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3Deze focusgroep studie geeft inzicht in de redenen en motieven van vrouwen om vroegtijdig te stoppen met het geven van borstvoeding of om vroegtijdig kunstvoeding te gaan geven. De resultaten van dit onderzoek zijn gebaseerd op een kwalitatief onderzoek met 10 focusgroepen met in totaal 69 vrouwen die op het moment van het onderzoek borstvoeding gaven aan hun kind maar die vroegtijdig kunstvoeding gingen geven naast de borstvoeding (voordat de baby 6 maanden oud was), en vrouwen die borstvoeding hebben gegeven maar die op het moment van het onderzoek, voordat de baby 6 maanden oud was,
daarmee waren gestopt. Het doel van het onderzoek is niet geweest om kwantitatieve gegevens op te leveren; daartoe is kwantitatief vervolgonderzoek nodig.
MULTIFILE
Uit onderzoek blijkt dat borstvoeding belangrijke langetermijneffecten heeft op de gezondheid van zowel kinderen als moeders. Veel moeders ervaren echter problemen met borstvoeding en stoppen eerder dan ze zouden willen. Eén van de belangrijkste redenen dat vrouwen vroegtijdig stoppen met borstvoeding is de vaak lastige combinatie van borstvoeding en werk. Daarom is het belangrijk om te weten hoe organisaties borstvoedende moeders beter kunnen ondersteunen. Sjoukje van Dellen, postdoconderzoeker bij de Hanzehogeschool Groningen, schreef er een proefschrift over waarop zij in juni 2022 aan de Rijksuniversiteit Groningen promoveerde.
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Background
The challenge of combining professional work and breastfeeding is a key reason why women choose not to breastfeed or to stop breastfeeding early. We posited that having access to a high-quality lactation room at the workplace could influence working mothers’ satisfaction and perceptions related to expressing breast milk at work, which could have important longer term consequences for the duration of breastfeeding. Specifically, we aimed to (1) develop a checklist for assessing the quality of lactation rooms and (2) explore how lactation room quality affects lactating mothers’ satisfaction and perceptions. Drawing on social ecological insights, we hypothesized that the quality of lactation rooms (operationalized as any space used for expressing milk at work) would be positively related to mothers’ satisfaction with the room, perceived ease of, and perceived support for milk expression at work.
Methods
We conducted two studies. In Study 1 we developed a lactation room quality checklist (LRQC) and assessed its reliability twice, using samples of 33 lactation rooms (Study 1a) and 31 lactation rooms (Study 1b). Data were collected in the Northern part of the Netherlands (between December 2016 and April 2017). Study 2 comprised a cross-sectional survey of 511 lactating mothers, working in a variety of Dutch organizations. The mothers were recruited through the Facebook page of a popular Dutch breastfeeding website. They completed online questionnaires containing the LRQC and measures aimed at assessing their satisfaction and perceptions related to milk expression at work (in June and July 2017).
Results
The LRQC was deemed reliable and easy to apply in practice. As predicted, we found that objectively assessed higher-quality lactation rooms were associated with increased levels of satisfaction with the lactation rooms, perceived ease of milk expression at work, and perceived support from supervisors and co-workers for expressing milk in the workplace.
Conclusions
The availability of a high-quality lactation room could influence mothers’ decisions regarding breast milk expression at work and the commencement and/or continuation of breastfeeding. Future studies should explore whether and how lactation room quality affects breastfeeding choices, and which aspects are most important to include in lactation rooms.
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BACKGROUND: Pre-term infants with bronchopulmonary dysplasia (BPD) are at risk of acquiring brain abnormalities. Combined with ongoing breathing difficulties, this may influence the development of their sucking patterns.
OBJECTIVE: To determine the longitudinal development of sucking patterns from birth until 10 weeks' post-term age in pre-term infants with and without BPD.
