Birth of a very low birth weight preterm infant and the intention to breastfeed 'naturally'

An interpretive phenomenological study involving 17 Australian parents was undertaken to explore parents' experiences of breastfeeding very low birth weight (VLBW) preterm infants from birth to 12 months of age. Data were collected from 45 individual interviews held with both mothers and fathers, which were then transcribed verbatim and analysed using thematic analysis. From this study, the analysis identified the following themes: the intention to breastfeed naturally; breast milk as connection; the maternal role of breast milk producer; breastmilk as the object of attention; breastfeeding and parenting the hospitalised baby and the demise of breastfeeding. The discussion presented here presents the theme of the intention to breastfeed 'naturally'. This study found that all of the participant women decided to breastfeed well before the preterm birth, and despite the birth of a VLBW preterm infant continued to expect the breastfeeding experience to be normal regardless of the difference of the postpartum experience. It is without doubt that for these parents the pro-breastfeeding rhetoric is powerfully influential and thus successful in promoting breastfeeding. Furthermore, all participants expected breastfeeding to be 'natural' and satisfying. There is disparity between parents' expectations of breastfeeding 'naturally' and the commonplace reality of long-term breast expression and uncertain at-breast feeding outcomes. How the parents came to make the decision to breastfeed their unborn child -- including the situations and experiences that have influenced their decision making -- and how the preterm birth and the dominant cultures subsequently affected that decision will be discussed. The findings have implications for midwifery education and maternity care professionals who support parents making feeding decisions early in pregnancy and those striving to breastfeed preterm infants.     

Expressed breastmilk handling and storage guidelines available to mothers in the community: A scoping review

BackgroundThere is an increasing number of mothers expressing their breastmilk, which presents new issues for infant feeding. A primary concern is handling, storage, and warming of expressed breastmilk.MethodsA scoping review was undertaken to explore online guidelines for handling and storage of expressed human breastmilk which are readily accessible to Australian mothers. Six common terms and questions regarding expressed breastmilk handling and storage were run through Google, Bing, and Yahoo search engines, and government health websites, informal milk sharing sites, and other sites frequently referenced on social media breastfeeding support pages.ResultsThe top ten most cited resources were comparatively analysed. Only two of the resources were Australian based. There was a great variance in the guidelines offered for both handling and storage of expressed breastmilk. The most conservative storage recommendations for fresh breastmilk were up to 4 h at room temperature and 72 h in the refrigerator. The least conservative recommendations allowed fresh breastmilk to be stored at room temperature for up to 10 h and in the refrigerator for up to 8 days, albeit strictly dependent on the temperature of the room and cleanliness of the expression. The majority of recommendations cited the same primary source. All resources stated that thawed milk should never be refrozen.ConclusionsThere are minimal Australian-based guidelines, and even less primary research, in the expressed breastmilk handling and storage space. The resources readily available to women in the community setting vary in ease of comprehension and can cause confusion.