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| 2. |
- Baylis, Rebecca, et al.
(author)
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First-time events between parents and preterm infants are affected by the designs and routines of neonatal intensive care units
- 2014
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In: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 103:10, s. 1045-1052
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Journal article (peer-reviewed)abstract
- Aim: Early parental bonding with preterm babies is particularly important, and the aim of our study was to explore when parents experienced what they regarded as important events for the first time while their infant was in the neonatal intensive care unit (NICU).Methods: The study was part of a longitudinal project on Kangaroo Mother Care at two Swedish university hospitals. The parents of 81 infants completed questionnaires during their infants' hospital stay.Results: Most parents saw and touched their infants immediately after birth, but only a few could hold them skin to skin or swaddle them. Other important events identified by parents included the first time they performed care giving activities and did so independently, interaction and closeness with the infant, signs of the infant's recovery and integration into the family. The timing of the events depended on the physical design of the NICU, whether parents' could stay with their infant round-the-clock and when they were allowed to provide care under supervision and on their own.Conclusion: The design and routines of the NICU dictated when parents first interacted with their infants. Clinical guidelines that facilitate early contact with preterm babies can help parents to make the transition to their parental role.
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| 3. |
- Blomqvist, Ylva Thernström, 1974-, et al.
(author)
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Initiation and extent of skin-to-skin care at two Swedish neonatal intensive care units
- 2013
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In: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 102:1, s. 22-28
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Journal article (peer-reviewed)abstract
- Aim To describe initiation and extent of parents application of skin-to-skin care (SSC) with their preterm infants at two Swedish neonatal intensive care units.Methods The duration of SSC was recorded in 104 infants medical charts during their hospital stay, and the parents answered a questionnaire.Results Both parents were involved in the practice of SSC. Three infants experienced SSC directly after birth, 34 within 1 h, 85 within 24 h and the remaining 19 at 2478 h postbirth. SSC commenced earlier (median age of 50 min) in infants whose first SSC was with their father instead of with their mother (median age of 649 min: p < 0.001). The earlier the SSC was initiated, the longer the infant was cared for skin-to-skin per day during his/her hospital stay (p < 0.001). The median daily duration of SSC was 403 min.Conclusion Early initiation of SSC had positive impact on the extent of parents application of SSC. Even though the infants in this study were cared for skin-to-skin to a high extent, there is a potential for extended use of SSC in this type of hospital setting for reducing separation between infants and parents.
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- Blomqvist, Ylva Thernström, 1974-, et al.
(author)
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Parents need support to find ways to optimise their own sleep without seeing their preterm infant's sleeping patterns as a problem
- 2017
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In: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 106:2, s. 223-228
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Journal article (peer-reviewed)abstract
- AIM: This study described how parents perceived their own sleep, and their infants', during neonatal intensive care unit (NICU) admission and after discharge. It also explored the infants' sleeping location at home.METHODS: The study was conducted in the NICUs of two Swedish university hospitals. The parents of 86 infants - 86 mothers and 84 fathers - answered questionnaires during their infants' hospital stay, at discharge and at the infants' corrected ages of two, six and 12 months. The parents' own sleep was explored with the Insomnia Severity Index.RESULTS: Mothers reported more severe insomnia than fathers during their infants' hospitalisation, and these higher insomnia severity scores were associated with more severe infant sleep problems at discharge (p = 0.027) and at two months (p = 0.006) and 12 months (p = 0.002) of corrected age. During the study period, 4%-10% of the parents reported severe or very severe infant sleeping problems. The bed-sharing rate was 75% after discharge and about 60% at the corrected age of 12 months.CONCLUSION: Maternal insomnia during an infant's hospital stay was associated with later perceptions of sleep problems in their children. Parents need support to find solutions for optimal sleep without seeing their child's sleeping patterns as a problem.
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| 6. |
- Blomqvist, Ylva Thernström, 1974-, et al.
(author)
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Swedish mothers' experience of continuous Kangaroo Mother Care
- 2011
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:9-10, s. 1472-1480
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Journal article (peer-reviewed)abstract
- Aims. To characterise the first infants receiving continuous Kangaroo Mother Care from birth to discharge in a Swedish neonatal intensive care unit and to investigate their mothers' experiences of this model of care. Background. Admission of a newborn infant to a neonatal intensive care unit commonly implies separation of the new mother from her infant. Kangaroo Mother Care is a model of neonatal care which supports the parental role as primary care-giver and contributes to minimising the separation between the infant and parents. Design. A retrospective survey design. Method. A purposive sample consisting of 23 mother-infant pairs. Relevant infant data were obtained from their medical records. A questionnaire with questions about the infant's care and regarding Kangaroo Mother Care was designed for this study. Results. The infants were born at a gestational age of 31-41 weeks, birth weight ranging from 1715-3700 g. The mothers of these moderately preterm and ill newborn infants showed good acceptance of the idea of providing their infants with continuous Kangaroo Mother Care during their stay at the neonatal intensive care unit. The mothers' evaluations of this method were predominantly positive. Negative comments concerned lack of information about practical application of the method, and some mothers perceived their infants' care during the night as exhausting. No mother would have preferred not to perform continuous Kangaroo Mother Care or to terminate Kangaroo Mother Care earlier than they did. Conclusions. These mothers accepted this model of care very well, provided that they received the help and support they required. Relevance to clinical practice. Mothers whose infants are admitted to an neonatal intensive care units in settings similar to the study setting should be offered opportunities to be present and provide Kangaroo Mother Care for their infants, to the extent that they are able and willing to do so and as permitted by the infant's medical condition and care.
