Maternal Physical Health Research Articles

Primary and secondary prevention of postpartum depression

Pregnancy is one of the important life events in a woman's life, which in the face of pregnancy, childbirth and breastfeeding process, maternal psychology and physiology will have obvious changes, among which postpartum depression is more common. Postpartum depression (PPD) is a mental syndrome with obvious depressive symptoms or typical depressive episodes during the puerperal period. Its etiology is complex, with sleepiness, gloomy expression, crying and other symptoms in clinic, and even some patients will have suicidal tendencies, which seriously endangers maternal physical and mental health. In recent years, the adverse events caused by postpartum depression have attracted more and more social attention, and postpartum women's mental health has become a hot spot in clinical research. Clinical workers should improve the awareness of postpartum depression, and strengthen the maternal mental health screening, so as to detect psychological abnormalities as early as possible and give timely intervention measures. In view of the high incidence of postpartum depression, it is very important to establish a sound mental health service system for pregnant women. This paper will analyze the high risk factors of PPD summarized the targeted primary prevention and secondary prevention, and proposed prevention strategies before and after the onset of postpartum depression, respectively, to provide theoretical basis for effectively preventing the occurrence of postpartum depression or delaying the progression of postpartum depression.

Trends and adverse pregnancy and birth outcomes associated with stimulant-related disorder diagnosis.

Stimulant-related disorders (SRD), or the continued misuse of illicit or prescribed stimulants, during pregnancy can have adverse health effects for mothers and infants. This study aimed to measure prevalence and trends of SRD diagnosis in pregnancy, and associations between SRD diagnosis and adverse maternal and infant health outcomes, among pregnant individuals in California. Retrospective cohort study. California, USA. Pregnant individuals from the Study of Outcomes in Mothers and Infants (SOMI) with singleton live births between 2012 and 2020 (n = 3 740 079). SRD diagnosis (excluding cocaine) and maternal (gestational diabetes, gestational hypertension [gHTN], severe maternal morbidity [SMM]) and infant (very preterm birth [gestational age <32 weeks], preterm birth [gestational age 32-37 weeks], neonatal intensive care unit [NICU] admission, small for gestational age [SGA]) outcomes were classified using International Classification of Disease (ICD) codes and vital statistics. Risk ratios were estimated with modified Poisson log linear regression that accounted for sibling pregnancies. Covariates included maternal sociodemographic characteristics, mental and physical health problems, nicotine use and co-occurrence of other diagnosed substance use disorders. Bias analyses were conducted to address unmeasured confounding and exposure misclassification. SRD diagnosis among pregnant individuals increased from 2012 to 2020 (554 to 748 per 100 000 births). SRD diagnosis was associated with an increased risk of SMM (adjusted risk ratio [aRR] = 2.3; 95% confidence interval [CI] = 2.2-2.5), gHTN (aRR = 1.8; 95% CI = 1.7-1.9), very preterm birth (aRR = 2.2, 95% CI = 2.0-2.5), preterm birth (aRR = 2.1, 95% CI = 2.1-2.2) and NICU admission (aRR = 2.0, 95%CI = 1.9-2.0), and a decreased risk of gestational diabetes (aRR = 0.8; 95% CI = 0.8-0.9). SRD diagnosis was not associated with infants born SGA. Findings were generally robust to unmeasured confounding and misclassification of diagnosis. Stimulant-related disorder diagnosis during pregnancy appears to be associated with an increased risk for select adverse maternal and infant health outcomes including severe maternal morbidity, gestational hypertension, very preterm birth, preterm birth and neonatal intensive care unit admission.

Physiology of Human Lactation and Strategies to Support Milk Supply for Breastfeeding

Despite advances across the globe in breastfeeding initiation rates, many families continue to report they are not meeting their breastfeeding goals. Concerns about milk supply, infant nutritional intake, and infant weight gain are among the most commonly cited reasons for early breastfeeding cessation. Nurses working with individuals during the perinatal period are uniquely positioned to educate families and offer evidence-based interventions to promote optimal milk supply, infant growth, and maternal mental and physical health. Such interventions include early and frequent skin-to-skin care, emptying of the breast, and professional lactation support. By implementing such evidence-based practices in the first hours after birth and connecting families to lactation support in the first 14 days, nurses can begin to help families achieve their breastfeeding goals.

