Mothers Of Premature Newborns Research Articles

The effect of training the fathers to support their wives on stress and self-efficacy in mothers of premature newborns hospitalized in NICU: a quasi-experimental study

BackgroundThe birth of premature newborns and their separation from family due to their hospitalization in the Neonatal Intensive Care Unit (NICU) cause stress in the parents, especially mothers. We conducted this study aimed to evaluate whether training the fathers to support their wives impacts premature newborn mothers’ stress and self-efficacy or not?MethodsA quasi-experimental (before-after study) including one experimental and control group was used. Data were collected from Seventy-five parents with newborns hospitalized in NICU (n = 30) in the intervention and (n = 45) in usual care groups. Settings were the NICUs of the two international, educational, specialty, and subspecialty Nemazee and Hafez hospitals of the Shiraz University of Medical Science. Fathers in the intervention group learned how to support their wives and provide care for their premature newborns. The control group received the usual care. Mother’s stress and self-efficacy were measured using validated questionnaires.ResultsData analysis showed that the mean scores of mothers’ stress and self-efficacy from pre-intervention to post-intervention were significantly decreased and increased respectively in the intervention group (p <0.001). At the same time, there was no significant difference in the control group.ConclusionWhen fathers are trained to support their wives and do so, it relieves the stress and improves the mothers’ self-efficacy, and has a direct effect on providing care to their premature newborns. Therefore, it is recommended that measures should be taken so that the fathers be present, participate in providing care, and support their wives and newborns in NICU.Trial registrationIRCT20171130037691N1.

Promoting Breastfeeding and Lactation Among Mothers of Premature Newborns in a Hospital in China

ObjectiveTo promote breastfeeding and lactation in mothers separated from their premature infants admitted to the NICU in a hospital in China. DesignFor this evidence-based practice project we used a mixed method of survey measures and interviews and were guided by the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research Into Practice framework. Setting/Local ProblemObstetric unit of a Women and Children’s Hospital in China from September 2017 to August 2018. Before the project, the partial breastfeeding rate in the hospital was 17.9%, and the exclusive breastfeeding rate of premature infants was 1.8%; these rates were much lower than the national breastfeeding rate in the country. ParticipantsSeventeen nurses and 70 mothers of premature infants. Intervention/MeasurementsThe project included three phases: (a) finding the best evidence to promote breastfeeding in the literature and identifying the gaps between best practice and current practice, (b) implementing best practice strategies, and (c) comparing pre- and postintervention outcomes. Based on the evidence in the literature and the barriers, strategies were implemented in practice to promote breastfeeding and lactation among women separated from their preterm newborns. Chi-square and t tests were performed to compare the pre-/postintervention differences. ResultsPartial breastfeeding rates increased from 17.9% to 52.7%, and exclusive breastfeeding rates increased from 1.8% to 4.1%. Compliance with breastfeeding guidelines and measures of maternal lactation volume both improved significantly. ConclusionPromoting breastfeeding and lactation among mothers of premature infants requires not only scientific knowledge but also a caring environment and family-centered practice.

