Effects of an Early Breastfeeding Education and Proactive Telephone Support Program for Mothers of Preterm Infants: A Quasi-experimental Study
DOI:
https://doi.org/10.60099/prijnr.2024.268608Keywords:
Breast milk volume, Breastfeeding duration, Breastfeeding program, Breastfeeding rate, Education, Exclusive breastfeeding, Preterm infants, Quasi-experimentAbstract
Breast milk is optimal for both term and preterm infants as it provides essential nutrition and immunity. However, mothers of preterm infants often have insufficient milk supply, resulting in low breastfeeding rates, including in Thailand, where this quasi-experimental study was undertaken. We investigated the effects of an early breastfeeding education and proactive telephone support program, including early breastfeeding education and proactive telephone support. This included breastfeeding outcomes, including total breast milk volume, duration of exclusive breastfeeding, and exclusive breastfeeding rates at discharge and three months post-discharge in mothers of preterm infants. The participants included 57 mother-infant dyads and their families. The participants were assigned to either the control group (n = 28) receiving routine care or the experimental group (n = 29) receiving the intervention program. The assignment was done using purposive sampling and matching the number of pregnancies and gestational age between the two groups. Data were collected using the Demographic Characteristics Questionnaire, the Breast Milk Expressing Record Form, the Oral Care with Breast Milk Record Form, and the Breastfeeding Practice and Problems Record Form. Data analysis was performed using the chi-square test, Mann-Whitney U test, independent t-test, and descriptive statistics.
The results indicated that, after receiving the program, the total breast milk volume from day 1 to day 7 and the duration of exclusive breastfeeding in the experimental group were significantly higher and longer than in the control group. At discharge, the rate of exclusive breastfeeding in the experimental group was higher than that of the control group but with no statistical difference. However, the experimental group had a significantly higher exclusive breastfeeding rate at three months than the control group. This study confirmed the program’s effectiveness in increasing the exclusive breastfeeding rate at three months. Nurses can integrate this program to promote breastfeeding as a critical component of preterm infant care. Still, a long-term follow-up study requires comprehensive testing of its effectiveness.
References
Belfort MB, Perrin M. Delivering on the promise of human milk for extremely preterm infants in the NICU. JAMA. 2024;331(7):567–569. doi: 10.1001/jama.2023.26820. DOI: https://doi.org/10.1001/jama.2023.26820
Lugonja N, Marinković V, Pucarević M, Miletić S, Stojić N, Crnković D, Vrvić M. Human milk- the biofluid that nourishes infants from the first day of life. Foods. 2024;13(9):1298. doi: org/10.3390/foods13091298 DOI: https://doi.org/10.3390/foods13091298
World Health Organization. Breastfeeding [Internet]. 2023 [cited 2023 June 6]. Available from: https://www.who.int/health-topics/breastfeeding#tab=tab_2
Department of Health, Ministry of Public Health. Ministry of Public Health campaign breastfeeding aims for 2025 to push 50 percent of babies to be exclusively breastfed for 6 months [Internet]. 2021 [cited 2023 October 6]. Available from: https://multimedia.anamai.moph.go.th/news/050864/
Jiang X, Jiang H, Shan SS, Huang R. Breastfeeding experience of postnatal mothers
separated from preterm infants after discharge: a phenomenology qualitative approach. BMC Preg Childbirth. 2024;24(1):28. doi: org/10.1186/s12884-023-06230-z
National Statistical Office of Thailand. Thailand Multiple Indicator Cluster Survey 2022, Survey Findings Report. Bangkok: National Statistical Office of Thailand; 2023.
