Date Presented 04/03/2025
Breastfeeding in the neonatal intensive care unit (NICU) presents a unique challenge to mothers of sick or preterm infants. This scoping review investigates the programs and interventions used to support mothers of infants in the NICU with breastfeeding.
Primary Author and Speaker: Marissa Fogg
Contributing Authors: Katarina M. Garibian, Jewel Elias Crasta
PURPOSE: The NICU is a unique environment that provides challenges to breastfeeding. This review investigated the programs and interventions used to support mothers of infants in the NICU with breastfeeding.
DESIGN: A scoping review following PRISMA-ScR guidelines was conducted in July 2024. Articles were included in the review if they were published between the years of 2004-2024, written in English, included mothers of preterm infants in the NICU, and analyzed the effects of a breastfeeding support method.
METHODS: Data regarding objectives, rating, design, participant characteristics, intervention, outcome measures, active ingredients, results, and interpretations was extracted. Critical appraisals were completed using Cincinnati Children’s LEGEND appraisal tool. Descriptive analyses were used to synthesize main findings, such as intervention themes and sub-themes, study characteristics and design, results, and outcome measures.
RESULTS: A total of 4,458 articles were screened and 13 studies were included in the review. Three intervention themes emerged: peer support (n=3), education (n=9), and non-traditional interventions (n=4). Peer support was provided in person or virtually. Education interventions included virtual or in-person maternal education, education with telephone support, and staff education. Non-traditional interventions included mindfulness training, auriculotherapy, progressive muscle relaxation, and stress inoculation training. Outcomes included breastfeeding self-efficacy and knowledge, and perceived stress and anxiety.
DISCUSSION: Results provide novel synthesis on comprehensive supports within occupational therapy’s scope of practice. Overall, the use of additional breastfeeding support in the hospital has positive effects on breastfeeding-related outcomes. Occupational therapists should address both parts of the breastfeeding dyad and facilitate breastfeeding support for mothers of their patients to optimize breastfeeding success.
References
Zhang, J., Li, Y., Zhu, L., Shang, Y., & Yan, Q. (2024). The effectiveness of online breastfeeding education and support program on mothers of preterm infants: A quasi-experimental study. Midwifery, 130, 103924. https://doi.org/10.1016/j.midw.2024.103924
Khoramirad, A., Taheri, L., Eskandari, N., & Abedini, Z. (2024). Effect of mindfulness-based neurodevelopmental care on infant outcomes in NICU. Journal of Neonatal Nursing, 30(3), 237–242. https://doi.org/10.1016/j.jnn.2023.10.001
Héon, M., Goulet, C., Garofalo, C., Nuyt, A. M., & Levy, E. (2016). An Intervention to Promote Breast Milk Production in Mothers of Preterm Infants. Western Journal of Nursing Research, 38(5), 529–552. https://doi.org/10.1177/0193945914557501
Abugov, H., Marín, S. C. O., Semenic, S., & Arroyave, I. C. (2021). Barriers and facilitators to breastfeeding support practices in a neonatal intensive care unit in Colombia. Investigación y Educación En Enfermería, 39(1), Article 1. https://doi.org/10.17533/udea.iee.v39n1e11
