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Breastfeeding Patterns in Preterm Infants Born at 28-33 Gestational Weeks
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Perinatal, neonatal och barnkardiologisk forskning)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.ORCID iD: 0000-0001-5955-1278
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
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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.

Place, publisher, year, edition, pages
2015. Vol. 31, no 3, p. 377-385
National Category
Clinical Medicine Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-254708DOI: 10.1177/0890334415586406ISI: 000358070300010PubMedID: 25956792OAI: oai:DiVA.org:uu-254708DiVA, id: diva2:819336
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: 2020-10-14
In thesis
1. Care for the New-Born: Breastfeeding and Skin-to-Skin Contact
Open this publication in new window or tab >>Care for the New-Born: Breastfeeding and Skin-to-Skin Contact
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Breastfeeding is associated with improved health in mothers and children and human milk is especially beneficial for preterm infants. The vast majority of pregnant women in Sweden intend to breastfeed, but breastfeeding rates are suboptimal, with even lower rates for preterm infants.

The overall aim of this thesis was to describe breastfeeding patterns of preterm and term infants and to evaluate an intervention based on the Ten steps to successful breastfeeding on breastfeeding outcomes.

In Paper I, mothers of preterm infants reported large variations in breastfeeding frequencies and patterns. The median breastfeeding frequencies from birth to six months ranged from 10–14 times per 24 hours with the majority practicing on demand breastfeeding.

In Paper II the median daily duration of skin-to-skin contact in preterm infants during the hospital stay was associated with earlier breastfeeding attainment. Infants commenced full breastfeeding at a median postmenstrual age of 35+0 weeks (range 32+1 to 37+5). Breastfeeding duration was shorter than national statistics.

Paper III describes the development and implementation of a breastfeeding support program for term and preterm infants using Intervention Mapping. The method was time-consuming, but allowed for a solid theoretical base, high involvement of stakeholders and was sufficiently comprehensive.

Paper IV included term infants at age two months and their mothers and consisted of a baseline group and intervention group. Mothers reported large variations in breastfeeding frequencies and patterns. Mothers in the intervention group breastfed more frequently, in median 14 times compared to 11 times in the baseline group, and they also practiced on demand breastfeeding to a larger extent. Mothers with exclusive breastfeeding reported higher self -efficacy.

This thesis provides a better understanding of breastfeeding patterns in preterm and term infants and it demonstrates that breastfeeding frequencies and on demand breastfeeding can be influenced with improved breastfeeding support. For preterm infants, breastfeeding attainment is facilitated by skin-to-skin-contact and they have the capability to breastfeed at a low postmenstrual age. This thesis also demonstrates a possible link between breastfeeding patterns and mothers’ ability to interpret infant cues. Intervention Mapping is a useful tool in the development of breastfeeding support programs.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2020. p. 73
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1692
Keywords
Breastfeeding, Lactation, Human Milk, Newborn, Infant, Preterm Infant, Kangaroo Mother Care, Mother-infant interaction, Parent-Child Relations, Object Attachment, Self Efficacy, Implementation Science, Quality of healthcare, Quality improvement
National Category
Medical and Health Sciences
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-421577 (URN)978-91-513-1039-8 (ISBN)
Public defence
2020-12-03, Sal IX, Universitetshuset, Biskopsgatan 3, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2020-11-12 Created: 2020-10-14 Last updated: 2021-01-22

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Oras, PaolaThernström Blomqvist, YlvaHedberg Nyqvist, KerstinRubertsson, ChristineHellström-Westas, LenaFunkquist, Eva-Lotta

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