World Health Organization. Global breastfeeding scorecard 2021: protecting breastfeeding through bold national actions during the COVID-19 pandemic and beyond [internet]. 2021 [cited 2023 October 6]. Available from: https://www.who.int/publications/i/item/WHO-HEP-NFS-21.45
Putra RA. Analysis of risk factors for necrotizing enterocolitis (NEC) in newborns: a systematic literature review. SJPed. 2024;2(1):52-8. doi: org/10.59345/sjped.v2i1.97 DOI: https://doi.org/10.59345/sjped.v2i1.97
Pinto F, Fernandes E, Virella D, Abrantes A, Neto MT. Born preterm: a public health issue. Port J Public Health. 2019;37(1):38-49. 2019;37:38–49. doi: 10.1159/000497249 DOI: https://doi.org/10.1159/000497249
Brockway M, Azad MB. Evidence to support targeted investment in breastfeeding education among families of low socioeconomic status. Evid Based Nurs. 2024;27(2):51. doi: org/10.1136/ebnurs-2023-103810. DOI: https://doi.org/10.1136/ebnurs-2023-103810
Medina IMF, Fernández-Sola C, López-Rodríguez MM, Hernández-Padilla JM, Lasserrotte MdMJ, Granero-Molina J. Barriers to providing mother's own milk to extremely preterm infants in the NICU. Adv. Neonatal Care. 2019;19(5):349-60. doi: 10.1097/ANC.0000000000000652. DOI: https://doi.org/10.1097/ANC.0000000000000652
Skaaning D, Brødsgaard A, Kronborg H, Kyhnæb A, Pryds O, Carlsen E. Maternal Reasons for early termination of exclusive breastfeeding in premature infants: a prospective study. J. Perinat. Neonatal Nurs. 2024;38(1):88-97. doi: 10.1097/JPN.0000000000000693. DOI: https://doi.org/10.1097/JPN.0000000000000693
Thepha T, Marais D, Bell J, Muangpin S. Facilitators and barriers to exclusive breastfeeding in Thailand: a narrative review. J Comm Pub Health Nurs. 2017;03(01). doi: 10.4172/2471-9846.1000160. DOI: https://doi.org/10.4172/2471-9846.1000160
Meek JY, Noble L, Policy statement: breastfeeding and the use of human milk. Pediatrics. 2022;150(1):e2022057988. doi: org/10.1542/peds.2022-057988. DOI: https://doi.org/10.1542/peds.2022-057988
Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice (6th ed.). Upper Saddle River, NJ: Pearson Prentice Hall; 2011.
Yang Y, Brandon D, Lu H, Cong X. Breastfeeding experiences and perspectives on support among Chinese mothers separated from their hospitalized preterm infants: a qualitative study. Int Breastfeed J. 2019;14(1):1-7. doi: org/10.1186/s13006-019-0242-9. DOI: https://doi.org/10.1186/s13006-019-0242-9
Yuen M, Hall OJ, Masters GA, Nephew BC, Carr C, Leung K, et al. The effects of breastfeeding on maternal mental health: a systematic review. J Womens Health. 2022;31(6):787-807. doi: org/10.1089/jwh.2021.0504. DOI: https://doi.org/10.1089/jwh.2021.0504
Wu W, Zhang J, Silva Zolezzi I, Fries LR, Zhao A. Factors influencing breastfeeding practices in China: a meta‐aggregation of qualitative studies. Matern Child Nutr. 2021;17(4):e13251. doi: org/10.1111/mcn.13251. DOI: https://doi.org/10.1111/mcn.13251
Dukuzumuremyi JPC, Acheampong K, Abesig J, Luo J. Knowledge, attitude, and practice of exclusive breastfeeding among mothers in East Africa: a systematic review. Int. Breastfeed. J. 2020;15:1-17. doi: org/10.1186/s13006-020-00313-9. DOI: https://doi.org/10.1186/s13006-020-00313-9
Hamze L, Mao J, Reifsnider E. Knowledge and attitudes towards breastfeeding practices: a cross-sectional survey of postnatal mothers in China. Midwifery. 2019;74:68-75. doi: org/10.1016/j.midw.2019.03.009. DOI: https://doi.org/10.1016/j.midw.2019.03.009
Riaz A, Bhamani S, Ahmed S, Umrani F, Jakhro S, Qureshi AK, et al. Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study. Int. Breastfeed. J. 2022;17(1):1-8. doi: org/10.1186/s13006-022-00495-4. DOI: https://doi.org/10.1186/s13006-022-00495-4
Pender N, Murdaugh C, Parsons M. Health promotion in nursing practice. Singapore: Pearson; 2006.
Ayran G, Çelebioğlu A. Education of parents in increasing breastfeeding rates, success, and self-efficacy levels. J Pediatr Res. 2022;9(2):175-83. doi: 10.4274/jpr.galenos.2022.56514. DOI: https://doi.org/10.4274/jpr.galenos.2022.56514
Jerin I, Akter M, Talukder K, Talukder M, Rahman MA. Mobile phone support to sustain exclusive breastfeeding in the community after hospital delivery and counseling: a quasi-experimental study. Int Breastfeed J. 2020;15(1):1-11. doi: org/10.1186/s13006-020-00258-z. DOI: https://doi.org/10.1186/s13006-020-00258-z
Giannì ML, Lanzani M, Consales A, Bestetti G, Colombo L, Bettinelli ME, et al. Exploring the emotional breastfeeding experience of first-time mothers: implications for healthcare support. Front Pediatr. 2020;8:199. doi:org/10.3389/fped.2020.00199. DOI: https://doi.org/10.3389/fped.2020.00199
Nasrabadi M, Vahedian-Shahroodi M, Esmaily H, Tehrani H, Gholian-Aval M. Factors affecting exclusive breastfeeding in the first six months of birth: an exploratory-descriptive study. J Midwifery Reprod. Health. 2019;7(3): 1749-1764. doi: 10.22038/jmrh.2018.27330.1297.
