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      Breastfeeding the late preterm infant: experiences of mothers and perceptions of public health nurses

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          Abstract

          Background

          The promotion and maintenance of breastfeeding with late preterm infants (LPIs) remain under examined topics of study. This dearth of research knowledge, especially for this population at-risk for various health complications, requires scientific investigation. In this study, we explore the experiences of mothers and the perceptions of public health nurses (PHNs) about breastfeeding late preterm infants in Calgary, Alberta, Canada.

          Methods

          We used an exploratory mixed methods design with a convenience sample of 122 mothers to gather quantitative data about breastfeeding. We collected qualitative data by means of individual face-to-face interviews with 11 mothers and 10 public health nurses. Data were collected from April 2013 to June 2014. We then employed an interpretive thematic analysis to identify central themes and relationships across narratives.

          Results

          We collected 74 complete data sets about breastfeeding. During the first 6–8 weeks postpartum, 61 mothers breastfed their infants. Of these, 51 partially breastfed and 10 exclusively breastfed. For qualitative purposes, the researchers interviewed 11 mothers with late preterm babies and three themes emerged: significant difficulty with breastfeeding, failing to recognize the infant’s feeding distress and disorganized behavior, and the parental stress caused by the multiple feeding issues. The public health nurses’ comments reinforced and expanded on what the mothers reported. The themes for the nurses included: challenges with initiating breastfeeding, challenges during breastfeeding, and the need for stimulation during breastfeeding.

          Conclusion

          Mothers face challenges when breastfeeding their late preterm infants and public health nurses can guide them through this experience. Families with a late preterm infant need to be informed about the challenges associated with breastfeeding a late preterm infant. It is necessary for all health care professionals to receive proper training on safe and effective breastfeeding of late preterm infants. It is essential for public health nurses to communicate effectively with families of late preterm infants to provide anticipatory guidance about potential challenges and strategies to resolve any breastfeeding problems.

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          Most cited references37

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          Using Mixed-Methods Sequential Explanatory Design: From Theory to Practice

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            Choose your method: a comparison of phenomenology, discourse analysis, and grounded theory.

            The purpose of this article is to compare three qualitative approaches that can be used in health research: phenomenology, discourse analysis, and grounded theory. The authors include a model that summarizes similarities and differences among the approaches, with attention to their historical development, goals, methods, audience, and products. They then illustrate how these approaches differ by applying them to the same data set. The goal in phenomenology is to study how people make meaning of their lived experience; discourse analysis examines how language is used to accomplish personal, social, and political projects; and grounded theory develops explanatory theories of basic social processes studied in context. The authors argue that by familiarizing themselves with the origins and details of these approaches, researchers can make better matches between their research question(s) and the goals and products of the study.
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              "Late-preterm" infants: a population at risk.

              Late-preterm infants, defined by birth at 34(0/7) through 36(6/7) weeks' gestation, are less physiologically and metabolically mature than term infants. Thus, they are at higher risk of morbidity and mortality than term infants. The purpose of this report is to define "late preterm," recommend a change in terminology from "near term" to "late preterm," present the characteristics of late-preterm infants that predispose them to a higher risk of morbidity and mortality than term infants, and propose guidelines for the evaluation and management of these infants after birth.
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                Author and article information

                Contributors
                adosani@mtroyal.ca
                jshemraj@ucalgary.ca
                premjis@ucalgary.ca
                gcurrie@mtroyal.ca
                smreilly@ucalgary.ca
                aklodha@ucalgary.ca
                marilyn.young@albertahealthservices.ca
                hallm@ucalgary.ca
                Journal
                Int Breastfeed J
                Int Breastfeed J
                International Breastfeeding Journal
                BioMed Central (London )
                1746-4358
                8 May 2017
                8 May 2017
                2016
                : 12
                : 23
                Affiliations
                [1 ]ISNI 0000 0000 9943 9777, GRID grid.411852.b, , School of Nursing and Midwifery, Mount Royal University, ; 4825 Mount Royal Gate SW, Calgary, AB T3E 6K6 Canada
                [2 ]ISNI 0000 0004 1936 7697, GRID grid.22072.35, O’Brien Institute of Public Health, , University of Calgary, ; Calgary, AB Canada
                [3 ]ISNI 0000 0004 1936 7697, GRID grid.22072.35, , Undergraduate Student, University of Calgary, ; 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
                [4 ]ISNI 0000 0004 1936 7697, GRID grid.22072.35, Faculty of Nursing, , University of Calgary, ; 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
                [5 ]ISNI 0000 0001 0684 7358, GRID grid.413571.5, , Alberta Children’s Hospital Research Institute, ; Calgary, AB Canada
                [6 ]Department of Paediatrics, Section of Neonatology, Alberta Health Services, Foothills Medical Centre, 1403 29th Street NW, Calgary, AB T2N 2T9 Canada
                [7 ]ISNI 0000 0001 0693 8815, GRID grid.413574.0, Prenatal & Postpartum Services, , Public Health Calgary Zone, Alberta Health Services, ; 1430, 10101 Southport Road SW, Calgary, AB T2W 3N2 Canada
                Author information
                http://orcid.org/0000-0001-6817-3571
                Article
                114
                10.1186/s13006-017-0114-0
                5422948
                28503191
                b8ce0dcc-47f9-4b0c-84f7-9bf79327305d
                © The Author(s). 2017

                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
                : 18 November 2016
                : 2 May 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000002, Alberta Centre for Child, Family and Community Research;
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Obstetrics & Gynecology
                late preterm infant,breastfeeding,mothers’ experiences,public health nurses’ perceptions,canada

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