Research Article
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The Attitudes and Practices Among Neonatal Nurses Regarding Breastfeeding Support in The Neonatal Intensive Care Unit During Covid-19

Year 2023, Volume: 20 Issue: 1, 195 - 202, 27.04.2023
https://doi.org/10.35440/hutfd.1201220

Abstract

Objective: Neonatal nurses have a main role which include promote and facilitate breastfeeding in in the Neonatal Intensive Care Unit (NICU). This study was conducted to determine the practices and attitudes of nurses towards breastfeeding support, which has critical importance in breastfeeding for newborns hospitalized in NICU during the Covid-19 pandemics.
Material and method: The study was a cross-sectional descriptive survey design conducted with 252 nurses who were members of the Neonatology Nurses Society. The Data Collection Form, Survey Questionnaire, and the Iowa Infant Feeding Attitude Scale (IIFAS) were used for data collection.
Results: The IIFAS median score of the participants was 70.0 (IQR=9.0). Statistically differences in the IIFAS scores were found according to age (χ2=11.703, p=0.008), education status in nursing (χ2=9.257; p=0.01), and status of attending to international scientific meetings (Z=-2.360; p=0.018). Participants who were age between 26-30 years (n=76, 30.2%), had post-education degree in nursing (n=32, 12.7%), and attended to international scientific meetings (n=47, 18.6) had higher positive attitudes of breastfeeding. The nurses (n=126, 50%) stated that it was difficult to reach mothers in terms of breastfeeding for newborns, and 61.8% of them (n=156) stated that they had difficulty initiating the mother-baby attachment process in the NICU.
Conclusions: Although the attitudes of NICU nurses towards breast milk and breastfeeding were at a moderate level in our study, they struggled to support and maintain the lactation and they implemented to a number of supportive feeding practice in NICUs.

Thanks

We would like to thank Turkish Neonatology Nursing Society who give permision for study and supported our work.

References

  • 1. World Health Organization. What is COVID-19? [Internet]. Switzerland: World Health Organization; 2020. [cited 2022 March 4]. Available from: https://www.who.int/news-room/q-a detail/coronavirus-disease-covid-19).
  • 2. Bembich S, Tripani A, Mastromarino S, Di Risio G, Castelpiet-ra E, Risso FM. Parents experiencing NICU visit restrictions due to COVID‐19 pandemic. Acta Paediatrica 2021;110(3):940-41.
  • 3. Muniraman H, Ali M, Cawley P, Hillyer J, Heathcote A, Pon-nusamy V, et al. Parental perceptions of the impact of neo-natal unit visitation policies during COVID-19 pandemic. BMJ Paediatr Open. 2020 Nov 11;4(1):e000899.
  • 4. Erdei C, Liu CH. The downstream effects of COVID-19: a call for supporting family wellbeing in the NICU. J Perinatol. 2020;40:1283–5.
  • 5. Darcy Mahoney A, White RD, Velasquez A, Barrett TS, Clark RH, Ahmad KA. Impact of restrictions on parental presence in neonatal intensive care units related to coronavirus dis-ease 2019. J Perinatol. 2020;40(Suppl 1):36-46.
  • 6. Tscherning C, Sizun J, Kuhn P. Promoting attachment be-tween parents and neonates despite the COVID-19 pan-demic. Acta Paediatr. 2020;109:1937–43.
  • 7. Moro GE, Bertino E. Breastfeeding, human milk collection and containers, and human milk banking: Hot topics during the COVID-19 pandemic. J Hum Lact. 2020;36(4):604-8.
  • 8. Ashini A, Alsoufi A, Elhadi M. Parental perception of neona-tal ICU visitation during the COVID-19 pandemic. Int J Gyne-col Obstet. 2021;20:48-7.
  • 9. Naranje KM, Gupta G, Singh A, Bajpai S, Verma A, Jaiswal R, et al. Neonatal COVID-19 infection management. J Neona-tol. 2020;34:88–98.
  • 10. World Health Organization. Guideline: counselling of women to improve breastfeeding practices. [Internet]. Switzerland: World Health Organization; 2018. [cited 2022 March 4]. Avai-lable from: https://apps.who.int/iris/bitstream/handle/10665/280133/9789241550468-eng.pdf?ua=1
  • 11. World Health Organization Breastfeeding and COVID-19. [Internet]. Switzerland: World Health Organization; [cited 2022 May 4]. Available from: https://www.who.int/news-room/commentaries/detail/breast feeding-and-covid-19.
  • 12. Centers for Disease Control and Prevention. Coronavirus disease (COVID-19) and breastfeeding. Guidance on breast-feeding for infants in the context of COVID-19. [Internet]. Centers for Disease Control and Prevention; 2020. [cited 2022 May 6]. Available from: https://www. cdc.gov/breastfeeding/breastfeeding-special-circumstances/ maternal-or-infant-illnesses/covid-19-and-breastfeeding.html.
  • 13. Gibbs D, Odeh N, Theron M, Harding C. Level 1 neonatal nursing staff perceptions of their role: a qualitative Frame-work Analysis study investigating the complex and diverse workload undertaken by nurses in special care baby units. J Neonatal Nurs. 2021;27:244–50.
  • 14. Froh E, Dahlmeier K, Spatz DL. NICU nurses and lactation-based support and care. Adv Neonat Care. 2017;17(3):203-8.
  • 15. Turner M, Chur‐Hansen A, Winefield H. The neonatal nurses' view of their role in emotional support of parents and its complexities. J Clin Nurs. 2014. 23(21-22);3156-3165.
  • 16. Bień A, Kulesza-Brończyk B, Przestrzelska M, Iwanowicz-Palus G, Ćwiek D. The attitudes of Polish women towards breastfeeding based on the Iowa Infant Feeding Attitude Scale (IIFAS). Nutrients. 2021;13(12):4338.
  • 17. Shaw C, Gallagher K, Petty J, Mancini A, Boyle B. Neonatal nursing during the COVID-19 global pandemic: A thematic analysis of personal reflections. J Neonatal Nurs. 2021;27(3):165-71.
  • 18. De La Mora A, Russell DW. The Iowa Infant feeding attitude scale: Analysis of reliability and validity. J Appl Soc Psychol. 1999;29(11): 2362-80.
  • 19. Eksioğlu A, Yeşil Y, Çeber Turfan E. Bebek Beslenmesi Tutum Ölçeği’nin (IOWA) Türkçeye uyarlanması: Geçerlik ve güve-nirlik çalışması. Koç Üniversitesi Hemşirelikte Eğitim ve Araş-tırma Dergisi (HEAD). 2016;13(3):209-15.
