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J. Jpn. Acad. Midwif., Vol. 21, No. 2, 58-70, 2007 原 著 人工栄養がなかった時代に子育てをした女性の母乳哺育体験に関する研究 Experiences of breastfeeding for Japanese women who raised children in a time when breast milk substitutes were not readily available Yumi ITAYA 1 Mariko KITAGAWA 2 抄 録 目的 対象と方法 1195513 結果 134 16 結論 1 Gifu University, Nursing Course, School of Medicine Nagoya City University, School of Nursing, Doctoral Course 2 Nagoya City University, School of Nursing 20076120071115 58 2122007

キーワード : Abstract Purpose The purpose of this study was to explore and describe the experiences of women who breastfed their children in Japan s postwar period when breast milk substitutes were not readily available. Methods The subjects of the study were 13 healthy elderly women who gave birth to their first child in 1955 or earlier, and who raised their infants on breast milk. Information on women's experiences breastfeeding their children were gathered mainly from semi-structured interviews. The interview data were recorded after obtaining the consent of the women. Afterwards, transcripts were prepared and a qualitative inductive analysis was performed with reference to the methods of ethnography. Results Four categories such as: good lactation and physicality, positive thought and behavior toward the continuation of breastfeeding ; psychosocial involvement toward breastfeeding by others ; and affirmative self-concept of themselves as mothers, along with the following sixteen subcategories including as: [the continuation of good lactation]; [a lifestyle promoting natural lactation]; [nursing continuation and contraception effect]; [acquisition of knowledge and information about breastfeeding]; [nursing custom assuming autonomous feeding]; [experience of the pleasant feeling that nursing brings]; [extension of weaning time]; [firm convictions as to the value of breastfeeding]; [pain and distress from restricted free nursing]; [another person s decision as to breast milk deprivation]; [strong support and trust of mother]; [nursing support that a midwife makes a difference]; [cooperation among community through back up of mother s milk]; [guarding and passing on breastfeeding tradition and experience]; [smooth acquisition of breastfeeding skills and confidence in child care]; and [formation development of high maternal role awareness]. These were extracted from the descriptive data on the breastfeeding of these 13 women. Conclusion In Japan s postwar reconstruction years breast milk substitutes were not readily available, and women who experienced breastfeeding at that time were self-aware with regard to good lactation; they inherited the psychosocial involvement toward breastfeeding by others; they had a positive attitude and behavior with regard to the continuation of breastfeeding; and may be assumed to have had an affirmative self-concept of themselves as mothers through the act of raising their children on breast milk. These women and their families were motivated by the belief that there is only mother's milk to bring up my child. Key Words: elderly women, breastfeeding experiences, postwar period Ⅰ. はじめに 30197550 WHO 199010 Baby Friendly Hospital Initiative200517 1 44.2 3 38.01 5.13 21.0, 1994/2002 Hill, 1997 1975 ; 1981 ; 1990 1983 J. Jpn. Acad. Midwif., Vol. 21, No. 2, 2007 59

2001 1960 35 1960 2030 7080 Ⅱ. 方法 1. 対象 1955301 G 13 2. 研究協力への依頼手順と倫理的配慮 GG 2005720ID 05006 3. データ収集方法 IC 4. データ収集期間 20057252006311 5. データ分析方法 Ⅲ. 結果 1. 対象の背景 179.43.7 12.50.8 60 21 2 2007

表 1 情報提供者の背景 事例 年齢 A 77 B 79 C 84 D 80 E 86 F 82 G 78 H 73 J 84 K 75 L 77 M 80 N 77 家業 出産年 出産時の年齢 出産場所授乳期間母乳分泌状況代替乳の経験乳房トラブル S23 19 2 S25 21 2 S27 23 2 S20 21 1 S22 22 1 S24 24 1 S28 26 S22 26 2 S25 29 8 S26 30 2 S23 23 1 S26 26 S27 27 23 S31 31 3 S25 31 1 S27 33 1 S24 26 2 S26 28 4 S25 23 2 S28 26 2 S29 21 2 S32 24 45 S22 25 1 S26 29 1 S26 20 2 S31 25 2 S28 24 23 1 S40 36 23 S26 25 3 S29 28 3 S30 26 3 S35 31 3 123.9 3.1 G 1454 1.811 2. 調査地の概要 G7kmGK H 225m 17101 107245720.41 3. 昭和 20 30 年代当時の生活文化 2000 2125 22 J. Jpn. Acad. Midwif., Vol. 21, No. 2, 2007 61

25 30 35 100 2 23 G 292 688163035 11335 G83 7 19 4. 当時の女性の母乳哺育体験 15133 11658233 1 2 3954200053106,000 13 416 2 1 3 1 A2 B D K F L 2 M C J L 62 21 2 2007

表 2 母乳哺育体験カテゴリー カテゴリーサブカテゴリー根拠となる背景 良好な乳汁分泌と身体性 授乳継続への積極的思考と行動 他者による母乳哺育への心理社会的関与 母親としての肯定的な自己概念の再形成 23 1 B 3 J. Jpn. Acad. Midwif., Vol. 21, No. 2, 2007 63

64 21 2 2007 A 1 B 2,3 F D 2 5 1 G 38 B 2 M E 2 A M 3 B D 4 11 3 N

M H 5 H H 3 5 1 1 D L N C J. Jpn. Acad. Midwif., Vol. 21, No. 2, 2007 65

66 21 2 2007 2 A 3 1 1 J L 4 23 M B 1 J2 K 5 J

45 11 M 4 3 1 A D J 2 A B 3 N B M Ⅳ. 考察 1. 当時の授乳女性の乳汁分泌と身体性 13 J. Jpn. Acad. Midwif., Vol. 21, No. 2, 2007 67

, 2000 1, 2000 190 70752, 1999 Judith, 1990/1997 2. 授乳継続への積極的思考と行動をもたらしたもの 4 5, 2005 1960, 2003, 2006 3. 母乳哺育をとりまく人々と授乳女性へのかかわり 20032030 1 68 21 2 2007

, 1973/1977 2006 4. 母乳哺育を通じた母親としての肯定的な自己概念の再形成 Rubin, 1984/1997 Reece, 1992 1998/1991 4 4 4 4 4 4 4 2006 Winnicott1957/1885 Ⅴ. 結論 1 謝 辞 J. Jpn. Acad. Midwif., Vol. 21, No. 2, 2007 69

文献 2003 63. 2003 45. 19731977 16-20. 2000, 13(12), 121-126. 19881991 49. 2000 267-268. 2006, 47(1), 125-133. Hill, P, Humenick, S. et al. (1997). Effects of parity and weaning practices on breastfeeding duration, Public Health Nursing, 14(4), 227-234. 2001 22 273-289. 2000107. Judith Goldsmith (1990)1997 130-133. 1990 215-226. 20061, 47 (1), 117-124. 1994 2002 WHO 257. 1999 502. 2006231. 1975. Reece, SM. (1992). The parent expectations survey: A measure of perceived self efficacy, Clinical Nursing Research. 1 (4), 336-346. Rubin, R. (1984)1997 158-159. 1981 217-28. 2005, 46(1), 163-169. Winnicott, D.W. (1957)1985 92. 198333-34. 70 21 2 2007