Browsing by Author "Brockway, Meredith L."

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    Effect of Alberta Family Integrated Care (FICare) on Breastfeeding Self-Efficacy and Breastmilk Feeding in Moderate and Late Preterm Infants
    (2019-07-03) Brockway, Meredith L.; Benzies, Karen Marie; Carr, Eloise C. J.; Aziz, Khalid
    Background: Breastfeeding self-efficacy (BSE) predicts breastfeeding outcomes in mothers of full-term infants; however, neonatal intensive care unit (NICU) practices may impede BSE and breastmilk feeding in mothers of preterm infants. Alberta Family Integrated Care (FICare) integrates parents into the care of their infant while in the NICU, by enhancing parent support, parent education and information sharing. The objective of this PhD work was to explore how Alberta FICare works to inform maternal BSE and resultant infant feeding outcomes in mothers of moderate (320/7 – 336/7 weeks) and late preterm infants (340/7 – 356/7 weeks). Methods: I conducted an explanatory sequential mixed-methods sub-study of the Alberta FICare trial. Based on BSE change scores between admission and discharge for mothers in the intervention group, I invited mothers scoring in the top or bottom quintiles to participate in interviews about infant feeding experiences in the NICU. Interviews were analyzed using inductive thematic analysis. To assess the effects of FICare on BSE and breastmilk feeding rates at discharge, I used repeated measures ANCOVA and Chi square. Finally, I used an integration matrix to integrate qualitative and quantitative findings. Results: Overall, I included 457 mothers/infant dyads (70 twins; M = 336/7 weeks gestation) from the FICare trial. Interviews with 14 mothers revealed three major themes: (a) institutional influences, (b) relationship with the pump, and (c) establishing breastfeeding. FICare was effective at improving BSE for mothers of late preterm infants, F(1, 232) = 3.97, p = .048, partial η2 = .017, but not for mothers of moderate preterm infants, F(1, 191) = 0.79, p = .375. Although exclusive breastmilk feeding rates at discharge in late preterm infants enrolled in the FICare group were higher compared to the standard care group, these differences were not statistically significant, 72.3% versus 62.2%, χ2(1) = 2.90, p = 0.089; no notable difference in exclusive breastmilk feeding was observed in moderate preterm infants. Conclusion: FICare is an effective model of care to improve BSE in mothers of late preterm infants at discharge from the NICU. More research is required to understand why FICare did not improve BSE in mothers of moderate preterm infants.