Mothers’ experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidence
Abstract Background Mother-infant separation, which is occurring with an increasing incidence, is a barrier to direct breastfeeding. Owing to the importance of breast milk to hospitalized infants, mothers are actively encouraged to express milk during their infants’ neonatal intensive care unit (NIC...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-024-06323-3 |
| _version_ | 1797272871070859264 |
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| author | Xuemei Li Yongqi Li Lin Qian Peng Han Haoxue Feng Hui Jiang |
| author_facet | Xuemei Li Yongqi Li Lin Qian Peng Han Haoxue Feng Hui Jiang |
| author_sort | Xuemei Li |
| collection | DOAJ |
| description | Abstract Background Mother-infant separation, which is occurring with an increasing incidence, is a barrier to direct breastfeeding. Owing to the importance of breast milk to hospitalized infants, mothers are actively encouraged to express milk during their infants’ neonatal intensive care unit (NICU) stay. However, mothers are often faced with a number of challenges in this process. There is a need to understand such mothers’ real-life experiences of breast milk expression to develop supportive strategies to reduce the burden on mothers and increase breastfeeding rates. Methods A comprehensive search of 12 databases was conducted for relevant studies published from database construction to December 2022. All qualitative and mixed-method studies published in English and Chinese that reported on mothers’ experiences of human milk expression during separation from their hospitalized infants were included. Two reviewers independently conducted screening, data extraction, and quality appraisal, with disagreements resolved by a third reviewer. The process of searching followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The JBI Qualitative Assessment and Review Instrument was used to assess study quality and the credibility of study findings. Meta-aggregation was performed to integrate the results. Results This systematic review aggregated mothers’ experiences of milk expression during separation from their hospitalized infants. Database search yielded 600 records, of which 19 full-text documents were screened. Finally, 13 studies of good quality were included with data from 332 mothers across seven countries. A total of 61 primary findings with illustrations were extracted from the 13 eligible studies, the findings were generalized into 16 categories, and further were concluded as four synthesized findings: purpose and motivation, physical and emotional experiences, barrier factors, and coping styles. Conclusion Mothers were driven by extrinsic motivation in their decision to express breast milk. They experienced physical exhaustion and many negative emotional feelings while expressing. This process was affected by numerous barriers. Social support was essential to the initiation and maintenance of milk expression. Medical staff and families should pay more attention to the mental health of mothers with infants in the NICU. Future research should incorporate strategies to cope with emotional responses and offer practical strategies for managing milk expression. Systematic review registration [ www.crd.york.ac.uk ], identifier [PROSPERO 2022 CRD42022383080]. |
| first_indexed | 2024-03-07T14:35:31Z |
| format | Article |
| id | doaj.art-0945fe5abd7541fe8d5cd12cda041ca4 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-07T14:35:31Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-0945fe5abd7541fe8d5cd12cda041ca42024-03-05T20:39:55ZengBMCBMC Pregnancy and Childbirth1471-23932024-02-0124111710.1186/s12884-024-06323-3Mothers’ experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidenceXuemei Li0Yongqi Li1Lin Qian2Peng Han3Haoxue Feng4Hui Jiang5Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji UniversitySchool of Nursing, Naval Medical UniversityNursing Department, Shanghai East Hospital, Tongji UniversityShanghai Tenth People’s Hospital, School of Medicine, Tongji UniversityShanghai First Maternity and Infant Hospital, School of Medicine, Tongji UniversityNursing Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji UniversityAbstract Background Mother-infant separation, which is occurring with an increasing incidence, is a barrier to direct breastfeeding. Owing to the importance of breast milk to hospitalized infants, mothers are actively encouraged to express milk during their infants’ neonatal intensive care unit (NICU) stay. However, mothers are often faced with a number of challenges in this process. There is a need to understand such mothers’ real-life experiences of breast milk expression to develop supportive strategies to reduce the burden on mothers and increase breastfeeding rates. Methods A comprehensive search of 12 databases was conducted for relevant studies published from database construction to December 2022. All qualitative and mixed-method studies published in English and Chinese that reported on mothers’ experiences of human milk expression during separation from their hospitalized infants were included. Two reviewers independently conducted screening, data extraction, and quality appraisal, with disagreements resolved by a third reviewer. The process of searching followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The JBI Qualitative Assessment and Review Instrument was used to assess study quality and the credibility of study findings. Meta-aggregation was performed to integrate the results. Results This systematic review aggregated mothers’ experiences of milk expression during separation from their hospitalized infants. Database search yielded 600 records, of which 19 full-text documents were screened. Finally, 13 studies of good quality were included with data from 332 mothers across seven countries. A total of 61 primary findings with illustrations were extracted from the 13 eligible studies, the findings were generalized into 16 categories, and further were concluded as four synthesized findings: purpose and motivation, physical and emotional experiences, barrier factors, and coping styles. Conclusion Mothers were driven by extrinsic motivation in their decision to express breast milk. They experienced physical exhaustion and many negative emotional feelings while expressing. This process was affected by numerous barriers. Social support was essential to the initiation and maintenance of milk expression. Medical staff and families should pay more attention to the mental health of mothers with infants in the NICU. Future research should incorporate strategies to cope with emotional responses and offer practical strategies for managing milk expression. Systematic review registration [ www.crd.york.ac.uk ], identifier [PROSPERO 2022 CRD42022383080].https://doi.org/10.1186/s12884-024-06323-3Maternal separationNICUBreastfeedingBreast milk expressionExperienceQualitative study |
| spellingShingle | Xuemei Li Yongqi Li Lin Qian Peng Han Haoxue Feng Hui Jiang Mothers’ experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidence BMC Pregnancy and Childbirth Maternal separation NICU Breastfeeding Breast milk expression Experience Qualitative study |
| title | Mothers’ experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidence |
| title_full | Mothers’ experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidence |
| title_fullStr | Mothers’ experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidence |
| title_full_unstemmed | Mothers’ experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidence |
| title_short | Mothers’ experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidence |
| title_sort | mothers experiences of breast milk expression during separation from their hospitalized infants a systematic review of qualitative evidence |
| topic | Maternal separation NICU Breastfeeding Breast milk expression Experience Qualitative study |
| url | https://doi.org/10.1186/s12884-024-06323-3 |
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