Effect of Music Therapy on Relaxation and Breastfeeding Anxiety

Clinical nurses on a postpartum unit noted an opportunity to improve patient care during the breastfeeding process. Although breastfeeding is perceived to be a natural physiological process, many postpartum women experience breastfeeding anxiety. Maternal anxiety decreases the milk production by inhibiting the milk ejection reflex. The 8A’s evidence-based practice model was used to answer the PICO (P—patient, problem or population; I–intervention; C–comparison, control, or comparator; O—outcome(s)) question. To determine whether, among postpartum breastfeeding women, music therapy increased relaxation and reduced breastfeeding anxiety. Scientific literature demonstrates that music therapy is an effective evidenced-based intervention to improve the following outcomes: milk volume, cortisol level, anxiety-related behaviors, and self-reported relaxation and anxiety. The health care system’s Institutional Review Board approved the project with exempt status on July 26, 2019 (IRB#:1908801). All breastfeeding women who were admitted to the postpartum unit were offered the opportunity to participate. Implementation occurred for those who agreed to participate (n = 30) during one of the feedings between 24 and 96 hours postpartum. Using disposable earphones, women were asked to listen to music of their choice (lullaby, instrumental, or piano with nature sounds) for at least 5 minutes before the breastfeeding session. They then began breastfeeding while the same music played through a speaker. After breastfeeding sessions were completed, the participants filled out self-reported surveys. Using Likert-scale surveys, breastfeeding women reported feeling significantly more relaxed after breastfeeding, as evidenced by a mean score of 6.07 (0 = not relaxed to 7 = very relaxed). The change in breastfeeding anxiety level through survey questions, “I have previously been anxious about breastfeeding,” and “I am anxious about breastfeeding in the future,” was statistically significant (p < .001). Music therapy increases relaxation, decreases breastfeeding anxiety, and, therefore, enhances the milk ejection reflex. Furthermore, past research has found that maternal anxiety decreases the chance of breastfeeding success and increases the risk for postpartum depression. Future projects could examine the effect of music therapy on exclusive breastfeeding rate, postpartum depression, and pumped-milk volume produced by mothers of premature newborns.

The Effects of Listening to Music on Breast Milk Production by Mothers of Premature Newborns in the Neonatal Intensive Care Unit: A Randomized Controlled Study

Objective: This study was a randomized controlled experiment to determine the effects of listening to music on breast milk production in Turkish mothers with premature newborns. Methods: The study consisted of two groups of randomly selected mothers (n = 20 each) of newborns in the neonatal intensive care unit (NICU) of two university hospitals in Istanbul between November 2017 and November 2018. On the first day, all mothers were provided with training for milking with pumps. On the second through fourth days, mothers in the music group (MG) underwent two sessions of milking with music and a pump for 15 minutes at 11:00 and 16:00; the mothers in the control group underwent two sessions of milking without music. To evaluate stress levels, Spielberger's State-Trait Anxiety Inventory was administered and salivary cortisol tests were taken on the first and final days of the study. Results: The mean age of participants was 28.5 ± 5.3 years, the mean gestational week was 32.21 ± 2.26, and the mean birth weight of the newborns was 1748 ± 533.4 g. The state and total anxiety scores of the MG were statistically low (p < 0.05). There was no difference between the MG and control group in the amount of breast milk produced; however, the final test cortisol levels of the MG group were significantly lower compared with the pretest measurements (p < 0.05). Conclusion: Listening to music in the NICU while breastfeeding can help reduce stress levels in mothers to premature newborns and support breast milk production.

Exact determination of optimal nutritional composition for at-risk newborns tolerating enteral intake-breast milk analysis as a routine future standard in neonatal care.

To analyse the dynamics of macronutrients in breast milk in Slovakian women and compare the dynamics between mothers of hospitalized newborns and donors of human breast milk relative to the gestational age of their babies. Human milk samples were collected from 101 breastfeeding women and analysed once or repeatedly from September 2017 to August 2018. Group A consisted of 79 mothers of newborns hospitalized at the Neonatal Department of Intensive Medicine (NDIM) of whom 69 were mothers of premature newborns (subgroup A1) and 10 were mothers of term babies (subgroup A2). Group B consisted of 22 breast milk donors registered at the Human Milk Bank at National Institute of Children's Diseases (NICHD). Of these, 4 were mothers of premature newborns (subgroup B1) and 18 were mothers of term newborns (subgroup B2). From subgroup A1, we chose two mothers, one with a hypotrophic newborn and another with a eutrophic newborn. The results were obtained by using the MIRIS breast‑milk analyzer. The overall dynamics of macronutrients correspond with other studies, however, we demonstrated that the level of macronutrients in individual cases were different. The determination of macronutrients in human milk is essential in neonatal care. It provides information about the nutritional value of breast milk and helps to optimise nutrition according to the individual needs of newborns (Fig. 10, Ref. 16).

