âBreastfeedingâ carries different connotations for mothers in N/IICU
The Children's Hospital of Philadelphia Aug 12, 2017
For mothers of children in the Newborn/Infant Intensive Care Unit (N/IICU), breastfeeding not only provides their child with vital nutrients and immune components, it can also be a powerful way to bond with their babies. However, given the medical fragility of these infants, the path to traditional breastfeeding is not always attainable. Researchers at ChildrenÂs Hospital of Philadelphia (CHOP) set out to understand what breastfeeding means to these mothers and how setting attainable goals can help their babies in the N/IICU.
The findings were published in the Journal of Human Lactation.
For this study, researchers worked with 11 mothers of infants with congenital diaphragmatic hernia (CDH).
ÂWe found early on that Âbreastfeeding didnÂt necessarily mean holding the baby to the breast, says Elizabeth Froh, PhD, MS, RN, clinical supervisor of the Lactation Team at CHOP and lead author of the study. ÂFor the most part, mothers felt happy as long as their baby was getting their milk, whether by pumping or traditional breastfeeding.Â
One mother, Tessa, expressed her Âbreastfeeding goal as getting her son to drink human milk, no matter how he was able to: ÂI think breastfeeding and bottle feeding are the same, right? Because heÂs getting potentially the exact same thing. HeÂs getting breast milk, still. I feel like if he can take a bottle before we go home, then thatÂs fine. My goal is to get home with a feeding tube and with something else; I want him to be able to either take a bottle or breastfeed  whichever one. ThatÂs my goal before we go home.Â
The researchers argue the terminology of Âbreastfeeding needs to be expanded to include possibilities outside of direct feeding at the breast. Clinicians should make sure mothers of infants with CDH understand that direct breastfeeding wonÂt be possible at first but the provision of human milk is essential for an infant with CDH. Spatz developed a 10–step model that starts with informed decision and sets the mother up on the pathway to be able to breastfeed her child.
ÂIf a mother in the N/IICU wants to one day breastfeed her child in the traditional sense, they need to be taught the importance of pumping early and pumping often with a hospital–grade electric pump, says Diane Spatz,PhD, RN–BC, FAAN, Director of the Lactation Program at CHOP and study co–author. ÂThe benefit is two–fold: the motherÂs body is learning how to produce milk, and the baby is able to get all the benefits of human milk although being fed through a feeding tube.Â
The Breastfeeding and Lactation Program also works with patients within the Center for Fetal Diagnosis and Treatment (CFDT) at CHOP, home of the Garbose Family Special Delivery Unit, the worldÂs first birthing unit within a pediatric hospital dedicated to healthy mothers carrying babies with serious and life–threatening birth defects. The goal is to provide a thorough, individualized plan for the provision of human milk as well as direct breastfeeding if that is the mothers goal prior to delivery.
Another mother, Kenya, explained her son motivated her to keep pumping while he was in the N/IICU: ÂMy second day when I didnÂt get any milk, I looked at pictures of my son and I pumped. I imagined him being there. I imagined myself holding him, and even though that entire day I didnÂt get any milk, I pumped consistently every two hours, and since then IÂve had a beautiful flow of milk.Â
Although it was not the original intent of the authors to study the link between breastfeeding and motherhood, some mothers, like Sandra, said breastfeeding her baby made her feel more connected: ÂI feel like pumping for the last two months has been worth it. I feel like IÂm finally able to soothe her. I feel like a mom more than anything.Â
Go to Original
The findings were published in the Journal of Human Lactation.
For this study, researchers worked with 11 mothers of infants with congenital diaphragmatic hernia (CDH).
ÂWe found early on that Âbreastfeeding didnÂt necessarily mean holding the baby to the breast, says Elizabeth Froh, PhD, MS, RN, clinical supervisor of the Lactation Team at CHOP and lead author of the study. ÂFor the most part, mothers felt happy as long as their baby was getting their milk, whether by pumping or traditional breastfeeding.Â
One mother, Tessa, expressed her Âbreastfeeding goal as getting her son to drink human milk, no matter how he was able to: ÂI think breastfeeding and bottle feeding are the same, right? Because heÂs getting potentially the exact same thing. HeÂs getting breast milk, still. I feel like if he can take a bottle before we go home, then thatÂs fine. My goal is to get home with a feeding tube and with something else; I want him to be able to either take a bottle or breastfeed  whichever one. ThatÂs my goal before we go home.Â
The researchers argue the terminology of Âbreastfeeding needs to be expanded to include possibilities outside of direct feeding at the breast. Clinicians should make sure mothers of infants with CDH understand that direct breastfeeding wonÂt be possible at first but the provision of human milk is essential for an infant with CDH. Spatz developed a 10–step model that starts with informed decision and sets the mother up on the pathway to be able to breastfeed her child.
ÂIf a mother in the N/IICU wants to one day breastfeed her child in the traditional sense, they need to be taught the importance of pumping early and pumping often with a hospital–grade electric pump, says Diane Spatz,PhD, RN–BC, FAAN, Director of the Lactation Program at CHOP and study co–author. ÂThe benefit is two–fold: the motherÂs body is learning how to produce milk, and the baby is able to get all the benefits of human milk although being fed through a feeding tube.Â
The Breastfeeding and Lactation Program also works with patients within the Center for Fetal Diagnosis and Treatment (CFDT) at CHOP, home of the Garbose Family Special Delivery Unit, the worldÂs first birthing unit within a pediatric hospital dedicated to healthy mothers carrying babies with serious and life–threatening birth defects. The goal is to provide a thorough, individualized plan for the provision of human milk as well as direct breastfeeding if that is the mothers goal prior to delivery.
Another mother, Kenya, explained her son motivated her to keep pumping while he was in the N/IICU: ÂMy second day when I didnÂt get any milk, I looked at pictures of my son and I pumped. I imagined him being there. I imagined myself holding him, and even though that entire day I didnÂt get any milk, I pumped consistently every two hours, and since then IÂve had a beautiful flow of milk.Â
Although it was not the original intent of the authors to study the link between breastfeeding and motherhood, some mothers, like Sandra, said breastfeeding her baby made her feel more connected: ÂI feel like pumping for the last two months has been worth it. I feel like IÂm finally able to soothe her. I feel like a mom more than anything.Â
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