Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia

Objective. To assess breastfeeding support practices and related barriers and facilitators in a large Intensive Care Unit, Neonatal (NICU) in Medellín, Colombia, as part of a broader quality improvement initiative to enhance breastfeeding support. Methods. A mixed-methods descriptive design was u...

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Autores principales:	Haley Abugov, Sandra Catalina Ochoa Marín, Sonia Semenic, Isabel Cristina Arroyave
Formato:	article
Lenguaje:	EN
Publicado:	Universidad de Antioquia 2021
Materias:	infant, newborn breast feeding intensive care units, neonatal milk, human quality improvement Nursing RT1-120
Acceso en línea:	https://doaj.org/article/9a2b1d75d7564c8d88871cc55aa8dd37
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spelling	oai:doaj.org-article:9a2b1d75d7564c8d88871cc55aa8dd372021-11-26T20:06:09ZBarriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia2216-028010.17533/udea.iee.v39n1e11https://doaj.org/article/9a2b1d75d7564c8d88871cc55aa8dd372021-03-01T00:00:00Zhttps://revistas.udea.edu.co/index.php/iee/article/view/345527https://doaj.org/toc/2216-0280Objective. To assess breastfeeding support practices and related barriers and facilitators in a large Intensive Care Unit, Neonatal (NICU) in Medellín, Colombia, as part of a broader quality improvement initiative to enhance breastfeeding support. Methods. A mixed-methods descriptive design was used to collect data on care practices and outcomes related to NICU breastfeeding support. Data sources included the Neo-BFHI’s self-assessment questionnaire of breastfeeding policies and practices, clinical observations, and a retrospective review of 51 patient charts. Results. Of the 51 charts reviewed, 98% of the infants received breastmilk during their hospitalization but the majority (84%) also received formula and only 8% of infants were exclusively breastfed at the time of NICU discharge. All NICU staff received education on mother and baby-friendly care, and the unit complied with the International Code of Marketing of Breast-milk substitutes. However, resources to support lactation (e.g., access to breastfeeding specialists, breast pumps, written teaching materials for parents) were limited, and infants were only allowed to consume milk expressed within the hospital. Mother-infant separation, as well as staff beliefs and care routines, also limited important breastfeeding support practices such as skin-to-skin care and early initiation of direct breastfeeding. Conclusion. The self-assessment questionnaire and observations revealed a high value for breastfeeding and a family-centered approach to care in the NICU. Key challenges to sustaining breastfeeding in the NICU included a lack of facilities for supporting parental presence, barriers to expression and provision of mother’s milk, and a high rate of bottle-feeding with formula.Haley AbugovSandra Catalina Ochoa MarínSonia SemenicIsabel Cristina ArroyaveUniversidad de Antioquiaarticleinfant, newbornbreast feedingintensive care units, neonatalmilk, humanquality improvementNursingRT1-120ENInvestigación y Educación en Enfermería, Vol 39, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	infant, newborn breast feeding intensive care units, neonatal milk, human quality improvement Nursing RT1-120
spellingShingle	infant, newborn breast feeding intensive care units, neonatal milk, human quality improvement Nursing RT1-120 Haley Abugov Sandra Catalina Ochoa Marín Sonia Semenic Isabel Cristina Arroyave Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia
description	Objective. To assess breastfeeding support practices and related barriers and facilitators in a large Intensive Care Unit, Neonatal (NICU) in Medellín, Colombia, as part of a broader quality improvement initiative to enhance breastfeeding support. Methods. A mixed-methods descriptive design was used to collect data on care practices and outcomes related to NICU breastfeeding support. Data sources included the Neo-BFHI’s self-assessment questionnaire of breastfeeding policies and practices, clinical observations, and a retrospective review of 51 patient charts. Results. Of the 51 charts reviewed, 98% of the infants received breastmilk during their hospitalization but the majority (84%) also received formula and only 8% of infants were exclusively breastfed at the time of NICU discharge. All NICU staff received education on mother and baby-friendly care, and the unit complied with the International Code of Marketing of Breast-milk substitutes. However, resources to support lactation (e.g., access to breastfeeding specialists, breast pumps, written teaching materials for parents) were limited, and infants were only allowed to consume milk expressed within the hospital. Mother-infant separation, as well as staff beliefs and care routines, also limited important breastfeeding support practices such as skin-to-skin care and early initiation of direct breastfeeding. Conclusion. The self-assessment questionnaire and observations revealed a high value for breastfeeding and a family-centered approach to care in the NICU. Key challenges to sustaining breastfeeding in the NICU included a lack of facilities for supporting parental presence, barriers to expression and provision of mother’s milk, and a high rate of bottle-feeding with formula.
format	article
author	Haley Abugov Sandra Catalina Ochoa Marín Sonia Semenic Isabel Cristina Arroyave
author_facet	Haley Abugov Sandra Catalina Ochoa Marín Sonia Semenic Isabel Cristina Arroyave
author_sort	Haley Abugov
title	Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia
title_short	Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia
title_full	Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia
title_fullStr	Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia
title_full_unstemmed	Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia
title_sort	barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in colombia
publisher	Universidad de Antioquia
publishDate	2021
url	https://doaj.org/article/9a2b1d75d7564c8d88871cc55aa8dd37
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Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia

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