Factors Influencing Parent Reports of Facilitators and Barriers to Human Milk Supply in Neonatal Intensive Care Units

Alves, Elisabete; Magano, Raquel; Amorim, Mariana; Nogueira, Conceição; Silva, Susana

doi:10.1177/0890334416664071

Cited by 43 publications

(45 citation statements)

References 38 publications

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“…Some researchers defined DOL-II as lactation onset occurring after 72 h postpartum (11,12). DOL-II was a common issue occurring in mothers of preterm infants (4,13). The definition of OOL-II in this study is a pragmatic approach similar to that reported by Meier et al (14).…”

Section: Discussionmentioning

confidence: 86%

Successful Full Lactation Achieved by Mothers of Preterm Infants Using Exclusive Pumping

Huang

Feng

2020

Front. Pediatr.

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Background: Some mothers of preterm infants suffer from difficulties in initiating and maintaining adequate milk production. This study was designed to investigate the milk production in mothers of preterm infants using hospital-grade breast pumps and to study the nutrient content of their milk. Methods: This was an observational prospective study. Mothers of preterm infants with gestational age < 32 weeks or birth weight < 1,500 g who were admitted to our hospital from August 2016 to December 2017 were recruited. A pumping diary and a questionnaire were completed by mothers (n = 30). Milk samples from before, during, and after each pumping session on days 7 and 14 postpartum were analyzed. Results: The median time to onset of lactogenesis II was 75.4 h. Mean milk output increased gradually, meeting key thresholds of 350 g/d on day 6, 500 g/d on day 8, and close to 750 g/d on day 14. Then, all mean milk outputs were over 750 g/d. The mean milk output exceeded the mean feeding volume on days 7, 14, 21, 28, 35, and 42. Mothers using hospital-grade breast pumps had more cumulative milk production compared with mothers using hand expression. The milk yield on days 7 and 14 were positively correlated to that on days 21, 28, 35, and 42. Milk outputs on days 7, 14, and 42 of mothers with a pumping frequency of ≥ 6 times/d were greater than mothers with a pumping frequency of < 6 times/d. Threshold values for milk output on day 7 (cut-off, 406.8 g/d; sensitivity, 68.2%; specificity, 100%) and day 14 (cut-off, 518.0 g/d; sensitivity, 81.8%; specificity, 100%) were identified as predicting a milk output of more than 750 g/d on day 42. Fat and energy levels were higher in hind-milk than fore-or mixed-milk on days 7 and 14. Those who pumped ≥ 6 times/d had higher levels of fat, carbohydrate, and energy in their milk on day 7. Conclusion: Most preterm infants' mothers using a hospital-grade pump with a pumping frequency of ≥ 6 times/d can reach full lactation successfully. Nutrient analysis of the human milk should be performed.

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Section: Discussionmentioning

confidence: 86%

Successful Full Lactation Achieved by Mothers of Preterm Infants Using Exclusive Pumping

Huang

Feng

2020

Front. Pediatr.

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“…In qualitative studies exploring the mother's experiences of feeding their late preterm infants at home during the first weeks of life, mothers describe their exhaustion due to their efforts to adhere to imposed feeding schedules and conflicting advice from health care staff (Cescutti‐Butler, Hemingway, & Hewitt‐Taylor, ; Dosani et al, ; Radtke Demirci et al, ). Insufficient milk supply is one of the most common reasons women give for breastfeeding cessation, and this applies to mothers of preterm (Alves, Magano, Amorim, Nogueira, & Silva, ; Boucher, Brazal, Graham‐Certosini, Carnaghan‐Sherrard, & Feeley, ; Gianni et al, ), late preterm (Kair & Colaizy, ), and term infants (Gatti, ). The results of the present study suggest that a perception of having an abundance of breast milk, which is the opposite of having a perceived insufficient milk supply, during the first week at home, is a facilitator for exclusive LPT breastfeeding at 1 month.…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding progression in late preterm infants from birth to one month

