Concurrent Session 2D - Healthy Life Trajectories: Indigenous Health & Interprofessional Practice
The application of breastfeeding self-efficacy theory applied to mothers of moderate and late preterm infants: A qualitative exploration
Thursday, February 13, 2020
5:00 PM – 5:15 PM
Introduction: Breastmilk feeding of preterm infants reduces morbidities and improves outcomes. However, breastmilk feeding rates in preterm infants are substantially lower than in term infants. Breastfeeding Self-Efficacy (BSE) theory is a social change theory that is predictive of exclusive breastfeeding at 2-months postpartum in mothers of full-term infants. However, BSE has not been well-explored in mothers of moderate (320/7 – 336/7 weeks gestational age [GA]) and late (340/7 – 366/7 weeks GA) preterm infants. We aimed to explore maternal experiences with feeding these preterm infants while in the neonatal intensive care unit (NICU) and assess applicability of BSE theory in this population.
Methods: We conducted a qualitative descriptive exploration of maternal experiences with infant feeding while in the NICU, as part of a larger mixed-methods study. Using purposive, maximum variation sampling, we selected mothers of preterm infants born at 320/7 – 346/7 weeks, who experienced high mean differences in their BSE scores between NICU admission and discharge. Data were analyzed using a thematic approach. To explore and describe BSE within the context of the NICU, we super-imposed the four sources of information from BSE theory onto the identified themes.
Results: Fourteen mothers participated in semi-structured telephone interviews with infants ranging from 2-7 months old. Three main themes emerged: (a) institutional influences, (b) relationship with the pump, and (c) establishing breastfeeding, with an emphasis on the importance of direct breastfeeding at discharge. Overlaying the four sources of information from BSE highlighted the presence of verbal persuasion, performance accomplishment, and physiologic/affective responses. Vicarious experience was not identified in maternal experiences with infant feeding in the NICU.
Conclusion: Our findings suggest that BSE theory is applicable to mothers of moderate and late preterm infants. NICU healthcare providers’ awareness of the apparent influence of institutional culture and the emphasis of pumping on maternal BSE may impact breastfeeding outcomes.