Facilitating Early Breast Milk Expression in Mothers of Very Low Birth Weight Infants

Parker, Leslie A.; Hoffman, Jacqueline; Mahoney, Ashley Darcy

doi:10.1097/nmc.0000000000000408

Cited by 19 publications

(8 citation statements)

References 25 publications

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“…The current study is consistent with the previous studies, which have shown that the practice of delayed initiation of breastfeeding was mainly among mothers with LBW infants [27], [28]. This may have several explanations.…”

Section: Discussionsupporting

confidence: 93%

Risk Factors Associated with Initiation of Breastfeeding among Mothers with Low Birth Weight Babies: A Cross-sectional Multicenter Study in Abu Dhabi, United Arab Emirates.

Taha¹,

Hassan²,

Wikkeling-Scott³

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: Early initiation of breastfeeding is important for good lactation outcomes and has long been recommended by the World Health Organization. Recommendations are based on research showing that breastfeeding saves children’s lives, particularly among vulnerable populations such as low birth weight (LBW) neonates. In spite of a consistent rise in LBW deliveries, and in spite of the importance of breastfeeding for the survival of LBW neonates, a dearth of research exists regarding early initiation of breastfeeding for this population. AIM: The aim of this study was to investigate the prevalence of, and factors associated with the initiation of breastfeeding among mothers with children aged <2 years who were LBW in Abu Dhabi, United Arab Emirates (UAE). METHODS: The data for this cross-sectional study were extracted from a larger project on the evaluation of breastfeeding practices in Abu Dhabi. The original data were collected from seven health-care centers located in different urban and suburban areas of Abu Dhabi during 2017. A structured questionnaire was used by trained research assistants who collected relevant data from mothers during the interview. RESULTS: The study included a total of 1822 mothers of children below the age of 2 years; 175 (9.6%) of those children were identified as LBW. The mean standard deviation [SD] ages of the mothers and the children were 30.5 (5.0) years and 6.0 (5.1) months, respectively. The mean birth weight (SD) of the LBW children was 2079.6 (255.0) grams. Forty (29.9%) mothers of LBW children initiated breastfeeding within the 1 st h. Sixty-four (47.8%) were delivered vaginally, and 70 (52.2%) were delivered through cesarean section (CS). In multivariable logistic regression analysis, the only factor associated with delayed initiation of breastfeeding among the LBW children was CS (adjusted odds ratio 2.33; 95% confidence interval 1.07, 5.07). CONCLUSION: The prevalence of LBW was 9.6%, and it was associated with delayed initiation of breastfeeding as compared to the normal birth weight babies. While early initiation of breastfeeding should be promoted for all newborns, LBW infants are recognized as a vulnerable group and thus require additional support. There should be more emphasis on promoting and facilitating breastfeeding for LBW babies, especially those delivered by CS.

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Section: Discussionsupporting

confidence: 93%

Risk Factors Associated with Initiation of Breastfeeding among Mothers with Low Birth Weight Babies: A Cross-sectional Multicenter Study in Abu Dhabi, United Arab Emirates.

Taha¹,

Hassan²,

Wikkeling-Scott³

et al. 2020

Open Access Maced J Med Sci

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show abstract

“…The lack of time and staff to support the milk expression of mothers has been reported to be a barrier against promoting milk expression in the early postpartum period [ 26 ]. Nevertheless, securing time and human resources necessary for implementing care related to milk expression was difficult to solve immediately with only the efforts of the individual nurses and nurse-midwives.…”

Section: Discussionmentioning

confidence: 99%

“…Another concern was that the perception of the mother’s condition was a factor in how well nurse-midwives could implement care for milk expression. It has previously been shown that obstetric nurses hesitated to provide care for milk expression to mothers with high blood pressure or mothers giving birth by cesarean section because of concerns about increased blood pressure and stress [ 26 ]. However, stimulation of the nipples induces the secretion of oxytocin which has positive effects including lowering of the blood pressure and levels of hormones related to stress, reducing pain associated with labor, and helping mothers acquire a maternal role by increasing social skills and reducing anxiety [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants

Tanaka

Horiuchi

2021

Int Breastfeed J

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Background 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. Methods 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. Results 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. Conclusions 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.

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“…Unfortunately, inadequate staffing and lack of nursing time prevent the nurse from assisting the new mother in expressing BM sooner (Parker et al, 2018). As a result, BM expression is delayed in this population.…”

Section: Introductionmentioning

confidence: 99%

Effect of Prenatal Lactation Education on Lactation Success in Mothers at Risk of Preterm Delivery

Richburg

2018

UFJUR

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Background:Mothers of preterm infants often produce insufficient amounts of breast milk (BM). Early initiation of BM expression following delivery is associated with increased lactation success, but lack of nursing time delays BM expression in this population.Purpose:To determine if providing antenatal breast expression education to the support person (SP) of mothers at risk of preterm delivery improves lactation success.Methods: Twenty women at risk for delivering a preterm infant and their SP were randomized into two groups. Mothers and their SP in Group 1 received education regarding how to use a breast pump and a breast pump was placed into their hospital room. Group 2 received standard care. Data regarding BM volume produced, time to initiation of BM expression and time to onset of lactogenesis stage II was collected.Results: While there was no difference in time to onset of lactogenesis stage II, mothers in Group 1 initiated BM expression 2.5 hours earlier than those in Group 2. Overall, BM production was higher in Group 1.Limitations: This study had a relatively small sample size (n=19). Only mothers delivering 31-33 weeks gestation were included. This is a single-center study, which may limit generalizability.Conclusion: Prenatal lactation education of mothers of preterm infants and their SP is feasible and may increase lactation success.

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Facilitating Early Breast Milk Expression in Mothers of Very Low Birth Weight Infants

Abstract: Obstetric nurses encounter barriers when facilitating early HM expression in mothers giving birth to VLBW infants. It is possible these barriers could be removed through improvements in education, use of innovative staffing strategies, and maintenance of evidence-based policies.

Cited by 19 publications

References 25 publications

Risk Factors Associated with Initiation of Breastfeeding among Mothers with Low Birth Weight Babies: A Cross-sectional Multicenter Study in Abu Dhabi, United Arab Emirates.

Risk Factors Associated with Initiation of Breastfeeding among Mothers with Low Birth Weight Babies: A Cross-sectional Multicenter Study in Abu Dhabi, United Arab Emirates.

Implementing an education program for nurse-midwives focused on early essential care for breast milk expression among mothers of preterm infants

Effect of Prenatal Lactation Education on Lactation Success in Mothers at Risk of Preterm Delivery

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