Mothers’ experience of feeding their preterm infant during the first months of life within a vulnerable population in South Africa

Date
2021-03
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY : Background: Preterm birth is a rising and significant threat to maternal and child health globally. Being the mother of a preterm infant is universally described as a challenging and stressful experience. Mothers of preterm infants with low socio-economic status and from linguistic minority groups, such as poor Afrikaans speaking mothers, face additional challenges that may influence their experience of caring for their preterm infant, namely poverty and limited linguistic and cultural representation within the health constitution. The universal challenges of being a mother of a preterm infant, combined with the more specific challenges of living in poverty and experiencing poor linguistic and cultural representation, bring about risks for both mother and infant. This includes poor maternal mental health; poor mother-infant bonding and attachment; and potential suboptimal developmental outcomes for the child. Research aims: The main aim was to describe and explain how Afrikaans-speaking mothers, living in low socio-economic circumstances in the Western Cape, experienced caring for their preterm infant in the first months of life. The outcomes may facilitate better understanding of the early communication and feeding intervention needs of mothers of at-risk neonates from culturally and linguistically diverse contexts living in poverty. Method: The study entailed a cross-sectional, qualitative design which was exploratory and descriptive in nature. Eleven participants, selected through a purposive sampling method, participated in individual in-depth interviews where a semi-structured discussion schedule was implemented. Nine interviews were then thematically analysed. Participants were Afrikaans-speaking mothers with low socio-economic status who brought their preterm infant (chronological age range of three to six months) for a follow-up appointment at a High-risk Clinic at a public tertiary hospital in Cape Town. The participants were a vulnerable group about whom little information was available in the research literature. Findings: The task of feeding their preterm infant during the hospitalisation period was a significant experience for the participants. Feeding was perceived as a progressive task that is goal-driven and continuously demands a new method of feeding, higher volumes of milk, and increased weight gain in the infant to reach the eventual goal of discharge from hospital. This task was perceived as stressful due to various factors of which insufficient breastmilk supply was a significant contributor. Furthermore, the hospital setting was perceived as something that added to their anxiety surrounding feeding, but simultaneously had the potential to decrease their anxiety. The mothers felt that over time and with experience both they and their infants gradually became more comfortable and skilled in the task of feeding. When the mother-infant dyad was able to breastfeed successfully it was described as an ‘amazing experience’ and one that made the participants feel like mothers at last. Conclusion: The participants experienced feeding as one of the most significant stressors related to caring for their infant, especially in the first months of life while the infant was hospitalised. Various factors were identified that had positive and/or negative influences on this experience. The study findings have implications with regard to future research, as well as education and clinical practice for all healthcare professionals working with preterm mother-infant dyads from culturally and linguistically diverse contexts living in poverty.
AFRIKAANSE OPSOMMING : Agtergrond: Premature geboorte is ‘n stygende en beduidende bedreiging vir moeder- en kindergesondheid wêreldwyd. Om die moeder van ‘n premature baba te wees, word universeel as ‘n uitdagende en stresvolle ervaring beskryf. Moeders van premature babas met lae sosio-ekonomiese status en wat behoort aan linguistiese minderheidsgroepe, soos arm Afrikaanssprekende moeders, ervaar bykomstige uitdagings wat hul ervaring van sorggewing vir hul premature baba kan beïnvloed, naamlik armoede en beperkte kulturele en linguistiese verteenwoordiging in die gesondheidstelsel. Die universele uitdagings verbonde daaraan om die moeder van ‘n premature baba te wees, tesame met die meer spesifieke uitdagings van in armoede te lewe en beperkte linguistiese en kulturele verteenwoordiging te ervaar, lei tot risiko’s vir beide moeder en kind. