Lactation Support as a Proxy Measure of Family-Centered Care Quality in Neonates with Life-Limiting Conditions—A Comparative Study (original) (raw)
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Journal of Human Lactation, 2021
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Advances in neonatal care : official journal of the National Association of Neonatal Nurses, 2016
The provision of human milk and breastfeeding is essential in the neonatal intensive care unit (NICU) population. However, recent national research has demonstrated very low percentages of NICU nurses providing lactation-based support and care to patients and families, and less than half of all NICUs have an International Board Certified Lactation Consultant (IBCLC) on staff. The purpose of this study was to describe how NICU bedside nurses are providing lactation-based support and care during their shifts and the frequency of that support. The secondary aim was to gain an understanding of the NICU nurses' attitudes toward human milk and breastfeeding. Through a prospective descriptive cohort design, the authors of this study created and disseminated a web-based survey (SurveyMonkey) of 21 questions including the Iowa Infant Feeding Attitude Scale (IIFAS) to a Northeastern urban hospital staff of bedside nurses. A total of 140 of the 389 eligible NICU bedside nurses responded to...
Expansion of the Ten Steps to Successful Breastfeeding into Neonatal Intensive Care
Journal of Human Lactation, 2012
The World Health Organization/United Nations Children’s Fund Baby-Friendly Hospital Initiative: Revised, Updated, and Expanded for Integrated Care (2009) identifies the need for expanding the guidelines originally developed for maternity units to include neonatal intensive care. For this purpose, an expert group from the Nordic countries and Quebec, Canada, prepared a draft proposal, which was discussed at an international workshop in Uppsala, Sweden, in September 2011. The expert group suggests the addition of 3 “Guiding Principles” to the Ten Steps to support this vulnerable population of mothers and infants:1. The staff attitude to the mother must focus on the individual mother and her situation.2. The facility must provide family-centered care, supported by the environment.3. The health care system must ensure continuity of care, that is, continuity of pre-, peri-, and postnatal care and post-discharge care.The goal of the expert group is to create a final document, the Baby Fri...
Journal of Human Lactation, 2013
In the World Health Organization/United Nations Children’s Fund document Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, neonatal care is mentioned as 1 area that would benefit from expansion of the original Ten Steps to Successful Breastfeeding. The different situations faced by preterm and sick infants and their mothers, compared to healthy infants and their mothers, necessitate a specific breastfeeding policy for neonatal intensive care and require that health care professionals have knowledge and skills in lactation and breastfeeding support, including provision of antenatal information, that are specific to neonatal care. Facilitation of early, continuous, and prolonged skin-to-skin contact (kangaroo mother care), early initiation of breastfeeding, and mothers’ access to breastfeeding support during the infants’ whole hospital stay are important. Mother’s own milk or donor milk (when available) is the optimal nutrition. Efforts should be ma...
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2013
Objective To synthesise what is known about the parents' views on factors that help or hinder breast milk supply during their infants' hospitalisation in neonatal intensive care units (NICU). Methods A systematic search of PubMed, ISI WoK, PsycINFO and SciELO, targeting studies presenting original empirical data that examined parents' perspectives regarding breast milk supply experiences in NICU, was performed. Based on content analysis, three independent researchers synthesised the findings of seven studies. Categories of facilitators and barriers were identified using quotations stated in the studies: parents' breast milk supply experience; parents-professionals relationships; characteristics of the NICU; and parents' social background and expectations. Results The studies, five qualitative and two mixed methods, were published between 1994 and 2011. With heterogeneous study designs, fathers' perspectives were analysed in one article. Only one study defined breastfeeding. According to parents' perspectives, successful breast milk supply in NICU depends on coherent and accurate knowledge about its techniques and benefits, reinforcement of mothers' motivation and alignment between NICU's routines and parents' needs. Parents perceived issues related to their own current breast milk supply experience, simultaneously, as main facilitators and barriers. Parents-professionals relationship constituted the second group of facilitators, but the fourth of barriers. The characteristics of the NICU were more relevant as a barrier than as a facilitator. Conclusions Although parents' perspectives are grounded on individual child-focused experiences, their emphasis on learning and motivation guided by shortterm goals opens room to the collective intervention of experts. This may facilitate the engagement of mothers, fathers and health professionals on family-centred care.
Advances in Neonatal Care, 2019
Background: Family-centered care (FCC) in neonatal intensive care units (NICUs) was initiated in 1992 to promote a respectful response to individual family needs and support parental participation in care and decision-making for their infants. Although benefits of FCC have been reported, changes in the maternal experience in the NICU are unknown. Purpose: The purpose of this study was to compare mothers' experiences in NICUs where FCC is the standard of care and to compare these with the experiences of mothers 2 decades ago. Methods: In this qualitative descriptive design, mothers of infants born under 32 weeks postconceptional age were asked to describe their experiences with their infant's birth and hospitalization. Open-ended probing questions clarified maternal responses. Saturation was reached after 14 interviews. Iterative coding and thematic grouping was used for analysis. Results: Common themes that emerged were: (1) visiting; (2) general caregiving; (3) holding; (4)...
Investigación y Educación en Enfermería, 2021
Objective. To assess breastfeeding support practices and related barriers and facilitators in a large Intensive Care Unit, Neonatal (NICU) in Medellín, Colombia, as part of a broader quality improvement initiative to enhance breastfeeding support. Methods. A mixed-methods descriptive design was used to collect data on care practices and outcomes related to NICU breastfeeding support. Data sources included the Neo-BFHI’s self-assessment questionnaire of breastfeeding policies and practices, clinical observations, and a retrospective review of 51 patient charts. Results. Of the 51 charts reviewed, 98% of the infants received breastmilk during their hospitalization but the majority (84%) also received formula and only 8% of infants were exclusively breastfed at the time of NICU discharge. All NICU staff received education on mother and baby-friendly care, and the unit complied with the International Code of Marketing of Breast-milk substitutes. However, resources to support lactation (...