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. 2018 Jul 6:13:29.
doi: 10.1186/s13006-018-0168-7. eCollection 2018.

Breastfeeding self-efficacy and breastmilk feeding for moderate and late preterm infants in the Family Integrated Care trial: a mixed methods protocol

Meredith Brockway  1 , Karen M Benzies  1 , Eloise Carr  1 , Khalid Aziz  2
Affiliations

Breastfeeding self-efficacy and breastmilk feeding for moderate and late preterm infants in the Family Integrated Care trial: a mixed methods protocol

Meredith Brockway et al. Int Breastfeed J. .

Abstract

Background: Breastmilk is the ideal nutrition for preterm infants. Yet, breastmilk feeding rates among preterm infants are substantially lower than those of full-term infants. Barriers incurred through hospital care practices as well as the physical environment of the neonatal intensive care unit (NICU) can result in physical and emotional separation of infants from their parents, posing a substantial risk to establishing and maintaining breastfeeding. Additionally, current practitioner-focused care provision in the NICU can result in decreased breastfeeding self-efficacy (BSE), which is predictive of breastfeeding rates in mothers of preterm infants at 6 weeks postpartum.

Methods: Family Integrated Care (FICare) integrates and supports parents to actively participate in the care of their infant while in the NICU. Nested within the broader FICare trial, we will conduct an explanatory sequential mixed methods study to investigate if FICare improves maternal BSE and rates of breastmilk feeding in moderate and late preterm infants at discharge from the NICU. In phase 1, we will calculate the mean difference between admission and discharge BSE scores for the intervention group. Mothers who score in the top and bottom 20th percentile of change scores will be invited to participate in a semi-structured telephone interview exploring maternal experiences with infant feeding in the NICU. We will conduct inductive thematic analysis to identify and describe the facilitators and barriers of FICare on maternal feeding experiences. Once data saturation is achieved and themes have been established, phase 2 will revisit the quantitative data to determine whether FICare was impactful on BSE and breastmilk feeding rates. Findings from the qualitative and quantitative phases will be integrated to determine how infant feeding experiences on FICare units work to improve or detract from maternal BSE and rates of breastmilk feeding.

Discussion: FICare may help to improve maternal BSE and rates of breastmilk feeding in moderate and late preterm infants. Improved breastmilk feeding outcomes can have a substantial impact on overall infant health, developmental outcomes, and maternal-infant bonding and will help to improve long-term health outcomes for moderate and late preterm infants.

Trial registration: (NCT02879799). Registered May 27, 2016 protocol version June 9, 2016 Version 2.

Keywords: Breastfeeding; Breastfeeding self-efficacy; Breastmilk feeding; Mixed-methods; Thematic analysis.

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Conflict of interest statement

Ethics approval was received from the Conjoint Health Research Ethics Board, University of Calgary (REB 15–0067). Written informed consent will be obtained for all research participants. Supporting documents (model consent form), protocol amendments, and processes of consent or assent and confidentiality can be found at Family Integrated Care (FICare) in Level II Neonatal Intensive Care Units: study protocol for a cluster randomized controlled trial [30].Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliation.

Figures

Fig. 1
Fig. 1
Study flow diagram. Overview of the study design. Rectangles depict quantitative phase, ovals depict qualitative phases, and hexagons depict integration phases. Abbreviations: cluster randomized control trial (cRCT), Breastfeeding Self-efficacy Scale (BSES), covariates (Cov), length of stay (LOS), Edinburgh Postnatal Depression Scale (EPDS)
Fig. 2
Fig. 2
FICare model of change
Fig. 3
Fig. 3
Situation of present study within larger FICare clustered randomised control trial
See this image and copyright information in PMC

References

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