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Health care professionals report positive experience with a breastfeeding training program based on the Baby-Friendly Hospital Initiative for Neonatal Intensive Care
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Perinatal, Neonatal and Pediatric Cardiology Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Healthcare Sciences and e-Health.ORCID iD: 0000-0001-5104-1281
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Perinatal, Neonatal and Pediatric Cardiology Research.ORCID iD: 0000-0001-5955-1278
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2023 (English)In: Journal of Perinatal & Neonatal Nursing, ISSN 0893-2190, E-ISSN 1550-5073, Vol. 29, no 1, p. 75-80Article in journal (Refereed) Published
Abstract [en]

Support from health care professionals (HCPs) with good knowledge and positive attitudes toward breastfeeding has been associated with better breastfeeding outcomes in the mothers of preterm infants. The aim of the study was to describe HCPs' experiences of a breastfeeding training program. A total of 48 specialist registered nurses, registered nurses, assistant nurses and physicians working at a neonatal intensive care unit attended a breastfeeding training program and answered a questionnaire including Likert scales and open-ended questions. The participants reported that their interest in breastfeeding had increased as a median (range) of 10 (8–10) on a 10-point scale and rated to what extent they had received new tools for breastfeeding support as a median of 10 (8–10) after training. There were no differences in the median between different professions' ratings. Qualitative content analysis of the open-ended questions resulted in two categories: Discussions of the case scenarios in the group and Knowledge regarding breastfeeding. The results showed that discussions based on breastfeeding scenarios were perceived as valuable; the health care professionals reported receiving new knowledge and useful practical skills. This program was shown to increase health care professionals’ interest in breastfeeding and is useful for different health care professions.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 29, no 1, p. 75-80
Keywords [en]
attitudes, Baby-Friendly Hospital Initiative for Neonatal Intensive Care, breastfeeding support, healthcare staff, mother, preterm infant, training program
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-408018DOI: 10.1016/j.jnn.2022.02.008OAI: oai:DiVA.org:uu-408018DiVA, id: diva2:1421352
Available from: 2020-04-02 Created: 2020-04-02 Last updated: 2024-06-14Bibliographically approved
In thesis
1. Self-efficacy in breastfeeding mothers of term and preterm born infants
Open this publication in new window or tab >>Self-efficacy in breastfeeding mothers of term and preterm born infants
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Breast milk is beneficial for all infants, but especially for infants born preterm and optimizing breastfeeding can enhance health outcomes. Despite this, breastfeeding duration has declined in more than twenty years in Sweden and even more among preterm infants. Mothers’ self-efficacy is a modifiable factor that can affect breastfeeding duration and Breastfeeding Self-efficacy Scale-Short Form (BSES-SF) has been tested in several countries in order to identify mothers with low self-efficacy in breastfeeding, however, the scale has not been validated for a Swedish sample. Moreover, there is a need for evidence-based breastfeeding support programs adapted for the healthcare professionals (HCPs) working with mothers of preterm infants.

A first aim of the present thesis was to psychometrically test the BSES-SF among mothers to both term- and preterm infants and to examine whether self-efficacy predicts breastfeeding duration. A secondary aim was to evaluate a breastfeeding support program based on Baby-Friendly Hospital Initiative for Neonatal Intensive Care (Neo-BFHI) and to describe HCPs’ experiences of the program.

Papers I and II show potential for BSES-SF to be used in research with the aim to identify mother’s self-efficacy in breastfeeding. In Paper III findings reveal that self-efficacy predicts the mother’s adaptation to the infant. This is an important finding as the mother's adaptation to the infant is closely related to the theories of bonding and attachment. Paper IV describes and evaluates a training program for neonatal intensive HCPs based on Neo-BFHI’s ten steps to successful breastfeeding, with main results indicating that the training program was appreciated by the HCPs. In Paper V, we constructed and evaluated an instrument that measures the attitudes to breastfeeding and skin-to-skin contact among neonatal intensive care units’ HCPs. Findings suggest that the instrument could be used to evaluate future Neo-BFHI interventions to improve breastfeeding duration as well as HCPs’ support and skills.

The main conclusion of this thesis is that mothers’ low self-efficacy in the early phase can be an important predictor for shorter breastfeeding duration. The breastfeeding training program was regarded as relevant and useful according to different HCPs categories and was shown to increase the HCPs’ interest in breastfeeding and provide them with tools for improved breastfeeding support. The program is designed in a way that makes it easy to copy and spread to other neonatal intensive care units in Sweden and it can also be used for newly employed HCPs.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2020. p. 67
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1663
Keywords
adaptation, Baby-Friendly, breastfeeding, mother, preterm infant, self-efficacy, support, training
National Category
Pediatrics Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-408022 (URN)978-91-513-0934-7 (ISBN)
Public defence
2020-05-27, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskjölds väg 20, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2020-05-06 Created: 2020-04-02 Last updated: 2020-06-16

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Gerhardsson, EmmaOras, PaolaMattsson, ElisabetThernström Blomqvist, YlvaFunkquist, Eva-Lotta

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