A Typology of Breastfeeding Mothers of Preterm Infants: A Qualitative Analysis

Breastfeeding is an important element of motherhood with a preterm infant, but the role of maternal emotions in relation to breastfeeding is vague.\nTo describe maternal emotions regarding and insights into breastfeeding during the first year after a preterm birth.\nIn total, 80 mothers of preterm infants (<35 gestational weeks) participated in this secondary analysis of a larger study. The data were collected with an open question at discharge and 3, 6, and 12 months after the expected birth date and analyzed using thematic analysis.\nA typology of breastfeeding mothers of preterm infants was created. The group of survivors wished to be breastfeeding mothers, but after some unexpected difficulties, they had to give up their dream. The disappointment alleviated with time, but some of the mothers still harbored self-accusations after a year. The highfliers were mothers who succeeded in breastfeeding because of their own persistence. They described breastfeeding as enjoyable for both the mother and the infant. The pragmatist mothers breastfed because it was the general norm and a practical way to feed the infant; breastfeeding caused neither passion nor discomfort. The group of bottle-feeding-oriented mothers expressed that breastfeeding did not interest them at any point.\nBeing aware of the typology could help nurses and midwives carefully observe mothers' individual counselling needs. Mothers' wishes and decisions regarding breastfeeding need to be respected and supported without any judgment.\nThe possibilities to tailor breastfeeding interventions based on the typology should be investigated.\nBACKGROUND\nPURPOSE\nMETHODS\nFINDINGS\nIMPLICATIONS FOR PRACTICE\nIMPLICATIONS FOR RESEARC

Missing data resilient decision-making for healthcare IoT through personalization: A case study on maternal health

Remote health monitoring is an effective method to enable tracking of at-risk patients outside of conventional clinical settings, providing early-detection of diseases and preventive care as well as diminishing healthcare costs. Internet-of-Things (IoT) technology facilitates developments of such monitoring systems although significant challenges need to be addressed in the real-world trials. Missing data is a prevalent issue in these systems, as data acquisition may be interrupted from time to time in long-term monitoring scenarios. This issue causes inconsistent and incomplete data and subsequently could lead to failure in decision making. Analysis of missing data has been tackled in several studies. However, these techniques are inadequate for real-time health monitoring as they neglect the variability of the missing data. This issue is significant when the vital signs are being missed since they depend on different factors such as physical activities and surrounding environment. Therefore, a holistic approach to customize missing data in real-time health monitoring systems is required, considering a wide range of parameters while minimizing the bias of estimates. In this paper, we propose a personalized missing data resilient decision-making approach to deliver health decisions 24/7 despite missing values. The approach leverages various data resources in IoT-based systems to impute missing values and provide an acceptable result. We validate our approach via a real human subject trial on maternity health, in which 20 pregnant women were remotely monitored for 7 months. In this setup, a real-time health application is considered, where maternal health status is estimated utilizing maternal heart rate. The accuracy of the proposed approach is evaluated, in comparison to existing methods. The proposed approach results in more accurate estimates especially when the missing window is large.</p

Hospital routines promote parent–infant closeness and cause separation in the birthing unit in the first 2 hours after birth: A pilot study

BackgroundDespite the evidence of multiple benefits of early skin-to-skin contact, it does not always happen and infants are separated from their parents because of different hospital practices. The aim of this study was to explore parent–infant closeness and separation, and which factors promote closeness or result in separation in the birthing unit in the first 2 hours after birth from the point of view of staff members.MethodsThis qualitative descriptive pilot study was conducted in one university hospital in Finland in December 2014. Midwives and auxiliary nurses working in the birthing unit were eligible for the study. The data were collected with a new application downloaded on a smartphone. The participants were asked to record all the closeness and separation events they observed between the infants and parents using the application.ResultsThe application was used during 20 work shifts by 14 midwives or auxiliary nurses. The participants described more closeness than separation events. Our findings indicated that the staff of the birthing unit aimed for mother–infant closeness, and father–infant closeness was a secondary goal. Closeness was mostly skin-to-skin contact and justified as a normal routine care practice. Infants were separated from their parents for routine measurements and because of infants’ compromised health.ConclusionRoutines and normal care practices both promoted parent–infant closeness and caused separation. Parent–infant closeness and separation were controlled by staff members of the birthing unit.</p