Perspectives of health professionals on factors that facilitate and hinder breastfeeding in premature infants in a neonatal unit
DOI:
https://doi.org/10.5216/ree.v25.73940Keywords:
Breast Feeding, Neonatal Nursing, Health Personnel, Infant, Premature, Intensive Care Units, NeonatalAbstract
Objective: to analyze the main factors that hinder and facilitate breastfeeding of preterm infants in the neonatal unit from the perspective of health professionals. Methods: cross-sectional study conducted with 148 professionals in two neonatal units. Data were analyzed using descriptive statistics, Pearson’s χ2 test, and Fisher’s Exact or Mann- Whitney’s test, with a significance level of 5%. Results: the clinical condition of the preterm infant (29.0%) and the mother’s emotional condition (27.0%) stood out among the main factors hindering breastfeeding preterm infants in neonatal units. The main facilitators were the mother’s willingness/desire to breastfeed (24.3%) and the health professionals’ support (23.0%); these factors were similarly distributed in the studied institutions, except for the neonatal unit’s infrastructure, which was indicated as a more predominant breastfeeding hindering factor in one of the institutions (p = 0.002). Conclusion: healthcare professionals considered breastfeeding in premature newborns to depend mainly on mother-baby conditions. The promotion and support of breastfeeding in neonatal units are still a challenge for professional practice. Improving the infrastructure of neonatal units and strengthening the conditions that favor mothers’ willingness/desire to breastfeed are important perspectives.
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Perin J, Mulick A, Yeung D, Villavicencio F, Lopez G, Strong KL, et al. Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet Child Adolesc Health. 2022 Feb;6(2):106-15. https://doi.org/10.1016/S2352-4642(21)00311-4
Organización Mundial de la Salud. Nacimientos prematuros [Internet]. 2022 [cited 2023 Jan 12]. Available from: https://www.who.int/es/news-room/fact-sheets/detail/preterm-birth
Hilditch C, Howes A, Dempster N, Keir A. What evidence- based strategies have been shown to improve breastfeeding rates in preterm infants? J Paediatr Child Health. 2019 Aug;55(8):907-14. https://doi.org/10.1111/jpc.14551
Crippa BL, Colombo L, Morniroli D, Consonni D, Bettinelli ME, Spreafico I, et al. Do a few weeks matter? Late preterm infants and breastfeeding issues. Nutrients. 2019 Feb;11(2):312. https://doi.org/10.3390/nu11020312
Luz LS, Minamisava R, Scochi CGS, Salge AKM, Ribeiro LM, Castral TC. Predictive factors of the interruption of exclusive breastfeeding in premature infants: a prospective cohort. Rev Bras Enferm. 2018 Nov-Dec;71(6):2876-82. https://doi.org/10.1590/0034-7167-2017-0762
Crowe L, Chang A, Wallace K. Instruments for assessing readiness to commence suck feeds in preterm infants: effects on time to establish full oral feeding and duration of hospitalization. Cochrane Database of Syst Rev. 2016 Aug;(8):CD005586. https://doi.org/10.1002/14651858.CD005586.pub3
World Health Organization. WHO recommendations for care of the preterm or low-birth-weight infant. [Internet]. 2022 [cited 2022 Dec 8]; Available from: https://apps.who.int/iris/bitstream/handle/10665/363697/9789240058262-eng.pdf
Mekonnen AG, Yehualashet SS, Bayleyegn AD. The effects of kangaroo mother care on the time to breastfeeding initiation among preterm and LBW infants: a meta-analysis of published studies. Int Breastfeed J. 2019 Feb;14:12. https://doi.org/10.1186/s13006-019-0206-0
Lamounier JA, Chaves RG, Rego MAS, Bouzada MCF. Iniciativa Hospital Amigo da Criança: 25 anos de experiência no Brasil. Rev Paul Pediatr. 2019 Oct-Dec;37(4):486-93. https://doi.org/10.1590/1984-0462/;2019;37;4;00004
Maastrup R, Haiek LN, Neo-BFHI Survey Group. Compliance with the “Baby-friendly Hospital Initiative for Neonatal Wards” in 36 countries. Matern Child Nutr. 2019 Apr;15(2):e12690. https://doi.org/10.1111/mcn.12690
Nyqvist KH, Kylberg E, Hansen MN, Haggkvist AP, Maastrup R, Frandsen AL, et al. The Neo-BFHI: the baby- friendly hospital initiative expanded for neonatal wards [Internet]. 2015 [cited 2023 Feb 9]; Available from: http://www.ilca.org/main/learning/resources/neo-bfhi
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Atenção humanizada ao recém-nascido: método Canguru: manual técnico [Internet]. Brasília: Ministério da Saúde; 2017 [cited 2023 Feb 11]; Available from: https://bvsms.saude.gov.br/bvs/publicacoes/atencao_humanizada_metodo_canguru_manual_3ed.pdf