  • 20. Ergin AB, Özdilek R, Özdemir S. Ebelik öğrencilerinin bebek beslenmesine yönelik tutumlarının belirlenmesi. Ebelik ve Sağlık Bilimleri Dergisi. 2020;3(3):166-77.
  • 21. Froh E, Dahlmeier K, Spatz DL. NICU nurses and lactation-based support and care. Adv Neonat Care. 2017;17(3):203-8.
  • 22. Brodribb W, Fallon A, Jackson C, Hegney D. Breastfeeding and Australian GP registrars-their knowledge and attitudes. J Hum Lact. 2008;24(4):422–30.
  • 23. Creedy DK, Cantrill RM, Cooke M. Assessing midwives’ breastfeeding knowledge: Properties of the newborn feed-ing ability questionnaire and breastfeeding initiation practic-es scale. Int Breastfeed J. 2008;3:7.
  • 24. Ouyang Y, Xu Y, Zhang Q. Survey on breastfeeding among Chinese female physicians and nurses: Breastfeeding in Chi-nese medical staff. Nursing & Health Sciences. 2012;14(3):298–303.
  • 25. Yang H, Chen L. Current status of obstetric nurses’ breast-feeding knowledge and its influencing factors. Journal of Aerospace Medicine, 2016;27(4):520–21.
  • 26. Zhu J, Zhang H, Wang L, Li W, Jiang S, Zhen X. Investigation on obstetrics nurses’ breastfeeding knowledge and its influ-encing factors. J Nurs Adm. 2012:12(9);622–24.
  • 27. Amin TT, Abdulrahman AG, Muhaidib NSA, Hamdan OAA. (2014). Breastfeeding attitudes and knowledge among futu-re female physicians and teachers in Saudi Arabia. Health Science Journal. 2014:8(1);102–14.
  • 28. Bernaix LW, Schmidt CA, Arrizola M, Iovinelli D, Medina-Poelinez C. Success of a lactation education program on NI-CU Nurses’ knowledge and attitudes. Journal of Obstetric, Gynecologic & Neonatal Nursing, 2008;37(4):436–45.
  • 29. Centers for Disease Control and Prevention. Strategies to prevent obesity and other chronic diseases: The CDC guide to strategies to support breastfeeding mothers and babies. Atlanta: Centers for Disease Control and Prevention; 2013. U.S. Department of Health and Human Services. [cited 2022 June 4]. Available from: https://www.cdc.gov/breastfeeding/pdf/bf-guide-508.pdf
  • 30. Aiken LH, Sloane DM, Bruyneel L, Van den Heede K, Griffiths P, Busse R, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective obser-vational study. Lancet 2014;383(9931):1824–30.
  • 31. Hallowell SG, Rogowski JA, Spatz DL, Hanlon AL, Kenny M, Lake ET. Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes da-ta. Int J Nurs Stud. 2016;53:190-203.
  • 32. Franck LS, Cormier DM, Hutchison J, Moore D, Bisgaard R, Gay C, et al. A multisite survey of NICU healthcare professi-onals' perceptions about family-centered care. Adv Neona-tal Care. 2021;21(3):205-13.
  • 33. Bergman NJ. Birth practices: Maternal- neonate separation as a source of toxic stress. Birth Defects Res. 2019;111:1087-109.
  • 34. Sarki M, Parlesak A, Robertson, A. Comparison of national cross-sectional breast-feeding surveys by maternal educa-tion in Europe (2006–2016). Public Health Nutr. 2018;22:848–61.
  • 35. Lyons, S.; Currie, S.; Peters, S.; Lavender, T.; Smith, D.M. The association between psychological factors and breastfee-ding behaviour in women with a body mass index (BMI) ≥ 30 kg m−2: A systematic review. Obes. Rev. 2018, 19, 947–959.
  • 36. Moore ER, Bergman N, Anderson GC, Medley N. Early skin‐to‐skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews 2016, Is-sue 11. Art. No.: CD003519.
  • 37. Conde‐Agudelo A, Díaz‐Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD002771.
  • 38. World Health Organization. Clinical management of severe acuterespiratory infection (SARI) when COVID-19 disease is suspected. Interim Guidance. Switzerland: World Health Or-ganization; 2020. [cited 2022 March 4]. Available from: https://apps.who.int/iris/handle/10665/331446
  • 39. Britton C, McCormick FM, Renfrew MJ, Wade A, King SE. Support for breastfeeding mothers. Cochrane Database of Syst Rev. 2007(1):CD001141.

