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Funkquist, Eva-Lotta
Publications (10 of 10) Show all publications
Gerhardsson, E., Hildingsson, I., Mattsson, E. & Funkquist, E.-L. (2018). Prospective questionnaire study showed that higher self-efficacy predicted longer exclusive breastfeeding by the mothers of late preterm infants. Acta Paediatrica, 107(5), 799-805
Open this publication in new window or tab >>Prospective questionnaire study showed that higher self-efficacy predicted longer exclusive breastfeeding by the mothers of late preterm infants
2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 5, p. 799-805Article in journal (Refereed) Published
Abstract [en]

Aim: An important variable that influences breastfeeding outcomes is how confident a woman feels about her ability to breastfeed successfully at an early stage. We investigated breastfeeding self‐efficacy in the mothers of late preterm infants.

Methods: This was a prospective, comparative study that focused on mothers who had delivered babies at 34 + 0 to 36 + 6 weeks and were recruited in 2012–2015 from a neonatal intensive care unit and a postnatal ward at a Swedish university hospital. The Breastfeeding Self‐Efficacy Scale‐Short Form (BSES‐SF) was used to psychometrically assess the mothers at 40 weeks of postmenstrual age (n = 148) and at three months of corrected age (n = 114).

Results: The BSES‐SF scores were higher in the 87% of mothers that exclusively breastfed when their babies reached 40 weeks (57.1 out of 70) than those who did not (41.4, p < 0.001), indicating better self‐efficacy. The figures remained higher in the 68% of exclusive breastfeeding mothers at three months of corrected age (60.9 versus 51.7).

Conclusion: Self‐efficacy was an important predictor of the length of breastfeeding in mothers of late preterm infants, and the BSES‐SF can be used to detect low self‐efficacy that could lead to early breastfeeding cessation.

Keywords
Breastfeeding, Infant, Late preterm, Mother, Self-efficacy
National Category
Obstetrics, Gynecology and Reproductive Medicine Pediatrics
Identifiers
urn:nbn:se:uu:diva-353364 (URN)10.1111/apa.14229 (DOI)000430115100013 ()29352489 (PubMedID)
Available from: 2018-06-19 Created: 2018-06-19 Last updated: 2018-06-19Bibliographically approved
Hedberg Nyqvist, K., Rosenblad, A., Volgsten, H., Funkquist, E.-L. & Mattsson, E. (2017). Early skin-to-skin contact between healthy late preterm infants and their parents: an observational cohort study. PeerJ, 5, Article ID e3949.
Open this publication in new window or tab >>Early skin-to-skin contact between healthy late preterm infants and their parents: an observational cohort study
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2017 (English)In: PeerJ, ISSN 2167-8359, E-ISSN 2167-8359, Vol. 5, article id e3949Article in journal (Refereed) Published
Abstract [en]

Background

Skin-to-skin contact (SSC) is an important factor to consider in the care of late preterm infants (born between 34 0/7 and 36 6/7 completed weeks of gestation). The literature suggests that SSC between preterm infants and their mothers facilitates breastfeeding. However, more studies are needed to explore potential dose-response effects between SSC and breastfeeding as well as studies that explicitly investigate SSC by fathers among late preterm infants. The aim was to investigate the duration of healthy late preterm infants’ SSC with the mother and father, respectively, during the first 48 h after birth and the associations with breastfeeding (exclusive/partial at discharged), clinical and demographic variables.

Methods

This was an observational cohort study in which parents to healthy late preterm infants, born between 34 5/7 and 36 6/7 completed weeks of gestation, recorded duration of SSC provided by mother and father, respectively. Demographic and clinical variables were retrieved from the medical records and were used as predictors. Multiple linear regression analysis was used to assess the association between the predictors and the outcome, SSC (hours), separately for mothers and fathers.

