The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants: Study protocol for a randomized controlled trial

Background: Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at < 37 gestational weeks), mothers of preterm infants have shorter breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mothers' sense of trust in their own capacity and thereby facilitate breastfeeding. Methods/design: A multicentre randomized controlled trial has been designed to evaluate the effectiveness and cost-effectiveness of person-centred proactive telephone support on breastfeeding outcomes for mothers of preterm infants. Participating mothers will be randomized to either an intervention group or control group. In the intervention group person-centred proactive telephone support will be provided, in which the support team phones the mother daily for up to 14 days after hospital discharge. In the control group, mothers are offered a person-centred reactive support where mothers can phone the breastfeeding support team up to day 14 after hospital discharge. The intervention group will also be offered the same reactive telephone support as the control group. A stratified block randomization will be used; group allocation will be by high or low socioeconomic status and by NICU. Recruitment will be performed continuously until 1116 mothers (I: 558 C: 558) have been included. Primary outcome: proportion of mothers exclusively breastfeeding at eight weeks after discharge. Secondary outcomes: proportion of breastfeeding (exclusive, partial, none and method of feeding), mothers satisfaction with breastfeeding, attachment, stress and quality of life in mothers/partners at eight weeks after hospital discharge and at six months postnatal age. Data will be collected by researchers blind to group allocation for the primary outcome. A qualitative evaluation of experiences of receiving/providing the intervention will also be undertaken with mothers and staff. Discussion: This paper presents the rationale, study design and protocol for a RCT providing person-centred proactive telephone support to mothers of preterm infants. Furthermore, with a health economic evaluation, the cost-effectiveness of the intervention will be assessed

Through a mother's lens: a qualitative analysis reveals how temporal experience shifts when a boy born preterm has cystic fibrosis

We present a qualitative case study of one woman's experience of bringing up a child with cystic fibrosis (CF), born prematurely, using interpretative phenomenological analysis (IPA). This mother's existential account portrays time sequences for developmental milestones and synchronization of lifecycle events as atypical. Her perception of her child fluctuated radically; illness seemed to displace time, which collapsed with adversity. The temporal relations of CF and preterm birth are blurred at certain points. Although the challenge of compromised health may in some ways have promoted her son's development, his immature self-expression moved this mother towards an insider perspective of his experience. Cystic fibrosis is an ominous presence that demands respect even when the child is well. Anticipating the psychological impact of biomedical interventions can help to minimize trauma and maximize adaptation. Talking and play at transitional time points may assist the way parents and children assimilate temporal disruptions