Alberta Family Integrated Care (FICare) and Breastfeeding for Moderate to Late Preterm Infants: Cluster Randomized Controlled Trial 2 Month Follow-up
Date
2023-01-02
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Abstract
Introduction: Human milk, specifically mothers’ own milk, is the optimal nutrition for infants and has significant protective effects, which are even greater for infants born prematurely. Compared to full-term infants, fewer preterm infants achieve exclusive breastfeeding to age 6 months. Aim: The purpose of this study was to examine the risks and protective factors associated with breastfeeding at age 2 months in moderate and late preterm infants who received Alberta Family Integrated Care (FICare) versus Standard Care while in the Neonatal Intensive Care Unit (NICU). Alberta FICare is a novel care model that empowers parents to build their knowledge, skill, and confidence in caring for their preterm infant. Methods: A longitudinal follow-up to the Alberta FICare cluster randomized controlled trial was conducted. Alberta FICare data for 455 infants (n = 204 Alberta FICare; n = 251 Standard Care) and their mothers were linked to feeding type data (exclusive human milk, non-exclusive human milk, or no human milk) collected at the infant’s 2-month public health immunization visit. Multinomial logistic regression was used to examine the factors associated with proportions of breastfeeding at age 2 months. Results: After controlling for covariates, there was a significant group difference favoring Standard Care versus Alberta FICare for non-exclusive breastfeeding compared to no breastfeeding at age 2 months. There were no significant group differences in model sub-analyses comparing exclusive breastfeeding versus non-exclusive breastfeeding and exclusive breastfeeding versus no breastfeeding. Mothers with singletons, higher education, higher parental NICU stress, higher breastfeeding self-efficacy, and feeding exclusively human milk at discharge were more likely to provide exclusive breastfeeding at age 2 months. Conclusion: Infants in the Standard Care group were more likely to receive non-exclusive breastfeeding at age 2 months compared to no breastfeeding. Group (Alberta FICare versus Standard Care) was not significant when comparing exclusive breastfeeding outcomes. Of the factors associated with exclusive breastfeeding in preterm infants, breastfeeding self-efficacy is a potentially modifiable one that could be targeted for interventions. Further research is required to examine the association between higher parental NICU stress and exclusive breastfeeding.
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Keywords
preterm infant, human milk feeding, breastfeeding, family integrated care, neonatal intensive care, breastfeeding self-efficacy
Citation
Moe, A. M. (2023). Alberta Family Integrated Care (FICare) and Breastfeeding for Moderate to Late Preterm Infants: Cluster Randomized Controlled Trial 2 Month Follow-up (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.