Improving Human Milk and Breastfeeding Practices in the NICU

Fugate, Karen Klotz; Hernández, Ivonne; Ashmeade, Terri; Miladinović, Branko; Spatz, Diane L.

doi:10.1111/1552-6909.12566

Cited by 12 publications

(17 citation statements)

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“…Evidence suggests that some interventions specifically targeting mothers in the NICU have been successful (Fugate, Ivonne, Terri, Miladinovic, & Spatz, ; McInnes & Chambers, ; Meier, Engstrom, Mingolelli, Miracle, & Kiesling, ; Merewood et al, ; Pinelli, Atkinson, & Saigal, ). Education and support approaches range from meetings with lactation consultants and other healthcare professionals to peer counselling from mothers in the community and programs for fathers (Furman, Killpack, Matthews, Davis, & O'Riordan, ; McInnes & Chambers, ; Meier et al, ; Merewood et al, ; Pinelli et al, ).…”

Section: Discussionmentioning

confidence: 99%

Predictors of breastfeeding non‐initiation in the NICU

Gertz

DeFranco

2019

Maternal & Child Nutrition

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This study compared predictors of breastfeeding non-initiation between infants who were and were not admitted to the NICU so that interventions can target high-risk mothers whose infants desperately need breastmilk. This was a population-based retrospective cohort study of singleton Ohio live births using birth certificates, 2006-2015. In babies who were and were not admitted to the NICU, a multivariable logistic regression model assessed the association between breastfeeding non-initiation and predictors relating to the mother, neonate, and labour and delivery events while adjusting for covariables. Of 1,463,506 births, 76,855 infants were admitted to the NICU (5.8% of study population), and breastfeeding was not initiated in 39.4% of them, compared with 31.5% of infants in the newborn nursery, p < 0.001. Apart from abnormal newborn conditions, smoking during pregnancy was the most significant risk factor for not breastfeeding in the NICU (RR 1.91 [95% CI 1.82-2.02]) and newborn nursery (RR 2.10 [95% CI 2.08-2.13]), followed by socioeconomic factors and multiparity. Limited prenatal visits (≤5) were a significantly higher risk factor in the NICU (RR 1.41 [95% CI 1.34-1.49]) than in the newborn nursery (RR 1.24 [95% CI 1.22-1.26]). Intentional home birth and use of infertility treatment were associated with breastfeeding initiation. The rate of breastfeeding initiation is lower in infants admitted to the NICU than those who are not, especially among mothers with limited prenatal care. Interventions should target mothers who smoke because they are least likely to breastfeed, and their babies, who are prone to serious health conditions, could especially benefit from breastmilk.

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Section: Discussionmentioning

confidence: 99%

Predictors of breastfeeding non‐initiation in the NICU

Gertz

DeFranco

2019

Maternal & Child Nutrition

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“…However, this depends on the infant's need and the volume of milk produced, which makes this statement not applicable for all situations. Premature infants may have difficulties in coordinating their ability to suck, swallow, and breathe, and/or to maintain sucking long enough to remove hindmilk, in short or long sessions, thus demonstrating signs of drowsiness and/or withdrawal (Fugate, Hernandez, Ashmeade, Miladinovic, & Spatz, ). The effectiveness of premature infants’ feeding must be evaluated carefully, by observing signs shown by them during the breastfeeding process.…”

Section: Discussionmentioning

confidence: 99%

Validation of Nursing Outcomes Related to Breastfeeding Establishment

Emídio¹,

Moorhead

Oliveira

et al. 2019

Int J of Nursing Knowl

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PURPOSE To clinically validate indicators of the nursing outcomes “Breastfeeding establishment: Infant (1000)” and “Breastfeeding establishment: maternal (1001)”, and their conceptual and operational definitions in infants admitted to a neonatal unit and their mothers. METHOD This study utilized several methods in a stepwise approach including an integrative review of the literature, content validation, and clinical validation. The content validity index was performed by eight experts, who evaluated revised content of the studied nursing outcomes. In the clinical validation, 61 mother–infant dyads were evaluated by two pairs of nurses: one pair used an instrument with developed definitions, whereas the other used an instrument without definitions. The evaluations were compared using Fleiss’ kappa and weighted kappa. RESULTS The agreement between all evaluators was considered excellent for almost all nursing outcome indicators related to the mothers. The pair of evaluators using the definitions had an agreement greater than 0.80 for most indicators. For the pair that did not use the definitions, agreement was poor. CONCLUSION There was an increase in uniformity and accuracy between the assessments when using the conceptual and operational definitions for the nursing outcome indicators related to Breastfeeding establishment. IMPLICATIONS FOR NURSING PRACTICE This study contributed to the development of terms within the Nursing Outcomes Classification, and enriched the body of nursing knowledge.

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“…1–3 However, mothers of preterm infants face significant barriers to on-going milk production, including delayed lactogenesis after delivery, low milk supply, mother-infant separation, and exclusive pumping burden. 4–10 Hospital practices that support mothers’ milk production include staff and parental education, early milk expression (≤6 hours), and skin-to-skin care. 11–13…”

Section: Introductionmentioning

confidence: 99%