Promoting Breastfeeding and Lactation Among Mothers of Premature Newborns in a Hospital in China

Yu, Guiling; Liu, Furong; Zhao, Yingxin; Kong, Yan; Wei, Holly

doi:10.1016/j.nwh.2020.11.005

Cited by 10 publications

(16 citation statements)

References 19 publications

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“…After removing duplicates, the titles/abstracts of 69 articles were screened, and 49 articles were excluded. We reviewed the full text of 20 studies; 16 studies (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) were included in systematic review and four studies (33)(34)(35)(36) were excluded because of insufficient primary outcomes or same study cohort; 13 studies were included in the meta-analysis for the primary outcome (17-21, 23, 24, 27-32), another 3 studies were excluded due to insufficient dichotomous data. Figure 1 shows the detailed flow chart.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies (641 infants) ( 20 , 31 , 32 ) reported the rate of any breastfeeding during hospitalization, with high heterogeneity ( I 2 = 90%), and QI improved the rate of any breastfeeding during hospitalization ( RR = 1.89, 95% CI: 1.09–3.29, P = 0.02) ( Figure 4 ). Subgroup analysis by country showed that heterogeneity was low among the Chinese studies ( I 2 = 0%), and the rate was significantly improved after QI ( RR = 2.34, 95% CI: 1.94–2.83, P < 0.00001), which may be related to the higher compliance and acceptance of the participants.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies (1,084 infants) ( 20 , 21 , 31 , 32 ) reported the rate of exclusive MOM during hospitalization, for which large heterogeneity was found ( I 2 = 86%), and QI did not make a significant difference between the two groups ( RR = 1.53, 95% CI: 0.78–2.98, P = 0.22) ( Figure 5 ). In the study measurements of Zhou et al ( 31 ), there was a statistical value of 0; when we removed this study, the heterogeneity was dramatically reduced ( I 2 = 0%), indicating that it was the source of heterogeneity, and the comprehensive results suggested that QI could still significantly increase the rate of exclusive MOM during hospitalization ( RR = 1.21, 95% CI: 1.08–1.35, P = 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies ( 17 , 22 , 24 ) did not report the major process outcomes ( Table 3 ). Two different studies reported the process outcomes of prenatal human milk education ( 26 , 32 ), first milk expression within 6 h ( 23 , 26 ), and any MOM at initiation of feeds separately ( 21 , 23 ), which were all improved significantly during the QI interventions. One study reported that QI improved any skin-to-skin care in the first month ( 26 ), oropharyngeal therapy doses administered in the first 7 days of life ( 30 ), and the rate of using hospital-grade pumps ( 23 ), respectively, but another study ( 25 ) showed a decline in the proportion of feeding donor human milk and no difference in the time of first MOM feeding.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies did not report the balancing outcomes ( 18 , 22 , 24 , 28 , 32 ) ( Table 3 ). Two studies ( 17 , 21 ) showed that the risk of NEC decreased significantly after implementation of the QI bundle, but four studies ( 26 , 27 , 30 , 31 ) showed no statistical differences.…”

Section: Resultsmentioning

confidence: 99%

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Quality Improvement to Increase Breastfeeding in Preterm Infants: Systematic Review and Meta-Analysis

Fang¹,

Wu²,

Han

et al. 2021

Front. Pediatr.

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Background and Objective: Due to its numerous health benefits, breast milk (BM) is recommended for preterm infants. Despite such recommendations, the rates of breastfeeding in preterm infants are lower than that in term infants. Quality improvement (QI) bundles increase breastfeeding in preterm infants, but their replication in neonatal intensive care units has had inconsistent outcomes.Methods: We used the Population or Problem, Intervention, Comparison, and Outcomes (PICO) framework to develop our search strategy, and searched MEDLINE, Embase, and the Cochrane Library from inception through January 15, 2021. Studies describing any active QI intervention to increase BM use in preterm infants were included. The primary outcome measure was the rate of any breastfeeding or exclusive mother's own milk (MOM) at discharge or during hospitalization.Results: Sixteen studies were eligible for inclusion and showed an acceptable risk of bias, and included 1 interrupted time series, study 3 controlled before-and-after studies, and 12 uncontrolled before-and-after studies; of these, 3 studies were excluded due to insufficient dichotomous data, 13 were included in the meta-analysis. In the meta-analysis, the rate of any breastfeeding was significantly improved at discharge and during hospitalization after QI [risk ratio (RR) = 1.23, 95% confidence interval (CI): 1.14–1.32, P < 0.00001 and RR = 1.89, 95% CI: 1.09–3.29, P = 0.02, respectively]. The rate of exclusive MOM after QI was also significantly increased at discharge (RR = 1.51, 95% CI: 1.04–2.18, P = 0.03), but not during hospitalization (RR = 1.53, 95% CI: 0.78–2.98, P = 0.22). However, after sensitivity analysis, the comprehensive results still suggested that QI could significantly improve the rate of exclusive MOM during hospitalization (RR = 1.21, 95% CI: 1.08–1.35, P = 0.001). Funnel plots and Egger's test indicated publication bias in the rate of any BF at discharge. We corrected publication bias by trim and fill analysis, and corrected RR to 1.272, 95% CI: (1.175, 1.369), which was consistent with the results of the initial model.Conclusions: A QI bundle appears to be effective for promoting BM use in preterm infants at discharge or during hospitalization.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Quality Improvement to Increase Breastfeeding in Preterm Infants: Systematic Review and Meta-Analysis

Fang¹,

Wu²,

Han

et al. 2021

Front. Pediatr.

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The development of an evidence-informed Convergent Care Theory: Working together to achieve optimal health outcomes

Wei

2022

International Journal of Nursing Sciences

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Background Healthcare is a complex and divergent system with uncertainty, unpredictability, and multi-layered stakeholders. The relationships among the stakeholders are multifaceted and dynamic, requiring continual interpersonal connections, networks, and co-evolution. It is pivotal to have an evidence-informed theory to explain the phenomenon, uniting the multifaceted stakeholders’ efforts. Purpose To describe the development of an evidence-informed theory, the Convergent Care Theory, assembling healthcare stakeholders to work together and achieve optimal health outcomes. Methods The Convergent Care Theory was developed using a theory synthesis approach based on empirical research and literature reviews published by the theory-proposing author. The empirical evidence was categorized into: patients and families, healthcare providers, healthcare organizations, and patients’ and healthcare providers’ self-care. Results The Convergent Care Theory includes four concepts: all-inclusive organizational care , healthcare professional collaborative care, person-centered precision care, and patients ’ and healthcare providers’ self-care . Achieving convergent care is a process requiring all stakeholders to work together. Six major facilitators emerged from the research evidence: competence, compassion, accountability, trusting, sharing, and engaging. Conclusion This article introduced the development process of the evidence-informed Convergent Care Theory. Healthcare systems are complex, with multiple stakeholders’ needs to meet. The Convergent Care Theory strives to unite healthcare stakeholders, bond resources, and join forces to achieve optimal healthcare outcomes. The underpinning of the theory is a caring culture, which is an underlying code for organizational and team behaviors and the foundation of optimal health outcomes.

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Impact of theory of planned behavior based intervention on breastfeeding patterns of the mothers with preterm infants: a randomized trial

Okhovat,

Janighorban,

Kazemi

2024

BMC Public Health

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Promoting Breastfeeding and Lactation Among Mothers of Premature Newborns in a Hospital in China

Cited by 10 publications

References 19 publications

Quality Improvement to Increase Breastfeeding in Preterm Infants: Systematic Review and Meta-Analysis

Quality Improvement to Increase Breastfeeding in Preterm Infants: Systematic Review and Meta-Analysis

The development of an evidence-informed Convergent Care Theory: Working together to achieve optimal health outcomes

Impact of theory of planned behavior based intervention on breastfeeding patterns of the mothers with preterm infants: a randomized trial

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