Although breastfeeding guidelines for infants admitted to the neonatal intensive care unit (NICU) have been introduced in Japan, these guidelines have not been reflected in practice. To improve this situation, it is important for nurses and nurse-midwives to acquire knowledge of appropriate care. This study examined changes in nurse-midwives’ knowledge, attitude, and implementation of appropriate care after implementing an education program focused on early essential care for breast milk expression among mothers of preterm infants. This pre- and post-intervention study using a single group was conducted from June 2018 to May 2019 and enrolled 36 nurse-midwives in one perinatal medical center. The education program content included nurses’ roles in early essential care for milk expression and the necessary care to promoting breast milk production among mothers of preterm infants. The nurse-midwives’ knowledge and attitude on care were investigated 3 months before (pre-1), just before (pre-2), just after (post-1), and 3 months after (post-2) the program. The nurse-midwives’ care implementation was investigated at pre-1, pre-2, and post-2. During this time, 11 mothers (before: 7, after: 4) reported the status of milk expression for 10 days after birth. The mean knowledge scores of the nurse-midwives at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p < 0.001). The attitude on care scores at post-1 and post-2 were significantly higher than that at pre-2 (post-1: p < 0.001, post-2: p = 0.010). The care implementation score at post-2 was significantly higher than that at pre-2 in eight items (e.g., Q7 Explain about the effect of initiating milk expression early and assist mothers in it). However, the education program did not cause any changes in the mothers’ initiation and frequency of milk expression, and breast milk volume after birth. The significant increases in the knowledge, attitude on care, and care implementation scores of the nurse-midwives suggest the beneficial effects of the education program. The small number of mothers in the survey on the practice of breast milk expression limited the full determination of the benefits of the education program for nurse-midwives.

中文翻译：

---

实施助产士教育计划，重点关注早产儿母亲母乳分泌的早期基本护理

尽管日本已经引入了新生儿重症监护病房 (NICU) 婴儿的母乳喂养指南，但这些指南并未在实践中得到体现。为了改善这种情况，护士和助产士获得适当护理的知识很重要。本研究调查了在实施一项侧重于早产儿母亲母乳挤出早期基本护理的教育计划后，助产士的知识、态度和实施适当护理的变化。这项使用单组的干预前和干预后研究于 2018 年 6 月至 2019 年 5 月进行，并在一个围产期医疗中心招募了 36 名助产士。教育计划内容包括护士在挤奶的早期基本护理中的作用以及促进早产儿母亲母乳生产的必要护理。在计划前3个月（pre-1）、就在（pre-2）、就在（post-1）和3个月后（post-2）调查护士-助产士的护理知识和态度。在pre-1、pre-2和post-2调查了助产士护理实施情况。在此期间，11位母亲（前：7，后：4）报告了出生后10天的乳汁分泌状况。护士-助产士在后1和后2的平均知识得分显着高于前2（后1：p <0.001，后2：p <0.001）。1 后和 2 后对护理评分的态度显着高于 2 前（1 后：p < 0.001，2 后：p = 0. 010)。post-2 的护理实施得分在 8 个项目中显着高于 pre-2（例如，Q7 解释早期开始挤奶的效果并帮助母亲）。然而，教育计划并没有导致母亲开始吸奶的频率和出生后的母乳量发生任何变化。助产士的知识、护理态度和护理实施得分的显着增加表明教育计划的有益效果。母乳喂养实践调查中的母亲人数较少，限制了对助产士教育计划的好处的充分确定。Q7 解释及早开始挤奶的效果并协助妈妈们）。然而，教育计划并没有导致母亲开始吸奶的频率和出生后的母乳量发生任何变化。助产士的知识、护理态度和护理实施得分的显着增加表明教育计划的有益效果。母乳喂养实践调查中的母亲人数较少，限制了对助产士教育计划的好处的充分确定。Q7 解释及早开始挤奶的效果并协助妈妈们）。然而，教育计划并没有导致母亲开始吸奶的频率和出生后的母乳量发生任何变化。助产士的知识、护理态度和护理实施得分的显着增加表明教育计划的有益效果。母乳喂养实践调查中的母亲人数较少，限制了对助产士教育计划的好处的充分确定。护士和助产士的护理实施分数表明教育计划的有益效果。母乳喂养实践调查中的母亲人数较少，限制了对助产士教育计划的好处的充分确定。护士和助产士的护理实施分数表明教育计划的有益效果。母乳喂养实践调查中的母亲人数较少，限制了对助产士教育计划的好处的充分确定。