Доминанта лактации: как женщина делает свой выбор?

Захарова И.Н., Сугян Н.Г., Оробинская Я.В. Доминанта лактации: как женщина делает свой выбор? Педиатрия. Consilium Medicum. 2025;2:114–119. DOI: 10.26442/26586630.2025.2.203341

© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.

________________________________________________

Zakharova IN, Sugian NG, Orobinskaya YaV. Lactation dominant: How does a woman make her choice? A review. Pediatrics. Consilium Medicum. 2025;2:114–119. DOI: 10.26442/26586630.2025.2.203341

Читать PDF

Аннотация

Грудное молоко обладает многочисленными полезными свойствами, однако в странах с высоким уровнем дохода показатели распространенности грудного вскармливания остаются ниже желаемых. Поддержка и продвижение исключительно грудного вскармливания в первые месяцы жизни способствует снижению заболеваемости, смертности и обеспечивает оптимальное развитие ребенка. Важную роль в этом процессе играют своевременное начало кормления, контакт «кожа-к-коже», профессиональная поддержка медицинского персонала и семейная мотивация. Образовательные программы и консультирование особенно важны в первые дни после рождения, а комплексный подход, включающий обучение, профессиональную поддержку и создание благоприятных условий, является перспективным методом улучшения показателей исключительно грудного вскармливания и любого грудного вскармливания.

Ключевые слова: грудное вскармливание, практика, контакт «кожа-к-коже», педиатр, мотивация, обучение, социальные факторы

________________________________________________

Breast milk has numerous health benefits, but in high-income countries, breastfeeding rates remain below the recommended. Support and promotion of exclusive breastfeeding in the first months of life contributes to the reduction of morbidity and mortality and ensures the optimal development of the child. The timely start of feeding, skin-to-skin contact, professional support from healthcare personnel, and family motivation all play a crucial role. Educational programs and counseling are particularly important in the first days after birth, and an integrated approach that includes training, professional support, and enabling environments is a promising method to improve the rates of exclusive breastfeeding and any breastfeeding.

Keywords: breastfeeding, practice, skin-to-skin contact, pediatrician, motivation, training, social factors

Полный текст

Материалы доступны только для специалистов сферы здравоохранения.
Чтобы посмотреть материал полностью Авторизуйтесь или зарегистрируйтесь.

