Fathers’ experiences of feeding their extremely preterm infants in family-centred neonatal intensive care: a qualitative study

Abstract

Background Extremely preterm infants need advanced intensive care for survival and are usually not discharged before they reach the time of expected birth. In a family-centred neonatal intensive care unit both parents are involved at all levels of care including the feeding process. However, studies focusing on fathers in this situation are scarce. The purpose of this study was to explore the experiences of feeding extremely preterm infants in a neonatal intensive care unit from fathers’ perspectives. Methods The study adopts a qualitative inductive method, reported according to the COREQ checklist. Seven fathers of extremely preterm infants (gestational age 24–27 weeks) in neonatal intensive care in Sweden were interviewed by telephone after discharge in 2013–2014. The interviews were analysed using a qualitative content analysis and confirmed by triangulation in 2021. Results Six sub-categories and two generic categories formed the main category: “a team striving towards the same goal”. The fathers were equally involved and engaged members of the feeding team all hours of the day. The fathers shared responsibility and practical duties with the mothers, and they provided as much support to the mothers as they could. However, the fathers found it difficult to support and encourage the mothers to breastfeed and express breastmilk when the breastmilk production was low. The fathers experienced a loss when breastfeeding was not successful. Conclusions The findings indicate that fathers want to be involved with infant care, including night-time feeds, and long and demanding feeding processes. Fathers and staff need to collaborate to provide the best support to mothers during the feeding process. This study may inspire hospital staff to acknowledge and support fathers to become more involved in the oral feeding process when an infant is born extremely preterm.

Factors influencing fathers’ involvement in the care of hospitalized preterm newborns in Balaka, Malawi

“…Work and other responsibilities have been reported in the current study as impeding fathers' involvement in the care of hospitalized preterm newborns. This is consistent with ndings from other studies [13,[44][45][46][47], which reported that multiple responsibilities prevented the fathers from being engaged in caregiving activities. It is worth noting that at the time of the study, the Malawi labour laws were not allowing for paternal leave for those formally employed, and also the majority of the participants were not in formal employment which meant they still needed to work to earn something for the families.…”

Supporting Premature Infants’ Oral Feeding in the NICU—A Qualitative Study of Nurses’ Perspectives

“…In previous studies, it was found that the most frequently given support was related to breastmilk expression [ 14 ], while mothers in another study from an FC NICU wished for more support with breastmilk expression and breastfeeding practice [ 15 ]. Fathers have described that they find it difficult to provide support with milk expression, but also that the nurses—in their effort to provide support—sometimes asked the mothers too often if they had expressed milk [ 16 ]. Providing breastmilk and breastfeeding support is an important and delicate task for nurses in the NICU that needs to be customized and delivered individually.…”

“…All authors are female. To further ensure the trustworthiness of the findings, a data source triangulation was performed in November 2021 [ 16 , 24 ]. Three nurses currently working in the participating NICUs read the final data analysis and provided feedback.…”

“…They found their partners to be the best source of support, but expressed a need for more emotional and practical support from nurses in order to manage to express milk and practice breastfeeding for many weeks [ 15 ]. Fathers in FC NICUs have described that they give as much support to the mothers as they can, but they find it difficult to know how best to support mothers when the breastmilk ceases and, in particular, to encourage mothers to pump when there is no milk [ 16 ]. The fathers wanted more support from nurses, for the mothers and for themselves [ 16 ].…”

“…Fathers in FC NICUs have described that they give as much support to the mothers as they can, but they find it difficult to know how best to support mothers when the breastmilk ceases and, in particular, to encourage mothers to pump when there is no milk [ 16 ]. The fathers wanted more support from nurses, for the mothers and for themselves [ 16 ].…”