This issue of The Journal of Perinatal & Neonatal Nursing is dedicated to the topic of breast-feeding. National goals and objectives have been established to increase the proportion of breast-feeding rates to 75% in the early postpartum period and the proportion of continued breast-feeding rates to be 50% at 6 months, and 25% at 12 months.1-3 The perinatal section provides hospital and community-based nurses information on strategies to promote and sustain breast-feeding.
Hospital and community-based nurses are instrumental in assisting new mothers with breast-feeding. In this issue, Walker discusses the importance of providing new mothers with consistent information and breast-feeding strategies to promote a successful experience during the first 48 hours after birth. Nurses need to be knowledgeable in helping new mothers with different breast-feeding positions, assessing-assisting with latch-on, and evaluating nutritive sucking and swallowing of the newborn(s) prior to discharge.
Inadequate or interrupted sleep patterns are not uncommon to new parents. Doan and colleagues examined newborn feeding patterns and sleep patterns of new parents 3 months after the birth of their first child. Participants kept a newborn feeding diary and wore a wrist actigraph to measure sleep and wake times. The authors provide new findings on supplementing breast-feeding with formula.
To meet national goals to increase breast-feeding rates, nurse researchers are evaluating attitudes, values, and beliefs on breast-feeding. Kingston and coauthors discuss the impact efficacy-enhancing experiences have on breast-feeding self-efficacy in mothers at 48 hours and again at 4 weeks postpartum. Breast-feeding self-efficacy was affected by vicarious experiences, verbal persuasion, and physiological influences. Gill and colleagues present their study on a revised Breast-feeding Attrition Prediction Tool (BAPT), which was translated into Spanish and administered antepartally to Mexican American women. The study provides factors related to the intent to breastfeed and continuation of breast-feeding.
Camune and Gabzdyl discuss the impact breast cancer has on pregnancy and lactation in childbearing women. The authors include an overview of breast cancer epidemiology, detection, treatment modalities, and the implications related to nursing care. This article provides nurses with a better understanding of the journey childbearing women encounter following the diagnosis of breast cancer and the role of the nurses in providing supportive care.
The neonatal topics for this breast-feeding issue emphasize the importance of neonatal nurses being actively engaged in evidence-based practice with neonates and their mothers and families in relation to breast-feeding as well as the significant contributions of nurse researchers to this topic. Human milk is vitally important for preterm and term infants and breast-feeding is universally recommended as superior for the first year of life compared to formula feeding.
Hurst provides a framework for approaching breast-feeding of preterm infants in the neonatal intensive care unit (NICU). Her conceptualization includes a 3-phase process that she calls the 3 M's of breast-feeding: medication, mother's milk feedings, and the mechanics of breast-feeding. These phases take into consideration the early trophic (medicine-like) feedings, the focus on adequate energy and mineral intake with mother's milk, and the later mechanics of breast-feeding as the infant matures and oral feeding is initiated.
Zukowsky's study of healthy preterm infants examines nutritional intake and developmental assessment through 6 months'corrected age. Developmental screening showed a significant difference between infants who received even some breast milk during those months that should further encourage neonatal nurses to reinforce the value of human milk and breast-feeding in the NICU.
Hill's research on healthy term infants focuses on predictors of infant feeding at 12 weeks postpartum and the need to identify and assist mothers with perceived inadequate milk supply. She identified supple-mentation with formula at week 6, inadequate milk supply at week 6, and frequency of breast stimulation less than 7.8 times daily at week 6 as predictors of feeding type by week 12.
Lessen and Crivelli-Kovach present their descriptive study on maternal, infant, and outside influences associated with the intention, initiation, and duration of breast-feeding for mothers of infants admitted to the NICU. Breast-feeding duration was significantly associated with education, marital status, ethnicity, income, assistance from nurses and lactation consultants, and feeding method along with milk type and milk volume at discharge.
Barbara J. Sittner, PhD, RN
Perinatal Editor
Susan Bakewell-Sachs, PhD, RN, APRN, BC
Neonatal Editor
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