Ethnic/racial diversity, maternal stress, lactation and very low birthweight infants

Abstract

Objective: (1) To compare maternal characteristics and psychological stress profile among African-American, Caucasian and Hispanic mothers who delivered very low birthweight infants. (2) To investigate associations between psychosocial factors, frequency of milk expression, skin-to-skin holding (STS), and lactation performance, defined as maternal drive to express milk and milk volume.Study Design: Self-reported psychological questionnaires were given every 2 weeks after delivery over 10 weeks. Milk expression frequency, STS, and socioeconomic variables were collected.Result: Infant birthweight, education, and milk expression frequency differed between groups. Trait anxiety, depression and parental stress in a neonatal intensive care unit (PSS:NICU) were similar. African-American and Caucasian mothers reported the lowest scores in state anxiety and social desirability, respectively. Maternal drive to express milk, measured by maintenance of milk expression, correlated negatively with parental role alteration (subset of PSS:NICU) and positively with infant birthweight and STS. Milk volume correlated negatively with depression and positively with milk expression frequency and STS.Conclusion: Differences between groups were observed for certain psychosocial factors. The response bias to self-reported questionnaires between groups may not provide an accurate profile of maternal psychosocial profile. With different factors correlating with maintenance of milk expression and milk volume, lactation performance can be best enhanced with a multi-faceted intervention program, incorporating parental involvement in infant care, close awareness and management of maternal mental health, and encouragement for frequent milk expression and STS.

Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study

“…27,28 A majority of factors negatively influencing milk volume in lactating mothers are not amendable to change, so clinicians must focus on modifiable interventions to increase milk volume. 13 Although some study findings have confirmed that earlier initiation of milk expression following delivery improves milk supply in mothers of VLBW infants, 26,28,38 many mothers delay milk expression for hours to days following delivery, which may negatively impact milk volume. Mothers should be encouraged and provided with support to initiate milk expression as soon as possible after delivery, preferably within the first hour.…”

Development of infant oral feeding skills: what do we know?

“…Because attainment of independent oral feeding is one of the criteria recommended by the American Academy of Pediatrics for hospital discharge (1), the longer these infants' transition from tube to independent oral feeding, the longer their hospitalization (2,3). Consequently, prolonged oral feeding difficulties increase medical costs and potential long-term oral feeding aversion and further increase maternal stress as mother-infant reunion is delayed (4)(5)(6)(7).…”

Estrés en padres de recién nacidos prematuros de muy bajo peso hospitalizados en unidades de cuidados intensivos neonatales. Estudio multicéntrico

“…9,10 Adicionalmente, no se obtuvo información acerca de otros factores que se han relacionado con el estrés parental, como lactancia materna, ansiedad y depresión. 18,32 La mayor fortaleza de este estudio es que incluye un importante número de centros y provee información novedosa para la región sudamericana.…”