Results

The mean (standard deviation [SD]) time per day spent with SSC with mothers (n = 64) and fathers (n = 64), was 14.7 (5.6) and 4.4 (3.3) hours during the first day (24 h) after birth and 9.2 (7.1) and 3.1 (3.3) hours during the second day (24 h), respectively. Regarding SSC with mothers, no variable was significantly associated with SSC during the first day, while the mean (95% confidence interval [CI]) time of SSC during the second day was 6.9 (1.4–12.4) hours shorter for each additional kg of birthweight (p = 0.014). Concerning SSC with fathers, the mean (95% CI) time of SSC during the first day was 2.1 (0.4–3.7) hours longer for infants born at night (p = 0.015), 1.7 (0.1–3.2) hours longer for boys (p = 0.033), 3.2 (1.2–5.2) hours longer for infants born by caesarean section (p = 0.003), and 1.6 (0.1–3.1) hours longer for infants exclusively breastfed at discharge (p = 0.040). During the second day, the mean (95% CI) time of SSC with fathers was 3.0 (0.6–5.4) hours shorter for each additional kg of birthweight (p = 0.014), 2.0 (0.5–3.6) hours longer for infants born during night-time (p = 0.011), 2.9 (1.4–4.4) hours longer if the mother was primipara (p < 0.001), and 1.9 (0.3–3.5) hours shorter if supplementary artificial milk feeds were given. None of the other predictors, i.e., mother’s age, gestational age, or induction of labor were significantly associated with infants’ SSC with mothers or fathers during any of the first two days after birth.

Conclusion

Future studies are warranted that investigate duration of SSC between late preterm infants and their parents separately and the associations with breastfeeding and other variables of clinical importance.

Keywords
Preterminfants, Skin-to-skincontact, Breastfeeding, Latepreterminfants, Mothers, Fathers
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-333035 (URN)10.7717/peerj.3949 (DOI)000413966900002 ()29104822 (PubMedID)
Available from: 2017-11-06 Created: 2017-11-06 Last updated: 2018-02-08Bibliographically approved
Blomqvist, Y. T., Hedberg Nyqvist, K., Rubertsson, C. & Funkquist, E.-L. (2017). Parents need support to find ways to optimise their own sleep without seeing their preterm infant's sleeping patterns as a problem. Acta Paediatrica, 106(2), 223-228
Open this publication in new window or tab >>Parents need support to find ways to optimise their own sleep without seeing their preterm infant's sleeping patterns as a problem
2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 2, p. 223-228Article in journal (Refereed) Published
Abstract [en]

AIM: This study described how parents perceived their own sleep, and their infants', during neonatal intensive care unit (NICU) admission and after discharge. It also explored the infants' sleeping location at home.

METHODS: The study was conducted in the NICUs of two Swedish university hospitals. The parents of 86 infants - 86 mothers and 84 fathers - answered questionnaires during their infants' hospital stay, at discharge and at the infants' corrected ages of two, six and 12 months. The parents' own sleep was explored with the Insomnia Severity Index.

RESULTS: Mothers reported more severe insomnia than fathers during their infants' hospitalisation, and these higher insomnia severity scores were associated with more severe infant sleep problems at discharge (p = 0.027) and at two months (p = 0.006) and 12 months (p = 0.002) of corrected age. During the study period, 4%-10% of the parents reported severe or very severe infant sleeping problems. The bed-sharing rate was 75% after discharge and about 60% at the corrected age of 12 months.

CONCLUSION: Maternal insomnia during an infant's hospital stay was associated with later perceptions of sleep problems in their children. Parents need support to find solutions for optimal sleep without seeing their child's sleeping patterns as a problem.

Keywords
Bed-sharing, Insomnia, Neonatal intensive care unit, Preterm infants, Sleep problems
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-311797 (URN)10.1111/apa.13660 (DOI)000397337100008 ()27925691 (PubMedID)
Available from: 2017-01-03 Created: 2017-01-02 Last updated: 2019-06-28Bibliographically approved
Oras, P., Thernström Blomqvist, Y., Hedberg Nyqvist, K., Gradin, M., Rubertsson, C., Hellström-Westas, L. & Funkquist, E.-L. (2016). Skin-to-skin contact is associated with earlier breastfeeding attainment in preterm infants. Acta Paediatrica, 105(7), 783-789
Open this publication in new window or tab >>Skin-to-skin contact is associated with earlier breastfeeding attainment in preterm infants
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2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 7, p. 783-789Article in journal (Refereed) Published
Abstract [en]

AIM:

This study investigated the effects of skin-to-skin contact on breastfeeding attainment, duration and infant growth in preterm infants, as this has not been sufficiently explored.

