A shorter breastfeeding duration in late preterm infants than term infants during the first year

Jónsdóttir, Rakel; Jónsdóttir, Helga; Örlygsdóttir, Brynja; Flacking, Renée

doi:10.1111/apa.15596

Cited by 25 publications

(23 citation statements)

References 25 publications

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“…Although a broad definition of breastfeeding was used during the literature search and selection of papers, positive experiences of feeding the infant were only described when the mother breastfed at breast in all papers. One reason for this could be that in many settings the norm and goal is to feed the infant directly at breast [ 5 , 8 ]. When mothers do not achieve this goal but instead feed the infant by alternative means, i.e., a bottle, the overall experience becomes negative.…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that even small changes in the prevalence of breast milk feeding may result in significant changes in health, healthcare costs, and economic productivity for preterm infants and their mothers [ 2 ]. Despite the overwhelming evidence of the value of breast milk for mothers and their preterm and/or LBW infants, there are wide variations in the initiation and duration rates of feeding breast milk [ 3 – 5 ], where preterm infants have shown to have a shorter breast milk feeding duration compared to term infants [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Positive breastfeeding experiences and facilitators in mothers of preterm and low birthweight infants: a meta-ethnographic review

et al. 2021

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Background Most qualitative research on breastfeeding the preterm or low-birthweight (LBW) infant has focused on negative insights; there are no comprehensive insights into how, when and why mothers experience positive breastfeeding experiences. We aimed to address this knowledge gap by exploring what characterizes and facilitates a positive breastfeeding experience in mothers of preterm and/or LBW infants. Methods A systematic review using meta-ethnographic methods was conducted. Search strategies involved a comprehensive search strategy on six bibliographic databases, citation tracking and reference checking. The analysis involved a reciprocal level of translation and a line of argument synthesis. Results Searches identified 1774 hits and 17 articles from 14 studies were included, representing the views of 697 mothers. A positive breastfeeding experience was identified as being ‘attuned’. Three themes and eight sub-themes were developed to describe what characterizes attuned breastfeeding. ‘Trusting the body and what it can do’, concerned how attuned breastfeeding was facilitated through understanding the bodily responses and capacity and feeling comfortable with holding the infant and to breastfeed. ‘Being emotionally present – in the here and now’ described the importance of feeling relaxed and reassured. ‘Experiencing mutual positive responses’, illuminated how attunement was related to feelings of mutuality - when the mother recognises the infant’s cues, responds to these signals and receives a positive response from the infant. The key factors to facilitate attuned breastfeeding were opportunities for prolonged close physical contact with the infant, positive relationships with and support from staff and peers, and being facilitated to breastfeed when the infant showed feeding cues. Conclusions This study provides new insights into what characterizes a positive breastfeeding experience and how staff can facilitate and enable mothers to achieve attuned breastfeeding. Improvements in units’ design, such as for rooming-in and having prolonged skin-to-skin contact, and care provided by knowledgeable, supportive and encouraging staff and peers, are crucial. The mother’s physical and emotional states and the infant’s behavioural responses and physiological signals should guide the process towards positive breastfeeding practices.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Positive breastfeeding experiences and facilitators in mothers of preterm and low birthweight infants: a meta-ethnographic review

et al. 2021

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“…The aim of the qualitative phase was to help explain and elaborate on the results obtained in the first phase [26,27]. According to this mixed-method study design, the first phase consisted of an analysis of the quantitative data on all twins in a longitudinal cohort survey of mothers of LPT (34 0 / 7 to 36 6 / 7 weeks) infants and term (37 0 / 7 to 41 6 / 7 weeks) infants [28,29]. In the second phase, the qualitative phase, issues from the first phase and literature were explored in individual semi-structured interviews with another population of mothers of LPT twins.…”

Section: Methodsmentioning

confidence: 99%

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

2022

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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.