\u201cBabies born early?\u201d - silences about prematurity and their consequences

BackgroundThe principal aim of this study was to understand how communication between parents and health professionals concerning prematurity occurs, from delivery to admission to the neonatal Intensive Care Unit.MethodsThis is an exploratory, descriptive study with a qualitative methodology. Data were collected using tape-recorded and Focal Groups technique interview with mothers of premature newborns and health professionals involved in caring for preterm infants, at southeast Brazil.ResultsThe word “premature” was not said or heard during prenatal care. From the narratives, it was observed that there was a lack of information available to pregnant women about preterm birth, failure in medical care regarding signs and symptoms reported by pregnant women, and lack of communication between the medical teams, mothers and family during delivery and Neonatal Intensive Care Unit (NICU) admission.ConclusionThere is a fine line between born too soon and die too soon, that increases stress, fear and distance impacting negatively over communication between mothers and health professionals during antenatal care, childbirth and NICU admission.

Domperidone and maternal milk volume in mothers of premature newborns

Background Mothers of premature newborns often have difficulty giving adequate breast milk volume to their infants. Domperidone is an antagonist of peripheral dopamine receptors and believed to increase breast milk production. In Indonesia, no study has been done to date on the effect of domperidone on maternal milk production in mothers of premature newborns. Objective To evaluate the effect of domperidone on milk production in mothers of premature newborns who failed to lactate.Methods A randomized controlled trial was conducted from July to December 2012 in the Perinatology Unit, Haji Adam Malik Hospital, Medan. Mothers of premature newborns were given lactation counseling for 7 days in order to increase their milk production. Mothers who failed to lactate after that time were enrolled in the study. Fifty subjects were assigned to receive either domperidone or a placebo for 7 days. Milk volume was measured every 2 hours (from 7 am to 9 pm), in the 24 hours before starting therapy, and on the 7th and 10th days (the 10th day being 3 days after stopping therapy). Results This study involved 25 mothers in the domperidone groups and 25 others in placebo group. After 7 days of therapy, mean breast milk volume was significantly higher in the domperidone group than in the placebo group [181.6 (SD 80.2) vs. 72.4 (SD 57.8) mL, respectively; 95%CI of differences 69.36 to 148.93; P=0.0001]. At day 10, breast milk production remained significantly higher in the domperidone group. Furthermore, in the domperidone group, no significant difference in mean breast milk volumes was noted between the 7th and 10th days (P=0.65). Conclusion In mothers of premature newborns who failed to lactate, domperidone therapy for 7 days causes significantly higher milk production compared to placebo.

Coping in Mothers of Premature Newborns After Hospital Discharge

The objective of the study is to determine the modulatory effect of interventions, specifically regarding the effect on the coping ability of mothers of preterm infants at the time of the infant's discharge from the neonatal intensive care unit (NICU). The design was a prospective, descriptive, correlational study. It was conducted with a sample of 144 mothers in two NICUs in Colombia. The study used the Coping and Adaptation Processing Scale Spanish modified version (CAPS). The data were collected from August 2014 to February 2015. The Coping and Adaptation Processing Scale (CAPS) was administered to the mothers at the time of the infants' discharges to home. Spearman rho correlation coefficient was calculated to assess a relationship between the levels of coping and transition conditions – personal, community. A multiple linear regression was used to determine if there was an association among personal, community, and societal conditions and levels of coping and the intervention effect. The results of the multiple regression analysis found that variables (such as income, information given at admission, and preparation for parenthood) influenced coping in mothers and showed statistical significance with p values of 0.032, 0.020 and 0.015 respectively. The interventions designed for each of the units of the individual institutions did not modulate the process of coping of mothers of preterm infants at discharge, even when interventions in each of the institutions have a different practice. It is important to start information about the care of children at home on admission and reinforce this information during the hospital stay in order to strengthen maternal coping at discharge. This information should be reviewed and consideration should be given as to the type of information and manner in which it is given to mothers. These actions would potentially improve the education and support program given in the units prior to the infant's discharge.

Impact of music therapy on breast milk secretion in mothers of premature newborns.

