Neonatal Intensive Care Unit, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Int Breastfeed J. 2022 Sep 8;17(1):68. doi: 10.1186/s13006-022-00507-3.
Twins and late preterm (LPT) infants are at an increased risk of being breastfed to a lesser extent than term singletons. This study aimed to describe the initiation and duration of any and exclusive breastfeeding at the breast for mothers of LPT twins and term twins during the first 4 months and to explore the breastfeeding experiences of mothers of LPT twins.
A sequential two-sample quantitative-qualitative explanatory mixed-methods design was used. The quantitative data were derived from a longitudinal cohort study in which 22 mothers of LPT twins and 41 mothers of term twins answered questionnaires at one and four months after birth (2015-2017). The qualitative data were obtained from semi-structured interviews with 14 mothers of LPT twins (2020-2021), based on results from the quantitative study and literature. Analysis included descriptive statistics of quantitative data and deductive content analysis of the qualitative data, followed by condensation and synthesis.
All mothers of LPT twins (100%) and most mothers of term twins (96%) initiated breastfeeding. There was no difference in any breastfeeding during the first week at home (98% versus 95%) and at 1 month (88% versus 85%). However, at 4 months, the difference was significant (44% versus 75%). The qualitative data highlighted that mothers of LPT twins experienced breastfeeding as complex and strenuous. Key factors influencing mothers' experiences and decisions were their infants' immature breastfeeding behaviors requiring them to express breast milk alongside breastfeeding, the burden of following task-oriented feeding regimes, and the lack of guidance from healthcare professionals. As a result, mothers started to question the worth of their breastfeeding efforts, leading to changes in breastfeeding management with diverse results. Support from fathers and grandparents positively influenced sustained breastfeeding.
Mothers of LPT twins want to breastfeed, but they face many challenges in breastfeeding during the first month, leading to more LPT twins' mothers than term twins' mothers ceasing breastfeeding during the following months. To promote and safeguard breastfeeding in this vulnerable group, care must be differentiated from routine term infant services, and healthcare professionals need to receive proper education and training.
与足月单胎婴儿相比，双胞胎和晚期早产儿（LPT）婴儿母乳喂养的程度较低。本研究旨在描述 LPT 双胞胎和足月双胞胎母亲在出生后前 4 个月开始母乳喂养和纯母乳喂养的情况，并探讨 LPT 双胞胎母亲的母乳喂养经验。
采用两阶段顺序、定量-定性解释性混合方法设计。定量数据来自一项纵向队列研究，其中 22 名 LPT 双胞胎母亲和 41 名足月双胞胎母亲在出生后 1 个月和 4 个月时回答了问卷（2015-2017 年）。定性数据来自于对 14 名 LPT 双胞胎母亲的半结构化访谈，基于定量研究和文献的结果。分析包括定量数据的描述性统计和定性数据的演绎内容分析，然后进行浓缩和综合。
所有 LPT 双胞胎母亲（100%）和大多数足月双胞胎母亲（96%）都开始了母乳喂养。在家中第一周的任何母乳喂养方面没有差异（98%比 95%）和 1 个月时（88%比 85%）。然而，在 4 个月时，差异显著（44%比 75%）。定性数据突出表明，LPT 双胞胎母亲的母乳喂养体验复杂且费力。影响母亲体验和决策的关键因素是她们婴儿不成熟的母乳喂养行为，需要她们在母乳喂养的同时挤出母乳，遵循以任务为导向的喂养制度的负担，以及缺乏医疗保健专业人员的指导。因此，母亲开始质疑母乳喂养的价值，导致母乳喂养管理发生变化，结果各不相同。父亲和祖父母的支持对持续母乳喂养产生了积极影响。
LPT 双胞胎母亲希望母乳喂养，但她们在第一个月面临许多母乳喂养挑战，导致更多的 LPT 双胞胎母亲而不是足月双胞胎母亲在接下来的几个月停止母乳喂养。为了在这个脆弱群体中促进和保护母乳喂养，护理必须与常规的足月婴儿服务区分开来，医疗保健专业人员需要接受适当的教育和培训。