A Qualitative Investigation of a Prenatal Mindfulness Relationship-Based (PMRB) Program to Support Maternal Mental Health and Mother–Baby Relationship During Pregnancy and Post-Partum

BackgroundPregnancy and the postpartum period are times of significant transition for women, with changes in maternal physical and mental health. The formation of a relationship between a mother and her baby is vital and has been recognised as laying the foundation for later child development. There is considerable evidence that this early relationship is influenced by a woman’s well-being during pregnancy and in the early post-partum period. Mindfulness-based programs have previously revealed positive outcomes, primarily in reducing maternal stress, anxiety, and depression. However, there remains a need for considering the influence of mindfulness on the mother-baby relationship and embodiment during pregnancy and the first trimester post-partum. This study aimed to conduct an in-depth exploration of pregnant women’s experiences of a nine-session prenatal mindfulness relationship-based (PMRB) program to support its feasibility.MethodsInformation about pregnant women’s (n = 13) experiences of the PMRB program was collected through online interviews during the sessions, including their birth stories. Responses to an open-ended question about how the program had supported them during pregnancy, labour/birth, and the first post-partum trimester were summarised using thematic analysis.ResultsSixteen themes were identified and organised in four categories: (1) expectations and motivations (healthy pregnancy and mental health, non-medicalised birth, contribution to the field); (2) experiences of the PMRB program (positive experiences, shared experience, engagement with mindfulness practices, pain, stress, and anxiety relief); (3) changes attributed to the PMRB program (a new way of responding to stressors, trusting the process, connecting to body, breath, and unborn baby, awareness of the unborn baby as a sentient being); (4) changes attributed to the mindfulness practice (increased mindfulness/self-awareness, stop look listen, embracing the moment, acceptance).ConclusionsThe evaluation suggested the PMRB program may help women cope with pain and emotional challenges and be more connected to their bodies and infant. The program may also help women become more aware of their unborn baby as a sentient being and the influence of their health and mental well-being on the baby development and health. Furthermore, the program may facilitate the mother-baby relationship during pregnancy, post-partum, and breastfeeding.PreregistrationThe trial has been successfully registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) following ethical approval from Bond University Human Research Ethics Committee (BUHREC—Application AS03534, approved 20 December 2022) and allocated the Australian clinical trials registration number (ACTRN): ACTRN12623000679684.

Leading Stressors and Coping Strategies Associated With Maternal Physical and Mental Health During the Extended Postpartum Period.

A critical gap exists in understanding stressors and coping that affect women's health beyond 6 weeks postpartum. Using new stressor and coping scales tailored to postpartum women, we examined the relationship of postpartum-specific stressors and coping to women's physical and mental health between 2 to 22 months after childbirth. A total of 361 women of diverse race, ethnicity, and functional abilities recruited through clinical and online methods completed online surveys that included Sources of Stress-Revised subscales, such as overload, changes after pregnancy, and low support resources; Postpartum Coping Scale subscales, such as self-regulation, self-care, and health promotion; Patient-Reported Outcomes Measurement Information System Global Health, covering physical and mental health dimensions; and social demographic items. Analyses included hierarchical linear regression models adjusted for social factors. Education and employment were the only social factors associated with physical and mental health, respectively. After adjusting for social factors, overload (P <.001) and coping through health promotion (P =.020) were the only additional variables associated with physical health. After adjusting for social factors, overload (P <.001) and low support resources (P =.002) and coping through self-care (P =.036) were the only additional variables associated with mental health. Thus, being overloaded was the key stressor associated with decreases in physical and mental health. Health promotion was associated with increases in physical health, and self-care was associated with increases in mental health. These findings point to directions for health care and community interventions to promote health for postpartum women under stress. Strengths of our study include application of stress and coping scales tailored to postpartum women, whereas a limitation is use of a cross-sectional design.

Environmental Exposures and Risks During Pregnancy.

The Women in Wilderness Medicine Research Committee of the Wilderness Medical Society conducted a narrative review to address considerations for pregnant individuals in wilderness environments. There is limited evidence behind many opinion-based recommendations on the safety of various environmental exposures in pregnancy. The authors reviewed the literature for the best available evidence, including observational studies, case series, limited controlled trials, and extrapolation from physiological data, as well as evaluating expert consensus statements. The benefits of exposure to natural environments include better pregnancy outcomes and improved maternal mental and physical health. Risks are similar to nonpregnant individuals with the added risks associated with maternal-fetal physiology in wilderness environments and difficulties of evacuation. This narrative review discusses pregnancy-specific concerns in extreme environments, including high altitude, hypothermia, hyperthermia, lightning strikes, envenomations, and common outdoor exposures.

