Shattnawi Khulood Kayed
Maternal & Child Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan.
Adv Neonatal Care. 2017 Oct;17(5):390-399. doi: 10.1097/ANC.0000000000000421.
Breastfeeding preterm infants is shown to have important health benefits for both infants and mothers. A positive relationship between mothers and healthcare teams and supportive practices tend to facilitate maternal competence and promote early initiation of breastfeeding within neonatal intensive care units (NICUs).
The aim of this study was to understand attitudes and behaviors of healthcare professionals toward breastfeeding practices and supporting mothers of preterm infants.
This study adopted an ethnographic research design that involved 135 hours of participant observation over a 6-month period and semistructured interviews of 10 nurses and 5 physicians.
Data analysis suggests that while staff members agree with the benefits of breastfeeding for preterm infants, the actual implementation of a breastfeeding policy within NICUs is problematic. Three key themes emerged. The first described the contradiction that exists between the staff beliefs and behaviors in relation to breastfeeding and supporting mothers. The second theme was related to staff working conditions, which described the lack of institutional support and barriers to supporting breastfeeding. The final theme of controlling relationships captured the essence of the practitioner to mother association. Together, these elements revealed a situation whereby the staff appeared more preoccupied with addressing the task of caring for the babies than with supporting mothers in feeding and subsequently caring for their preterm children.
The institutional barriers to breastfeeding promotion within NICUs should be addressed by healthcare providers. Actions that provide a supportive environment within NICUs for both mothers and nurses are essential to improve the overall quality of care.
Future research may include an examination of hospital policies and practices of promoting breastfeeding for preterm infants.
研究表明，母乳喂养早产儿对婴儿和母亲均具有重要的健康益处。母亲与医疗团队之间的积极关系以及支持性措施往往有助于增强母亲的能力，并促进新生儿重症监护病房（NICU）内的母乳喂养尽早开始。
本研究旨在了解医护人员对母乳喂养实践以及对早产儿母亲提供支持的态度和行为。
本研究采用人种志研究设计，在6个月的时间内进行了135小时的参与观察，并对10名护士和5名医生进行了半结构化访谈。
数据分析表明，虽然工作人员认同母乳喂养对早产儿有益，但在NICU内实际实施母乳喂养政策存在问题。出现了三个关键主题。第一个主题描述了工作人员在母乳喂养及支持母亲方面的信念与行为之间存在的矛盾。第二个主题与工作人员的工作条件有关，描述了缺乏机构支持以及支持母乳喂养的障碍。控制关系这一最终主题抓住了从业者与母亲关系的本质。这些因素共同揭示了一种情况，即工作人员似乎更专注于照顾婴儿的任务，而不是支持母亲进行喂养以及随后照顾她们的早产儿。
医疗服务提供者应解决NICU内促进母乳喂养的机构性障碍。在NICU内为母亲和护士提供支持性环境对于提高整体护理质量至关重要。
未来的研究可能包括对医院促进早产儿母乳喂养的政策和实践进行考察。
