Direct Breastfeeding Self-Efficacy of Mothers with Premature Infants

Development of a Protocol for the Direct Breastfeeding of Premature Infants in Neonatal Intensive Care Units

PURPOSE

This study aimed to develop a direct breastfeeding protocol for premature infants admitted to neonatal intensive care units (NICUs) and investigate its efficacy.

BACKGROUND

Direct breastfeeding increases the amount and duration of breastfeeding. However, NICUs have low direct feeding rates owing to medical staff anxiety, lack of knowledge and experience, and fear of overwork. Accordingly, this study developed a protocol for direct breastfeeding in the NICU and evaluated its effect.

METHODS

The protocol was developed through a literature review, expert validation, and preliminary investigation. Its application effects were identified using a nonexperimental, evidence-based research design targeting premature infants, their mothers, and NICU nurses.

RESULTS

The protocol comprised 5 areas and 23 items. Application of the protocol resulted in continuous weight gain of the infants and increased self-efficacy in the mothers' direct breastfeeding ( t = 3.219, P = .004). Significant increases were noted in NICU nurses' direct breastfeeding activities ( t = 3.93, P < .001), breastfeeding rates in the NICU ( P = .037), and direct breastfeeding rates ( P = .007).

CONCLUSIONS

Results underscore the value of an evidence-based protocol for improving breastfeeding rates in premature infants. This study highlights the need for continuous nursing education on protocol applications and human resource support.

Evaluation of a Mobile-based Maternal Feeding Education Program for Overweight Prevention in Infants

PURPOSE

The purpose of this study was to evaluate a mobile-based maternal feeding education program for overweight prevention in infants based on breastfeeding attitude, breastfeeding self-efficacy, breastfeeding duration, recognition of hunger and satiety cues of infants, and knowledge regarding providing solids foods.

METHODS

A nonequivalent control group pretest-posttest design was used for the study. Participants included 15 primiparas in the experimental group and 14 primiparas in the control group in all the follow-up tests. Using self-reported questionnaires in electronic format, data were collected four times (before the intervention, 1 month after childbirth, 3 months after childbirth, and 6 months after childbirth). Using SPSS 24 version, independent t-test and repeated-measures analysis of variance were used to test the effects of the mobile-based maternal feeding education program.

RESULTS

The experimental group showed significantly more positive breastfeeding attitude (F = 5.28, p = .008), higher breastfeeding self-efficacy (F = 3.50, p = .041), and increased breastfeeding duration (t = -2.09, p = .046) than the control group. In addition, the experimental group showed significantly improved knowledge regarding providing solid foods to the infants (F = 4.86, p = .009) in comparison with the control group. However, for education on recognizing hunger and satiety cues of infants, the mobile-based maternal feeding education program was not effective (F = 0.23, p = .878).

CONCLUSION

According to the results of this study, the mobile-based maternal feeding education program has the potential to contribute to overweight prevention in infants.