"It's Somebody Else's Milk": Unraveling the Tension in Mothers of Preterm Infants Who Provide Consent for Pasteurized Donor Human Milk.
"It's Somebody Else's Milk": Unraveling the Tension in Mothers of Preterm Infants Who Provide Consent for Pasteurized Donor Human Milk.
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DOI：
10.1177/0890334415617939
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发表时间：
2016-02
期刊：
影响因子：
--
通讯作者：
Patel A
中科院分区：
文献类型：
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作者：
Esquerra-Zwiers A;Rossman B;Meier P;Engstrom J;Janes J;Patel A
巴氏灭菌的供体母乳（DHM），而不是早产儿配方奶粉，建议早产儿当母亲的牛奶不可用。本研究探讨了产妇的决策过程中提供同意DHM喂养。在这项定性、描述性研究中，对20名早产儿（平均胎龄= 27周，出生体重= 942克）的母亲进行了深入的半结构化访谈。传统的内容分析被用来分析数据。虽然只有1位母亲以前对DHM有任何了解，但所有母亲都同意DHM，因为她们“希望对我的宝宝最好”。当婴儿的喂养需求超过自己的牛奶供应量时，母亲们相信DHM比配方奶粉更好。然而，大多数母亲描述了一种紧张关系，他们希望自己的婴儿只接受“自己的”乳汁，而DHM是“别人的乳汁”。这种成为唯一母乳供应商的愿望比对DHM质量和安全性的担忧更为普遍。母亲的紧张情绪通过信任NICU临床医生的建议，有足够的时间做出明智的决定，观察DHM的积极结果，并感到自己为婴儿做出了最好的决定。这些母亲的经历反映了只有在需要DHM时才与母亲取得同意的重要性，尊重母亲对DHM的信仰和价值观，并提供帮助，调解婴儿接受“别人的牛奶”的任何紧张关系。
Pasteurized donor human milk (DHM), rather than preterm infant formula, is recommended for premature infants when mother’s milk is not available. This study explored the maternal decision-making process in providing consent for DHM feedings. In-depth semistructured interviews were conducted with 20 mothers of premature (mean gestational age = 27 weeks, birth weight = 942 grams) infants hospitalized in the neonatal intensive care unit (NICU) in this qualitative, descriptive study. Conventional content analysis was used to analyze the data. Although only 1 mother had any previous knowledge of DHM, all mothers provided consent for DHM because they “wanted what is best for my baby.” Mothers trusted that DHM was better than formula when their infant’s feeding requirements exceeded their own milk supply. However, most mothers described a tension between wanting their infants to receive only “their” milk and DHM being “somebody else’s milk.” This desire to be the only provider of human milk was more common than concerns about the quality and safety of DHM. The mothers’ tension was mediated by trusting the NICU clinicians’ recommendations, having adequate time to make an informed decision, observing the positive outcomes of DHM, and feeling empowered that they made the best decision for their infant. The experiences of these mothers reflect the importance of approaching mothers for consent only when DHM is needed, respecting mothers’ beliefs and values about DHM, and providing help in mediating any tension with regard to their infants receiving “somebody else’s milk.”