 and LATCH ?7 within the first 24 hours, and BBAT ?7 and LATCH ?8 at the first week. These thresholds were found to be significant [AUC=0.695 (95% CI: 0.602–0.789; p<0.001), sensitivity: 88%, specificity: 47%]. Clinical outcomes showed that infants exclusively breastfed regained their birth weight in 6.44 ± 2.17 days, whereas those receiving formula supplementation did so in 7.98 ± 2.91 days (p<0.001). Furthermore, the rate of neonatal intensive care unit admission was significantly lower among exclusively breastfed infants (p=0.020). The BBAT and LATCH scores are reliable tools for the early assessment of breastfeeding success and the prediction of long-term breastfeeding continuation, and can be used interchangeably. Breastfeeding education, family structure, and early breastfeeding scores were identified as the strongest determinants of exclusive breastfeeding at day 40. The results of this study highlight the importance of objective assessment tools for early identification and support of at-risk mothers and infants. Keywords: Breast milk, breastfeeding, LATCH, Bristol Breastfeeding Assessment Tool.
ABSTRACT Comparison of Bristol and LATCH Breastfeeding Assessment Tools, Department of Child Health and Diseases, Medical Specialization Thesis Breast milk is the primary source of nutrition for infant growth and development. Objective assessment tools are needed to evaluate breastfeeding success, identify mothers requiring support, and increase breastfeeding rates. The Bristol Breastfeeding Assessment Tool (BBAT) and the LATCH score are widely used for this purpose. This study was conducted prospectively and cross-sectionally between September 2024 and March 2025 at Alanya Alaaddin Keykubat University Faculty of Medicine, Alanya Training and Research Hospital, with the participation of 157 healthy mothers and their term infants. The BBAT and LATCH scores were administered to the participants within the first 24 hours postpartum and during the first-week outpatient visit after discharge. Infant feeding status was monitored by telephone on the 14th and 40th days. The mean age of the mothers was 29.02 ± 6.29 years (min: 18, max: 45), and 58.0% (n=91) had received breastfeeding education. The planned duration of breastfeeding was reported as 21.70 ± 5.37 months (min: 2, max: 48), and the planned duration of exclusive breastfeeding as 6.80 ± 3.56 months (min: 2, max: 24). Breastfeeding scores at 24 hours were 6.37 ± 1.92 for BBAT and 8.03 ± 1.79 for LATCH; at the first week, 7.48 ± 1.10 for BBAT and 9.10 ± 1.33 for LATCH. Both scales showed significantly higher scores at day 7 compared to day 1 (p<0.001). The exclusive breastfeeding rate was 83.4% (n=132) at 24 hours, 68.8% (n=108) at day 7, 71.9% (n=113) at day 14, and 68.8% (n=108) at day 40. Correlation analyses revealed a strong positive correlation between BBAT and LATCH scores at both 24 hours and the first week (r=0.783, r=0.719, p<0.001). Logistic regression analysis demonstrated that, within the first 24 hours, each one-year increase in maternal age reduced the likelihood of exclusive breastfeeding by 13.5% (OR: 0.865, p=0.010), whereas each one-point increase in LATCH score increased it 2.8-fold (OR: 2.783, p<0.001). At day 40 postpartum, the likelihood of exclusive breastfeeding was increased 4.6- fold by the absence of maternal health problems (OR: 4.606, p=0.007), 23-fold by living in a nuclear family (OR: 22.985, p=0.002), 1.6-fold by each one-point increase in the initial 24-hour LATCH score (OR: 1.619, p=0.001), and 1.8-fold by each one-point increase in the first-week BBAT score (OR: 1.782, p=0.018). Conversely, lack of breastfeeding education reduced the likelihood of exclusive breastfeeding at day 40 by 93.5% (OR: 0.065, p=0.004). In ROC analysis, the cut-off values for predicting exclusive breastfeeding at day 40 were determined as BBAT ?6 and LATCH ?7 within the first 24 hours, and BBAT ?7 and LATCH ?8 at the first week. These thresholds were found to be significant [AUC=0.695 (95% CI: 0.602–0.789; p<0.001), sensitivity: 88%, specificity: 47%]. Clinical outcomes showed that infants exclusively breastfed regained their birth weight in 6.44 ± 2.17 days, whereas those receiving formula supplementation did so in 7.98 ± 2.91 days (p<0.001). Furthermore, the rate of neonatal intensive care unit admission was significantly lower among exclusively breastfed infants (p=0.020). The BBAT and LATCH scores are reliable tools for the early assessment of breastfeeding success and the prediction of long-term breastfeeding continuation, and can be used interchangeably. Breastfeeding education, family structure, and early breastfeeding scores were identified as the strongest determinants of exclusive breastfeeding at day 40. The results of this study highlight the importance of objective assessment tools for early identification and support of at-risk mothers and infants. Keywords: Breast milk, breastfeeding, LATCH, Bristol Breastfeeding Assessment Tool.
Açıklama
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