METHODS:

A prospective longitudinal study on Kangaroo mother care was carried out, comprising 104 infants with a gestational age of 28+0 to 33+6 and followed up to one year of corrected age. Parents and staff recorded the duration of skin-to skin contact during the stay in the neonatal intensive care unit (NICU). Medical data were collected through patient records and follow-up questionnaires were filled in by parents.

RESULTS:

The 53 infants who attained full breastfeeding in the NICU did so at a median (range) of 35+0 (32+1 to 37+5) weeks of postmenstrual age and skin-to-skin contact was the only factor that influenced earlier attainment in the regression analysis (R(2) 0.215 p<0.001). The daily duration of skin-to-skin contact during the stay in the NICU did not affect the duration of breastfeeding or infant growth after discharge. Furthermore, infant growth was not affected by the feeding strategy of exclusive, partial breastfeeding or no breastfeeding.

CONCLUSION:

A longer daily duration of skin-to-skin contact in the NICU was associated with earlier attainment of exclusive breastfeeding.

Keywords
Breastfeeding duration; family-centred care; human milk; infant growth; Kangaroo mother care
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-289173 (URN)10.1111/apa.13431 (DOI)000378565100018 ()27100380 (PubMedID)
Available from: 2016-04-29 Created: 2016-04-29 Last updated: 2019-06-28Bibliographically approved
Oras, P., Thernström Blomqvist, Y., Hedberg Nyqvist, K., Gradin, M., Rubertsson, C., Hellström-Westas, L. & Funkquist, E.-L. (2015). Breastfeeding Patterns in Preterm Infants Born at 28-33 Gestational Weeks. Journal of Human Lactation, 31(3), 377-385
Open this publication in new window or tab >>Breastfeeding Patterns in Preterm Infants Born at 28-33 Gestational Weeks
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2015 (English)In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 31, no 3, p. 377-385Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Studies of breastfeeding patterns during preterm infants' first year of life are scarce but are important for providing breastfeeding mothers of preterm infants with optimal support.

OBJECTIVE:

This study aimed to describe breastfeeding patterns in preterm infants up to 1 year of corrected age.

METHODS:

As part of a larger study on kangaroo mother care in Sweden, a 24-hour breastfeeding diary was sent home after discharge from hospital, and at 2, 6, and 12 months of the infant's corrected age. Eighty-three mothers responded to the follow-up questionnaires, and the number of respondents to the breastfeeding diary was 48 at discharge, 43 at 2 months, 22 at 6 months, and 8 at 12 months. Infants were born at a median (range) gestational age of 32 (28-33) weeks. Breastfeeding patterns were analyzed according to durations, frequencies per 24 hours, and intervals between sessions.

RESULTS:

In exclusively breastfed infants, the median (range) breastfeeding session frequency was 14 (8-26) times per 24 hours including 4 (1-9) times per night after discharge (n = 24) and 10 (6-25) times per 24 hours including 2 (0-5) times per night at 2 months (n = 23). In partially breastfed infants, the median (range) frequency was 5 (1-14) times per 24 hours including 2 (0-4) times per night at 6 months (n = 20) and 5.5 (1-12) times per 24 hours including 2 (0-3) times per night at 12 months (n = 8).

CONCLUSION:

Mothers reported large variations in breastfeeding patterns, with higher median breastfeeding session frequencies than previously described in term infants in affluent settings.

National Category
Clinical Medicine Pediatrics
Identifiers
urn:nbn:se:uu:diva-254708 (URN)10.1177/0890334415586406 (DOI)000358070300010 ()25956792 (PubMedID)
Note

This study was supported by grants from the Regional Research Council in the Uppsala-Orebro region, Uppsala County Council, and Uppsala University Funds.

Available from: 2015-06-10 Created: 2015-06-10 Last updated: 2019-06-28Bibliographically approved
Mattsson, E., Funkquist, E.-L., Wickström, M., Nyqvist, K. H. & Volgsten, H. (2015). Healthy late preterm infants and supplementary artificial milk feeds: Effects on breast feeding and associated clinical parameters. Midwifery, 31(4), 426-431
Open this publication in new window or tab >>Healthy late preterm infants and supplementary artificial milk feeds: Effects on breast feeding and associated clinical parameters
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2015 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 31, no 4, p. 426-431Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: to compare the influence of supplementary artificial milk feeds on breast feeding and certain clinical parameters among healthy late preterm infants given regular supplementary artificial milk feeds versus being exclusively breast fed from birth.