Enhancing Postpartum Health and Behavior: Evaluating The Impact of Postpartum Counselling in Eraviperoor Grama Panchayath

This study aims to assess the effectiveness of patient counseling in improving postpartum health and behavior in the context of Eraviperoor Grama Panchayath. Postpartum health is a critical period in a woman's life, and proper care and behavior during this phase significantly influence maternal and neonatal outcomes. This research employs a mixed-methods approach, combining quantitative surveys and qualitative interviews to comprehensively evaluate the impact of patient counseling on postpartum health and behavior. Objective: Effectiveness of patient counseling on postpartum health &amp; behavior. The quantitative aspect involves administering structured questionnaires to a sample of postpartum women who have received counseling. These surveys will focus on aspects such as maternal physical health, mental well-being, infant care practices, and adherence to recommended postpartum behaviors. The qualitative component comprises in-depth interviews and postpartum women to gain insights into their perceptions, experiences, and the challenges faced in implementing counseling interventions. It provides a deeper understanding of the nuances surrounding patient counseling in Eraviperoor Grama Panchayath. Results: The PPD was found to be 40% mild /moderate and 4% severe. Baby blues was found to be 77% prevalent. The effectiveness of counseling on overall maternal problems was found to be 96%.

‘Joining the Dots: Linking Prenatal Drug Exposure to Childhood and Adolescence’ – research protocol of a population cohort study

IntroductionPrenatal drug exposure (PDE) is one of the most important causes of child harm, but comprehensive information about the long-term outcomes of the families is difficult to ascertain. The Joining...

Association between antenatal common mental disorders symptoms, and adverse obstetric and perinatal outcomes: A community-based prospective cohort study in Eastern Ethiopia

BackgroundMaternal common mental disorders have broad implications for maternal and child mental and physical health that may have a long-lasting social and economic impact. This study aimed to assess the association between symptoms of antenatal common mental disorders and obstetric and perinatal outcomes in Eastern Ethiopia. MethodsA community-based prospective cohort study was conducted and a total of 1011 randomly selected pregnant women were followed up from February 1, 2021, to January 30, 2022. The modified Poisson regression model with a robust variance was fitted to examine the effect of the symptoms of antenatal common mental disorders on obstetric and perinatal outcomes. ResultsAntenatal common mental disorders (SRQ ≥ 6) were presented among 390 (38.58 %) pregnant women. In the final multivariate Poisson regression model, women with antenatal common mental disorders symptoms had an increased risk of some pregnancy complications (ARR = 1.65, 95 % CI: 1.59, 1.84). In the current study, symptoms of antenatal common mental disorders increased also the risk of preterm birth (ARR = 1.71; 95 % CI: 1.20, 2.42) and low birth weight (ARR = 1.93; 95 % CI: 1.36, 2.74). LimitationThe indirect effects of some potential mediators and moderators were not assessed in this study. ConclusionThe study found a high rate of symptoms of antenatal common mental disorders and adverse obstetric and perinatal outcomes. Antenatal common mental disorders symptoms may have considerable effects on individual and combined pregnancy complications and adverse perinatal outcomes.

The impact of maternal occupation on children’s health: A mediation analysis using the parametric G-formula

BackgroundPrevious studies have found that maternal occupational choice can directly impact fetal health and mothers’ energy and time available for childcare. Moreover, reduced caregiving time is associated with poorer child health. However, how maternal occupational factors (work nature/income/stress) affect child health has not been fully explored. MethodsData were extracted from China Family Panel Studies (CFPS) from 2014 to 2020. A parametric G-formula Model was constructed to simulate the direct impact of maternal occupational factors (work nature, income, and stress) on child health. Furthermore, we explored their indirect effects mediated by maternal physical health, mental health, or occupational factors for the overall sample and by different age groups of the children. ResultsMaternal work nature and income had positive direct impacts on child health, especially for children whose mothers were employers of budgeted positions. Maternal work stress had a negative direct impact on children's health. Maternal work stress mediated the positive impact of maternal work income (9%). Maternal work stress affected children's health directly for children aged under 6, while for children aged 7–15, it had an indirect impact mediated by maternal physical health (43%), mental health (44%), and income (47%). ConclusionAttention should be paid to maternal occupational factors (especially to work stress) and to the varying care needs of children from their mothers at different ages to improve children's health and prevent the transmission of maternal occupation to children's health.