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“…In this cohort study, maternal-infant separation was found to be most common in late preterm newborns (LPT)(34 + 0 –36 + 6 ), who had a low exclusive breastfeeding rate after discharge from the hospital, only 45 of 359 (12.5%) late premature infants were exclusively breastfed 6 months after discharge from the hospital, far below the WHO target of 50% exclusive breastfeeding rate at 6 months [ 27 ]. Several studies have revealed lower rates of breastfeeding initiation and shorter breastfeeding duration in LPT newborns when compared to term infants [ 37 , 38 ], despite the recognized short- and long-term effects of LPT births, as well as the mother and baby health benefits of breastfeeding [ 37 ]. These differences in breastfeeding could be due to a variety of factors, including maternal medical difficulties, delayed lactogenesis and infant clinical abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with post NICU discharge exclusive breastfeeding rate and duration amongst first time mothers of preterm infants in Shanghai: a longitudinal cohort study

Jiang

2022

Int Breastfeed J

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Background Breastfeeding is crucial for the preterm infants. Breast milk is not only food but also medicine. Few studies have focused on the longitudinal effects of exclusive breastfeeding outcome of preterm infants separated from their mothers after discharge, especially in Shanghai. We aimed to examine the exclusive breastfeeding rate and duration amongst first time mothers of preterm infants after discharge and its determinants. Methods Analyses were based on 500 preterm infants separated from their mothers in a tertiary maternity and infant-specialized hospital in Shanghai from September 2018 to September 2019.The Socio-demographic characteristics, breastfeeding knowledge questionnaire, breastfeeding self-efficacy short form scale, Edinburgh postpartum depression scale and breastfeeding family support scale were used for the investigation and the exclusive breastfeeding rate of premature infants was followed up on 1 month, 3 months and 6 months after discharge. The changing trend of breastfeeding knowledge, breastfeeding self-efficacy, postpartum depression and family support were measured by ANOVA at different stages. Using the chi-square test and multiple logistic regression, factors impacting the breastfeeding rate of preterm infants at three time intervals after discharge were investigated. The Kaplan Meier survival curve and cox regression model were used to analyze the determinants of exclusive breastfeeding duration of premature infants after discharge. Results Exclusive breastfeeding rates were 19.0, 17.2 and 10.4% at 1 month, 3 months and 6 months after discharge of preterm infants, respectively. The average length of exclusive breastfeeding duration was(3.69 ± 1.80)months. Finally, type of delivery (adjusted odds ratio [AOR] 1.564; 95% confidence interval [CI] 0.513,3.116), gestational age(AOR 0.612, 95% CI 0.236, 3.418), maternal family support (AOR 6.125,95% CI 6.359, 98.452) were discovered to be independent predictors on the exclusive breastfeeding rate at 6 months after preterm infants were discharged. Through the cox regression model, we found that a maternal planned pregnancy (HR 0.681, 95%CI 0.531,0.873), delivering breast milk during hospitalization (HR 0.797, 95%CI 0.412,2.288), NICU feeding mode during hospitalization (HR 1.221, 95%CI 0.128,1.381) and family support (HR 0.561, 95%CI 0.004,2.428) were significantly associated with the exclusive breastfeeding duration after discharge. Conclusions The exclusive breastfeeding outcome of premature infants was affected by many factors, so we should focus on the three levels of individual, family, society and design targeted intervention measures to increase the exclusive breastfeeding rate and prolong exclusive breastfeeding duration.

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A shorter breastfeeding duration in late preterm infants than term infants during the first year

Cited by 25 publications

References 25 publications

Positive breastfeeding experiences and facilitators in mothers of preterm and low birthweight infants: a meta-ethnographic review

Positive breastfeeding experiences and facilitators in mothers of preterm and low birthweight infants: a meta-ethnographic review

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

Factors associated with post NICU discharge exclusive breastfeeding rate and duration amongst first time mothers of preterm infants in Shanghai: a longitudinal cohort study

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