The promotion of breastfeeding is a simple and efficient strategy in reducing morbidity and mortality in neonates worldwide. Milk from the mother of a Preterm New Born (PTNB) infant contains a higher concentration of nutrients and energy than that produced by mothers of a full-term infant. Studies have shown that music therapy can reduce maternal anxiety, helping mothers cope with the hospitalization of their newborns in Neonatal Intensive Care Unit (NICU). To evaluate the impact of music therapy on amount of breast milk secretion among mothers of premature newborns by reducing maternal stress. Mothers of premature babies who were admitted to NICU at a tertiary health care centre were included as subjects. Mothers of premature infants were enrolled in the study once they came to NICU to express breast milk from Dec 2012 to May 2013. Each subject was assessed for 4 sessions on MT (Music Therapy) and 4 sessions on NMT (No Music Therapy) over 4 days. Breast milk was expressed using breast milk pump and quantity was measured for two sessions each day once at 11.00am and other at 4.00pm. Raga malkauns and yaman by flute was used for music therapy. MT was administered for 4 sessions in a randomized manner during the study period of 30mins (15mins prior to and 15mins during Breast milk amount). To assess the psychological stress, PSS questionnaire was administered on day 1 and day 4 of MT. Mother's saliva was collected to estimate salivary cortisol level on the last day of study during the sessions with MT and NMT. Music therapy was associated with a significant reduction in stress level as shown by improved PSS score and reduced salivary cortisol. Subjects who received music therapy had significant increase (p-value- 0.033) in breast milk expression when compared to mothers who didn't. Music therapy can be easily used in the breast milk expression room as a method to increase breast milk secretion in mothers who are stressed because of their neonates being admitted in NICU.

Music Therapy May Increase Breastfeeding Rates Among Mothers of Premature Newborns: A Randomized Controlled Trial

OBJECTIVE: To evaluate the impact of music therapy on breastfeeding rates among mothers of premature newborns. METHOD: In an open randomized controlled trial, mothers of premature neonates weighting ≤1750g were submitted to music therapy sessions three times a week for 60 minutes. The primary endpoint was breastfeeding rate (exclusive, predominant or continuous) at the moment of infant discharge and at the first follow-up visit (7-15 days after discharge). RESULTS: A total of 94 mothers (48 in the music therapy group and 46 in the comparison group) were studied. Breastfeeding was more frequent in the music therapy group at the moment of the infant hospital discharge (RR: 1.22; 95% CI: 0.99-1.51; P = .06; NNT = 6.3) and at the first follow-up visit (RR: 1.26; 95% CI: 1.01-1.57; P = .03; NNT = 5.6). Breastfeeding rates were higher in the intervention group at day 30 and day 60 after discharge, but these results were not statistically significant (RR: 1.21; 95% CI: 0.73-5.6 and RR: 1.28; 95% CI: 0.95-1.71 respectively). CONCLUSIONS: Music therapy increased breastfeeding rates in premature newborns at discharge, as well as 7-15 days later. This approach could be useful for increasing breastfeeding rates among premature newborns.[Editors note: The article presented here is republished from Jornal de Pediatria, 2011, 87(3), 206-212, doi: 10.2223/JPED.2086, with the kind permission from the publisher and the authors.]

The Effect of Two Different Domperidone Doses on Maternal Milk Production

The benefits of breast milk to the newborn infant are well established. The Canadian Paediatric Society recommends exclusive breastfeeding for the first 6 months of life for healthy, term infants. Mothers of premature newborns, however, may have difficulty providing an adequate supply of breast milk. Domperidone is officially used as a prokinetic agent. However, it is used widely around the world as a galactogogue. Despite its widespread use as a galactogogue, only a small number of investigators have studied domperidone for this indication. The purpose of this study was to determine an optimal dosage of domperidone as a galactogogue. Eligible subjects were randomized to receive domperidone 10 mg 3 times daily or domperidone 20 mg 3 times daily for 4 weeks. At week 5, the frequency was decreased to twice daily in both groups, and finally once daily for week 6. Over the entire first 4-week period, there was a significant increase in daily milk volumes within each group (P < .01). The between-group difference over this period, although not statistically significant, was clinically significant. Additionally, there was no significant within- or between-group difference during weeks 5 and 6. A dose of domperidone of 20 mg, 3 times daily instead of 10 mg, 3 times daily was associated with a clinical, but not statistically significant, increase in milk production.