DESIGN: a comparative study using quantitative methods. Data were collected via a parental diary and medical records.

METHODS: parents of 77 late preterm infants (34 5/7-36 6/7 weeks), whose mothers intended to breast feed, completed a diary during the infants׳ hospital stay.

FINDINGS: infants who received regular supplementary artificial milk feeds experienced a longer delay before initiation of breast feeding, were breast fed less frequently and had longer hospital stays than infants exclusively breast fed from birth. Exclusively breast-fed infants had a greater weight loss than infants with regular artificial milk supplementation. A majority of the mothers (65%) with an infant prescribed artificial milk never expressed their milk and among the mothers who used a breast-pump, milk expression commenced late (10-84 hours after birth). At discharge, all infants were breast fed to some extent, 43% were exclusively breast fed.

KEY CONCLUSIONS: clinical practice and routines influence the initiation of breast feeding among late preterm infants and may act as barriers to the mothers׳ establishment of exclusive breast feeding.

National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-242501 (URN)10.1016/j.midw.2014.12.004 (DOI)000353526100004 ()25596897 (PubMedID)
Available from: 2015-01-26 Created: 2015-01-26 Last updated: 2017-12-05Bibliographically approved
Gerhardsson, E., Nyqvist, K. H., Mattsson, E., Volgsten, H., Hildingsson, I. & Funkquist, E.-L. (2014). The Swedish Version of the Breastfeeding Self-Efficacy Scale-Short Form: Reliability and Validity Assessment. Journal of Human Lactation, 30(3), 340-345
Open this publication in new window or tab >>The Swedish Version of the Breastfeeding Self-Efficacy Scale-Short Form: Reliability and Validity Assessment
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2014 (English)In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 30, no 3, p. 340-345Article in journal (Refereed) Published
Abstract [en]

Background:

Among Swedish mothers, breastfeeding duration has been declining in recent years. An instrument for early identification of women at risk for shorter breastfeeding duration may be useful in reversing this trend.

Objectives:

The aims of this study were to translate and psychometrically test the Swedish version of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), examine the relationship between breastfeeding self-efficacy and demographic variables, and evaluate associations with breastfeeding continuation plans in Swedish mothers.

Methods:

The BSES-SF was translated into Swedish using forward and back translation. The sample consisted of 120 mothers who, during the first week postpartum, came for a routine follow-up visit at the postnatal unit in a university hospital. The mothers were compared based on demographic data and their future breastfeeding plans.

Results:

The Cronbach's alpha coefficient for internal consistency for the BSES-SF was 0.91 and the majority of correlation coefficients exceeded 0.3. A 1-factor solution was found that explained 46% of the total variance. There was no difference in confidence in breastfeeding between mothers with early hospital discharge and mothers who received postnatal care at the hospital. Primiparas who stayed longer at the hospital were less confident in breastfeeding than primiparas who had a shorter hospital stay. Breastfeeding mothers who planned to partially breastfeed in the near future had lower BSES-SF scores, compared to those who planned to continue exclusive breastfeeding.

Conclusion:

The Swedish version of the BSES-SF has good reliability, validity, and agreement with mothers' plans regarding breastfeeding continuation and exclusivity.

