بررسی تأثیر مصرف شربت دبس (حاوی شیره انگور، زعفران و لیموعمانی) بر الگوی شیردهی مادران زایمان کرده نخست‌زا: یک کارآزمایی بالینی تصادفی شده

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استادیار گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استادیار گروه طب سنتی، دانشکده طب سنتی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 استادیار گروه آمار زیستی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: سلامت و توانمندی جسمی و روانی مادر، از عوامل کلیدی در فرآیند تغدیه با شیر مادر است. در طب سنتی، شیره انگور را دبس یا دوشاب می­نامند. همچنین از تشابه خواص آن با شیر مادر گفته شده است. شربت دبس متشکل از آب انگور تغلیظ شده، لیموعمانی و زعفران، در طب ایرانی منبع تقویت مادر بعد از زایمان است. مطالعه حاضر با هدف بررسی تأثیر شربت دبس بر الگوی شیردهی در سه ماه اول بعد از زایمان انجام شد.
روشکار: این مطالعه کارآزمایی بالینی تصادفی سه‌سوکور در سال 1400-1399 بر روی 92 مادر زایمان کرده در بیمارستان‌های حافظ و شوشتری شیراز انجام شد. در گروه مداخله، شربت دبس تا 6 هفته و در گروه کنترل دارونما دریافت شد. داده­ها با پرسشنامه­ های مشخصات دموگرافیک و مامایی و پرسشنامه الگوی شیردهی جمع‌آوری شد. الگوی شیردهی در روزهای اول، دهم، 1 ماه و 3 ماه بعد از زایمان بررسی شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 26) و آزمون­ های تی مستقل، من‌ویتنی، کای دو و دقیق فیشر انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته ­ها: در روز اول تولد، الگوی شیردهی شامل تغذیه انحصاری با شیر مادر در دو گروه مداخله (82/97%) و کنترل (70/95%) تفاوت آماری معنی‌داری نداشت (500/0=p). الگوی شیردهی انحصاری با شیر مادر در روز دهم در دو گروه مداخله (7/71%) و کنترل (6/32%) (001/0=p)، روز سی‌ام در دو گروه مداخله (6/82%) و کنترل (8/34%) (001/0>p) و سه ماهگی در دو گروه مداخله (6/82%) و کنترل (6/32%) (001/0>p) تفاوت معنی‌داری نشان داد.
نتیجه­ گیری: مصرف شربت شیره انگور، زعفران و لیموعمانی (دبس) توسط مادر بر الگوی شیردهی در روز سوم، روز دهم، روز سی‌ام و 3 ماهگی مؤثر بوده و شیردهی مادر را ارتقاء می‌بخشد. 

کلیدواژه‌ها


عنوان مقاله [English]

The effect of molasses syrup (containing Vitis juice, saffron and Omani lemon) on the breastfeeding pattern of primiparous mothers: a randomized clinical trial

نویسندگان [English]

  • Mahboobeh Mojtahedi 1
  • Shahnaz Tork Zahrani 2
  • Mojgan Tansaz 3
  • Maliheh Nasiri 4
1 M.Sc. of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Assistant Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Assistant Professor, Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Assistant Professor, Department of Biostatistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Mother's physical and mental health and ability are the key factors in the breastfeeding process. In traditional medicine, grape juice is called Debs or Doshab. It has also been said that its properties are similar to mother's milk. Molasses syrup consisting of concentrated grape juice, Omani lemon and saffron is a source of strengthening the mother after childbirth in Iranian medicine. The present study was performed with aim to investigate the effect of molasses syrup on the breastfeeding pattern in the first three months after childbirth.
Methods: This three-blind randomized clinical trial study was conducted on 92 mothers who gave birth in Hafez and Shushtri hospitals in Shiraz in 2020-2021. In the intervention group, molasses syrup and in the control group, placebo was received for six weeks. Data were collected with demographic and midwifery questionnaire and breastfeeding pattern questionnaire. The breastfeeding pattern was examined on the first, tenth, one month and three months after delivery. Data were analyzed by SPSS software (version 26) and independent t, Mann-Whitney, Chi-square and Fisher's exact tests. P< 0.05 was considered statistically significant.
Results: The pattern of breastfeeding on the first day of birth, exclusive breastfeeding (EBF) in both intervention (97.82%) and control (95.70%) groups had no statistically significant difference (p=0.500). The pattern of exclusive breastfeeding with breast milk showed a significant difference on the 10th day in the intervention (71.7%) and control (32.6%) groups (p=0.001), on the 30th day in the intervention (82.6%) and control (34.8%) groups (p<0.001), and three months later in the intervention (82.6%) and control (32.6%) groups (p<0.001).
Conclusion: The consumption of grape juice, saffron and Omani lemon syrup (Debs) by the mother can be effective on the breastfeeding pattern on the 3rd day, 10th day, 30th day and third month and can improve the mother's breastfeeding.

کلیدواژه‌ها [English]

  • Breastfeeding pattern
  • Iranian traditional medicine
  • Omani lemon
  • Persian medicine
  • Saffron
  • Vitis juice
  1. Hajnasiri H. Assessment of Breastfeeding Self-Efficacy and Patterns and its Predictors in Mothers Living in Qazvin Province. Nursing And Midwifery Journal 2018; 15(10):777-87.
  2. Qasem W, Fenton T, Friel J. Age of introduction of first complementary feeding for infants: a systematic review. BMC pediatrics 2015; 15(1):1-11.
  3. Sharifirad G, Shahnazi H, Sedighi E, Mahaki B. The effect of supporter presence in education sessions of breastfeeding on knowledge, attitude and behavior of nulliparous women. Journal of Health 2018; 9(1):45-61.
  4. Salehzadeh K, Mirzajani Y, Saberi Y. Effects of a Submaximal Aerobic Exercise Intervention Program on Breast Milk Factors of Homemaker Mothers. The Scientific Journal of Rehabilitation Medicine 2017; 6(4):13-22.
  5. Tara F, Bagheri S. The effect of postpartum mother–infant skin-to-skin contact on exclusive breastfeeding in neonatal period: a randomized controlled trial. International Journal of Pediatrics 2017; 5(7):5409-17.
  6. Olang B, Farivar K, Heidarzadeh A, Strandvik B, Yngve A. Breastfeeding in Iran: prevalence, duration and current recommendations. International breastfeeding journal 2009; 4(1):1-10.
  7. Organization WH. Global Nutrition Targets 2025: Stunting Policy Brief. World Health Organization; 2014.
  8. Thulier D, Mercer J. Variables associated with breastfeeding duration. Journal of Obstetric, Gynecologic & Neonatal Nursing 2009; 38(3):259-68.
  9. Maleki-Saghooni N, Amel Barez M, Moeindarbari S, Karimi FZ. Investigating the breastfeeding self-efficacy and its related factors in primiparous breastfeeding mothers. International Journal of Pediatrics 2017; 5(12):6275-83.
  10. Mokhtarian T, Farhud D, Malmir M, Mokhtarian T. Moral Imperative of Breastfeeding & Commitment to the Children's Rights. Ethics in Science & Technology 2017; 12(1):1-9.
  11. Jahangir M, Emaratkar E, Nakhaie S, Sadeghian M, Faghihzadeh S. The Causes of Insufficient Breast Milk and Approach to it: Perspectives of Persian Medicine and Classical Medicine. Medical History 2018; 10(34):95-108.
  12. Dimitraki M, Tsikouras P, Manav B, Gioka T, Koutlaki N, Zervoudis S, et al. Evaluation of the effect of natural and emotional stress of labor on lactation and breast-feeding. Archives of gynecology and obstetrics 2016; 293(2):317-28.
  13. Khichi GQ, Channar MS, Woraich E, Bajwa SN. Patterns of Breast Feeding in Children Under two Years of Age in Bahawalpur. Pakistan Journal of Medical Sciences 2001; 17(2):94-8.
  14. Siahi M, Shiravi A, Nasrabadi M. The effect of aqueous extract of fennel on prolactin secretion and lactation female. J. Res. Anim. Biol. Damghan 2009; 1(33):55-63.
  15. Bingel AS, Farnsworth NR. Higher plants as potential sources of galactagogues. Economic and medicinal plant research 1994; 6:1-.
  16. Fazel N, Esmaeili H, Shamaeian Razavi N. Effect of cumin oil on post partum hemorrhage after cesarean. Iranian Journal of Medicinal and Aromatic Plants Research 2013; 29(1):97-104.
  17. Paritakul P, Ruangrongmorakot K, Laosooksathit W, Suksamarnwong M, Puapornpong P. The effect of ginger on breast milk volume in the early postpartum period: A randomized, double-blind controlled trial. Breastfeeding Medicine 2016; 11(7):361-5.
  18. Mousavi T, Rafiei A, Amjadi O, Yoosefpour M, Zakavi A. Medicinal and nutritional properties of grapes in islamic references, traditional, and modern medicine. Journal of Mazandaran University of Medical Sciences 2015; 25(130):169-90.
  19. Aghili A, Shirazi SM. Makhzan al advie. Tehran: Sabz Arang, Tehran Univercity of Medicine; 2012.
