Breastfeeding needs of mothers of preterm infants in China: a qualitative study informed by the behaviour change wheel

Abstract

Background Although breastfeeding is strongly recommended, the breastfeeding rate of preterm infants in China remains significantly low. In addition to the global structural challenges to breastfeeding and the physiological immaturity of preterm infants, Chinese mothers of preterm infants face unique challenges of maternal-infant separation after birth. Moreover, little is known about Chinese mothers’ specific needs in coping with the difficulties posed by these challenges. This study utilized the Behaviour Change Wheel to investigate the breastfeeding needs of Chinese preterm mothers that may facilitate its practice in the future. Method A qualitative descriptive design was implemented in Wuhan in 2022. Based on purposeful sampling, 13 preterm mothers were recruited from a NICU in a Grade III Class A hospital in Wuhan, China. Face-to-face semi-structured interviews were conducted to collect data using the interview guide developed by the Theoretical Domains Framework. Theoretical Thematic Analysis was used to review the data in 6 steps to identify themes. Results Five major themes emerged: (1) capability: ability to interpret infants’ cues and identify problems, and need for breastfeeding knowledge and skills training; (2) physical opportunity: cleanliness and quietness in household environment, private lactation spaces and breastfeeding tools in workplaces and hospitals; (3) social opportunity: family support, peer support, and authoritative support from healthcare providers; (4) reflective motivation: information on health impacts of breastfeeding; (5) automatic motivation: maternal-infant bonding, free of aversive stimulus. Conclusion Preterm mothers’ needs to enable breastfeeding were diverse, including increasing their capability, physical and social opportunities, and reflective and automatic motivation. People, resources and environments associated with these needs should be engaged together to stablish a conducive structural environment for breastfeeding. The policy change for “zero separation” and implementation of kangaroo care should also be implemented in Chinese neonatal intensive care units. Future studies are needed to design effective interventions according to mothers’ specific needs.

Experiences of Indonesian nurses in improving preterm oral feeding readiness in special care units: A qualitative descriptive study

“…Descriptive research by Cardin et al ( 2023 ) investigated the understanding of the complexities of oral feeding within a cultural context. Other qualitative studies have explored mothers’ experiences, expectations, and psychosocial needs regarding feeding (Clapton-Caputo et al, 2021 ; Thomson et al, 2023 ; Yang et al, 2022 ; Yu et al, 2023 ). Pramono et al ( 2022 ) investigated Indonesian nurses’ experiences with successful breastfeeding, but it was not specific to preterm infants in the enteral to oral feeding transition period in special care units.…”

“…Most qualitative research conducted thus far has explored the experience of oral feeding readiness from the perspective of parents of preterm infants (Cardin et al, 2023 ; Clapton-Caputo et al, 2021 ; Hariati et al, 2023 ; Thomson et al, 2023 ; Yang et al, 2022 ; Yu et al, 2023 ). In contrast to previous studies involving parents of preterm infants admitted to special care units, the current research focuses on nurses working in special care units at levels II and III.…”