Dissertations & Theses (Open Access)

Date of Award

Fall 12-15-2023

Degree Name

Doctor of Philosophy in Nursing (PhD)

Advisor(s)

Cathy L. Rozmus, PhD

Second Advisor

Carina Katigbak, PhD

Third Advisor

Diane Wardell, Ph.D

Fourth Advisor

Amy Hair, M.D.

Abstract

Abstract

Background: Supporting preterm infants with mother’s own milk (MOM) can improve health outcomes and decrease mortality.1 Freshly pumped MOM, within four hours of expression, has the highest availability of bioactive components versus stored MOM. However, fresh milk is often not readily available due to the disconnected process of breastfeeding that occurs with preterm infants in the NICU. One convenient solution to improve access to fresh MOM is for the mother to pump at the infant's bedside. This intervention could improve the mother's pumping experience and provide the infant access to fresh MOM.

Purpose: This study aimed to evaluate the feasibility (e.g. enrollment, retention, and adherence) of daily bedside pumping for the first month of NICU admission for mothers of infants born at < 32 weeks and explore the mothers' experiences of pumping at the bedside.

Methods: The feasibility of bedside pumping in the NICU was evaluated using a mixed methods approach. English and Spanish-speaking mothers were asked to pump at the bedside and complete a four-question survey daily for one month or through infant discharge. After 30 days, the participating mothers were interviewed to understand their experiences.

Results: An ethnically diverse population of 28 mothers were recruited. Twenty-three of the 28 (82%) mothers pumped at the bedside at least once. The study met the a priori criteria for enrollment and retention but not the criteria for adherence. A total of 53.5% of the infants received MOM at 30 days of life and 50% at discharge. Most mothers described bedside pumping evoked feelings of bonding, increased MOM production, and motivation to keep pumping for their NICU infant. Barriers were similar between mothers and did not indicate adherence to bedside pumping.

Implications for Practice: For some mothers, bedside pumping improved their breastfeeding experience in the NICU. Maternal coping was seen as a moderator for barriers and facilitators to bedside pumping. In conclusion, the findings suggest that finding ways to improve maternal coping, access to pumping supplies, and provide privacy could improve adherence to bedside pumping and pave the way for studies requiring access to fresh MOM.

Keywords

Human milk, Mother’s Own Milk, Breastfeeding, Prematurity, Neonatal Intensive Care, Nursing, Lactation, Coping

Included in

Nursing Commons

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