“Breastfeeding at Night Is Awesome” Mothers’ Intentions of Continuation of Breastfeeding Extreme and Very Preterm Babies upon Discharge from a Kangaroo Mother Care Unit of a Tertiary Hospital in South Africa

Abstract

Kangaroo mother care (KMC) is effective in increasing mothers’ initiation and maintenance of breastfeeding (BF) for extreme and very preterm (VLBW) infants. Although South Africa has implemented KMC for more than two decades, little is known about mothers’ perspectives on KMC. The purpose of this study was to describe the BF intentions and practices of mothers of VLBW infants at home following discharge and assess the role long stay in KMC has on their decision to BF beyond discharge. This qualitative study was conducted at the KMC unit of a tertiary hospital in Pretoria, South Africa. Focus group interviews were conducted with 38 mothers of VLBW infants who had transitioned from neonatal intensive care (NICU) to KMC. We analysed transcripts following the five steps for qualitative thematic data analysis. Mothers were knowledgeable of the importance and value of BF preterm infants and conceded that breast milk has advantages over formula. Mothers had positive feelings toward BF their preterm infants. The stay in KMC increased the direct BF of their preterm infants, mothers’ BF efficacy, and had a positive influence on mothers’ intentions to continue BF following discharge and to exclusively breastfeed for six months. Their BF intentions, efficacy, and practices were influenced by the skilful BF counselling, training, and support they received from the nursing staff. High intention to BF among these mothers is suggestive of their knowledge and confidence in BF for their VLBW infants. It is important that nursing staff in NICU and KMC appreciate the significant role they play in mothers’ readiness and confidence to breastfeed beyond discharge.

Child Nutrition Outcomes and Maternal Nutrition-Related Knowledge in Rural Localities of Mbombela, South Africa

“…Lastly, the context in which children grow up in can never be ignored as one of the influences on their nutrition outcomes, and the literature documents family context, ethnicity, and social values [ 12 , 101 , 102 ]. The impact of cultural beliefs and traditional practices is acknowledged in this study considering that the study setting is known for strong cultural values and norms, as well as poverty.…”

“…For instance, over two thirds of children in this study were non-exclusively breastfed and mixed fed. These are normalized feeding practices in other African societies with health impacts on children’s health due to exposure to the risk of diarrhea and malnutrition [ 5 , 102 , 107 , 108 , 109 , 110 , 111 ]. Furthermore, the pressure exerted by the family to give the baby other food further exacerbates the problem of early introduction of solids and other liquids [ 108 , 110 ], which might explain why almost half of the children in this study started to consume solid foods under 3 months of age.…”

Monitoring the Use of Human Milk, the Ideal Food for Very Low-Birth-Weight Infants—A Narrative Review

“…DM availability [ 118 ] is considered as another effective element in promoting feeding with MOM, also through an earlier start to enteral feeding in VLBWs.…”

“…These findings are summarized in Table 2. Long hospitalization [78,79,97,98] MOM at discharge [99] Lack of communication, counseling Lack of breastfeeding support [110,111] Lack of mother's proximity [66] Dedicated spaces [48,111] Free access of parents [12,13] MOM within day 3 of age [62] High intake of MOM during the first postnatal week [68] Breastfeeding at discharge [108,109] Availability of DM [67,118] Active breastfeeding promotion/support of staff [51,69,76,78,[80][81][82][83] Baby-Friendly Hospital accreditation [67,76] Support of partner and family [66,116] KMC [51,[112][113][114]117]…”