Study | Country | Aim | Research method | No. of participants | Characteristics of participants | Results |
---|---|---|---|---|---|---|
Brodsgaard et al. (2022) [29] | Denmark | To explore the circumstances that affect lactation for mothers of premature infants and their significance | Qualitative exploratory approach Purposive sampling Semi-structured, individual interview Content analysis | 16 | Mothers of premature infants admitted to a university hospital NICU in the Capital region of Denmark | Three themes: 1. The birth preparation period has been interrupted. 2. Expressing human milk is essential for breastfeeding. 3. The motherhood journey encompasses breastfeeding. |
Fernández Medina et al. (2019) [30] | Spain | To describe and understand the experiences of mothers of extremely preterm infants regarding barriers to providing their own milk during infant hospital stay in the NICU | Qualitative, interpretative design using Gadamer’s hermeneutic approach Convenience sampling Semi-structured interviews A modified form of the stages developed by Fleming et al. | 15 | Mothers of extremely preterm infants who were admitted to a level III NICU in the southeast of Spain | Two themes: 1. Unexpected and unusual lactation. 2. Providing mother’s own milk to a tiny infant in an unknown technological environment. |
Yang et al. (2019) [18] | China | To understand Chinese mothers’ experiences of expressing breast milk for their preterm hospitalized infants and to identify the support they needed to establish and maintain an adequate milk supply | Husserl’s descriptive phenomenological approach Purposive sampling Semi-structured, individual interviews Thematic analysis | 11 | Mothers separated from their preterm infants admitted to three level III Beijing NICUs in 2017 | Four themes: 1. Providing breast milk is a way to identify as a mother. 2. Perceptions and intentions. 3. Milk expression makes mothers exhausted. 4. Health professional support for breastfeeding is urgently needed. |
Bujold et al. (2018) [31] | Canada | To document maternal experiences expressing human milk for their infant in the NICU as a closeness or separation experience, and to discover what factors gave rise to these perceptions | Qualitative descriptive approach Convenience sampling Audio recorded their thoughts and feelings with a smartphone application Thematic analysis | 15 | Mothers who were expressing while their infant was hospitalized in a level 3 urban Canadian NICU | Three themes: 1. Finding ways to cope with milk expression helps mothers feel close. 2. Being overwhelmed by the challenges and feeling separated. 3. Location and environment. |
Parker et al. (2018) [32] | USA | To examine the perceived barriers and facilitators of providing milk for very preterm infants during the hospitalization among Hispanic and non-Hispanic black mothers | Grounded theory approach Purposive sampling Semi-structured interviews Systematic, iterative approach to data analysis | 23 | Mothers that initiated milk production for their very preterm infants in the NICU—12 English and Spanish-speaking Hispanic mothers and 11 non-Hispanic black mothers | Four themes pertaining to general experiences: 1. Breastfeeding intent impacts mothers’ success in providing milk throughout the hospitalization. 2. Pumping milk for a hospitalized infant is repetitive and exhausting, and does not elicit the same emotional connection as breastfeeding. 3. Hospital providers are an important source of support, when sufficient time is spent to address ongoing issues. 4. Providing milk creates a unique sense of purpose when mothers otherwise feel a lack of control. Four themes pertaining to the experiences of Hispanic and non-Hispanic black mothers: 1. Breastfeeding as a cultural norm influences mothers’ intent to initiate and continue breastfeeding. 2. Hospital staff are viewed as more supportive when interactions and treatment are perceived as racially/ethnically unbiased. 3. Hospital staff are viewed as more supportive when communication occurs in the primary language. 4. Mother-infant separation creates logistical challenges that negatively impact ongoing milk production. |
Bower et al. (2017) [17] | USA | To describe mothers’ experiences expressing milk for their VLBW infants in a level 3 NICU | Phenomenological approach Purposive sampling Individual interviews and telephone interviews Colizzi’s seven-step phenomenological analysis | 17 | Mothers of VLBW at a local level 3 NICU in the southeastern United States | Three themes: 1. I was heartbroken. 2. Pumping is a full-time thing. 3. I literally sacrificed nights. |
Froh et al. (2017) [33] | USA | To describe the breastfeeding experience of mothers of infants with congenital diaphragmatic hernia (CDH) cared for in the NICU | Qualitative descriptive approach Purposive sampling Phased interviews Content analysis | 11 | Mothers with an CDH infant were recruited from a large level 3 NICU in an urban, northeastern pediatric hospital | Six themes: 1. Hopeful for breastfeeding. 2. Latching on … to the pump. 3. We’ve already worked so hard. 4. Getting the hang of it—it’s getting easier. 5. A good safety net. 6. Finding a way that works for us. |
Rossman et al. (2017) [34] | USA | To describe the human milk provision experiences, goals, and outcomes for teen mothers of LBW infants hospitalized in the NICU | A multi method study using a qualitative research design, survey, and infant medical records Purposive sampling In-depth, semi-structured individual interviews Content analysis | 15 | Teen mothers (12 black, 3 Hispanic) of LBW infants hospitalized in a tertiary NICU | Two themes: 1. Wanting to do the right thing. 2. Everything’s fine. |
Ikonen et al. (2016) [35] | Finland | To describe mothers’ experiences with expressing breast milk for preterm or small for gestational age (SGA) infants | Qualitative descriptive approach Convenience sampling Internet-based questionnaire with open-ended questions Inductive content analysis | 130 | Mothers who required to express milk for their preterm or SGA infants admitted to a NICU | Four themes: 1. Managing the situation. 2. Looking forward to easier breastfeeding. 3. Managing daily life. 4. Managing feelings. |
Rossman et al. (2013) [36] | USA | To describe the meaning of milk for mothers who are providing milk for their VLBW infants hospitalized in the neonatal intensive care unit | Qualitative descriptive approach Convenience sampling Semi-structured interviews Content analysis | 23 | Mothers of VLBW infants hospitalized in the level 3 NICU at a large Midwestern urban medical center | Two themes: 1. The healing properties of milk related to the infant. 2. The healing properties of milk related to the mother. |
Hurst et al. (2013) [37] | USA | To understand the experience of mothers of hospitalized very preterm infants related to their daily pumping milk routine during the NICU stay | Medical ethnographic approach Purposive sampling Semi-structured interviews Thematic analysis | 14 | Mothers expressing their milk using hospital-grade mechanical pumps exclusively to provide their breast milk for their infants in the level 2 NICU in southeastern Texas | Three themes: 1. Becoming a “mother–interrupted.” 2. A paradoxical experience. 3. Negotiating. |
Sisk et al. (2010) [38] | USA | To identify patterns of factors that supported or hindered initiation of breast milk expression and maintenance of breast milk production after the birth of a VLBW infant in a sample of US women with varied prenatal infant feeding intentions | Qualitative approach Purposive sampling Semi-structured, individual interviews Content analysis | 32 | Mothers who initiated breast milk expression after delivery of their LBW infants at the Sara Lee Center for Women’s Health NICU, Forsyth Medical Center. | Two themes: 1. Barriers and supports for initiation of breast milk expression. 2. Barriers and supports for maintenance of breast milk production. |
Sweet. (2008) [39] | Australia | To understand the breastfeeding experience of parents of VLBW preterm infants | Interpretive phenomenological approach Purposive sampling Semi-structured, individual interviews Thematic analysis | 10 | Mothers who intended to breastfeed their preterm VLBW infants in the NICU | Five themes: 1. Breastfeeding is initially not a priority. 2. Being a “good” parent. 3. Breastfeeding as a marker of “good” motherhood. 4. “So much is taken out of your hands.” 5. “You have to do it”—expressing is not a choice. |