Yenidoğan Hemşirelerinin Covid-19 Pandemisi Sırasında Yenidoğan Yoğun Bakım Ünitesinde Emzirme Desteğine Yönelik Tutum ve Uygulamaları

Year 2023, Volume: 20 Issue: 1, 195 - 202, 27.04.2023
https://doi.org/10.35440/hutfd.1201220

Abstract

Amaç: Yenidoğan hemşireleri, Yenidoğan Yoğun Bakım Ünitesi'nde (YYBB) emzirmeyi teşvik eden ve kolaylaştıran temel role sahiptir. Bu araştırma, Covid-19 pandemisi sırasında YYBÜ'de yatan yenidoğan bebeklerin anne sütü ile beslenmesinde kritik öneme sahip olan emzirme desteğine yönelik hemşirelerin uygulama ve tutumlarını belirlemek amacıyla yapılmıştır.
Materyal ve metod: Neonatoloji Hemşireleri Derneği üyesi 252 hemşire ile gerçekleştirilen araştırma kesitsel tanımlayıcı araştırma desenindedir. Verilerin toplanmasında Veri Toplama Formu, Anket Anketi ve Iowa Bebek Besleme Tutum Ölçeği (IBBTÖ) kullanılmıştır.
Bulgular: Katılımcıların IBBTÖ medyan puanı 70.0 (IQR=9.0) idi. IIFAS puanlarında yaşa (χ2=11.703, p=0.008), hemşirelik eğitim durumuna (χ2=9.257; p=0.01) ve uluslararası bilimsel toplantılara katılma durumuna (Z=-2.360; p=0.008) göre istatistiksel olarak anlamlı farklılık vardı. 26-30 yaş arası (n=76, %30.2), hemşirelik mezunu (n=32, %12.7) ve uluslararası bilimsel toplantılara katılan (n=47, 18.6) katılımcıların emzirmeye yönelik tutumları daha pozitifti. Hemşireler (n=126, %50) yenidoğan emzirme konusunda annelere ulaşmanın zor olduğunu, %61.8'i (n=156) YYBB'de anne-bebek bağlanma sürecini başlatmakta zorlandıklarını ifade etti.
Sonuç: Çalışmamızda YYBB hemşirelerinin anne sütü ve emzirmeye yönelik tutumları orta düzeyde olmasına rağmen emzirmeyi desteklemekte ve sürdürmekte zorlandılar ve YYBB'lerde destekleyici beslenme uygulamalar gerçekleştirdiler.