The Impact of Relationship on Goal Attainment in a Home-Based Family Support Program

Home-based family support programs provide early intervention to support families with young children. Home visiting models typically serve pregnant and parenting women with risk factors known to influence the caregiver-child relationship including history of trauma, low academic achievement, low income, limited support networks, maternal depression, and maternal substance use. Few, if any, home visiting models, however, were developed specifically to support families affected by maternal substance use. The Team for Infants Exposed to Substance use (TIES) Program is a home-based family support program exclusively serving families affected by maternal substance use. The model design and intensive services allow TIES participants to achieve significant positive outcomes in the program’s six goal areas: maternal substance use, parenting skills, child mental and physical health, maternal mental and physical health, family income, and family housing. Goal scores are assessed jointly by participants and staff throughout the program using a validated scale. Program staff hypothesize that goal attainment in these areas may be influenced by the therapeutic relationship developed between home visitors and participants. This relationship is assessed using the Working Alliance Inventory (WAI), a validated assessment of therapeutic alliance administered to both participants and staff. An analysis of 127 program participants shows that when controlling for home visitor WAI scores in multilevel models (MLMs), goal attainment scores improved from intake to discharge across all goal areas except for housing stability. These results stress the importance of the therapeutic relationship in maximizing TIES participants’ growth and success.

A Modeling Study of the Relationship Between Maternal Physical and Mental Health and Infant Behavior

The physical and mental health of the mother is one of the main factors affecting the healthy development of the infant. It is important to study the physical and psychological indicators of mothers and the corresponding interventions for the healthy growth of infants. In this paper, the relationship between mothers' physical and mental health and infants' behavior was investigated. Structural equation modeling (SEM) was used to analyze the standardized data, analyze the relationship between the influence of the paths of each factor, understand the composition of the paths of each factor node from a global perspective, and filter the quantitative variables within the factor through the factor loading coefficients, record the standardized coefficients and test the significance of the data to eliminate invalid paths, which in turn led to the correlation law. At the same time, the relationship model of the infant's behavioral characteristics with the mother's physical and psychological indicators was established using the LightGBM regression model for classification, so as to establish the relationship model, and get the model with good performance.

Prevalence of Neglect and Abuse During Labor and Delivery in a Tertiary Hospital

BACKGROUND:Childbirth is a significant event with a great impact on maternal physical and psychological health. Childbirth abuse has been reported in different countries with variable rates. This study aims to determine the prevalence of childbirth abuse during labor in a governmental hospital in Egypt.METHODS:This cross-sectional study was conducted from March 2020 to December 2021. We recruited 190 women. Patients were asked to fill in the Arabic-validated childbirth verbal abuse and neglect questionnaire immediately after delivery. The questionnaire consisted of four parts enquiring about personal data and childbirth history, the occurrence of physical violence, and other elements of satisfaction.RESULTS:Fifty (26.3%) patients were neglected during childbirth. Verbal abuse was reported by 25.8%. Two women (1.1%) were slapped (physical abuse) during childbirth. Women reported being satisfied and strongly satisfied at 57.9% and 37.9%, respectively. Multiparity (p-value .02), patient ignorance about the childbirth process (p-value .004), their rights (p-value .0001), and lack of participation in decision-making (p-value .0001) were associated with exposure to neglect. Verbal abuse was associated with the delivery time in addition (p-value .004).CONCLUSION:Neglect and abuse occurred significantly at the current facility.

Child educational progress in Born in Bradford pregnancies affected by gestational diabetes and also exposed to maternal common mental disorders

Gestational diabetes and the maternal mental disorders of anxiety and depression have been implicated in adverse offspring neuro-behavioural outcomes but these exposures have only been studied in isolation. 1051 children whose mothers were diagnosed with gestational diabetes in UK’s Born in Bradford cohort had linkage to maternal primary care records, providing diagnostic and treatment codes for depression and anxiety. Education record linkage provided results of the Early Years Foundation Stage Profile from the first year of school, aged five. Risk of not attaining a ‘Good level of development’ was analysed using multivariable Poisson regression within a generalised estimating equation framework. Multiple imputation was implemented for missing data. There was limited evidence of increased risk of failure to attain a ‘good level of development’ in those additionally exposed to maternal mental disorders (adjusted RR 1.21; 95% CI 0.94, 1.55). However, there was more evidence in children of Pakistani maternal ethnicity (adjusted RR 1.36; 95% CI 1.04, 1.77) than White British; this may have been driven by English not being the primary language spoken in the home. Therefore there may be groups with GDM in whom it is particularly important to optimise both maternal physical and mental health to improve child outcomes.

