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Trustful bonds: A key to "becoming a mother" and to reciprocal breastfeeding. Stories of mothers of very preterm infants at a neonatal unit
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Center for Clinical Research Dalarna. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Barnendokrinologisk forskning/Gustafsson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Barnendokrinologisk forskning/Gustafsson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Barnendokrinologisk forskning/Gustafsson)
2006 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 62, no 1, 70-80 p.Article in journal (Refereed) Published
Abstract [en]

A preterm birth and subsequent hospitalization of an infant at a neonatal unit (NU) implies an extraordinary life situation for mothers, in which the maternal role and breastfeeding begin and evolve in a medical and unfamiliar setting. Descriptions of how women experience “becoming a mother” and breastfeeding in such a situation are sparse and this question was addressed in the present study. In this qualitative study, inspired by the grounded theory approach, in-depth interviews were conducted with 25 mothers whose very preterm infants had been cared for in seven NUs in Sweden. Findings indicated the importance of quality in social bonds with the infant, father, staff and other mothers at the NU, for “becoming mothers” and experiencing mutually satisfying breastfeeding. Three themes comprised a structure for descriptions of experiences, social bonds and mediated emotions: (1) ‘loss’ of the infant and the emotional chaos—“putting life on hold”; (2) separation—a sign of being unimportant as a person and mother; and (3) critical aspects of becoming more than a physical mother. The qualities were described as trustful or distrustful, characterized by accompanying feelings of pride/trust or shame/distrust. Social bonds were affected not only by the interpersonal interplay but also by the public environment and care routines. In conclusion, the contextual setting and distrustful social bonds impaired the ability to “become mothers” and the sensation of reciprocity i.e. breastfeeding becoming dutiful and not mutually satisfying. As breastfeeding is an intimate interplay and a personal choice it was considered that the best breastfeeding support would seem to be provision of a favorable environment that enhances the mother's confidence in herself. The contextual setting should be modeled such as to create conditions for a trustful and reciprocal mother–infant bond.

Place, publisher, year, edition, pages
2006. Vol. 62, no 1, 70-80 p.
Keyword [en]
Sweden, Breastfeeding, Neonatal unit, Social bonds, Newborn, Maternal attainment
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-95916DOI: 10.1016/j.socscimed.2005.05.026PubMedID: 15992983OAI: oai:DiVA.org:uu-95916DiVA: diva2:170295
Available from: 2007-05-14 Created: 2007-05-14 Last updated: 2012-02-22Bibliographically approved
In thesis
1. Breastfeeding and Becoming a Mother: Influences and Experiences of Mothers of Preterm Infants
Open this publication in new window or tab >>Breastfeeding and Becoming a Mother: Influences and Experiences of Mothers of Preterm Infants
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to expand the knowledge and understanding of the processes of breastfeeding and becoming a mother in mothers of preterm infants.

For this purpose, in-depth interviews were conducted with 25 mothers, whose very preterm infants had received care in seven neonatal units (NU) in Sweden, 1-12 months after discharge (I-II). In addition, prospective population-based register studies were performed of infants born 1993-2001; among 35 250 term and 2093 preterm infants (III), and a subpopulation of 225 very preterm infants (IV). Data were obtained from the Child Health Service registry of breastfeeding in Uppsala and Örebro, the Medical Birth Registry, and Statistics Sweden.

The experiences of mother-infant separation, institutional authority, emotional exhaustion and disregard of breastfeeding as a relational interplay, comprised major hindrances to mothers’ experiences of breastfeeding as reciprocal and of a secure mother-infant relation, during and after the discharge from an NU (I-II). All studied socioeconomic factors, i.e. lower educational level, receiving unemployment benefit or social welfare or having a low equivalent disposable income, were individually adversely associated with breastfeeding up to six months of infants’ postnatal age, but were not found more decisive for weaning in mothers of preterm infants compared to those of term infants (III). Preterm infants were breastfed for a shorter time than term infants (III), but a long breastfeeding duration was evident. In addition, gestational age and neonatal disorders were not associated with breastfeeding duration in very preterm infants (IV).

In conclusion, this thesis shows that improvements in the NU environment and the caring paradigm are called for. Furthermore, as socioeconomic status clearly has an impact on breastfeeding duration, increased equity in health care in accordance with the individuals’ needs must be sought, where resources are allocated to ensure fulfilment of needs in more vulnerable mothers and infants.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 66 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 262
Keyword
Pediatrics, Breastfeeding, Becoming a mother, Preterm infants, Mothers, Register, Neonatal care, Neonatal unit, Socioeconomic status, Pediatrik
Identifiers
urn:nbn:se:uu:diva-7898 (URN)978-91-554-6901-6 (ISBN)
Public defence
2007-06-05, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskjöldsväg 20, Uppsala, 13:15
Opponent
Supervisors
Available from: 2007-05-14 Created: 2007-05-14Bibliographically approved

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