Abstract
BackgroundAssisting mothers to breastfeed is not easy when babies experience difficulties. In a neonatal intensive care unit (NICU), nurses often help mothers by using hands-on-breast without their permission. Little is known about how mothers feel about this unusual body touching. To gain more knowledge from mothers who lived through this experience, this hands-on practice was studied in a NICU in Sweden.MethodsBetween January and June 2001, in-depth interviews were conducted with ten mothers of preterm or sick term infants and all of them experienced the hands-on approach. In this research, Radnitzky's seven principles of hermeneutic interpretation were applied in order to interpret the meaning of mothers' responses. This article presents results related to the period of initiation of breastfeeding. This qualitative study was based on a combination of the models of Gustafsson, Orem, and Aarts' Marte Meo.ResultsFive main themes were identified: Insult to integrity, Manipulating the baby, Understanding and adjustment, Breasts as objects, Alternatives to this practice. Hands-on help in the breastfeeding situation was experienced as unpleasant and the women experienced their breasts as objectified. The mothers accepted the hands-on help given by nursing staff, even though they considered it unpleasant. Most mothers expressed a need for assistance when starting breastfeeding, but could not suggest any alternative to hands-on help such as demonstrating with an artificial breast and a doll.ConclusionThe study provides information about how mothers experience unexpected hands-on help with breastfeeding in a NICU, which has not been described previously. Since most mothers in this study regarded this behavior as unpleasant and not helpful mostly because it was unexpected and unexplained, it would be important to either explain beforehand to mothers what type of physical approach could be attempted on their body or better, to avoid this type of approach completely.
Highlights
Assisting mothers to breastfeed is not easy when babies experience difficulties
Research question How do mothers experience support by nursing staff in breastfeeding situations while their baby is in the neonatal intensive care unit (NICU)? This was the general question underlying this qualitative study
We report here only the sub-question pertaining to the hands-on approach: How do mothers experience hands-on support by nursing staff in breastfeeding situations while their baby is in a NICU?
Summary
Assisting mothers to breastfeed is not easy when babies experience difficulties. In a neonatal intensive care unit (NICU), nurses often help mothers by using hands-on-breast without their permission. Failures in breastfeeding can lead to anxiety, low self-confidence, and low self-esteem [3,4], and feelings of being a bad mother [5]. In these instances, the nursing staff's knowledge, attitudes and skills have a great impact on the mothers' self-confidence and ability to initiate breastfeeding [6,7]. Midwives and neonatal nurses who lack knowledge in breastfeeding management experience difficulties in giving timely and adequate information, and in supporting mothers [9]. HedbergNyqvist and her colleagues demonstrated that uniformity of language and approach from nursing staff increase the professional breastfeeding support to mothers [12]. Our clinical experience tell us that some nurses use a hands-on approach on their own body or on the mother's breast
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