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| 7. |
- Flacking, Renée, 1964-
(author)
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Breastfeeding and Becoming a Mother : Influences and Experiences of Mothers of Preterm Infants
- 2007
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis was to expand the knowledge and understanding of the processes of breastfeeding and becoming a mother in mothers of preterm infants. For this purpose, in-depth interviews were conducted with 25 mothers, whose very preterm infants had received care in seven neonatal units (NU) in Sweden, 1-12 months after discharge (I-II). In addition, prospective population-based register studies were performed of infants born 1993-2001; among 35 250 term and 2093 preterm infants (III), and a subpopulation of 225 very preterm infants (IV). Data were obtained from the Child Health Service registry of breastfeeding in Uppsala and Örebro, the Medical Birth Registry, and Statistics Sweden. The experiences of mother-infant separation, institutional authority, emotional exhaustion and disregard of breastfeeding as a relational interplay, comprised major hindrances to mothers’ experiences of breastfeeding as reciprocal and of a secure mother-infant relation, during and after the discharge from an NU (I-II). All studied socioeconomic factors, i.e. lower educational level, receiving unemployment benefit or social welfare or having a low equivalent disposable income, were individually adversely associated with breastfeeding up to six months of infants’ postnatal age, but were not found more decisive for weaning in mothers of preterm infants compared to those of term infants (III). Preterm infants were breastfed for a shorter time than term infants (III), but a long breastfeeding duration was evident. In addition, gestational age and neonatal disorders were not associated with breastfeeding duration in very preterm infants (IV).In conclusion, this thesis shows that improvements in the NU environment and the caring paradigm are called for. Furthermore, as socioeconomic status clearly has an impact on breastfeeding duration, increased equity in health care in accordance with the individuals’ needs must be sought, where resources are allocated to ensure fulfilment of needs in more vulnerable mothers and infants.
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| 8. |
- Flacking, Renée, et al.
(author)
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Effects of socioeconomic status on breastfeeding duration in mothers of preterm and term infants
- 2007
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 17:6, s. 579-584
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Journal article (peer-reviewed)abstract
- Background: The propensity to breastfeed is not only of importance with regard to the beneficial effects on the individual, but is also of concern as an indicator of health behaviour related to social conditions. Thus, our aim was to investigate the impact of socioeconomic status (SES) on breastfeeding duration in mothers of preterm and term infants. Methods: Prospective population based cohort study. Data for infants registered in breastfeeding databases of two Swedish counties 19932001 were matched with data from two national registriesthe Medical Birth Registry and Statistics Sweden. A total of 37 343 mothers of 2093 preterm and 35 250 term infants participated. Results: All socioeconomic factors; maternal educational level, maternal unemployment benefit, social welfare and equivalent disposable income, were strongly associated with breastfeeding when examined individually in mothers of preterm and term infants. Some of the associations attenuated when investigated simultaneously. Independently of SES and confounders, mothers of preterm infants were at higher risk of weaning before the infant was 2 months (adjusted odds ratio (OR) 1.70; 95 confidence interval ((Cl) 1.46-1.99)), 4 months (OR 1.79; Cl 1.602.01), 6 months (OR 1.48; Cl 1.331.64), and 9 months old (OR 1.19; Cl 1.061.34), compared with mothers of term infants. Conclusions: In Sweden, despite its social welfare support system and a positive breastfeeding tradition, SES clearly has an impact on the breastfeeding duration. Mothers of preterm infants breastfeed for a shorter time compared with mothers of term infants, even when adjustments are made for SES and confounders.
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| 9. |
- Flacking, Renée, et al.
(author)
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Long-term duration of breastfeeding in Swedish low birth weight infants
- 2003
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In: Journal of Human Lactation. - : SAGE Publications. - 0890-3344 .- 1552-5732. ; 19:2, s. 157-165
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Journal article (peer-reviewed)abstract
- The aim of this study was to describe the long-term incidence of breastfeeding in a geographically defined cohort of low birth weight (LBW) (< 2500 g) Swedish infants (N = 70) at discharge from a neonatal unit and at the postnatal ages of 2, 4, 6, and 8 months. The infants' breastfeeding data were examined retrospectively and compared to annual breastfeeding data for all infants born in the same year and county (N = 2,751). Ninety-three percent of the LBW infants were fed breast milk at discharge and 36% at 6 months, compared to 97% and 75%, respectively, of the county population. Cox regression analysis showed that multiparity was a significant predictor associated with shorter breastfeeding in LBW infants (odds ratio = 2.51. 95% confidence interval, 1.35-4.69). LBW infants had a high breastfeeding incidence but a significantly shorter duration than controls. This result indicates the need for intensified support throughout the breastfeeding period.
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| 10. |
- Flacking, Renée, et al.
(author)
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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
- 2006
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In: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 62:1, s. 70-80
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Journal article (peer-reviewed)abstract
- 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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