Faculty Mentor(s)

Dr. Anita Esquerra-Zwiers, Nursing

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Despite the importance of providing hospitalized extremely preterm (EP, < 32 weeks gestation) very low birth weight (VLBW, < 1500 grams) infants with mother’s own milk (MOM), a low percentage of neonates are discharged receiving MOM. The purpose of this study was to explore the experience of mothers of EP VLBW infants and related breastmilk provision in the neonatal intensive care unit (NICU) to develop a general theory of maternal breastmilk provision. This grounded theory study implemented classical qualitative methods. Transcribed maternal interviews were analyzed using the web-based data management and analysis platform of Dedoose. A total of 30 mothers, recruited within a large Midwestern hospital’s NICU, were included in this study. Ten participants provided longitudinal data, while 20 provided data at one-time point. Participants were primarily 22-25 years old (30%, n=10), Black (61%, n=20), multiparous (55%, n=18), living with the father of the baby (36%, n=12), and gave birth via Cesarean section (70%, n=23). Interview analyses yielded three core constructs: maternal psychosocial experiences, maternal cognitive experiences, and infant health. We hypothesized that these core constructs impact maternal breastmilk provision through the mediating factor of maternal health. The psychosocial construct encompasses relationships, responsibilities, resources, bonding, and control. The construct of cognition was categorized into knowledge level and initial breastfeeding intentions. Individual theme co-occurrence, chronological distribution of thematic influence, and general conclusions are pending, as they will be derived from code co-occurrence findings and a chronological understanding of the themes. Limitations include the use of a single hospital site for data collection and the hospital’s high level of support for lactating mothers. Future research should explore prominent themes that emerge from this study and their chronological impact on MOM provision. Nurses should implement evidence-based interventions related to these themes to support breastfeeding mothers of EP VLBW infants.


This research was supported by Medela and Rush University Golden Lamp and the Marion R. Van Dyke Clark Nursing Summer Research Fund.

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