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| 2. |
- Bergström, Eva-Britt, et al.
(författare)
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Postpartum depression in mothers of infants cared for in a Neonatal Intensive Care Unit : Incidence and associated factors
- 2012
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Ingår i: Journal of Neonatal Nursing. - : Elsevier. - 1355-1841 .- 1878-089X. ; 18:4, s. 143-51
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Tidskriftsartikel (refereegranskat)abstract
- This longitudinal cohort study investigated the incidence of postpartum depression (PPD) among mothers of infants cared for in two Neonatal Intensive Care Units (NICU) and factors related to PPD onset. 123 mothers were posted the Edinburgh Post-Natal Depression Scale (EPDS) and a questionnaire to record infant and maternal data at 1 month, and a repeat EPDS scale at 4 months post-discharge. PPD incidence was 15% at 1 month, 14% at 4 months, and varied by NICU (23% vs. 8%). Pre-pregnancy and/or antenatal depression was significantly associated with the incidence of PPD. Mothers who experienced PPD at 1 month had an almost eight fold risk of experiencing PPD at 4 months. Women who were not offered counselling during their infant’s stay on the NICU had a 60% increased risk for PPD onset. The findings highlight the need for routine pre-natal screening and targeted support for mothers with infants admitted to NICU.
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| 4. |
- Dykes, Fiona, et al.
(författare)
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Encouraging breastfeeding : A relational perspective
- 2010
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Ingår i: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 86:11, s. 733-736
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Tidskriftsartikel (refereegranskat)abstract
- Despite the WHO recommendations that babies should be breastfed exclusively for six months and thereafter for up to two years and beyond this pattern of feeding is far from the global norm. Although breastfeeding is triggered through biological mechanisms which have not changed with time, the perception of breastfeeding as a phenomenon is variable, as it not only reflects cultural values of motherhood but is also negotiable from the perspective of the individual. This paper argues that relationships are central to encouraging breastfeeding at an organisational, family and staff-parent level. This shifts our conceptualisations away from the primary focus of breastfeeding as nutrition which, in turn, removes the notion of breastfeeding as a productive process, prone to problems and failure.
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| 5. |
- Dykes, Fiona, et al.
(författare)
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Perceptions of European medical staff on the facilitators and barriers to physical closeness between parents and infants in neonatal units
- 2016
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 105:9, s. 1039-1046
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Studies have provided insights into factors that may facilitate or inhibit parent-infant closeness in neonatal units, but none have specifically focused on the perspectives of senior neonatal staff. The aim of this study was to explore perceptions and experiences of consultant neonatologists and senior nurses in five European countries with regard to these issues.METHODS: Six small group discussions and three one-to-one interviews were conducted with 16 consultant neonatologists and senior nurses representing nine neonatal units from Estonia, Finland, Norway, Spain and Sweden. The interviews explored facilitators and barriers to parent-infant closeness and implications for policy and practice and thematic analysis was undertaken.RESULTS: Participants highlighted how a humanising care agenda that enabled parent-infant closeness was an aspiration, but pointed out that neonatal units were at different stages in achieving this. The facilitators and barriers to physical closeness included socio-economic factors, cultural norms, the designs of neonatal units, resource issues, leadership, staff attitudes and practices and relationships between staff and parents.CONCLUSION: Various factors affected parent-infant closeness in neonatal units in European countries. There needs to be the political motivation, appropriate policy planning, legislation and resource allocation to increase measures that support closeness agendas in neonatal units. This article is protected by copyright. All rights reserved.
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| 6. |
- Ericson, Jenny, et al.
