Strategies to Support Sustained Breastfeeding of Late Preterm Multiple Birth Infants

Kuhnly, Joan Esper

doi:10.1111/1751-486x.12236

Cited by 2 publications

(2 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous research has noted that confusing or mismatching advice aimed at mothers of term infants is used for mothers of LPT infants from healthcare professionals where LPT infants and their mothers are not acknowledged as vulnerable and hence are not supported appropriately [40,46,56]. Additionally, mothers of twins often report that healthcare professionals give insufficient teaching specific to breastfeeding multiples, and they also receive conflicting advice about how to feed their infants [57,58]. This suggests that the knowledge and skills to counsel, guide, and support breastfeeding mothers of twins and LPT infants must be reconsidered.…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding initiation, duration, and experiences of mothers of late preterm twins: a mixed-methods study

2022

View full text Add to dashboard Cite

Background Twins and late preterm (LPT) infants are at an increased risk of being breastfed to a lesser extent than term singletons. This study aimed to describe the initiation and duration of any and exclusive breastfeeding at the breast for mothers of LPT twins and term twins during the first 4 months and to explore the breastfeeding experiences of mothers of LPT twins. Methods A sequential two-sample quantitative–qualitative explanatory mixed-methods design was used. The quantitative data were derived from a longitudinal cohort study in which 22 mothers of LPT twins and 41 mothers of term twins answered questionnaires at one and four months after birth (2015–2017). The qualitative data were obtained from semi-structured interviews with 14 mothers of LPT twins (2020–2021), based on results from the quantitative study and literature. Analysis included descriptive statistics of quantitative data and deductive content analysis of the qualitative data, followed by condensation and synthesis. Results All mothers of LPT twins (100%) and most mothers of term twins (96%) initiated breastfeeding. There was no difference in any breastfeeding during the first week at home (98% versus 95%) and at 1 month (88% versus 85%). However, at 4 months, the difference was significant (44% versus 75%). The qualitative data highlighted that mothers of LPT twins experienced breastfeeding as complex and strenuous. Key factors influencing mothers’ experiences and decisions were their infants’ immature breastfeeding behaviors requiring them to express breast milk alongside breastfeeding, the burden of following task-oriented feeding regimes, and the lack of guidance from healthcare professionals. As a result, mothers started to question the worth of their breastfeeding efforts, leading to changes in breastfeeding management with diverse results. Support from fathers and grandparents positively influenced sustained breastfeeding. Conclusions Mothers of LPT twins want to breastfeed, but they face many challenges in breastfeeding during the first month, leading to more LPT twins’ mothers than term twins’ mothers ceasing breastfeeding during the following months. To promote and safeguard breastfeeding in this vulnerable group, care must be differentiated from routine term infant services, and healthcare professionals need to receive proper education and training.

show abstract

Section: Discussionmentioning

confidence: 99%

Breastfeeding initiation, duration, and experiences of mothers of late preterm twins: a mixed-methods study

2022

View full text Add to dashboard Cite

show abstract

“…Future research should consider the impact of care avenues such as midwifery care, vaginal birth support, non-medical neonatal interventions, and non-clinical parental support on twin outcomes and costs among Medicaid beneficiaries. Practices such as skin-to skin kangaroo care (Conde-Aguidelo et al 2018), breastfeeding (Whitford et al 2018), and rooming in (Kuhnly 2015) may be particularly beneficial for twins and could potentially shorten NICU stays or prevent further hospitalizations. These practices may be particularly challenging, however, especially if the family has other children at home or if the mother is recovering from a cesarean section or other birth complications.…”

Section: Implications For Practicementioning

confidence: 99%

Twin Births in Medicaid: Prevalence, Outcomes, Utilization, and Cost in Four States, 2014–2015

Howell

Johnson

Cross‐Barnet

2020

Matern Child Health J

View full text Add to dashboard Cite

Objectives Twin births have increased in prevalence. Twin births are more likely to have poorer outcomes than singleton births and are more costly. However, although Medicaid paid for approximately half of U.S. births in 2016, little is known specifically about the incidence of twin births and related costs for Medicaid beneficiaries. This paper seeks to expand the knowledge of twin births covered by Medicaid. Methods We obtained data for singleton (N = 115,568) and twin (N = 3775) Medicaid-covered births in selected geographic areas of four states in 2014 and 2015. States provided linked birth certificates to Medicaid claims data for mothers and infants. We compared health care utilization and Medicaid costs for twins to singletons in the same geographic areas. Results The prevalence of Medicaid twins in the selected areas of these four states was 3.2% of births, identical to the rate of twins nationwide. Two thirds of Medicaid twins were born preterm, and average gestational age was 34.8 weeks. Mothers of twins had higher rates of C-Sect. (73.6% vs. 32.0% for singletons) and of neonatal intensive care use (45.2% vs. 11.1%). The average length of delivery stay for twins was 12.3 days, vs. 4.1, and the rate of hospital readmissions was almost twice as high. The total cost for mother and infant over the prenatal, delivery, and post-natal period for a pair of twins was $48,479, over two and a half times as high as for singleton births ($18,032). However, when considering the average cost of a single twin vs. a singleton birth, the cost differential is less ($24,239 vs. $18,032, or a ratio of 1.34). Conclusions Medicaid twins are a fragile population with poorer outcomes and higher service use than singleton infants. Twins contribute substantially to the Medicaid cost of maternity and newborn care. A variety of strategies can be used to improve twin outcomes and reduce costs.

show abstract

Strategies to Support Sustained Breastfeeding of Late Preterm Multiple Birth Infants

Cited by 2 publications

References 18 publications

Breastfeeding initiation, duration, and experiences of mothers of late preterm twins: a mixed-methods study

Breastfeeding initiation, duration, and experiences of mothers of late preterm twins: a mixed-methods study

Twin Births in Medicaid: Prevalence, Outcomes, Utilization, and Cost in Four States, 2014–2015

Contact Info

Product

Resources

About