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A Typology of Breastfeeding Mothers of Preterm Infants

A Qualitative Analysis

Niela-Vilén, Hannakaisa, PhD, RM; Axelin, Anna, PhD, RN; Salanterä, Sanna, PhD, RN; Melender, Hanna-Leena, PhD, RM

Section Editor(s): Dowling, Donna PhD, RN; ; Thibeau, Shelley PhD, RNC-NIC;

doi: 10.1097/ANC.0000000000000542
Oral Feeding Strategies: Special Series

Background: Breastfeeding is an important element of motherhood with a preterm infant, but the role of maternal emotions in relation to breastfeeding is vague.

Purpose: To describe maternal emotions regarding and insights into breastfeeding during the first year after a preterm birth.

Methods: In 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.

Findings: A 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.

Implications for Practice: Being 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.

Implications for Research: The possibilities to tailor breastfeeding interventions based on the typology should be investigated.

Department of Nursing Science, University of Turku, Turku, Finland (Drs Niela-Vilén, Axelin, and Salanterä); Turku University Hospital, Turku, Finland (Dr Salanterä); Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland (Dr Melender); and VAMK University of Applied Sciences, Vaasa, Finland (Dr Melender).

Correspondence: Hannakaisa Niela-Vilén, PhD, RM, Department of Nursing Science, University of Turku, Hannakaisa Niela-Vilén, FIN-20014 Turku, Finland (

Name of the institution where the work occurred: Department of Nursing Science, University of Turku, Turku Finland

The authors declare no conflicts of interests.

© 2019 by The National Association of Neonatal Nurses