Breastfeeding the late preterm infant: experiences of mothers and perceptions of public health nurses

Abstract

BackgroundThe promotion and maintenance of breastfeeding with late preterm infants (LPIs) remain under examined topics of study. This dearth of research knowledge, especially for this population at-risk for various health complications, requires scientific investigation. In this study, we explore the experiences of mothers and the perceptions of public health nurses (PHNs) about breastfeeding late preterm infants in Calgary, Alberta, Canada.MethodsWe used an exploratory mixed methods design with a convenience sample of 122 mothers to gather quantitative data about breastfeeding. We collected qualitative data by means of individual face-to-face interviews with 11 mothers and 10 public health nurses. Data were collected from April 2013 to June 2014. We then employed an interpretive thematic analysis to identify central themes and relationships across narratives.ResultsWe collected 74 complete data sets about breastfeeding. During the first 6–8 weeks postpartum, 61 mothers breastfed their infants. Of these, 51 partially breastfed and 10 exclusively breastfed. For qualitative purposes, the researchers interviewed 11 mothers with late preterm babies and three themes emerged: significant difficulty with breastfeeding, failing to recognize the infant’s feeding distress and disorganized behavior, and the parental stress caused by the multiple feeding issues. The public health nurses’ comments reinforced and expanded on what the mothers reported. The themes for the nurses included: challenges with initiating breastfeeding, challenges during breastfeeding, and the need for stimulation during breastfeeding.ConclusionMothers face challenges when breastfeeding their late preterm infants and public health nurses can guide them through this experience. Families with a late preterm infant need to be informed about the challenges associated with breastfeeding a late preterm infant. It is necessary for all health care professionals to receive proper training on safe and effective breastfeeding of late preterm infants. It is essential for public health nurses to communicate effectively with families of late preterm infants to provide anticipatory guidance about potential challenges and strategies to resolve any breastfeeding problems.

Mothers of preterm infants’ experiences of breastfeeding support in the first 12 months after birth: A qualitative study

“…This finding is supported by a qualitative study from Canada, in which public health nurses found it difficult to guide mothers of preterm infants in breastfeeding. 6 Our findings highlight the specific challenges health professionals face when supporting breastfeeding among mothers of preterm infants. Thus, our results suggest that health professionals need greater awareness and education about breastfeeding in preterm infants and providing genuine support for their mothers accordingly.…”

“…Both mothers and health professionals may face challenges with breastfeeding a preterm infant as a result of issues surrounding breastmilk expression, immature infant feeding behavior, and milk supply concerns. 6,7 In particular, nurses in child health care centers might not care for many preterm infants, and they therefore may lack knowledge of preterm infants' feeding behavior, which may result in inadequate support. This finding is supported by a qualitative study from Canada, in which public health nurses found it difficult to guide mothers of preterm infants in breastfeeding.…”

“…Genuine support was experienced as supportive in the following situations: when the mothers received support that was individually adapted and had no demands (SK72); Mothers not born in Sweden 9 (6) Vaginal birth 81 (54) Women with multiple births 23 (15) Infant gestational age at birth, weeks 34 [2] Infant gestational age at discharge, weeks 38 [2] Length of stay for the infant, days 24 [22] Exclusive breastfeeding The staff [at the neonatal unit] prepped me to continue expressing breast milk, which was good; I believe that much support is needed at that stage, before the child learns to breastfeed, when it is hard and stressful.…”

“…4 The time until a preterm infant can feed from the breast varies as a result of the immaturity of their breastfeeding behavior, and for some infants, breastfeeding difficulties may persist after discharge from the neonatal unit. 5,6 For mothers of preterm infants, breastfeeding may be perceived as both a positive bonding experience and/or a challenge because of immature infant breastfeeding behavior, breastmilk expression, and inadequate support. 7 Many studies [8][9][10][11] have highlighted the importance of breastfeeding support for helping mothers of full-term infants succeed in their breastfeeding goals.…”

Supporting Public Health Nurses with Breastfeeding Interventions for Late Preterm Infants

“…Kair and colleagues [19] found that mothers receive inadequate breastfeeding support post discharge. Dosani and colleagues [20] found that not only did mothers have various difficulties with breastfeeding, public health nurses (PHNs) also found it challenging to guide mothers in breastfeeding and provide anticipatory guidance. There are many reasons for this, including limited training received in undergraduate programs [21].…”