(författare)
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Breastfeeding and risk for ceasing in mothers of preterm infants - long-term follow-up
- 2018
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Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695 .- 1740-8709. ; 14:4
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Tidskriftsartikel (refereegranskat)abstract
- Breastfeeding is challenging for mothers of preterm infants. The aim of this paper is to describe risk factors for ceasing breastfeeding and methods of feeding until 12 months postnatal age in mothers who breastfed their preterm infants at discharge from neonatal intensive care units (NICUs). The data come from a randomised controlled trial, which evaluated the effectiveness on exclusive breastfeeding at 8 weeks of proactive telephone support compared with reactive support offered to mothers of preterm infants following discharge from NICU. Six NICUs across Sweden randomised a total of 493 mothers. We used regression and survival analyses to assess the risk factors for ceasing breastfeeding and the long-term outcomes of the intervention. The results showed that 305 (64%) of the infants were breastfed at 6 months and 49 (21%) at 12 months. Partial breastfeeding at discharge, low maternal educational level, and longer length of stay in the NICU increased the risk for ceasing breastfeeding during the first 12 months. Furthermore, the Kaplan-Meier analysis showed that the proportion of mothers who ceased breastfeeding did not differ between the intervention (n = 231) and controls (n = 262) during the first 12 months (log-rank test p = .68). No difference was found between groups on method of feeding. More than 85% of the infants were fed directly at the breast. These findings provide important insights for health professionals who are supporting mothers of preterm infants to breastfeed long term.Registered in www.clinicaltrials.gov (NCT01806480).
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| 8. |
- Ericson, Jenny, et al.
(författare)
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Breastfeeding duration in preterm infants and the effects of a proactive telephone support: a randomized controlled trial
- 2018
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Konferensbidrag (refereegranskat)abstract
- IntroductionThe first months at home may be troublesome for mothers of preterm infants (< 37 gestational weeks) due to lack of support and thereby an increased risk for ceasing breastfeeding (Kair, Flaherman, Newby, & Colaizy, 2015; Niela-Vilen, Axelin, Melender, & Salantera, 2015). Breastfeeding prevalence in preterm infants is lower than in term infants and decreases during the first months at home (Akerstrom, Asplund, & Norman, 2007; Flacking, Nyqvist, Ewald, & Wallin, 2003). The aim of this trial was to evaluate the effects of a proactive breastfeeding telephone support to mothers of preterm infants on breastfeeding, method of feeding and to describe breastfeeding duration and risks for ceasing breastfeeding up to one year of infant age. MethodThis is a multicentre randomized controlled trial with six neonatal units in Sweden participated. At each unit a breastfeeding support team, BST (10 staff/unit) recruited, randomized and delivered the telephone support to eligible and participating mothers. The intervention was a proactive telephone call initiated by the BST day 1-14 after discharge from the neonatal unit. In the control group, the mothers received a telephone number to the BST if they wanted to call and ask or talk about anything. The outcomes reported were breastfeeding, method of feeding, duration of and risks for ceasing breastfeeding. All researchers were blind to group allocation throughout the study period. ResultsIn total 493 mothers were randomized. There were no statistical significant differences between intervention (n=231) and control (n=262) group on breastfeeding, at discharge (OR 0.70, 95% CI 0.44-1.12, p=0.09), eight weeks after discharge (OR 1.12, 95% CI 0.75-1.69, p=0.45), six months (OR 1.21, 95% CI 0.78-1.88, p=0.29) and 12 months (OR 0.87, 95% CI 0.42-1.79, p=0.52) of infant age. Not either on method of feeding. Most infants received human milk directly at the breast; few infants received human milk by bottle, cup or tube feeding. At discharge, eight weeks after discharge and six months of infant age 82%, 58% and 23% of the infants were exclusively breastfed respectively. At 12 months of infant age, 21% were partially breastfed. Partial breastfeeding at discharge (HR 1.81, 95%CI 1.35-2.41, p=<0.001) and secondary school or lower maternal educational level (HR 1.42, 95%CI 1.13-1.79, p=0.003) increased the risk for ceasing breastfeeding during the infants first year of life. A shorter length of stay in weeks reduced the risk of ceasing breastfeeding during the infants first year of life (HR 0.96, 95% CI 0.92-0.99, p=0.021). ConclusionA two-week daily proactive telephone breastfeeding support did not affect exclusive breastfeeding and method of feeding during the infants first year of life. Few infants received human milk by other method than at breast-feeding. However, partial breastfeeding at discharge from the neonatal unit, secondary school or lower maternal educational level and longer hospital stay significantly increased the risk for ceasing breastfeeding during the infants first year of life. The study gives a unique long-term follow-up on breastfeeding in preterm infants.
