Preterm Infants' Mothers' Experiences With Milk Expression and Breastfeeding

Ikonen, Riikka; Paavilainen, Eija; Kaunonen, Marja

doi:10.1097/anc.0000000000000232

Cited by 73 publications

(85 citation statements)

References 30 publications

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“…An additional motive for prolonging the intervention is that breastfeeding problems such as low breast milk supply also occur later in the lactation period for some mothers. A low milk supply has previously been described as one of the main reasons for discontinuing breastfeeding .…”

Section: Discussionmentioning

confidence: 99%

Proactive telephone support provided to breastfeeding mothers of preterm infants after discharge: a randomised controlled trial

et al. 2018

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AimThe aim was to evaluate the effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants after discharge from neonatal intensive care units (NICU).MethodsBetween March 2013 and December 2015, a randomised controlled trial was conducted at six NICUs across Sweden. At each NICU, a breastfeeding support team recruited, randomised and delivered the support to participating mothers. The intervention group received a daily proactive telephone call up to 14 days after discharge from the support team. The control group could initiate telephone contact themselves. Primary outcome was exclusive breastfeeding eight weeks after discharge. Secondary outcomes were maternal satisfaction with breastfeeding, attachment, quality of life and parental stress.ResultsIn total, 493 mothers were randomised, 231 to intervention group and 262 to control group. There were no differences between the groups for exclusive breastfeeding, odds ratio 0.96, 95% CI 0.66–1.38, nor for maternal satisfaction with breastfeeding, attachment or quality of life. The intervention group reported significantly less parental stress than the controls, t = 2.44, 95% CI 0.03–0.23, effect size d = 0.26.ConclusionIn this trial, proactive telephone support was not associated with increased exclusive breastfeeding prevalence eight weeks following discharge. However, intervention group mothers showed significantly lower parental stress.

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Section: Discussionmentioning

confidence: 99%

Proactive telephone support provided to breastfeeding mothers of preterm infants after discharge: a randomised controlled trial

et al. 2018

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“…Indeed, in the present study, the possibility of having the baby in the same room as the mother or being able to see him without time constraints was reported to be effective in promoting breastfeeding in 27 % of cases. A total of 24 (20 %) infants had to be admitted to level III care until their clinical conditions stabilized, which could have further prolonged the separation from their mother and increased maternal anxiety; this, in turn, could have negatively affected lactogenesis II [1, 17]. Indeed, NICU-admitted infants have been reported to be particularly susceptible to poor breastfeeding outcomes [18].…”

Section: Discussionmentioning

confidence: 99%

Facilitators and barriers of breastfeeding late preterm infants according to mothers’ experiences

et al. 2016

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BackgroundLate preterm infants account for the majority of preterm births. They are at an increased risk of neonatal mortality and morbidity and are less likely to initiate breastfeeding and to be exclusively breastfed at discharge compared to infants born at term. The aim of this study was to identify the facilitators and barriers to breastfeeding during hospital stays according to the experiences of mothers of late preterm infants.MethodsWe conducted a cross-sectional questionnaire survey. Mothers who intended to breastfeed and had given birth to a newborn admitted to level I and II care, with a gestational age of 34 0/7 to 36 6/7 weeks, were enrolled. Sociodemographic data, neonatal variables, mode of feeding and feeding status at discharge were also collected.ResultsA total of 92 mothers who had given birth to 121 infants were enrolled. At discharge, any human milk was fed to 94 % of infants, with exclusively human milk being fed in 43 % of cases; exclusively formula was fed to 6 % of infants. In the multivariate analysis, having expressed breast milk was independently associated with an increased risk of being fed with either any human milk or formula only (OR = 2.73, 95 % CI 1.05–7.1, p = 0.039), whereas being encouraged to practice kangaroo mother care tended to have a protective effect (OR = 0.46, 95 % CI 0.2–1.06, p = 0.07).ConclusionsBased on the present findings, health care professionals should strive to fully implement breastfeeding support for mothers of late preterm infants who intend to breastfeed, in particular optimizing breast milk expression and promoting kangaroo mother care. Further studies are needed to gain further insight into the complex interplay of the factors that modulate breastfeeding outcome in late preterm infants.

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“…(Lechner & Vohr, 2017;Vohr et al, 2007;Vohr et al, 2017). Breastfeeding a very preterm infant also reinforces the mother's caregiving role in the neonatal intensive care unit (NICU) and can promote bonding (Flacking, Ewald, Nyqvist, & Starrin, 2006;Ikonen, Paavilainen, & Kaunonen, 2015). However, breastfeeding a very preterm infant is challenging, requiring the mother to pump milk regularly until her child has acquired the capacity to suckle at the breast and posing multiple logistic challenges during the long neonatal hospitalization (Callen & Pinelli, 2005;Nye, 2008).…”

Section: Introductionmentioning

confidence: 99%

Low breastfeeding continuation to 6 months for very preterm infants: A European multiregional cohort study

Bonnet

Blondel

Piedvache

et al. 2018

Maternal & Child Nutrition

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Breastfeeding confers multiple benefits for the health and development of very preterm infants, but there is scarce information on the duration of breastfeeding after discharge from the neonatal intensive care unit (NICU). We used data from the Effective Perinatal Intensive Care in Europe population-based cohort of births below 32 weeks of gestation in 11 European countries in 2011-2012 to investigate breastfeeding continuation until 6 months. Clinical and sociodemographic characteristics were collected from obstetric and neonatal medical records as well as parental questionnaires at 2 years of corrected age. Among 3,217 ever-breastfed infants, 34% were breastfeeding at 6 months of age (range across countries from 25% to 56%); younger and less educated mothers were more likely to stop before 6 months (adjusted relative risk [aRR] <25 years: 0.68, 95% CI [0.53, 0.88], vs. 25-34 years; lower secondary: 0.58, 95% CI [0.45, 0.76] vs. postgraduate education). Multiple birth, bronchopulmonary dysplasia (BPD), and several neonatal transfers reduced the probability of continuation but not low gestational age, fetal growth restriction, congenital anomalies, or severe neonatal morbidities. Among infants breastfeeding at discharge, mixed versus exclusive breast milk feeding at discharge was associated with stopping before 6 months: aRR = 0.60, 95% CI [0.48, 0.74]. Low breastfeeding continuation rates in this high-risk population call for more support to breastfeeding mothers during and after the neonatal hospitalization, especially for families with low socio-economic status, multiples, and infants with BPD. Promotion of exclusive breastfeeding in the NICU may constitute a lever for improving breastfeeding continuation after discharge.

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Preterm Infants' Mothers' Experiences With Milk Expression and Breastfeeding

Abstract: Future research is needed about mothers' experiences using supplementation methods, test-weighing, exploring experiences of mothers of late-preterm infants, and the validity of the concept of coping with this phenomenon.

Cited by 73 publications

References 30 publications

Proactive telephone support provided to breastfeeding mothers of preterm infants after discharge: a randomised controlled trial

Proactive telephone support provided to breastfeeding mothers of preterm infants after discharge: a randomised controlled trial

Facilitators and barriers of breastfeeding late preterm infants according to mothers’ experiences

Low breastfeeding continuation to 6 months for very preterm infants: A European multiregional cohort study

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