Jónsdóttir

Skuladottir

et al. 2019

Maternal & Child Nutrition

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This study aimed to describe and compare breastfeeding progression, infants' feeding behaviours, maternal feeding difficulties, and mothers' usage of breastfeeding interventions for singleton late preterm (LPT) and term infants. A further aim was to identify associated factors for exclusive breastfeeding at breast at 1 month in LPT infants.This was a cohort study where mothers of LPT infants from a neonatal unit (n = 60), LPT infants from a maternity unit (n = 62), and term infants from a maternity unit (n = 269) answered a questionnaire approximately 1 month after delivery. Findings showed no significant differences in exclusive breastfeeding at breasts between LPT infants admitted to the neonatal unit compared with the maternity unit, during the first week at home (38% vs. 48%), or at 1 month of age (52% vs. 50%). Term infants were more likely to be exclusively breastfed at the breast (86% and 74%, p < 0.05) compared with LPT infants. Multiple regression analysis showed that usage of a nipple shield, not feeding breast milk exclusively during the first week at home, or feeding less than 10 times per day at 1 month were statistically significant for not exclusively breastfeed at the breast. A protective factor was the mothers' experience of having an abundance of milk during the first week at home. In conclusion, LPT infants are less likely to be exclusively breastfed at the breast than term infants, highlighting the need for further research to guide interventions aimed at optimising exclusive breastfeeding rates.

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“…The mothers in the sample were a mean age of 28.4 years (SD = 6.9), and the majority claimed to have a partner (Alves, Magano, Amorim, Nogueira, & Silva, ; Fernández Medina et al., ; Sassá et al., ), characteristics that are considered protective for breastfeeding. There were no differences between studies in relation to the women's parity; however, cesarean section was the most common birth method (Alves et al., ; Briere et al., ; Fernández Medina et al., ; Sassá et al., ). The present study, and those cited, were conducted at maternity hospitals that are reference centers for women with complications during pregnancy and infant birth, which may explain the greater number of cesarean sections.…”

Section: Discussionmentioning

confidence: 99%

Validation of Nursing Outcomes Related to Breastfeeding Establishment

Emídio¹,

Moorhead

Oliveira

et al. 2019

Int J of Nursing Knowl

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PURPOSE To clinically validate indicators of the nursing outcomes “Breastfeeding establishment: Infant (1000)” and “Breastfeeding establishment: maternal (1001)”, and their conceptual and operational definitions in infants admitted to a neonatal unit and their mothers. METHOD This study utilized several methods in a stepwise approach including an integrative review of the literature, content validation, and clinical validation. The content validity index was performed by eight experts, who evaluated revised content of the studied nursing outcomes. In the clinical validation, 61 mother–infant dyads were evaluated by two pairs of nurses: one pair used an instrument with developed definitions, whereas the other used an instrument without definitions. The evaluations were compared using Fleiss’ kappa and weighted kappa. RESULTS The agreement between all evaluators was considered excellent for almost all nursing outcome indicators related to the mothers. The pair of evaluators using the definitions had an agreement greater than 0.80 for most indicators. For the pair that did not use the definitions, agreement was poor. CONCLUSION There was an increase in uniformity and accuracy between the assessments when using the conceptual and operational definitions for the nursing outcome indicators related to Breastfeeding establishment. IMPLICATIONS FOR NURSING PRACTICE This study contributed to the development of terms within the Nursing Outcomes Classification, and enriched the body of nursing knowledge.

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Factors Influencing Parent Reports of Facilitators and Barriers to Human Milk Supply in Neonatal Intensive Care Units

Abstract: The parent's gender and education and the infant's birth weight are crucial considerations for establishing optimal practices for supporting breastfeeding.

Cited by 43 publications

References 38 publications

Successful Full Lactation Achieved by Mothers of Preterm Infants Using Exclusive Pumping

Successful Full Lactation Achieved by Mothers of Preterm Infants Using Exclusive Pumping

Breastfeeding progression in late preterm infants from birth to one month

Validation of Nursing Outcomes Related to Breastfeeding Establishment

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