Feeding Preterm Infants

Two authors independently evaluated each article for relevant using a predefined set of criteria. Inclusion and exclusion criteria were specified and were appropriate for the review. The researchers were concerned with the effect education and support for the mothers had on the exclusive breastfeeding rates of healthy newborns. Inclusion criteria included randomized controlled trials (RCT) or quasi-experimental trails. The types of articles included are those that discussed interventions through education or support given to the mother prenatal/postnatal, or a combination. All delivery types were included. For

McGrath, J. (2004). State of the science: Feeding readiness in the preterm infant. Journal of

Kangaroo mother care was first started in Colombia in 1978. This practice involves an infant being placed skin-to-skin with a parent, early breastfeeding and discharge as well as follow up care (Conde-Aguelo, Belizan & Diaz-Rossello, 2012). Evidence has shown that this practice compared to the use of an incubator for infants with low birth weight has significantly decreased infant mortality. The benefits that this practice provides are stabilization of newborn temperature, lowered risk of infection, increase in newborn growth, and shorter hospital stay (Conde-Aguelo, Belizan & Diaz-Rossello, 2012). Although there are numerous benefits to kangaroo care, it’s implementation in neonatal intensive units has been limited. According to 129 neonatal

Research subjects were homogeneous in term of demographic information of mothers (age, educational level, employment, parity, abortion, still birth, and delivery method), and thus there was no significant between-groups difference in his regard. Research subjects were also homogeneous in terms of demographic information of infants (gender, gestational age, infant's age at the time of sampling, head circumference, the 1st and 5th minutes APGAR scores, birth weight, weight at the time of sampling, cause of hospitalization), and thus there was no significant between-groups difference in this regard.

In a study conducted in the United Kingdom by Brown, Raynor, and Lee (2011), their aim was to examine healthcare professionals’ and mothers’ ideas about what exactly effects decisions to either breastfeed or formula feed their child. The participants included in the study were twenty healthcare professionals and twenty-three mothers. The professionals were recruited by opportunity sampling or naturally occurring groups and the mothers were recruited using posters that were placed in local nurseries and different community centers. Theses community centers were located in a variety of places with “varying degrees of social deprivation.” Both groups engaged in interviews but the questions were different. Some of the questions that they asked the healthcare professionals wanted to gauge their experience with mothers and why they believed that the breastfeeding rate was low in the UK and the questions that they asked the mothers had to do with their experience with breastfeeding or formula feeding. Prior to the interview, the mothers gave information regarding their educational background, income, marital status, their infants’ birth weight and gestational age at birth. If the child was born prematurely, with low birth weight, or with serious health issues, then the interview wasn’t conducted. Additionally, the mothers gave information on the length of time that

In 2014, Hillary Moore, a student in the DNP program, published an article titled “Improving Kangaroo Care Policy and Implementation in the Neonatal Intensive Care” in the Journal of Neonatal Nursing. In the article she mentioned that the “immediate separation between mother and infant” could have negative effects on the health of the mother and of the infant (2014). Due to the risk of impaired attachment or bonding of the mother and infant, she advises to practice kangaroo care during each visit. She defines kangaroo care as “the act of skin-to-skin contact between mother and infant.” Kangaroo care was first introduced in 1983 in Bogota, Columbia. One advantage of kangaroo care is that it does not cost money to do it or implement it. On the

The health benefits of breastfeeding are established, but low breastfeeding rates remain a U.S. public health concern. The Baby-Friendly Hospital Initiative (BFHI) designed Ten Steps to Successful Breastfeeding (Ten Steps) as a guideline to increase breastfeeding rates. The Centers for Disease Control and Prevention (CDC) established the Maternity Practices in Infant Nutrition and Care (mPINC) biennial survey in 2007 to monitor U.S. maternity care facilities on the basis of the Ten Steps guideline.1 Researchers have used the mPINC data in multiple studies identifying practices in U.S. maternity care facilities that can guide public health initiatives to improve breastfeeding outcomes in the U.S.

The rate of exclusive breast-feeding at OHSU before they implemented the new pacifier policy was 80%, however researchers were hoping to increase this percentage. By implementing this new policy the hospital was moving towards becoming a “Baby-Friendly” hospital. This term is only applicable to 10% of hospitals in the United States and not giving pacifiers to breast-fed babies is one of the ten steps required for this coveted certification. Researchers at OHSU were shocked to find that when they limited infant pacifier use exclusive breast-feeding rates decreased. Researchers discovered “after tracking 2,249 babies born between June 2010 and August 2011 [WANT TO DELETE they noted] that exclusive breast-feeding rates dropped from 79% of infants between July and November 2010 to 68% between January and August 2011” (Rochman, 2012 p. 1). The percentage of babies that only received formula remained consistent, while infants that required supplemental formula increased from 18% to 28%. Dr. Carrie Phillipi a Co-author of the study and associate professor of pediatrics at OHSU was really surprised at the effects of limiting pacifier use, she thought “limiting pacifier use would improve breast-feeding rates” (Rochman, 2012 p. 1). Dr. Phillipi presented at the annual meeting of the Pediatric