References

  • 1. World Health Organization. What is COVID-19? [Internet]. Switzerland: World Health Organization; 2020. [cited 2022 March 4]. Available from: https://www.who.int/news-room/q-a detail/coronavirus-disease-covid-19).
  • 2. Bembich S, Tripani A, Mastromarino S, Di Risio G, Castelpiet-ra E, Risso FM. Parents experiencing NICU visit restrictions due to COVID‐19 pandemic. Acta Paediatrica 2021;110(3):940-41.
  • 3. Muniraman H, Ali M, Cawley P, Hillyer J, Heathcote A, Pon-nusamy V, et al. Parental perceptions of the impact of neo-natal unit visitation policies during COVID-19 pandemic. BMJ Paediatr Open. 2020 Nov 11;4(1):e000899.
  • 4. Erdei C, Liu CH. The downstream effects of COVID-19: a call for supporting family wellbeing in the NICU. J Perinatol. 2020;40:1283–5.
  • 5. Darcy Mahoney A, White RD, Velasquez A, Barrett TS, Clark RH, Ahmad KA. Impact of restrictions on parental presence in neonatal intensive care units related to coronavirus dis-ease 2019. J Perinatol. 2020;40(Suppl 1):36-46.
  • 6. Tscherning C, Sizun J, Kuhn P. Promoting attachment be-tween parents and neonates despite the COVID-19 pan-demic. Acta Paediatr. 2020;109:1937–43.
  • 7. Moro GE, Bertino E. Breastfeeding, human milk collection and containers, and human milk banking: Hot topics during the COVID-19 pandemic. J Hum Lact. 2020;36(4):604-8.
  • 8. Ashini A, Alsoufi A, Elhadi M. Parental perception of neona-tal ICU visitation during the COVID-19 pandemic. Int J Gyne-col Obstet. 2021;20:48-7.
  • 9. Naranje KM, Gupta G, Singh A, Bajpai S, Verma A, Jaiswal R, et al. Neonatal COVID-19 infection management. J Neona-tol. 2020;34:88–98.
  • 10. World Health Organization. Guideline: counselling of women to improve breastfeeding practices. [Internet]. Switzerland: World Health Organization; 2018. [cited 2022 March 4]. Avai-lable from: https://apps.who.int/iris/bitstream/handle/10665/280133/9789241550468-eng.pdf?ua=1
  • 11. World Health Organization Breastfeeding and COVID-19. [Internet]. Switzerland: World Health Organization; [cited 2022 May 4]. Available from: https://www.who.int/news-room/commentaries/detail/breast feeding-and-covid-19.
  • 12. Centers for Disease Control and Prevention. Coronavirus disease (COVID-19) and breastfeeding. Guidance on breast-feeding for infants in the context of COVID-19. [Internet]. Centers for Disease Control and Prevention; 2020. [cited 2022 May 6]. Available from: https://www. cdc.gov/breastfeeding/breastfeeding-special-circumstances/ maternal-or-infant-illnesses/covid-19-and-breastfeeding.html.
  • 13. Gibbs D, Odeh N, Theron M, Harding C. Level 1 neonatal nursing staff perceptions of their role: a qualitative Frame-work Analysis study investigating the complex and diverse workload undertaken by nurses in special care baby units. J Neonatal Nurs. 2021;27:244–50.
  • 14. Froh E, Dahlmeier K, Spatz DL. NICU nurses and lactation-based support and care. Adv Neonat Care. 2017;17(3):203-8.
  • 15. Turner M, Chur‐Hansen A, Winefield H. The neonatal nurses' view of their role in emotional support of parents and its complexities. J Clin Nurs. 2014. 23(21-22);3156-3165.
  • 16. Bień A, Kulesza-Brończyk B, Przestrzelska M, Iwanowicz-Palus G, Ćwiek D. The attitudes of Polish women towards breastfeeding based on the Iowa Infant Feeding Attitude Scale (IIFAS). Nutrients. 2021;13(12):4338.
  • 17. Shaw C, Gallagher K, Petty J, Mancini A, Boyle B. Neonatal nursing during the COVID-19 global pandemic: A thematic analysis of personal reflections. J Neonatal Nurs. 2021;27(3):165-71.
  • 18. De La Mora A, Russell DW. The Iowa Infant feeding attitude scale: Analysis of reliability and validity. J Appl Soc Psychol. 1999;29(11): 2362-80.
  • 19. Eksioğlu A, Yeşil Y, Çeber Turfan E. Bebek Beslenmesi Tutum Ölçeği’nin (IOWA) Türkçeye uyarlanması: Geçerlik ve güve-nirlik çalışması. Koç Üniversitesi Hemşirelikte Eğitim ve Araş-tırma Dergisi (HEAD). 2016;13(3):209-15.
  • 20. Ergin AB, Özdilek R, Özdemir S. Ebelik öğrencilerinin bebek beslenmesine yönelik tutumlarının belirlenmesi. Ebelik ve Sağlık Bilimleri Dergisi. 2020;3(3):166-77.
  • 21. Froh E, Dahlmeier K, Spatz DL. NICU nurses and lactation-based support and care. Adv Neonat Care. 2017;17(3):203-8.