Morbidity and healthcare use among mothers of children with cancer: A population-based study.

The impact of a child's cancer diagnosis on subsequent maternal physical health is unclear. We identified all Ontario children diagnosed less than 18years with cancer between 1992 and 2017. Linkage to administrative databases identified mothers who were matched to population controls. We identified physical health conditions, acute healthcare use, and preventive healthcare use through validated algorithms using healthcare data, and compared them between exposed (child with cancer) and unexposed mothers. Predictors of health outcomes were assessed among exposed mothers. We identified 5311 exposed mothers and 19,516 matched unexposed mothers. For exposed mothers, median age at last follow-up was 48years, (interquartile range: 42-53). Exposed mothers had an increased risk of cancer (hazard ratio [HR] 1.2, 95% confidence interval [95% CI]: 1.0-1.5, p=.03), but not of any other adverse physical outcomes or of increased acute healthcare use. Exposed mothers were more likely to receive influenza vaccinations (odds ratio 1.4, 95% CI: 1.3-1.5, p<.0001), and underwent cancer screening at the same rate as unexposed mothers. Among exposed mothers, bereavement was associated with a subsequent increased risk of cancer (HR 1.7, 95% CI: 1.2-2.5, p=.004) and death (HR 2.2, 95% CI: 1.2-4.1, p=.01). Mothers of children with cancer are at increased risk of developing cancer, but not of other adverse physical health outcomes, and were equally or more likely to be adherent to preventive healthcare practices. Bereaved mothers were at increased risk of subsequent cancer and death. Interventions targeting specific subpopulations of mothers of children with cancer or focused on screening for specific cancers may be warranted.

Associations between parental well-being and early learning at home before and during the COVID-19 pandemic: observations from the China Family Panel Studies.

COVID-19-related lockdowns and preschool closures resulted in many young children spending all their time at home. Some parents had to manage child care while working from home, and increased demands may have led them to experience considerable stress. Evidence indicates that among parents with young children, those who had pre-existing mental and physical conditions adapted less well than other parents. We considered associations between parental well-being and the home learning environment for young children. We leveraged data from the nationally representative China Family Panel Studies. We analyzed longitudinal data collected before (2018) and during (2020) the pandemic. Participants were parents of 1,155 preschoolers (aged 3-5 years in 2020). Moderated mediation models were conducted. Maternal and paternal psychological well-being, depression, physical health, and physical illness in 2018 and 2020 were predictors. The frequency of marital and intergenerational conflicts in 2020 were mediators. Primary caregiver-reported engagement in home learning activities and family educational expenditure and parent-reported time spent on child care in 2020 were outcome variables. The number of COVID-19 cases in each province 3 months before the 2020 assessment was the moderator. Child, parental, and household characteristics and urbanicity were covariates. Controlling for covariates, improvements in parental psychological well-being predicted more home learning activities and increases in paternal depression predicted less time spent by fathers on child care. Negative changes in maternal physical health predicted less family educational expenditure and mothers spending more time on child care. Family conflicts mediated the association between maternal physical illness in 2018 and family educational expenditure. The number of COVID-19 cases in a province (i) was positively associated with mothers spending more time on child care, (ii) moderated the association of improvements in maternal physical health and mothers spending less time on child care, and (iii) moderated the association of family conflicts and more family educational expenditure. The findings indicate that decreased parental psychological and physical well-being foretells reductions in monetary and non-monetary investment in early learning and care at home. Regional pandemic risk undermines maternal investment in early learning and care, especially for those with pre-existing physical conditions.

8th ABM/EABM European Regional Conference May 11–13, 2023 Split, Croatia

8^th ABM/EABM European Regional Conference May 11–13, 2023 Split, Croatia

Length of Maternity Leave Impact on Mental and Physical Health of Mothers and Infants, a Systematic Review and Meta-analysis.