Список литературы

1. Hoddinott J, Alderman H, Behrman JR, et al. The economic rationale for investing in stunting reduction. Matern Child Nutr. 2013;9 Suppl. 2(Suppl 2.):69-82. DOI:10.1111/mcn.12080
2. WHO, t. s. Implementation of the Baby-friendly Hospital Initiative. World Health Organization: Available at: https://yandex.ru/search/?text=2.+https%3A%2F%2Fwww.who.int%2Ftools%2Felena%2Fbbc%2Fimplementation-b.... Accessed: 20.06.2025.
3. Guideline: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. World Health Organization. Available at: http://www.who.int/nutrition/publications/guidelines/breastfeeding-facilities-maternitynewborn/en/ Accessed: 22.06.2025.
4. Pérez-Escamilla R. Breastfeeding in the 21st century: How we can make it work. Soc Sci Med. 2020;244:112331. DOI:10.1016/j.socscimed.2019.05
5. Prentice AM. Breastfeeding in the Modern World. Ann Nutr Metab. 2022;78 Suppl. 2:29-38. DOI:10.1159/000524354
6. Bagci Bosi AT, Eriksen KG, Sobko T, et al. Breastfeeding practices and policies in WHO European Region Member States. Public Health Nutr. 2016;19(4):753-64. DOI:10.1017/S1368980015001767
7. Грудное вскармливание детей первого года жизни. Росстат. Режим доступа: https://rosstat.gov.ru/search?q=грудное+вскармливание. Ссылка активна на 28.06.2025 [Breastfeeding of children in the first year of life. Rosstat. Available at: https://rosstat.gov.ru/search?q=грудное+вскармливание. Accessed: 28.06.2025 (in Russian)].
8. Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. DOI:10.1016/S0140-6736(15)01024-7
9. Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002;360(9328):187-95. DOI:10.1016/S0140-6736(02)09454-0
10. Kozhimannil KB, Jou J, Attanasio LB, et al. Medically complex pregnancies and early breastfeeding behaviors: a retrospective analysis. PLoS One. 2014;9(8):e104820. DOI:10.1371/journal.pone.0104820
11. Snyder K, Hulse E, Dingman H, et al. Examining supports and barriers to breastfeeding through a socio-ecological lens: a qualitative study. Int Breastfeed J. 2021;16(1):52. DOI:10.1186/s13006-021-00401-4
12. Saleh L. Women's Perceived Quality of Care and Self-Reported Empowerment With Centering Pregnancy Versus Individual Prenatal Care. Nurs Womens Health. 2019;23(3):234-44. DOI:10.1016/j.nwh.2019.03.008
13. Jackson L, De Pascalis L, Harrold J, Fallon V. Guilt, shame, and postpartum infant feeding outcomes: A systematic review. Matern Child Nutr. 2021;17(3):e13141. DOI:10.1111/mcn.13141
14. Lawton R, Ashley L, Dawson S, et al. Employing an extended Theory of Planned Behaviour to predict breastfeeding intention, initiation, and maintenance in White British and South-Asian mothers living in Bradford. Br J Health Psychol. 2012;17(4):854-71. DOI:10.1111/j.2044-8287.2012.02083.x
15. Kehinde J, O'Donnell C, Grealish A. The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review. Midwifery. 2023;118:103579. DOI:10.1016/j.midw.2022.10357
16. Santacruz-Salas E, Aranda-Reneo I, Segura-Fragoso A, et al. Mothers' Expectations and Factors Influencing Exclusive Breastfeeding during the First 6 Months. Int J Environ Res Public Health. 2019;17(1):77. DOI:10.3390/ijerph17010077
17. Haroon S, Das JK, Salam RA, et al. Breastfeeding promotion interventions and breastfeeding practices: a systematic review. BMC Public Health. 2013;13 Suppl. 3(Suppl. 3):S20. DOI:10.1186/1471-2458-13-S3-S20
18. Rollins NC, Bhandari N, Hajeebhoy N, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017):491-504. DOI:10.1016/S0140-6736(15)01044-2
19. Marín Gabriel MA, Llana Martín I, López Escobar A, et al. Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn. Acta Paediatr. 2010;99(11):1630-4. DOI:10.1111/j.1651-2227.2009.01597.x
20. Widström AM, Brimdyr K, Svensson K, et al. Skin-to-skin contact the first hour after birth, underlying implications and clinical practice. Acta Paediatr. 2019;108(7):1192-204. DOI:10.1111/apa.14754
21. Meyerink RO, Marquis GS. Breastfeeding initiation and duration among low-income women in Alabama: the importance of personal and familial experiences in making infant-feeding choices. J Hum Lact. 2002;18(1):38-45. DOI:10.1177/089033440201800106
22. Falceto OG, Giugliani ER, Fernandes CL. Couples' relationships and breastfeeding: is there an association? J Hum Lact. 2004;20(1):46-55. DOI:10.1177/0890334403261028
23. Rodgers RF, Fischer LE, Zimmerman E. Partner influences, breastfeeding, and body image and eating concerns: An expanded biopsychosocial model. Appetite. 2022;169:105833. DOI:10.1016/j.appet.2021.105833
24. Zimmerman E, Rodgers RF, O'Flynn J, Bourdeau A. Weight-Related Concerns as Barriers to Exclusive Breastfeeding at 6 Months. J Hum Lact. 2019;35(2):284-91. DOI:10.1177/0890334418797312
25. Hoddinott P, Britten J, Prescott GJ, et al. Effectiveness of policy to provide breastfeeding groups (BIG) for pregnant and breastfeeding mothers in primary care: cluster randomised controlled trial. BMJ. 2009;338:a3026. DOI:10.1136/bmj.a3026
26. Ware J, Piovanetti Y. Pediatricians Are Perfectly Positioned to Help Mothers Reach Their Breastfeeding Goals. Pediatrics. 2020;145(4):e20200216. DOI:10.1542/peds.2020-0216
27. Brand E, Kothari C, Stark MA. Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum. J Perinat Educ. 2011;20(1):36-44. DOI:10.1891/1058-1243.20.1.36
28. Pérez-Escamilla R, Buccini GS, Segura-Pérez S, Piwoz E. Perspective: Should Exclusive Breastfeeding Still Be Recommended for 6 Months? Adv Nutr. 2019;10(6):931-43. DOI:10.1093/advances/nmz039
29. Scime NV, Metcalfe A, Nettel-Aguirre A, et al. Breastfeeding difficulties in the first 6 weeks postpartum among mothers with chronic conditions: a latent class analysis. BMC Pregnancy Childbirth. 2023;23(1):90. DOI:10.1186/s12884-023-05407-w
30. Meek JY, Feldman-Winter L, Noble L. Optimal Duration of Breastfeeding. Pediatrics. 2020;146(5):e2020021063. DOI:10.1542/peds.2020-021063
31. Kellams A, Harrel C, Omage S, et al. ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeed Med. 2017;12:188-98. DOI:10.1089/bfm.2017.29038.ajk
32. Feldman-Winter L, Kellams A, Peter-Wohl S, et al. Evidence-Based Updates on the First Week of Exclusive Breastfeeding Among Infants ≥35 Weeks. Pediatrics. 2020;145(4):e20183696. DOI:10.1542/peds.2018-3696
33. Shah MH, Roshan R, Parikh T, et al. LATCH Score at Discharge: A Predictor of Weight Gain and Exclusive Breastfeeding at 6 Weeks in Term Healthy Babies. J Pediatr Gastroenterol Nutr. 2021;72(2):e48-e52. DOI:10.1097/MPG.0000000000002927