National Category
Nursing Obstetrics, Gynecology and Reproductive Medicine Pediatrics
Identifiers
urn:nbn:se:uu:diva-219398 (URN)10.1177/0890334414523836 (DOI)000340424100016 ()24574154 (PubMedID)
Available from: 2014-02-28 Created: 2014-02-28 Last updated: 2017-12-05Bibliographically approved
Funkquist, E.-L., Tuvemo, T., Jonsson, B., Serenius, F. & Nyqvist, K. H. (2010). Influence of test weighing before/after nursing on breastfeeding in preterm infants. Advances in Neonatal Care, 10(1), 33-39
Open this publication in new window or tab >>Influence of test weighing before/after nursing on breastfeeding in preterm infants
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2010 (English)In: Advances in Neonatal Care, ISSN 1536-0903, E-ISSN 1536-0911, Vol. 10, no 1, p. 33-39Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Swedish hospitals apply various regimens for preterm infants' nutrition in connection with their mothers' establishment of breastfeeding. Milk intake is assessed either by test weighing before and after breastfeeding or by observing the infant's suckling behavior (ie, clinical indices). These differing policies may lead to differences in infants' feeding progress. The purpose of this study was to compare effects on breastfeeding and weight gain of preterm infants, depending on whether the volume of breast milk intake when suckled in the hospital was estimated by "clinical indices" or determined by test weighing. SUBJECTS: Sixty-four infants treated at a unit applying test weighing were compared with 59 infants treated at a unit assessing milk intake by "clinical indices." DESIGN AND METHODS: A retrospective, descriptive, and comparative design was used to explore the consequences of different nutrition regimens. Data were obtained from a review of hospital medical records. PRINCIPAL RESULTS: The infants treated at the hospital where test weighing was practiced attained exclusive breastfeeding at an earlier postmenstrual age (PMA) and were also discharged at an earlier PMA. However, the 2 study units were alike regarding the proportion of infants attaining exclusive breastfeeding, the postnatal age when this occurred, and the weight pattern in hospital. CONCLUSION: To establish breastfeeding in preterm infants, test weighing before and after breastfeeding and gradual reduction of supplementation are both applicable regimens. Mothers can be encouraged to choose either of them, although test weighing may help infants attain exclusive breastfeeding at an earlier PMA.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-126244 (URN)10.1097/ANC.0b013e3181cbf910 (DOI)20150780 (PubMedID)
Available from: 2010-06-07 Created: 2010-06-07 Last updated: 2017-12-12Bibliographically approved
Funkquist, E.-L., Tuvemo, T., Jonsson, B., Serenius, F. & Hedberg Nyqvist, K. (2010). Preterm appropriate for gestational age infants: size at birth explains subsequent growth. Acta Paediatrica, 99(12), 1828-1833
Open this publication in new window or tab >>Preterm appropriate for gestational age infants: size at birth explains subsequent growth
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2010 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 12, p. 1828-1833Article in journal (Refereed) Published
Abstract [en]

Aim: The aim was to evaluate growth and breastfeeding up to 18 months corrected age (CA) among preterm appropriate for gestational age (AGA) infants whose mothers initiated breastfeeding during the infants' hospital stay. Methods: One hundred and twenty-seven preterm AGA infants with a median birth weight of 2320 (769-3250) g and gestational age 34.29 (25.00-35.86) weeks were evaluated up to a CA of 18 months. A retrospective, descriptive and comparative design was used. Data were obtained by chart review of hospital medical records and a questionnaire completed by the mothers. Results: The changes in standard deviation scores (SDS) during the infants' hospital stay were -0.9 for weight, -0.3 for length and -0.5 for head circumference (HC). Infants with higher SDS at birth showed more negative changes from birth to discharge. Median increments in SDS from discharge to a CA of 2 months were as high as, or higher than, the loss from birth to discharge. Conclusion: Preterm AGA infants with higher SDS for weight, length and HC at birth are at higher risk of inadequate growth during their hospital stay.

Keywords
breastfeeding, growth, preterm AGA infant
National Category
Pediatrics
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-130160 (URN)10.1111/j.1651-2227.2010.01966.x (DOI)000283690300018 ()
Available from: 2010-09-07 Created: 2010-09-02 Last updated: 2017-12-12Bibliographically approved
Funkquist, E.-L., Carlsson, M. & Hedberg Nyqvist, K. (2005). Consulting on feeding and sleeping problems in child health care: what is at the bottom of advice to parents?. Journal of Child Health Care, 9(2), 137-152
Open this publication in new window or tab >>Consulting on feeding and sleeping problems in child health care: what is at the bottom of advice to parents?
2005 (English)In: Journal of Child Health Care, Vol. 9, no 2, p. 137-152Article in journal (Refereed) Published
Keywords
Child heath service, controlled crying, diet consulting, self-determination, sleep consulting
Identifiers
urn:nbn:se:uu:diva-70376 (URN)doi:10.1177/1367493505051404 (DOI)
Available from: 2006-03-14 Created: 2006-03-14 Last updated: 2011-01-12
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