Becker GE, Smith HA, Cooney F. Methods of milk expression for lactating women. Cocharane Database Syst Rev. 2016 Sep;9:CD006170. https://doi.org/10.1002/14651858.CD006170.pub5
Collins CT, Gillis J, Mcphee AJ, Suganuma H, Makrides M. Avoidance of bottles during the establishment of breast feeds in preterm infants. Cocharane Database Syst Rev. 2016 Oct;10:CD005252. https://doi.org/10.1002/14651858.CD005252.pub4
Conde-Agudelo A, Belizán JM, Diaz-Rossello J. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cocharane Database Syst Rev. 2016 Aug;8:CD002771. https://doi.org/10.1002/14651858.CD002771.pub4
Vizzari G, Morniroli D, Consales A, Capelli V, Crippa BL, Colombo L, et al. Knowledge and attitude of health staff towards breastfeeding in NICU setting: are we there yet? An Italian survey. Eur J Pediatr. 2020 Nov;179(11):1751-9. https://doi.org/10.1007/s00431-020-03678-5
Greene Z, O’Donnell CP, Walshe M. Oral stimulation for promoting oral feeding in preterm infants. Cochrane Database Syst Rev. 2016 Sep;9(9):CD009720. https://doi.org/10.1002/14651858.CD009720.pub2
Gianni ML, Bezze EN, Sannino P, Baro M, Roggero P, Muscolo S, et al. Maternal views on facilitators of and barriers to breastfeeding preterm infants. BMC Pediatr. 2018 Aug;18(1):283. https://doi.org/10.1186/s12887-018-1260-2
Abugov H, Marín SCO, Semenic S, Arroyave IC. Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia. Invest Educ Enferm. 2021 Feb;39(1):e11. https://doi.org/10.17533/udea.iee.v39n1e11
Uema RTB, Tacla MTGM, Zani AV, Souza SNDH, Rossetto EG, Santos JCT. Insucesso na amamentação do prematuro: alegações da equipe. Semina: Ciências Biológicas e da Saúde. 2015 Mar;36(1 Supl):199-208. http://doi.org/10.5433/1679-0367.2015v36n1Suplp199
Jaafar SH, Ho JJ, Lee KS. Rooming-in for new mother and infant versus separate care for increasing the duration of breastfeeding. Cochrane Database Syst Rev. 2016 Aug;(8):CD006641. https://doi.org/10.1002/14651858.CD006641.pub3
Fonseca RMS, Milagres LC, Franceschini SCC, Henriques BD. The role of human milk banks in promoting maternal and infant health: a systematic review. Cien Saude Colet. 2021 Jan;26(1):309-18. https://doi.org/10.1590/1413-81232020261.24362018
Pierrat V, Coquelin A, Cuttini M, Khoshnood B, Glorieux I, Claris O, et al. Translating neurodevelopmental care policies into practice: the experience of neonatal ICUs in France-the EPIPAGE-2 cohort study. Pediatr Crit Care Med. 2016 Oct;17(10):957-67. https://doi.org/10.1097/PCC.0000000000000914
Lau C. Breastfeeding challenges and the preterm mother- infant dyad: a conceptual model. Breastfeed Med. 2018 Jan;13(1):8-17. https://doi.org/10.1089/bfm.2016.0206
Wagner LPB, Mazza VA, Souza SRRK, Chiesa A, Lacerda MR, Soares L. Strengthening and weakening factors for breastfeeding from the perspective of the nursing mother and her family. Rev Esc Enferm USP. 2020;54:e03563. https://doi.org/10.1590/S1980-220X2018034303564
Giannì ML, Bezze E, Sannino P, Stori E, Plevani L, Roggero P, et al. Facilitators and barriers of breastfeeding late preterm infants according to mothers’ experiences. BMC Pediatr. 2016 Nov 8;16(1):179. https://doi.org/10.1186/s12887-016-0722-7
Walty CMRF, Duarte ED. O aleitamento materno de recém-nascido prematuros após a alta hospitalar. Rev Enferm Cent-Oeste Min. 2017;7:e1689. https://doi.org/10.19175/recom.v7i0.1689
Shattnawi KK. Healthcare professionals’ attitudes and practices in supporting and promoting the breastfeeding of preterm infants in NICUs. Adv Neonatal Care. 2017 Oct;17(5):390-9. https://doi.org/10.1097/ANC.0000000000000421
Bueno LGS, Teruya KM. Aconselhamento em amamentação e sua prática. J Pediatr (Rio J). 2004 Nov;80(5):s126-s130. https://doi.org/10.1590/S0021-75572004000700003
World Health Organization. Guideline counseling of women to improvement breastfeeding practices [Internet]. 2022 [cited 2023 Feb 7]. Available from: https://www.who.int/publications/i/item/9789241550468
Tambani E, Giannì ML, Bezze EN, Sannino P, Sorrentino G, Plevani L, et al. Exploring the gap between needs and practice in facilitating breastfeeding within the neonatal intensive care setting: an Italian survey on organizational factors. Front Pediatr. 2019 July;7:276. https://doi.org/10.3389/fped.2019.00276
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