  20. Zeinali M, Zirak MR, Rezaee SA, Karimi G, Hosseinzadeh H. Immunoregulatory and anti-inflammatory properties of Crocus sativus (Saffron) and its main active constituents: A review. Iranian Journal of Basic Medical Sciences 2019; 22(4):334.
  21. Kalantari Meybodi MS. The effects of Crocus sativus (Saffron) on cardiovascular diseases from Iranian traditional medicine to modern phytotherapy. Iranian Journal of Cardiovascular Nursing 2018; 6(4):70-7.
  22. World Health Organization. Neonatal and perinatal mortality: country, regional and global estimates. World Health Organization; 2006.
  23. Jana AK. Interventions for promoting the initiation of breastfeeding: RHL commentary. The World Health Organization Reproductive Health Library; 2009.
  24. Araban M, Karimian Z, Kakolaki ZK, McQueen KA, Dennis CL. Randomized controlled trial of a prenatal breastfeeding self-efficacy intervention in primiparous women in Iran. Journal of Obstetric, Gynecologic & Neonatal Nursing 2018; 47(2):173-83.
  25. Veeranki SP, Nishimura H, Krupp K, Gowda S, Arun A, Madhivanan P. Suboptimal breastfeeding practices among women in rural and low-resource settings: a study of women in rural Mysore, India. Annals of Global Health 2017; 83(3-4):577-83.
  26. Pakpour A, Alijanzadeh M, Pouresmaeil M, Taherkhani F, Mohammadgholiha R, Jozi N. Predictive factors associated with breastfeeding initiation and duration behaviors of 6-months postpartum mothers referred to health centers in the city of Qazvin based on theory of planned behavior. Iranian Journal of Health Education and Health Promotion 2016; 4(1):20-30.
  27. Jahangir M, Emaratkar E, Nakhaie Sh, Sadeghian M, Faghihzadeh S. The Causes of Insufficient Breast Milk and Approach to it: Perspectives of Persian Medicine and Classical Medicine. Medical History Journal 2018; 10(34):95-108.
  28. Goweily AP. Using Herbal Medicine Among Breastfeeding Mothers: A Cross-Sectional Study. World Journal of Pharmaceutical Research 2019; 8(9):1891-1913.
  29. Nasiri M, Sadeghi O, Eshaghi Shahrezai H. Assessment of Therapeutic Properties of Quranic Fruits and Their Conformity to the Findings of Modern Medical Sciences. Science and Religion Studies 2014; 5(9):133-52.
  30. Galipeau R, Baillot A, Trottier A, Lemire L. Effectiveness of interventions on breastfeeding self‐efficacy and perceived insufficient milk supply: A systematic review and meta‐analysis. Maternal & Child Nutrition 2018; 14(3):e12607.
  31. Hatamikia M, Mohammadi Sani A, Zomorodi S. Effect of different clarifying agents on the physico-chemical and microbial properties of grape juice concentrate. Journal of Innovation in Food Science and Technology 2013; 6(1):83-90.
  32. Farias M, Wohlenberg LK, Gonçalves TK, Schaffer DK, Hilger RD, Braccini Neto C, et al. Effect of grape juice on some biochemical and oxidative stress parameters in serum and liver enzymes of pregnant and lactating rats. Issues in Biological Sciences and Pharmaceutical Research 2015; 3(4):37-46.
  33. Izadpanah A, Alahyari E, Torshizi M, Khazaie Z, Sharifzadeh G, Hosseini M. Effect of grape seed powder on postpartum hemorrhage in vaginal delivery: a randomized controlled clinical trial. Iran J Obstet Gynecol Infertil 2018; 21(10):30-7.
  34. Wahner-Roedler DL, Bauer BA, Loehrer LL, Cha SS, Hoskin TL, Olson JE. The effect of grape seed extract on estrogen levels of postmenopausal women: a pilot study. Journal of dietary supplements 2014; 11(2):184-97.
  35. Tester J. Saffron and women with mild-to-moderate postpartum depression. Australian Journal of Herbal and Naturopathic Medicine 2018; 30(1):35-7.
  36. Fukui H, Toyoshima K, Komaki R. Psychological and neuroendocrinological effects of odor of saffron (Crocus sativus). Phytomedicine 2011; 18(8-9):726-30.
  37. Suryawanshi JA. An overview of Citrus aurantium used in treatment of various diseases. African Journal of Plant Science 2011; 5(7):390-5.