A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth

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Abstract

Background

Being a mother of a preterm infant (< 37 gestational weeks) puts the mother in a vulnerable and fragile situation wherein breastfeeding is an important part of becoming a mother and bonding with the infant. Nevertheless, the breastfeeding experience of mothers during the first year after a preterm birth has not been well studied. To develop professional caring and supporting relationships, it is important to address this knowledge gap. The aim of this study was to describe the breastfeeding experience of mothers of preterm infants from birth up until 12 months after birth.

Methods

The data in this qualitative study are derived from a multicentre randomized controlled trial where 270 mothers of preterm infants provided 496 written comments through questionnaires containing open-ended questions. The questionnaires were sent to the mother three times during the first 12 months after birth. A thematic network analysis based on hermeneutical philosophy was used to analyse and interpret the resulting data to describe the mothers’ experiences of breastfeeding.

Results

Three organizing themes, namely, “navigating smoothly,” “navigating with a struggle” and “navigating in ambiguity” were revealed in the mothers’ narratives regarding their breastfeeding experiences during the first 12 months after birth. These organizing themes were further interpreted as one global theme that was deemed “ A journey to finding one’s unique way in breastfeeding.”

Conclusion

Mothers of preterm infants are in an exposed and vulnerable situation when initiating breastfeeding during the first year. This situation leads to a unique journey wherein each mother navigates through breastfeeding depending on her individual situation. An awareness of the diversity of breastfeeding experiences may contribute to the provision of professional caring and supportive relationships.

Trial registration

www.clinicaltrial.gov NCT01806480 registered 7 March 2013.

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Most cited references 24

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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.

Bengt Starrin, Renée Flacking, Uwe Ewald … (2005)

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.

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“Caring for insiderness”: Phenomenologically informed insights that can guide practice

Les Todres, Kathleen Galvin, Karin Dahlberg (2014)

Understanding the “insider” perspective has been a pivotal strength of qualitative research. Further than this, within the more applied fields in which the human activity of “caring” takes place, such understanding of “what it is like” for people from within their lifeworlds has also been acknowledged as the foundational starting point in order for “care” to be caring. But we believe that more attention needs to be paid to this foundational generic phenomenon: what it means to understand the “insiderness” of another, but more importantly, how to act on this in caring ways. We call this human phenomenon “caring for insiderness.” Drawing on existing phenomenological studies of marginal caring situations at the limits of caring capability, and through a process of phenomenologically oriented reflection, we interrogated some existential themes implicit in these publications that could lead to deeper insights for both theoretical and applied purposes. The paper provides direction for practices of caring by highlighting some dangers as well as some remedies along this path.

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A metasynthesis of qualitative breastfeeding studies.

Antonia M Nelson (2024)

To date, exclusive breastfeeding rates worldwide remain modest despite multiple breastfeeding initiatives. Much breastfeeding research has been conducted, but to facilitate greater understanding, cumulative knowledge development is required. The author used Noblit and Hare's (1988) method to synthesize 15 qualitative breastfeeding studies. Synthesized studies revealed that breastfeeding is an "engrossing, personal journey," which is very physical and requires maternal commitment, adaptation, and support from multiple sources. Breastfeeding was also shown to have significant personal impact on mothers and to require time for resolution on discontinuing. These findings suggest that health care practitioners can provide the most meaningful breastfeeding support by acknowledging each mother's individual breastfeeding capacity, goals, comfort level with her own body, support network, tolerance of breastfeeding difficulties, and willingness to make the life adaptations that breastfeeding requires. An individually tailored breastfeeding plan is suggested to facilitate both a satisfactory maternal breastfeeding experience and to maximize breastfeeding exclusivity and duration.

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Author and article information

Contributors

Lina Palmér: lina.palmer@hb.se

Jenny Ericson:

ORCID: http://orcid.org/0000-0002-3460-7500

jenny.ericson@ltdalarna.se

Journal

Journal ID (nlm-ta): Int Breastfeed J

Journal ID (iso-abbrev): Int Breastfeed J

Title: International Breastfeeding Journal

Publisher: BioMed Central (London )

ISSN (Electronic): 1746-4358

Publication date (Electronic): 1 August 2019

Publication date PMC-release: 1 August 2019

Publication date Collection: 2019

Volume: 14

Electronic Location Identifier: 35

Affiliations

[1 ]ISNI 0000 0000 9477 7523, GRID grid.412442.5, Faculty of Caring Science, Work Life and Social Welfare, , University of Borås, ; Borås, Sweden

[2 ]ISNI 0000 0001 0304 6002, GRID grid.411953.b, School of Education, Health and Social Studies, , Dalarna University, ; Falun, Sweden

[3 ]ISNI 0000 0004 1936 9457, GRID grid.8993.b, Center for Clinical Research Dalarna, , Uppsala University, ; Falun, Sweden

[4 ]ISNI 0000 0004 0624 1040, GRID grid.414744.6, Department of Pediatrics, , Falu Hospital, ; Falun, Sweden

Author information

Jenny Ericson http://orcid.org/0000-0002-3460-7500

Article

Publisher ID: 229

DOI: 10.1186/s13006-019-0229-6

PMC ID: 6670148

PubMed ID: 30627208

SO-VID: 1865cbc8-9618-4c2b-80ae-923c47dffda4

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 28 January 2019

Date accepted : 22 July 2019

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: breastfeeding,experiences,first year,mothers,preterm infant,qualitative

Data availability:

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: breastfeeding, experiences, first year, mothers, preterm infant, qualitative

A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth

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Abstract

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Conclusion

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Estudio del peso al nacer

Most cited references 24

Trustful bonds: a key to "becoming a mother" and to reciprocal breastfeeding. Stories of mothers of very preterm infants at a neonatal unit.

“Caring for insiderness”: Phenomenologically informed insights that can guide practice

A metasynthesis of qualitative breastfeeding studies.

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