Practices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across Europe
Abstract Background Emerging knowledge about supportive neurodevelopmental neonatal care shows the need for an individual approach to establish breastfeeding. However, evidence on how cue-based breastfeeding is supported in neonatal intensive care units (NICUs) is scarce. Therefore, the aim was to d...
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| Language: | English |
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BMC
2025-01-01
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| Series: | International Breastfeeding Journal |
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| Online Access: | https://doi.org/10.1186/s13006-024-00697-y |
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| author | Bente Silnes Tandberg Hege Grundt Ragnhild Maastrup Annie Aloysius Livia Nagy Renée Flacking |
| author_facet | Bente Silnes Tandberg Hege Grundt Ragnhild Maastrup Annie Aloysius Livia Nagy Renée Flacking |
| author_sort | Bente Silnes Tandberg |
| collection | DOAJ |
| description | Abstract Background Emerging knowledge about supportive neurodevelopmental neonatal care shows the need for an individual approach to establish breastfeeding. However, evidence on how cue-based breastfeeding is supported in neonatal intensive care units (NICUs) is scarce. Therefore, the aim was to describe supporting practices for cue-based breastfeeding. Method Through Delphi rounds, a questionnaire was developed comprising questions on the usage and occurrence of supportive practices for cue-based breastfeeding. A multinational online survey was distributed September to October in 2023 to NICUs in Europe using snowball sampling. Practices such as the practice of skin-to-skin contact (SSC), restrictions for breastfeeding, providing information to parents, observing and responding to infants’ cues were explored. Results The survey was completed by 105 neonatal units across 15 European countries. Less than half (46%) of the NICUs had no restrictions upon placing the infant in SSC with the parents. Approximately half (49%) of the NICUs stated that infants had SSC within the first hour after birth. Many units (68%) had some restriction for breastfeeding. One week after birth, 48% of the NICUs encouraged breastfeeding for infants at 33 postmenstrual age whenever the infant showed cues, regardless of scheduled tube feeding time. This percentage increased to 59% at 33–35 gestational age. Less than half of the units (47%) stated that they had the necessary tools/instruments to support the transition from tube feeding to breastfeeding. There were variations in how milk intake was assessed, such as weighing before and after breastfeeding or estimating milk intake by time spent sucking. Infants in 50% of the units had to be fed exclusively orally before discharge. Many units (65%) provided specific support to or enabled discharge before the infant was exclusively orally fed. Conclusion European NICUs employ supportive practices, SSC, early initiation of breastfeeding, and provide information to parents. Staff plays a significant role in fostering cue-based feeding in preterm infant-mother dyads. There still exist restrictions for SSC and breastfeeding. To understand the impact of different strategies and practices, there is need for evaluations by parents and testing of the implementation of cue-based feeding practices in neonatal care. |
| format | Article |
| id | doaj-art-1ee9d73c8e344e3cb1bd8bcf3ff548ae |
| institution | Kabale University |
| issn | 1746-4358 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | International Breastfeeding Journal |
| spelling | doaj-art-1ee9d73c8e344e3cb1bd8bcf3ff548ae2025-01-05T12:47:49ZengBMCInternational Breastfeeding Journal1746-43582025-01-012011910.1186/s13006-024-00697-yPractices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across EuropeBente Silnes Tandberg0Hege Grundt1Ragnhild Maastrup2Annie Aloysius3Livia Nagy4Renée Flacking5Department of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital TrustDepartment of Neonatology, Haukeland University HospitalKnowledge Centre for Breastfeeding Infants with Special Needs, Department of Neonatology, Copenhagen University Hospital RigshospitaletDepartment of Neonatology, Imperial College Healthcare NHS TrustMelletted a helyem Egyesület (Right(s) Beside You Association)School of Health and Welfare, Dalarna UniversityAbstract Background Emerging knowledge about supportive neurodevelopmental neonatal care shows the need for an individual approach to establish breastfeeding. However, evidence on how cue-based breastfeeding is supported in neonatal intensive care units (NICUs) is scarce. Therefore, the aim was to describe supporting practices for cue-based breastfeeding. Method Through Delphi rounds, a questionnaire was developed comprising questions on the usage and occurrence of supportive practices for cue-based breastfeeding. A multinational online survey was distributed September to October in 2023 to NICUs in Europe using snowball sampling. Practices such as the practice of skin-to-skin contact (SSC), restrictions for breastfeeding, providing information to parents, observing and responding to infants’ cues were explored. Results The survey was completed by 105 neonatal units across 15 European countries. Less than half (46%) of the NICUs had no restrictions upon placing the infant in SSC with the parents. Approximately half (49%) of the NICUs stated that infants had SSC within the first hour after birth. Many units (68%) had some restriction for breastfeeding. One week after birth, 48% of the NICUs encouraged breastfeeding for infants at 33 postmenstrual age whenever the infant showed cues, regardless of scheduled tube feeding time. This percentage increased to 59% at 33–35 gestational age. Less than half of the units (47%) stated that they had the necessary tools/instruments to support the transition from tube feeding to breastfeeding. There were variations in how milk intake was assessed, such as weighing before and after breastfeeding or estimating milk intake by time spent sucking. Infants in 50% of the units had to be fed exclusively orally before discharge. Many units (65%) provided specific support to or enabled discharge before the infant was exclusively orally fed. Conclusion European NICUs employ supportive practices, SSC, early initiation of breastfeeding, and provide information to parents. Staff plays a significant role in fostering cue-based feeding in preterm infant-mother dyads. There still exist restrictions for SSC and breastfeeding. To understand the impact of different strategies and practices, there is need for evaluations by parents and testing of the implementation of cue-based feeding practices in neonatal care.https://doi.org/10.1186/s13006-024-00697-yCue-based feedingBreastfeedingNeonatal intensive careNeonatal intensive care unitPreterm infant |
| spellingShingle | Bente Silnes Tandberg Hege Grundt Ragnhild Maastrup Annie Aloysius Livia Nagy Renée Flacking Practices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across Europe International Breastfeeding Journal Cue-based feeding Breastfeeding Neonatal intensive care Neonatal intensive care unit Preterm infant |
| title | Practices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across Europe |
| title_full | Practices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across Europe |
| title_fullStr | Practices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across Europe |
| title_full_unstemmed | Practices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across Europe |
| title_short | Practices supporting cue-based breastfeeding of preterm infants in neonatal intensive care units across Europe |
| title_sort | practices supporting cue based breastfeeding of preterm infants in neonatal intensive care units across europe |
| topic | Cue-based feeding Breastfeeding Neonatal intensive care Neonatal intensive care unit Preterm infant |
| url | https://doi.org/10.1186/s13006-024-00697-y |
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