METHODS: The sucking patterns of 16 pre-term infants with BPD and 15 pre-term infants without BPD were prospectively assessed with the Neonatal Oral-Motor Assessment Scale. The infants were matched for gestational age (<30 weeks). We recorded approximately 12 feeding episodes per infant, from 34 until 50 weeks' post-menstrual age. We diagnosed the infants' sucking patterns as normal, dysfunctional, or disorganized. Then, we examined the development of the sucking patterns in relation to relevant clinical characteristics.
RESULTS: Thirty (21%) of 142 feeding episodes of the pre-term infants with BPD and 36 (23%) of 156 of those without BPD were diagnosed as normal (non-significant). Of the abnormal patterns, 3 were diagnosed as dysfunctional and 229 as disorganized. Before term-equivalent age, definitely abnormal sucking patterns were more prevalent in the pre-term infants with BPD than in those without BPD: 69 (49%) and 47 (30%) episodes, respectively (χ(2) = 10.7, p < 0.01). In particular, the abnormal patterns including the item 'incoordination', defined as the inability to coordinate sucking and swallowing with breathing, were more prevalent: 36 and 15%, respectively (χ(2) = 6.37, p < 0.05). There was no difference between the two groups regarding the age at which they acquired normal sucking patterns. Relevant clinical characteristics did not influence the development of the sucking patterns.
CONCLUSIONS: The developmental characteristic of sucking patterns in infants with BPD was that these infants were unable to coordinate swallowing with breathing. This was the case especially prior to term-equivalent age; after term-equivalent age, the development of sucking closely resembled that of pre-term infants without BPD.
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Voorwoord in James McKenna - Veilig slapen met je baby
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In 2040 werkt de logopedist nog maar nauwelijks in een eigen behandelruimte. Cliënten en hun naasten vinden samen met de logopedist in hun dagelijkse omgeving een nieuwe balans in communiceren. Nieuwe kennis is gemakkelijk bereikbaar en de logopedist weet deze op waarde te schatten en toe te passen.
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Voeding speelt een belangrijke rol bij de preventie en behandeling van ziekten. In de verpleegkundige basiszorg is voeding een fundament dat alle zorgactiviteiten voor eten en drinken omvat. Het is daarom belangrijk dat er in de opleiding tot bachelor verpleegkundige voldoende aandacht is voor voeding.
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Background: In the Netherlands, 81% of mothers initiate breastfeeding. After one month the percentage of mothers still breastfeeding drops, despite positive intentions. Little is known about women’s perceptions of breastfeeding during the period of intention.
Aim: This qualitative study aimed to gain insight into these perceptions among first-time mothers from middle and high socioeconomic backgrounds in the northern part of the Netherlands.
Methods: We used the theory of planned behaviour as the deductive model. In 2008, 16 in-depth interviews were conducted with 8 mothers who intended to breastfeed. The interviews were conducted at two time points (prepartum and postpartum) and covered the same period (that is, from the time when the intention was formed until after childbirth). The interviews were transcribed verbatim and analysed using grounded theory.
Findings: Five inductive themes were identified: combining breastfeeding with work, learning about breastfeeding, making arrangements for childbirth, reflecting on the intention, and becoming a mother. During the extended period of intention, the women anticipated breastfeeding, but were cautious in expressing their intentions. They felt that the experience of becoming a mother would be critical to their breastfeeding outcomes.
Conclusion: The theory of planned behaviour has been widely used in breastfeeding research. However, the period of intention is relatively long for breastfeeding. Rather than recommending an intensification of antenatal breastfeeding education, recommendations must incorporate the awareness that practising breastfeeding should not be considered the continuous outcome of the intention to do so – it takes a mother to practise breastfeeding.
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In the Netherlands 75% of the mothers start breastfeeding their infants.
After 1 month this is 46% (CBS 2012). International guidelines (WHO)
recommend that mothers should breastfeed until 6 months. In this study
- that is part of a larger Dutch study on mothers’ decisions to stop or to
continue breastfeeding - we focus on mothers’ breastfeeding knowledge.
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