Abstract

BackgroundMothers’ 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).MethodsThis 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.ResultsDuring 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.ConclusionsBreastfeeding 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.Trial registrationThe randomized controlled trial was registered NCT01806480 with www.clinicaltrials.gov on 2013-03-07.

Highlights

  • Mothers’ satisfaction with breastfeeding is important for breastfeeding duration but rarely investigated in mothers of preterm infants

  • Mothers with a lower educational level (p < 0.001), mothers not born in Sweden (p < 0.001) and mothers who were partially or not breastfeeding 8 weeks after discharge and at a postnatal age of 6 months (p =

  • Our findings showed that mothers who partially breastfed at discharge and at 6 months after birth, had a higher parental stress or a very preterm infant, had a decrease in maternal breastfeeding satisfaction

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Summary

Introduction

Mothers’ satisfaction with breastfeeding is important for breastfeeding duration but rarely investigated in mothers of preterm infants. How mothers of preterm infants experience the breastfeeding journey varies; for some mothers, breastfeeding is experienced as a positive and smooth journey, while for others, breastfeeding may be burdensome and less positive [4, 5]. The latter kind of experience may be due to a range of factors, e.g., insufficient milk supply, few emotional or practical resources and support, limited person-based support from staff or non-facilitative care routines, and result in earlier weaning from breastfeeding [5, 6]. During hospitalization and after discharge, mothers may sustain breastfeeding because they enjoy it and find it pleasurable or because of a cultural norm of breastfeeding and the idea that a ‘good mum breastfeeds’ [7,8,9]

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