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| 9. |
- Ericson, Jenny, et al.
(författare)
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Breastfeeding satisfaction post hospital discharge and associated factors - a longitudinal cohort study of mothers of preterm infants
- 2021
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Ingår i: International Breastfeeding Journal. - : BioMed Central (BMC). - 1746-4358. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mothers' satisfaction with breastfeeding is important for breastfeeding duration but rarely investigated in mothers of preterm infants. The aim of this study was to describe breastfeeding satisfaction and associated factors during the first year in mothers of preterm infants (gestational age < 37 weeks). Methods: This longitudinal cohort study, based on secondary analysis data from a randomized controlled trial, included 493 mothers of 547 preterm infants. Data on breastfeeding duration and satisfaction, parental stress and attachment were collected at 8 weeks post discharge, and at 6 and 12 months after birth. Breastfeeding satisfaction was measured by the Maternal Breastfeeding Evaluation Scale. Descriptive statistics and linear mixed effect models were used when analyzing the data. Results: During the first 12 months breastfeeding satisfaction increased in the mean summary scores and points in the dimensions "role attainment" and "lifestyle and maternal body image". In the dimension "infant growth and satisfaction", there was an increase in mean points from 6 to 12 months after birth, but not between 8 weeks after discharge and 12 months after birth. The findings also showed that partial and no breastfeeding, higher parental stress, and infant gestational age < 32 weeks were associated with decreased breastfeeding satisfaction. Older maternal age and greater maternal attachment were associated with increased maternal breastfeeding satisfaction. There were no associations between maternal breastfeeding satisfaction and maternal educational level, parity, multiple birth, or maternal birth country other than Sweden, during the first 12 months after birth. Conclusions: Breastfeeding satisfaction was clearly associated with breastfeeding duration during the first year after birth. Breastfeeding satisfaction may be important to take into account when supporting breastfeeding and when designing interventions to support breastfeeding. Furthermore, these findings highlight the complexity of breastfeeding and emphasize the need for early and good support during neonatal care, so that mothers feel trust in themselves and their infant and in exclusive breastfeeding at discharge and in the first months thereafter.
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| 10. |
- Ericson, Jenny, et al.
(författare)
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Changes in the prevalence of breast feeding in preterm infants discharged from neonatal units : a register study over 10 years
- 2016
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Ingår i: BMJ Open. - London, United Kingdom : BMJ Publishing Group Ltd. - 2044-6055. ; 6:12
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Tidskriftsartikel (refereegranskat)abstract
- Objective: There are indications that the prevalence of exclusively breastfed preterm infants is decreasing in Sweden. The objective was to investigate trends in exclusive breast feeding at discharge from Swedish neonatal units and associated factors in preterm infants.Design, setting and participants: This is a register study with data from the Swedish Neonatal Quality Register. Data from 29 445 preterm infants (gestational age (GA) <37 weeks) who were born during the period 2004–2013 were retrieved. Data included maternal, perinatal and neonatal characteristics. Data were analysed for the whole population as well as for 3 GA groups.Results: From 2004 to 2013, the prevalence of exclusive breast feeding decreased, in extremely preterm (GA 22–27 weeks) from 55% to 16%, in very preterm (GA 28–31 weeks) from 41% to 34% and in moderately preterm infants (GA 32–36 weeks) from 64% to 49%. The decline was statistically significant (p<0.001) in all 3 GA groups. This decline remained significant when adjustments were made for factors negatively associated with exclusive breast feeding andwhich became more prevalent during the study period, that is, small for GA (all groups) and maternal mental illness (very preterm and moderately preterm infants).Conclusions: In the past 10 years, Sweden has experienced a lower rate of exclusive breast feeding in preterm infants, especially in extremely preterm infants. The factors analysed in this study explain only a small proportion of this decline. The decline in exclusive breast feeding at discharge from neonatal units raises concern and present challenges to the units to support and promote breast feeding.
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