Sweet Linda
Flinders University Rural Clinical School, Flinders University, Adelaide, SA, Australia.
Int Breastfeed J. 2008 Dec 17;3:30. doi: 10.1186/1746-4358-3-30.
Breast milk is considered the optimal nutrition for all newborn infants. While there is high initiation of lactation among mothers of preterm infants in Australia, there is a rapid decline of continued lactation. Furthermore, there is an inverse relationship between infant gestation and duration of lactation. To better understand the breastfeeding experience of parents of very low birth weight (VLBW) preterm infants an interpretive phenomenological study was conducted.
This longitudinal study was conducted using an interpretive phenomenological approach. Data were collected from 17 parents through 45 individual interviews with both mothers and fathers, from birth to 12 months of age. This data was then transcribed verbatim and analysed using thematic analysis.
The analysis identified six primary themes: the intention to breastfeed naturally; breast milk as connection; the maternal role of breast milk producer; breast milk as the object of attention; breastfeeding and parenting the hospitalised baby and the demise of breastfeeding. This paper reports on the theme of 'breast milk as connection'.Providing expressed breast milk offered one way the mothers could be physiologically and emotionally connected to their preterm infant while they were in the constant care of hospital staff. Indeed, breast milk was considered the only way the new mother could connect her body (or part there of) to her preterm baby in hospital. This sense of connection however, comes at a cost. On the one hand, the breast milk offers a feeling of connection to the baby, but, on the other, this connection comes only after disconnection of the mother and baby and - through breast expression - mother and her milk. This ability of breast milk to connect mother and baby makes the expressed breast milk highly valued, and places unexpected pressure on the mother to produce milk as integral to her sense of motherhood.
The findings of this study have implications for healthcare practice. It is evident that the association of breastfeeding success with mothering success only jeopardises some families' self-esteem and sense of parenting ability. These findings suggest it would be beneficial to find alternate ways to connect preterm infants and their parents in the preterm nursery environment, and find more positive ways to support breastfeeding.
母乳被认为是所有新生儿的最佳营养来源。在澳大利亚，尽管早产婴儿的母亲开始母乳喂养的比例很高，但持续母乳喂养的比例却迅速下降。此外，婴儿的孕周与母乳喂养的持续时间呈反比关系。为了更好地了解极低出生体重（VLBW）早产儿父母的母乳喂养经历，开展了一项诠释现象学研究。
本纵向研究采用诠释现象学方法。从婴儿出生至12个月大期间，通过对17位父母（包括母亲和父亲）进行45次个人访谈收集数据。然后将这些数据逐字转录，并使用主题分析法进行分析。
分析确定了六个主要主题：自然母乳喂养的意愿；母乳作为联系纽带；母乳生产者的母亲角色；母乳作为关注对象；在医院照顾住院婴儿时的母乳喂养与育儿以及母乳喂养的终止。本文报告“母乳作为联系纽带”这一主题。提供挤出来的母乳是母亲在医院工作人员持续照料其早产儿期间，在生理和情感上与婴儿建立联系的一种方式。事实上，母乳被认为是新妈妈在医院将自己的身体（或身体的一部分）与早产儿联系起来的唯一途径。然而，这种联系感是有代价的。一方面，母乳提供了与婴儿的联系感，但另一方面，这种联系只有在母婴分离之后，通过挤奶，母亲和她的乳汁才能建立起来。母乳连接母婴的这种能力使得挤出来的母乳备受珍视，并给母亲带来意想不到的压力，要求她分泌乳汁，因为这是她作为母亲的身份感不可或缺的一部分。
本研究结果对医疗保健实践具有启示意义。显然，将母乳喂养的成功与育儿的成功联系起来只会损害一些家庭的自尊和育儿能力感。这些研究结果表明，在早产儿保育环境中找到其他方法来建立早产儿与其父母之间的联系，并找到更积极的方式来支持母乳喂养，将是有益的。