  • 22. Brodribb W, Fallon A, Jackson C, Hegney D. Breastfeeding and Australian GP registrars-their knowledge and attitudes. J Hum Lact. 2008;24(4):422–30.
  • 23. Creedy DK, Cantrill RM, Cooke M. Assessing midwives’ breastfeeding knowledge: Properties of the newborn feed-ing ability questionnaire and breastfeeding initiation practic-es scale. Int Breastfeed J. 2008;3:7.
  • 24. Ouyang Y, Xu Y, Zhang Q. Survey on breastfeeding among Chinese female physicians and nurses: Breastfeeding in Chi-nese medical staff. Nursing & Health Sciences. 2012;14(3):298–303.
  • 25. Yang H, Chen L. Current status of obstetric nurses’ breast-feeding knowledge and its influencing factors. Journal of Aerospace Medicine, 2016;27(4):520–21.
  • 26. Zhu J, Zhang H, Wang L, Li W, Jiang S, Zhen X. Investigation on obstetrics nurses’ breastfeeding knowledge and its influ-encing factors. J Nurs Adm. 2012:12(9);622–24.
  • 27. Amin TT, Abdulrahman AG, Muhaidib NSA, Hamdan OAA. (2014). Breastfeeding attitudes and knowledge among futu-re female physicians and teachers in Saudi Arabia. Health Science Journal. 2014:8(1);102–14.
  • 28. Bernaix LW, Schmidt CA, Arrizola M, Iovinelli D, Medina-Poelinez C. Success of a lactation education program on NI-CU Nurses’ knowledge and attitudes. Journal of Obstetric, Gynecologic & Neonatal Nursing, 2008;37(4):436–45.
  • 29. Centers for Disease Control and Prevention. Strategies to prevent obesity and other chronic diseases: The CDC guide to strategies to support breastfeeding mothers and babies. Atlanta: Centers for Disease Control and Prevention; 2013. U.S. Department of Health and Human Services. [cited 2022 June 4]. Available from: https://www.cdc.gov/breastfeeding/pdf/bf-guide-508.pdf
  • 30. Aiken LH, Sloane DM, Bruyneel L, Van den Heede K, Griffiths P, Busse R, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective obser-vational study. Lancet 2014;383(9931):1824–30.
  • 31. Hallowell SG, Rogowski JA, Spatz DL, Hanlon AL, Kenny M, Lake ET. Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes da-ta. Int J Nurs Stud. 2016;53:190-203.
  • 32. Franck LS, Cormier DM, Hutchison J, Moore D, Bisgaard R, Gay C, et al. A multisite survey of NICU healthcare professi-onals' perceptions about family-centered care. Adv Neona-tal Care. 2021;21(3):205-13.
  • 33. Bergman NJ. Birth practices: Maternal- neonate separation as a source of toxic stress. Birth Defects Res. 2019;111:1087-109.
  • 34. Sarki M, Parlesak A, Robertson, A. Comparison of national cross-sectional breast-feeding surveys by maternal educa-tion in Europe (2006–2016). Public Health Nutr. 2018;22:848–61.
  • 35. Lyons, S.; Currie, S.; Peters, S.; Lavender, T.; Smith, D.M. The association between psychological factors and breastfee-ding behaviour in women with a body mass index (BMI) ≥ 30 kg m−2: A systematic review. Obes. Rev. 2018, 19, 947–959.
  • 36. Moore ER, Bergman N, Anderson GC, Medley N. Early skin‐to‐skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews 2016, Is-sue 11. Art. No.: CD003519.
  • 37. Conde‐Agudelo A, Díaz‐Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD002771.
  • 38. World Health Organization. Clinical management of severe acuterespiratory infection (SARI) when COVID-19 disease is suspected. Interim Guidance. Switzerland: World Health Or-ganization; 2020. [cited 2022 March 4]. Available from: https://apps.who.int/iris/handle/10665/331446
  • 39. Britton C, McCormick FM, Renfrew MJ, Wade A, King SE. Support for breastfeeding mothers. Cochrane Database of Syst Rev. 2007(1):CD001141.
There are 39 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Derya Suluhan 0000-0002-7358-7266

Nevin İnan Yurdagül 0000-0001-8985-2020

Dilek Yıldız 0000-0001-8757-4493

Fadik Çökelek 0000-0001-9033-2014

Eyyup Sabri Şeyhanlı 0000-0002-1800-1357

Early Pub Date April 27, 2023
Publication Date April 27, 2023
Submission Date November 8, 2022
Acceptance Date April 4, 2023
Published in Issue Year 2023 Volume: 20 Issue: 1

Cite

Vancouver Suluhan D, İnan Yurdagül N, Yıldız D, Çökelek F, Şeyhanlı ES. The Attitudes and Practices Among Neonatal Nurses Regarding Breastfeeding Support in The Neonatal Intensive Care Unit During Covid-19. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(1):195-202.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty