A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth

Lina Palmér, Jenny Ericson, Lina Palmér, Jenny Ericson

Abstract

Background: Being a mother of a preterm infant (< 37 gestational weeks) puts the mother in a vulnerable and fragile situation wherein breastfeeding is an important part of becoming a mother and bonding with the infant. Nevertheless, the breastfeeding experience of mothers during the first year after a preterm birth has not been well studied. To develop professional caring and supporting relationships, it is important to address this knowledge gap. The aim of this study was to describe the breastfeeding experience of mothers of preterm infants from birth up until 12 months after birth.

Methods: The data in this qualitative study are derived from a multicentre randomized controlled trial where 270 mothers of preterm infants provided 496 written comments through questionnaires containing open-ended questions. The questionnaires were sent to the mother three times during the first 12 months after birth. A thematic network analysis based on hermeneutical philosophy was used to analyse and interpret the resulting data to describe the mothers' experiences of breastfeeding.

Results: Three organizing themes, namely, "navigating smoothly," "navigating with a struggle" and "navigating in ambiguity" were revealed in the mothers' narratives regarding their breastfeeding experiences during the first 12 months after birth. These organizing themes were further interpreted as one global theme that was deemed "A journey to finding one's unique way in breastfeeding."

Conclusion: Mothers of preterm infants are in an exposed and vulnerable situation when initiating breastfeeding during the first year. This situation leads to a unique journey wherein each mother navigates through breastfeeding depending on her individual situation. An awareness of the diversity of breastfeeding experiences may contribute to the provision of professional caring and supportive relationships.

Trial registration: www.clinicaltrial.gov NCT01806480 registered 7 March 2013.

Keywords: Breastfeeding; Experiences; First year; Mothers; Preterm infant; Qualitative.

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Basic themes, organizing themes and the global theme that illustrate the findings and the analytic process. The tracks are intertwined with each other and can be understood as tracks on a map where the goal is to find one’s own unique way in breastfeeding

References

    1. Flacking R, Nyqvist KH, Ewald U. Effects of socioeconomic status on breastfeeding duration in mothers of preterm and term infants. Eur J Pub Health. 2007;17(6):579–584. doi: 10.1093/eurpub/ckm019.
    1. Dosani A, Hemraj J, Premji SS, Currie G, Reilly SM, Lodha AK, et al. Breastfeeding the late preterm infant: experiences of mothers and perceptions of public health nurses. Int Breastfeed J. 2016;12:23. doi: 10.1186/s13006-017-0114-0.
    1. Kair LR, Flaherman VJ, Newby KA, Colaizy TT. The experience of breastfeeding the late preterm infant: a qualitative study. Breastfeed Med. 2015;10(2):102–106. doi: 10.1089/bfm.2014.0121.
    1. Niela-Vilen H, Axelin A, Melender HL, Salantera S. Aiming to be a breastfeeding mother in a neonatal intensive care unit and at home: a thematic analysis of peer-support group discussion in social media. Matern Child Nutr. 2015;11(4):712–726. doi: 10.1111/mcn.12108.
    1. Flacking R, Ewald U, Nyqvist KH, Starrin B. Trustful bonds: a key to “becoming a mother” and to reciprocal breastfeeding. Stories of mothers of very preterm infants at a neonatal unit. Soc Sci Med. 2006;62(1):70–80. doi: 10.1016/j.socscimed.2005.05.026.
    1. Ikonen R, Paavilainen E, Kaunonen M. Preterm infants’ mothers’ experiences with milk expression and breastfeeding: an integrative review. Adv Neonatal Care. 2015;15(6):394–406. doi: 10.1097/ANC.0000000000000232.
    1. Ericson J, Palmer L. Mothers of preterm infants’ experiences of breastfeeding support in the first 12 months after birth: a qualitative study. Birth. 2019;46:129–136. doi: 10.1111/birt.12383.
    1. Flacking R, Ewald U, Starrin B. “I wanted to do a good job”: experiences of ‘becoming a mother’ and breastfeeding in mothers of very preterm infants after discharge from a neonatal unit. Soc Sci Med. 2007;64(12):2405–2416. doi: 10.1016/j.socscimed.2007.03.008.
    1. Niela-Vilen H, Axelin A, Salantera S, Melender HL. A typology of breastfeeding mothers of preterm infants: a qualitative analysis. Adv Neonatal Care. 2019;19(1):42–50. doi: 10.1097/ANC.0000000000000542.
    1. Ericson J, Eriksson M, Hellstrom-Westas L, Hoddinott P, Flacking R. Proactive telephone support provided to breastfeeding mothers of preterm infants after discharge: a randomised controlled trial. Acta Paediatr. 2018;107:791–798. doi: 10.1111/apa.14257.
    1. Ericson J, Flacking R, Udo C. Mothers’ experiences of a telephone based breastfeeding support intervention after discharge from neonatal intensive care units: a mixed-method study. Int Breastfeed J. 2017;12:50. doi: 10.1186/s13006-017-0142-9.
    1. Ericson J, Eriksson M, Hellstrom-Westas L, Hagberg L, Hoddinott P, Flacking R. The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants: study protocol for a randomized controlled trial. BMC Pediatr. 2013;13:73. doi: 10.1186/1471-2431-13-73.
    1. Gadamer H-G. In: Truth and method. First paperbacktranslation revised by. Weinsheimer J, Marshall DG, editors. London: Bloomsbury; 2013.
    1. Dahlberg K, Dahlberg H, Nyström M. Reflective lifeworld research. 2. Ed. Lund: Studentlitteratur. 2008. pp. 23–94.
    1. Attride-Stirling J. Thematic networks: an analytic tool for qualitative research. Qual Res. 2001;1(3):385–405. doi: 10.1177/146879410100100307.
    1. Nelson AM. A metasynthesis of qualitative breastfeeding studies. J Midwifery Womens Health. 2006;51(2):e13–e20. doi: 10.1016/j.jmwh.2005.09.011.
    1. Charlick SJ, McKellar L, Gordon AL, Pincombe J. The private journey: an interpretative phenomenological analysis of exclusive breastfeeding. Women Birth. 2019;32(1):e34–e42. doi: 10.1016/j.wombi.2018.03.003.
    1. Palmer L, Carlsson G, Mollberg M, Nystrom M. Severe breastfeeding difficulties: existential lostness as a mother-women's lived experiences of initiating breastfeeding under severe difficulties. Int J Qual Stud Health Well-being. 2012;7:10846. doi: 10.3402/qhw.v7i0.10846.
    1. van Wijlen JE. Breastfeeding woman or lactating object? A critical philosophical discussion on the influence of Cartesian dualism on breastfeeding in the neonatal intensive care unit. J Clin Nurs. 2019;28(5–6):1022–1031. doi: 10.1111/jocn.14686.
    1. Merleau-Ponty M. The phenomenal fields, p. 61–74 and the synthesis of One’s own body, 171–177. London: Routledge; 1962. Phenomenology of perception.
    1. Todre L, Galvin KT, Dahlberg K. ‘Caring for insiderness’: phenomenologically informed insights that can guide practice. Int J Qual Stud Health Well-Being. 2014;9:21421. doi: 10.3402/qhw.v9.21421.
    1. Dahlberg K. Evaluation for a caring society. Abma MVT, editor. Charlotte: Information Age Publishers; 2018. The art of understanding; pp. 51–76.
    1. Dahlberg K, Segesten K. Hälsa och vårdande: i teori och praxis [health and caring: in theory and praxis] 1. Stockholm: Natur & kultur; 2010. pp. 103–156.
    1. Hall Smith P, Hausman LB, Labbok M. Beyond health, beyond choice: breastfeeding constraints and realities. In: Hausman LB, editor. Feminism and breastfeeding: rhetoric, ideology, and the material realities of women’s lives. New Brunswick: Rutgers University Press; 2012. pp. 15–24.
    1. Labbok MH, Smith PH, Taylor EC. Breastfeeding and feminism: a focus on reproductive health, rights and justice. Int Breastfeed J. 2008;3:8. doi: 10.1186/1746-4358-3-8.
    1. Van Esterik P. Breastfeeding and feminism. Int J Gynaecol Obstet. 1994;47(Suppl):S41–S50. doi: 10.1016/0020-7292(94)02233-O.
    1. Palmer L. Amning och existens: Moderskap, sårbarhet och ömsesidigt beroende vid inledande amning [breastfeeding and existence. Motherhood, vulnerability and independency when initiating breastfeeding] Växjö: Linnaeus University Press; 2015.
    1. Smith PH. Social justice at the core of breastfeeding protection, promotion and support: a conceptualization. J Hum Lact. 2018;34(2):220–225. doi: 10.1177/0890334418758660.
    1. Collins CT, Gillis J, McPhee AJ, Suganuma H, Makrides M. Avoidance of bottles during the establishment of breast feeds in preterm infants. Cochrane Database Syst Rev. 2016;10:Cd005252.
    1. Briere CE, McGrath JM, Cong X, Brownell E, Cusson R. Direct-breastfeeding in the neonatal intensive care unit and breastfeeding duration for premature infants. Appl Nurs Res. 2016;32:47–51. doi: 10.1016/j.apnr.2016.04.004.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren