Journal of Perinatal & Neonatal Nursing最新文献

Purpose: The objective of the present research is to develop the "Postpartum Breastfeeding Comfort Scale" and evaluate its psychometric properties.

Background: It is thought that to increase breastfeeding success and ensure the continuity of effective breastfeeding, mothers' breastfeeding problems should be assessed holistically, physical, psychospiritual, sociocultural, and environmental factors that may cause deterioration in comfort should be determined, and a comfort-oriented nursing support can be provided accordingly.

Methods: The present research was conducted using a methodological cross-sectional design. Reporting was guided by the STROBE checklist: Strengthening the Reporting of Observational Studies in Epidemiology statement. The "Postpartum Breastfeeding Comfort Scale" was developed in 4 steps: (1) creating an item pool; (2) testing the scale's content validity, criterion-related validity, and reliability; (3) performing exploratory factor analysis (EFA); and (4) performing confirmatory factor analysis (CFA).

Results: The content validity index was satisfactory. Three factors were included, and 58.38% of the total variance in the scale was explained by the 15 items. Confirmatory factor analysis supported the 3-factor structure. Cronbach's alpha coefficient was found to be 0.80 for the entire scale. Test-retest reliability was 0.95.

Conclusion and implications: The Postpartum Breastfeeding Comfort Scale has good test-retest reliability, internal consistency reliability, content validity, construct validity, and criterion-related validity. We predict that the Postpartum Breastfeeding Comfort Scale will be a useful tool for assessing mothers' breastfeeding comfort by nurses.

Purpose: This study aimed to examine the relationship between attitudes toward sexuality during pregnancy and sexual quality of life.

Methods: This descriptive and correlational study included 433 pregnant women who either visited the non-stress test unit of a public hospital between October 2021 and March 2022 or participated online via Google Forms, email, and WhatsApp between June and July 2022. Data were collected using 3 tools: the Pregnant Women's Introductory Information Form, the Sexual Quality of Life-Female Scale, and the Attitude Toward Sexuality During Pregnancy Scale.

Results: Multiple linear regression analysis revealed that employment status, income level, receiving information about sexual life during pregnancy, satisfaction with sexual life before pregnancy, and satisfaction with sexual life during pregnancy significantly influenced sexual quality of life scores.

Conclusions: Pregnant women who hold positive beliefs and values about sexuality during pregnancy, experience less anxiety related to sexual activity, and who approve of sexuality during pregnancy tend to have higher sexual quality of life.

Implications for practice and research: Understanding the perceptions and concerns that contribute to negative attitudes toward sexuality during pregnancy, and providing individualized, evidence-based counseling can support the sexual well-being of pregnant women and their partners.

Purpose: This pilot study investigated the effects of an mHealth-based post-neonatal intensive care unit (NICU) discharge intervention on parenting self-efficacy and attachment among parents of preterm infants and explored its potential for wider implementation.

Methods: This study employed a nonequivalent control group pretest and posttest design at a Level IV regional NICU referral center in South Korea. Forty parents of preterm infants were recruited and equally divided into the experimental and control groups. The final analysis included data from 15 parents per group. The experimental group received a 1-week intervention via Todak-Todak, a mobile app providing educational content, developmental play activities, diary function, and interactive communication with NICU nurses. Descriptive statistics, chi-square tests, and paired t-tests were used for data analysis.

Results: Parenting self-efficacy significantly improved in the experimental group (t = 3.86, P = .002), whereas the control group showed no change (t = 0.98, P = .343). Although attachment scores increased in the experimental group, they were statistically insignificant (t = 1.98, P = .068), whereas the control group showed no change (t = 0.00, P > .999).

Conclusion: Therefore, mHealth-based interventions were effective for fostering parenting self-efficacy among parents of preterm infants. The positive trend observed in parent-infant attachment suggests the need for long-term interventions to verify their impact.

Clinical implications: mHealth-based interventions offer practical, accessible, and cost-effective support to parents after NICU discharge. Replication with larger samples and longer durations is warranted to validate its effectiveness and guide integration into structured parental education.

Purpose: This study aimed to evaluate the effect of machine learning (ML)-based breastfeeding training (MLBT) on breastfeeding knowledge and continuation among mothers at risk of early cessation, identified by an ML model.

Design and methods: This quasi-experimental study, conducted in 2 phases using a pre-posttest design, included 90 mothers (45 intervention, 45 control). In Phase 1, an ML was developed to identify mothers at risk of early breastfeeding cessation. In Phase 2, MLBT training and data collection tools were developed based on risk profiles and delivered to the intervention group. Data were analyzed using chi-square tests, t-tests, and repeated-measures ANOVA.

Results: The intervention group showed significant improvements in breastfeeding knowledge across all 4 MLBT modules (P < .01) and in total knowledge scores (P < .001). At 2 and 4 months postpartum, full and partial breastfeeding rates were significantly higher in the intervention group than in the control group (P < .005).

Conclusion: The MLBT provided to mothers identified by the ML model effectively enhances breastfeeding knowledge and supports its continuation. Integrating ML into nursing practice can improve health care quality through more efficient and personalized solutions.

Practice implications: In a rapidly changing global context, innovative and evidence-based approaches are essential for breastfeeding support. This study offers guidance for developing and improving programs that promote sustained breastfeeding, contributing to maternal and infant health.

Objectives: To investigate the metabolic and immunologic impacts of transitioning from standard to improved parenteral nutrition in premature low birth-weight (PLBW) infants, and to provide evidence for optimized clinical nutrition support strategies.

Methods: From October 2022 to October 2024, 120 PLBW infants were included and split into 2 groups of 60 each: 1 receiving intravenous nutrition support (study group) and the other traditional nutrition support (control group). The study group received individualized intravenous nutrition within 24 hours after birth, containing nutrients such as glucose, amino acids, ω-3 fish oil medium/long-chain fat emulsions, vitamins, and minerals. The control group received enteral feeding combined with delayed intravenous nutrition. This study conducted a comprehensive assessment of the 2 groups of PLBW infants, with observation indicators covering the following aspects: growth and development indicators, bone metabolism indicators, growth regulatory factors, nutritional indicators, immune indicators, and nutrition-related complications.

Results: After the intervention, the study group showed significant improvements in body weight, head circumference, length growth rate, and bone metabolism indicators (25(OH)D 3 , Ca 2 ⁺, P, ALP) compared to the control group ( P < .05). The levels of growth regulatory factors (leptin, insulin-like growth factor-1, and growth hormone) and nutritional indicators (albumin, globulin, and prealbumin) were significantly increased in the study group, with more pronounced improvements in immune cells (CD3⁺ T, CD4⁺ T cells, and CD4⁺/CD8⁺ ratio) ( P < .05). In addition, the incidence of complications in the study group (6.67%) was significantly lower than that in the control group (30%), with a statistically significant difference (χ 2  = 4.537, P = .033).

Conclusion: Our findings demonstrate significant improvements in metabolic and immunologic outcomes when transitioning from standard to improved parenteral nutrition.

Purpose: This review critically evaluates the microbial risks, transmission routes, and cultural context of using expressed human milk as a topical remedy for neonatal eye conditions, and to reconcile its traditional use with current evidence-based neonatal care.

Background: Breastfeeding is essential for neonatal nutrition, promoting growth and immune protection. In some cultures, expressed human milk is used as a remedy for neonatal eye issues like redness and infections, due to its perceived antimicrobial properties. However, recent microbiological evidence reveals that milk can also harbor and transmit ocular pathogens.

Discussion: This review examines the microbial profile of human milk, encompassing beneficial commensals. Immunoglobulin-rich human milk contains antimicrobial peptides and oligosaccharides that contribute to neonatal immune defense. Still, it may also harbor potential contaminants such as Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. This article explores the potential transmission pathways of microorganisms through human milk, including maternal skin and nipple colonization, retrograde contamination during expression, and inadequate storage or handling. It highlights the microbial diversity of human milk and examines evidence of its role in neonatal eye infections.

Implications for research and practice: This paper highlights the interplay between traditional practices and evidence-based neonatal care, advocating culturally sensitive messaging that promotes breastfeeding proven benefits while discouraging unverified ocular use to safeguard infant eye health.

Purpose: To assess whether adding 5 minutes of slower, nutritive suction cycles to a standard 15-minute breast pump initiation program increases expressed milk volume during the first 4 days postpartum.

Background: Early and effective colostrum removal is critical for breastfeeding success and neonatal health. Standard initiation suction patterns are primarily non-nutritive and may be suboptimal for colostrum extraction.

Methods: This prospective pilot study was conducted at OLVG hospital in the Netherlands. Breastfeeding patients (n = 40) who gave birth after 36 weeks gestation with an infant aged ≤96-hour old and a clinical indication to express milk with a breast pump were recruited. Patients participated in one single 20-minute breast expression session using a hospital-grade electric breast pump with a 15 minute predominantly non-nutritive standard suction pattern followed by 5 minutes with a nutritive suction pattern. The primary outcome was the difference in the total expression volume after 20 min compared to 15 min of expression. Secondary outcomes were differences in expression volume by postpartum day, parity, mode of birth, and prior experience breastfeeding.

Results: The study found that the primary outcome total colostrum/milk expression volume after 20 minutes was significantly improved compared to 15 minutes of pumping (4.69 ml vs 7.6 ml, P < .001). With the additional 5 minutes yielding 36% of the total milk yield.

Conclusions: This study suggests an improvement in milk expression volume driven by the implementation of 5 minutes of additional of nutritive breast pump suction cycles.

Implications for practice and research: This pilot study contributes to novel insights into milk removal dynamics in the first days after birth.

Trial registration: Registered on clinical trials.gov NCT04619212. Date of registration: November 6, 2020.

Objective: To investigate the effect of Infant-Driven Feeding (IDF) on feeding outcomes and growth among preterm infants with a gestational age of 32 to 37 weeks at birth in the neonatal intensive care unit (NICU).

Methods: An interventional study was conducted to evaluate the effectiveness of an IDF protocol compared to a standard feeding regimen. The control group (N = 88) received the standard feeding protocol, while the experimental group (N = 92) received the IDF protocol. Data were collected between January 1 and December 31, 2022.

Results: The experimental group exhibited a higher average oral milk intake per minute than the control group (t = -7.762, P < .001). Additionally, the experimental group achieved full oral feeding in a significantly shorter time (t = 4.434, P < .001) compared to the control group. The experimental group also had a shorter nasogastric tube indwelling time (t = 4.372, P < .001) and length of hospital stay (t = 3.682, P < .001) compared to the control group. During the first week of life, the experimental group showed no significant differences in length (t = -1.475, P = .142), head circumference (t = -0.410, P = .683); however, weight gain on the 7th day was greater in the experimental group (t = -2.260, P = .025) when compared to the control group. The experimental group had a significantly lower incidence of vomiting (χ2 = 5.327, P = .021), oxygen desaturations (χ2 = 5.715, P = .017), and milk choking (χ2 = 6.105, P = .013) as compared to control group. There were no significant differences in the incidence of necrotizing enterocolitis (NEC) between the 2 groups (χ2 = -1.071, P = .284).

Conclusion: The implementation of IDF protocol in preterm infants with a gestational age of 32 to 37 weeks at birth in the NICU improved feeding outcomes, expedited the feeding process, and reduced complications associated with poor feeding. Moreover, it did not adversely affect the growth and development of these infants and enhanced their feeding safety.