________________________________________________

1. Hoddinott J, Alderman H, Behrman JR, et al. The economic rationale for investing in stunting reduction. Matern Child Nutr. 2013;9 Suppl. 2(Suppl 2.):69-82. DOI:10.1111/mcn.12080
2. WHO, t. s. Implementation of the Baby-friendly Hospital Initiative. World Health Organization: Available at: https://yandex.ru/search/?text=2.+https%3A%2F%2Fwww.who.int%2Ftools%2Felena%2Fbbc%2Fimplementation-b.... Accessed: 20.06.2025.
3. Guideline: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. World Health Organization. Available at: http://www.who.int/nutrition/publications/guidelines/breastfeeding-facilities-maternitynewborn/en/ Accessed: 22.06.2025.
4. Pérez-Escamilla R. Breastfeeding in the 21st century: How we can make it work. Soc Sci Med. 2020;244:112331. DOI:10.1016/j.socscimed.2019.05
5. Prentice AM. Breastfeeding in the Modern World. Ann Nutr Metab. 2022;78 Suppl. 2:29-38. DOI:10.1159/000524354
6. Bagci Bosi AT, Eriksen KG, Sobko T, et al. Breastfeeding practices and policies in WHO European Region Member States. Public Health Nutr. 2016;19(4):753-64. DOI:10.1017/S1368980015001767
7. Breastfeeding of children in the first year of life. Rosstat. Available at: https://rosstat.gov.ru/search?q=грудное+вскармливание. Accessed: 28.06.2025 (in Russian).
8. Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. DOI:10.1016/S0140-6736(15)01024-7
9. Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002;360(9328):187-95. DOI:10.1016/S0140-6736(02)09454-0
10. Kozhimannil KB, Jou J, Attanasio LB, et al. Medically complex pregnancies and early breastfeeding behaviors: a retrospective analysis. PLoS One. 2014;9(8):e104820. DOI:10.1371/journal.pone.0104820
11. Snyder K, Hulse E, Dingman H, et al. Examining supports and barriers to breastfeeding through a socio-ecological lens: a qualitative study. Int Breastfeed J. 2021;16(1):52. DOI:10.1186/s13006-021-00401-4
12. Saleh L. Women's Perceived Quality of Care and Self-Reported Empowerment With Centering Pregnancy Versus Individual Prenatal Care. Nurs Womens Health. 2019;23(3):234-44. DOI:10.1016/j.nwh.2019.03.008
13. Jackson L, De Pascalis L, Harrold J, Fallon V. Guilt, shame, and postpartum infant feeding outcomes: A systematic review. Matern Child Nutr. 2021;17(3):e13141. DOI:10.1111/mcn.13141
14. Lawton R, Ashley L, Dawson S, et al. Employing an extended Theory of Planned Behaviour to predict breastfeeding intention, initiation, and maintenance in White British and South-Asian mothers living in Bradford. Br J Health Psychol. 2012;17(4):854-71. DOI:10.1111/j.2044-8287.2012.02083.x
15. Kehinde J, O'Donnell C, Grealish A. The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review. Midwifery. 2023;118:103579. DOI:10.1016/j.midw.2022.10357
16. Santacruz-Salas E, Aranda-Reneo I, Segura-Fragoso A, et al. Mothers' Expectations and Factors Influencing Exclusive Breastfeeding during the First 6 Months. Int J Environ Res Public Health. 2019;17(1):77. DOI:10.3390/ijerph17010077
17. Haroon S, Das JK, Salam RA, et al. Breastfeeding promotion interventions and breastfeeding practices: a systematic review. BMC Public Health. 2013;13 Suppl. 3(Suppl. 3):S20. DOI:10.1186/1471-2458-13-S3-S20
18. Rollins NC, Bhandari N, Hajeebhoy N, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017):491-504. DOI:10.1016/S0140-6736(15)01044-2