Recent legislative decisions in the United States have encouraged discussion about national parental leave programs. Currently, over 47% of the United States workforce is female. However, the United States is the only nation of the 37 member countries in the Organization for Economic Co-Operation and Development (OECD) to have no national requirement for maternity leave. The first few months of a child's life are vital to their physical and mental development. Likewise, a gradual return to pre-partum functioning is important for a newly postpartum woman. While it has been shown that maternity leave positively impacts various measures of maternal and infant mental and physical health, we lack consensus on the optimal length of paid or unpaid maternity leave. Accordingly, we conducted a systematic review and meta-analysis to evaluate the optimal length of paid or unpaid maternity leave to encourage maternal and infant mental and physical health in the United States. A systematic review and meta-analysis were conducted to synthesize and critically evaluate the current research investigating the association between maternity leave and maternal and infant mental and physical health using the Preferred Reporting in Systematic Reviews and Meta-Analyses guidelines. Databases EMBASE, PsycInfo, and PubMed were searched using specific inclusion and exclusion criteria. Methodological Index for Non-Randomized Studies scale assessed the methodological quality of the included eligible studies. The magnitude of heterogeneity between-study was tested using The Cochrane χ2 test and the Moran's I2 statistic. Possible publication bias was assessed through the funnel plot and the Egger regression test. A p-value of < 0.10 will be considered as an indication for the existence of potential publication bias. All statistical analyses were carried out with Stata software version 15. A total of 21 studies were analyzed. It was found that longer maternity leave may decrease rates of maternal mental and physical health complaints. It was also found that longer maternity leave leads to more positive mother-child interactions, decreased infant mortality, and longer periods of breastfeeding. Maternity leave of 12weeks or more confers the greatest benefit for mothers and their infants.

Association of maternal physical and mental health characteristics with the hazard of having any medical condition or disability in Australian children: A 15-year birth cohort study

Any long-term medical condition or disability among children is a significant health issue. This study measured the incidence rate of any medical condition or disability among children from a nationally representative birth cohort, then used the random effect parametric survival regression model to assess whether the hazard of any medical condition or disability in children is associated with maternal physical and mental health characteristics (obesity, general health status, having a medical condition, stressful life events or mental illness). The study followed up 5019 children from the Longitudinal Study of Australian Children, assessing their time-to-event data from birth (2004) to 14 or 15 years of age (2018). The hazard rate of any medical condition or disability was 26.11 per 1000 person-years for all the children and 29.29 for the males—a noticeable gender difference. It was the highest (hazard rate: 62.90) among the children when their mothers had a medical condition, while the hazard rate was 22.40 per 1000 person-years among the children whose mothers had no medical conditions. The parametric panel regression results also suggested that the children of mothers with a medical condition during the 15-year study period were more likely to have a medical condition or disability (hazard ratio [HR]: 2.61, 95% confidence interval [CI]: 2.24–3.02) compared to the children of mothers with none. Similar trends were observed among children of mothers who had fair or poor general health (HR: 1.48, 95% CI: 1.15–1.91), obesity (HR: 1.40, 95% CI: 1.18–1.66) or experienced stressful life events (HR: 1.23, 95% CI: 1.06–1.43) over time compared to those whose mothers did not. These findings suggest that additional healthcare interventions targeting mothers with medical conditions, obesity, poor general health, or mental illness would help minimise the risk of medical conditions and disabilities among children.

Comparing Experiences of Women Who Were Direct Breastfeeding and Women Who Used Expressed Breast Milk to Feed Their Infants.

To provide understanding about feeding experiences of women who provide breast milk through direct breastfeeding and exclusive expression and to compare these experiences. A qualitative study was conducted to gather experiences from the perspectives of women who had given birth to a healthy, term infant within the past 12 months and exclusively fed breast milk for at least 2 weeks. The sample was recruited from motherhood and breastfeeding support groups on Facebook. Groups had state- or national-based memberships. Interviews were examined for themes that were compared between feeding groups using thematic analysis. Fifteen new mothers participated. Under the primary themes of Similarities and Differences, seven subthemes were identified: Fatigue, Importance of Support, Finding Joy in a Common Goal, Mixed Feelings, Trusting versus Tracking, Latching versus Body Failure, and Pumping in Isolation. Mothers who provide breast milk share common experiences and feelings of satisfaction. Expressed breast milk feeding offers some mothers a way to provide the benefits of breast milk while preserving a balance between maternal and infant physical and mental health needs. Understanding the different ways in which women manage breast milk feeding while balancing maternal and infant needs can prepare nurses to discuss various methods of breast milk feeding and provide individualized support.