And so, these are some reasons why breastmilk and breastfeeding are actively encouraged in health care (DHHS, 2014). However, when a new mother refuses to breastfeed it is “important for nurses to explore the positive and negative aspects of breastfeeding from the mother's perspective” (Barrientos & Bylaska-Davies, 2015). This is because “nurses spend the most time with mothers during the pre and post-partum period, as well as care for the infants following delivery”(Barrientos & Bylaska-Davies, 2015). Therefore with effective communication and education on different options for feeding, and by conducting frequent nutritional assessments of the infant the nurse can ensure adequate nutrition for the infant. The Best Start 3 Step Breastfeeding Counseling Strategy can be used: by asking the mother open-ended questions, affirming her feelings, and educating the mother on the advantages for both the mother and the child (Lazarov & Evans, 2011). It is important to note that educating the mother with information should not be overwhelming but should be in “small amounts of information that is relevant for the individual mother” (yellowpdf). If the new mother still is undecided about breastfeeding the nurse should continue to encourage the use of breastmilk, expressed milk, and pumping (DHHS,

The intent of this paper is to examine the clinical issue of the use of alternative feeding methods over bottle feeding in preterm infants whose mothers intend to breastfeed. Efficiently and effectively researching this issue begins with a clearly constructed search question, utilizing the PICOT format. Key words from the PICOT question will be used in nursing and medical databases of journal articles to uncover evidence. Relevant research will be critically appraised to assess the reliability, validity, and applicability of utilizing this alternative feeding method with preterm infants.

The nurse must be mindful of each intervention initiated and the possible benefits of the intervention against its potential harmful effects for both mother and fetus. Not providing basic comfort measures for the mother can cause serious physical and emotional problems and could lead to possible fatigue and feelings of failure from the mother. The priority of this nursing intervention is to provide the mother and fetus with the least discomfort as possible and

The authors kept a journal where findings were reported robustly with the inclusion of direct quotes from the participants. Appropriate questions were asked targeted at mothers’ experiences about breastfeeding. The open ended questions used efficiently met research aim despite the fact that no balance was maintain with close ended questions. The article lack detail information on validity and reliability of the questions used for the interview.

Health Systems. The availability of existing lactation services is somewhat limited. Public health does have a lactation nurse available but her time is usually spent following up with and doing home visits with new moms discharged from the hospital. That makes her availability after the first three to four weeks postpartum pretty limited. There is also a breastfeeding class offered to expecting moms, however the moms interviewed did not feel like there was enough education provided in this class. The local hospital also has a full time lactation consultant for inpatient moms, and several of the OB nurses are certified lactation consultants. Again, the moms interviewed did not feel that the education provided in the hospital was enough to promote breastfeeding to six months. Many of the moms interviewed were not aware of the above services, so there is again a lack of education and advertising. The town has one hospital, one walk in clinic, several doctor offices. It has providers in the specialty areas of cardiology, endocrinology, pediatrics, neurology, dermatology, nephrology, and family practice. There is an ambulance service also. Accessibility of services for lactation services are also limited. There is nothing offered in the evenings or weekends for lactation services. The location of public health is centrally located adding convenience. The cost of the public health services and the breastfeeding classes are free. The inpatient hospital lactation provider does charge a fee for a consultation. Among the women interviewed these services were all underutilized, usually

NNS is the repetitive mouthing by an infant on a blind nipple or a pacifier (Hill, 2005). It is thought that NNS enhances feeding performance and successful achievement of exclusive oral feedings in preterm infants (Kish, 2015). Asadollahpour, Yadegari, Soleimani, Khalesi (2015), Kish (2015), Hill (2015), Younesian et al. (2015), and Bache et al. (2014) implemented experimental groups and control groups to conduct trials to determine if NNS was an effective protocol to use in the NICU. A number of inclusion-exclusion criteria were determined for these trials such as, a premature newborn that was anywhere between 26 to 35 weeks and that was appropriate weight and length for their gestational age (GA). The infants could also have no congenital abnormalities or medical disorders known to affect feeding ability such as third or fourth degree hemorrhage, necrotizing enterocolitis, or asphyxia, the infants also had to be fed by a tube and not have any oxygen supplementation.

Citing extensive health benefits for both mother and infant, the American Academy of Pediatrics (AAP) recommends the exclusive breastfeeding of infants for six months after birth, followed by continued breastfeeding, with the addition of complimentary solids, until 12 months of age (Eidelman & Schanler, 2012). The health benefits for infants include decreased risk of infection and hospitalization, positive effects on neurodevelopment, decreased risk of obesity, and a decreased rate of infant mortality. Maternal benefits include acute results such as decreased postpartum blood loss and decreased instance of postpartum depression, and long-term positive effects such as a decreased risk of ovarian and breast cancer. From an organizational perspective, the benefits of breastfeeding is evidenced by higher maternal productivity, reduced turnover, increased morale, and lower absenteeism and reduced healthcare costs resulting from significantly lower instances of infant illness (Eidelman & Schanler, 2012; Witters-Green, 2003). Additionally, the AAP’s official policy statement indicates that “strategies that increase the number of mothers who breastfeed