A musicoterapia pode aumentar os índices de aleitamento materno entre mães de recém-nascidos prematuros: um ensaio clínico randomizado controlado

OBJECTIVE: To evaluate the impact of music therapy on breastfeeding rates among mothers of premature newborns. METHOD: In this open randomized controlled trial, mothers of premature neonates weighting < 1,750 g were submitted to music therapy sessions three times a week for 60 minutes. The endpoints were breastfeeding rates at the moment of infant hospital discharge and at follow-up visits (7-15 days, 30 and 60 days after discharge). RESULTS: A total of 94 mothers (48 in the music therapy group and 46 in the comparison group) were studied. Breastfeeding was significantly more frequent in the music therapy group at the first follow-up visit [relative risk (RR) = 1.26; 95% confidence interval (95%CI) = 1.01-1.57; p = 0.03; number needed to treat (NNT) = 5.6]. Moreover, this group showed higher breastfeeding rates at the moment of infant discharge (RR = 1.22; 95%CI = 0.99-1.51; p = 0.06; NNT = 6.3) and at days 30 and 60 after discharge (RR = 1.21; 95%CI = 0.73-5.6; p = 0.13 and RR = 1.28; 95%CI = 0.95-1.71; p = 0.09, respectively), but those results were not statistically significant. CONCLUSIONS: This study demonstrated that music therapy had a significant effect in increasing breastfeeding rates among mothers of premature newborns at the first follow-up visit, and also a positive influence (although not significant) that lasted up to 60 days after infant discharge. Music therapy may be useful for increasing breastfeeding rates among mothers of premature newborns.

Music therapy may increase breastfeeding rates among mothers of premature newborns: a randomized controlled trial

To evaluate the impact of music therapy on breastfeeding rates among mothers of premature newborns. In this open randomized controlled trial, mothers of premature neonates weighting ≤ 1,750 g were submitted to music therapy sessions three times a week for 60 minutes. The endpoints were breastfeeding rates at the moment of infant hospital discharge and at follow-up visits (7-15 days, 30 and 60 days after discharge). A total of 94 mothers (48 in the music therapy group and 46 in the comparison group) were studied. Breastfeeding was significantly more frequent in the music therapy group at the first follow-up visit [relative risk (RR) = 1.26; 95% confidence interval (95%CI) = 1.01-1.57; p = 0.03; number needed to treat (NNT) = 5.6]. Moreover, this group showed higher breastfeeding rates at the moment of infant discharge (RR = 1.22; 95%CI = 0.99-1.51; p = 0.06; NNT = 6.3) and at days 30 and 60 after discharge (RR = 1.21; 95%CI = 0.73-5.6; p = 0.13 and RR = 1.28; 95%CI = 0.95-1.71; p = 0.09, respectively), but those results were not statistically significant. This study demonstrated that music therapy had a significant effect in increasing breastfeeding rates among mothers of premature newborns at the first follow-up visit, and also a positive influence (although not significant) that lasted up to 60 days after infant discharge. Music therapy may be useful for increasing breastfeeding rates among mothers of premature newborns.

Exclusive Breastmilk Feeding in Maternity Care Facilities: The United States Breastfeeding Committee Toolkit

Breastfeeding MedicineVol. 5, No. 5 Hospitals Play a Critical RoleExclusive Breastmilk Feeding in Maternity Care Facilities: The United States Breastfeeding Committee ToolkitJoan Younger MeekJoan Younger MeekSearch for more papers by this authorPublished Online:13 Oct 2010https://doi.org/10.1089/bfm.2010.0043AboutSectionsView articleView Full TextPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited ByPromoting Breastfeeding and Lactation Among Mothers of Premature Newborns in a Hospital in ChinaNursing for Women's Health, Vol. 25, No. 1 Volume 5Issue 5Oct 2010 InformationCopyright 2010, Mary Ann Liebert, Inc.To cite this article:Joan Younger Meek.Exclusive Breastmilk Feeding in Maternity Care Facilities: The United States Breastfeeding Committee Toolkit.Breastfeeding Medicine.Oct 2010.253-255.http://doi.org/10.1089/bfm.2010.0043Published in Volume: 5 Issue 5: October 13, 2010PDF download