| 1. |
- 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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| 2. |
- 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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| 3. |
- Ericson, Jenny, et al.
(författare)
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Estimated Breastfeeding to Support Breastfeeding in the Neonatal Intensive Care Unit
- 2013
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Ingår i: Journal of Obstetric, Gynecologic and Neonatal Nursing. - : Elsevier BV. - 0884-2175 .- 1552-6909. ; 42:1, s. 29-37
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate the effects of estimated breastfeeding on infant outcomes in comparison to test weighing and to describe staff members experiences of estimated breastfeeding as a method for supporting the transition from tube feeding to breastfeeding. Design A mixed method evaluation. Setting Neonatal Intensive Care Unit (NICU) in Sweden. Participants The study included 365 preterm (25th36th gestational weeks) infants and 45 nurses or nurse assistants. Methods A retrospective comparative medical record study was used to assess infant outcomes during a period of test weighing (196 infants) and again after the implementation of estimated breastfeeding (169 infants). A qualitative survey was conducted to explore the staff experiences of estimated breastfeeding. Results No differences were found between groups regarding duration of tube feeding, length of hospital stay, gestational age, weight at discharge, and rate of any breastfeeding. Infants in the estimated breastfeeding group had a higher risk of not being exclusively breast milk fed than infants in the test-weighing group (OR = 2.76, CI [1.5, 5.1]). Staff perceived estimated breastfeeding as a more facilitative and less stressful method for mothers than test weighing. Some staff had difficulty following guidelines while simultaneously providing person-centered care. Conclusions Estimated breastfeeding is a nonintrusive and feasible method for assessing and supporting the transition from tube feeding to breastfeeding among preterm infants in a NICU. However, the increased risk for not being exclusively breastfed is of concern. Additional research is needed to assess whether this method is appropriate and feasible in varying contexts and cultures.
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| 4. |
- Ericson, Jenny, et al.
(författare)
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The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants : study protocol for a randomized controlled trial
- 2013
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Ingår i: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at < 37 gestational weeks), mothers of preterm infants have shorter breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mothers' sense of trust in their own capacity and thereby facilitate breastfeeding.Methods/design: A multicentre randomized controlled trial has been designed to evaluate the effectiveness and cost-effectiveness of person-centred proactive telephone support on breastfeeding outcomes for mothers of preterm infants. Participating mothers will be randomized to either an intervention group or control group. In the intervention group person-centred proactive telephone support will be provided, in which the support team phones the mother daily for up to 14 days after hospital discharge. In the control group, mothers are offered a person-centred reactive support where mothers can phone the breastfeeding support team up to day 14 after hospital discharge. The intervention group will also be offered the same reactive telephone support as the control group. A stratified block randomization will be used; group allocation will be by high or low socioeconomic status and by NICU. Recruitment will be performed continuously until 1116 mothers (I: 558 C: 558) have been included. Primary outcome: proportion of mothers exclusively breastfeeding at eight weeks after discharge.Secondary outcomes: proportion of breastfeeding (exclusive, partial, none and method of feeding), mothers satisfaction with breastfeeding, attachment, stress and quality of life in mothers/partners at eight weeks after hospital discharge and at six months postnatal age. Data will be collected by researchers blind to group allocation for the primary outcome. A qualitative evaluation of experiences of receiving/providing the intervention will also be undertaken with mothers and staff.Discussion: This paper presents the rationale, study design and protocol for a RCT providing person-centred proactive telephone support to mothers of preterm infants. Furthermore, with a health economic evaluation, the cost-effectiveness of the intervention will be assessed. Trial registration: NCT01806480
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| 5. |
- Ericsson, Jenny, et al.