19. Marín Gabriel MA, Llana Martín I, López Escobar A, et al. Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn. Acta Paediatr. 2010;99(11):1630-4. DOI:10.1111/j.1651-2227.2009.01597.x
20. Widström AM, Brimdyr K, Svensson K, et al. Skin-to-skin contact the first hour after birth, underlying implications and clinical practice. Acta Paediatr. 2019;108(7):1192-204. DOI:10.1111/apa.14754
21. Meyerink RO, Marquis GS. Breastfeeding initiation and duration among low-income women in Alabama: the importance of personal and familial experiences in making infant-feeding choices. J Hum Lact. 2002;18(1):38-45. DOI:10.1177/089033440201800106
22. Falceto OG, Giugliani ER, Fernandes CL. Couples' relationships and breastfeeding: is there an association? J Hum Lact. 2004;20(1):46-55. DOI:10.1177/0890334403261028
23. Rodgers RF, Fischer LE, Zimmerman E. Partner influences, breastfeeding, and body image and eating concerns: An expanded biopsychosocial model. Appetite. 2022;169:105833. DOI:10.1016/j.appet.2021.105833
24. Zimmerman E, Rodgers RF, O'Flynn J, Bourdeau A. Weight-Related Concerns as Barriers to Exclusive Breastfeeding at 6 Months. J Hum Lact. 2019;35(2):284-91. DOI:10.1177/0890334418797312
25. Hoddinott P, Britten J, Prescott GJ, et al. Effectiveness of policy to provide breastfeeding groups (BIG) for pregnant and breastfeeding mothers in primary care: cluster randomised controlled trial. BMJ. 2009;338:a3026. DOI:10.1136/bmj.a3026
26. Ware J, Piovanetti Y. Pediatricians Are Perfectly Positioned to Help Mothers Reach Their Breastfeeding Goals. Pediatrics. 2020;145(4):e20200216. DOI:10.1542/peds.2020-0216
27. Brand E, Kothari C, Stark MA. Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum. J Perinat Educ. 2011;20(1):36-44. DOI:10.1891/1058-1243.20.1.36
28. Pérez-Escamilla R, Buccini GS, Segura-Pérez S, Piwoz E. Perspective: Should Exclusive Breastfeeding Still Be Recommended for 6 Months? Adv Nutr. 2019;10(6):931-43. DOI:10.1093/advances/nmz039
29. Scime NV, Metcalfe A, Nettel-Aguirre A, et al. Breastfeeding difficulties in the first 6 weeks postpartum among mothers with chronic conditions: a latent class analysis. BMC Pregnancy Childbirth. 2023;23(1):90. DOI:10.1186/s12884-023-05407-w
30. Meek JY, Feldman-Winter L, Noble L. Optimal Duration of Breastfeeding. Pediatrics. 2020;146(5):e2020021063. DOI:10.1542/peds.2020-021063
31. Kellams A, Harrel C, Omage S, et al. ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeed Med. 2017;12:188-98. DOI:10.1089/bfm.2017.29038.ajk
32. Feldman-Winter L, Kellams A, Peter-Wohl S, et al. Evidence-Based Updates on the First Week of Exclusive Breastfeeding Among Infants ≥35 Weeks. Pediatrics. 2020;145(4):e20183696. DOI:10.1542/peds.2018-3696
33. Shah MH, Roshan R, Parikh T, et al. LATCH Score at Discharge: A Predictor of Weight Gain and Exclusive Breastfeeding at 6 Weeks in Term Healthy Babies. J Pediatr Gastroenterol Nutr. 2021;72(2):e48-e52. DOI:10.1097/MPG.0000000000002927

Авторы

И.Н. Захарова*¹, Н.Г. Сугян^1,2, Я.В. Оробинская^1,2

¹ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия;
²ГБУЗ Московской области «Химкинская клиническая больница», Химки, Россия
*zakharova-rmapo@yandex.ru

________________________________________________

Irina N. Zakharova*¹, Narine G. Sugian^1,2, Yana V. Orobinskaya^1,2

¹Russian Medical Academy of Continuous Professional Education, Moscow, Russia;
²Khimki Clinical Hospital, Khimki, Russia
*zakharova-rmapo@yandex.ru

Назад к списку

Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.