Stang S, Abdullah T, Marwang S. The influence of collaborative model between the role of husbands and healthcare workers on mother’s behavior in giving exclusive breastfeeding. Open Access Maced. J. Med. Sci. 2021;9(E):794-7. doi: org/10.3889/oamjms.2021.6603. DOI: https://doi.org/10.3889/oamjms.2021.6603
Arthibenyakul C, Sangperm P, Prasopkittikun T, Ngerncham S. The effects of self-efficacy promoting program on perceived self-efficacy, efficiency of breastfeeding and breastfeeding rate among mothers of late preterm infants. Nurs sci J. 2017;35(1):23-35.
Carpay NC, Kakaroukas A, D. Embleton N, van Elburg RM. Barriers and facilitators to breastfeeding in moderate and late preterm infants: a systematic review. Breastfeed Med. 2021;16(5):370-84. doi: 10.1089/bfm.2020.0379. DOI: https://doi.org/10.1089/bfm.2020.0379
Yu G, Liu F, Zhao Y, Kong Y, Wei H. Promoting breastfeeding and lactation among mothers of premature newborns in a hospital in China. NWH. 2021;25(1):21-9. doi: org/10.1016/j.nwh.2020.11.005. DOI: https://doi.org/10.1016/j.nwh.2020.11.005
Sarapat P, Fongkaew W, Jintrawet U, Mesukko J, Ray L. Perceptions and practices of parents in caring for their hospitalized preterm infants. Pacific Rim Int J Nurs Res. 2017;21(3):220-33.
Des Jarlais DC, Lyles C, Crepaz N, Group T. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health. 2004;94(3):361-6. DOI: https://doi.org/10.2105/AJPH.94.3.361
Ke J, Ouyang Y-Q, Redding SR. Family-centered breastfeeding education to promote primiparas’ exclusive breastfeeding in China. J Hum Lact. 2018;34(2):365-78. doi: org/10.1177/0890334417737293. DOI: https://doi.org/10.1177/0890334417737293
van Dellen SA, Wisse B, Mobach MP, Dijkstra A. The effect of a breastfeeding support programme on breastfeeding duration and exclusivity: a quasi-experiment. BMC Public Health. 2019;19(1):993. doi: org/10.1186/s12889-019-7331-y. DOI: https://doi.org/10.1186/s12889-019-7331-y
Fok D, Aris IM, Ho J, Chan Y-H, Rauff M, Lui JK, et al. Early initiation and regular breast milk expression reduces risk of lactogenesis II delay in at-risk Singaporean mothers in a randomised trial. Singapore Med J. 2019;60(2):80-88. doi: org/10.11622%2Fsmedj.2018067. DOI: https://doi.org/10.11622/smedj.2018067
Topothai C, Tangcharoensathien V. Achieving global targets on breastfeeding in Thailand: gap analysis and solutions. Int. Breastfeed. J. 2021;16(1):1-10. doi: org/10.1186/s13006-021-00386-0. DOI: https://doi.org/10.1186/s13006-021-00386-0
Moudi Z, Molashahi B, Imani M, Ansari H. Effects of a feasible supportive care program on breastfeeding behaviors and neonatal outcomes among the late preterm newborns in the southeast of Iran. J Neonatal Nurs. 2017;23(5):238-41. doi: org/10.1016/j.jnn.2017.02.008. DOI: https://doi.org/10.1016/j.jnn.2017.02.008
Farhadi R, Mehrpisheh S, Philip RK. Mobile-assisted virtual bonding enables breast milk supply in critically ill mothers with COVID-19: a reflection on the feasibility of telelactation. Cureus. 2021;13(3): e13699. doi: 10.7759/cureus.13699. DOI: https://doi.org/10.7759/cureus.13699
Chaves AFL, Ximenes LB, Rodrigues DP, Vasconcelos CTM, Monteiro J, Oriá MOB. Telephone intervention in the promotion of self-efficacy, duration and exclusivity of breastfeeding: randomized controlled trial. Rev. Latino-Am. Enfermagem. 2019;27:e3140. doi: 10.1590/1518-8345.2777-3140. DOI: https://doi.org/10.1590/1518-8345.2777-3140
Arslanoglu S, Boquien C-Y, King C, Lamireau D, Tonetto P, Barnett D, et al. Fortification of human milk for preterm infants: update and recommendations of the European Milk Bank Association (EMBA) working group on human milk fortification. Front. Pediatr. 2019;7:76. doi: org/10.3389/fped.2019.00076. DOI: https://doi.org/10.3389/fped.2019.00076
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