(författare)
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Decrease in Breast Milk intake in Preterm Infants Discharged from Swedish Neonatal Units 2004-2013
- 2014
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Konferensbidrag (refereegranskat)abstract
- Objective: Sweden is regarded as a very pro-breastfeeding culture with high rates of breastfeeding at discharge from hospital and during infancy. Among preterm infants in Sweden, the rates of breastfeeding at discharge from hospital were reported to be more than 90 % in the beginning of the 21 st century (Akerstrom 2007, Flacking 2003) However, lately there have been indications that breastfeeding incidence at discharge is decreasing among preterm infants cared for in Neonatal Units in Sweden. Thus, the objective was to describe breastfeeding incidence in preterm infants at discharge from neonatal units during the period 2004-2013.Method: This study was a registry study with data collected from the Swedish Neonatal Quality Register (SNQ), a national registry of all infants cared for in almost all Neonatal Units in Sweden. This study included 29.445 preterm infants (<37 gestational weeks, gw) who were discharged to home and where information on breastfeeding was available.Results: Preliminary findings indicated a decrease in exclusive breastfeeding from 57 % in 2004 to 30 % in 2013. The proportion of partially breastfed infants increased from 30 % in 2004 to 52 % in 2013. Although the proportion of partially breastfed infants increased, fewer infants were breastfed in 2013 (82 %) compared to 2004 (87 %). Among extremely preterm (<28 gw) infants (n=1936), the rate of any breastfeeding decreased from 56 % to 53 %; in very preterm (28-31 gw) infants (n=4595) from 81 % to 70 % and in moderately preterm (32-36 gw) infants (n=22.914) from 92 % to 87 %, during the study period. Gestational age at birth, multiple births, way of delivery and infants’ diseases did not seem to have increased during 2004-2013 and thereby influencing the decrease in breastfeeding. However, an increase in reported diseases in mothers was seen, from 15 % in 2004 to 29 % in 2013.Conclusions: Our preliminary findings show a decrease in breastfeeding incidence at discharge among preterm infants in Sweden during 2004-2013. Further analyses may indicate potential influencing factors. Our preliminary findings give rise to concern and present a challenge to those working with preterm infants and their families in Neonatal Units in their support to mothers and their infants.
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| 6. |
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| 7. |
- Eriksson, Mats, 1959-, et al.
(författare)
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Neonatal omvårdnad viktigt forskningsområde
- 2014
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Ingår i: Läkartidningen. - Stockholm : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 111:39, s. 1666-1666
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 8. |
- Finlayson, Kenneth, et al.
(författare)
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Mothers’ perceptions of family centred care in neonatal intensive care units
- 2014
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 5:3, s. 119-124
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore mothers' perceptions of family centred care (FCC) in neonatal intensive care units (NICUs) in England. Design: The qualitative experiences of 12 mothers from three NICUs in the UK were elicited using individual interviews. A thematic network analysis was conducted on the transcribed interviews. Main outcome measures: A central global theme supported by a number of organizing themes were developed reflecting the views of the mothers and their experiences of FCC. Results: A global theme of "Finding My Place" was identified, supported by six organizing themes: Mothering in Limbo; Deference to the Experts; Anxious Surveillance; Muted Relations, Power Struggles and Consistently Inconsistent. Mothers experienced a state of liminality and were acutely sensitive to power struggles, awkward relationships and inconsistencies in care. To try to maintain their equilibrium and protect their baby they formed deferential relationships with health professionals and remained in a state of anxious surveillance. Conclusions: This study illustrates that despite the rhetoric around the practice of FCC in NICUs, there was little in the mother's narratives to support this. It is of the utmost importance to minimize the consequences of the liminal experience, to improve staff-mother interactions and to facilitate mothers' opportunities to be primary caregivers.
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| 9. |
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| 10. |
- Flacking, Renée, 1964-, et al.
(författare)
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‘Being in a womb’ or ‘playing musical chairs’ : the impact of place and space on infant feeding in NICUs
- 2013
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Becoming a parent of a preterm baby requiring neonatal care constitutes an extraordinary life situation in which parenting begins and evolves in a medical and unfamiliar setting. Although there is increasing emphasis within maternity and neonatal care on the influence of place and space upon the experiences of staff and service users, there is a lack of research on how space and place influence relationships and care in the neonatal environment. The aim of this study was to explore, in-depth, the impact of place and space on parents’ experiences and practices related to feeding their preterm babies in Neonatal Intensive Care Units (NICUs) in Sweden and England.Methods: An ethnographic approach was utilised in two NICUs in Sweden and two comparable units in England, UK. Over an eleven month period, a total of 52 mothers, 19 fathers and 102 staff were observed and interviewed. A grounded theory approach was utilised throughout data collection and analysis.Results: The core category of ‘the room as a conveyance for an attuned feeding’ was underpinned by four categories: the level of ‘ownership’ of space and place; the feeling of ‘at-homeness’; the experience of ‘the door or a shield’ against people entering, for privacy, for enabling a focus within, and for regulating socialising and the; ‘window of opportunity’. Findings showed that the construction and design of space and place was strongly influential on the developing parent-infant relationship and for experiencing a sense of connectedness and a shared awareness with the baby during feeding, an attuned feeding.Conclusions: If our proposed model is valid, it is vital that these findings are considered when developing or reconfiguring NICUs so that account is taken of the influences of spatiality upon parent’s experiences. Even without redesign there are measures that may be taken to make a positive difference for parents and their preterm babies.
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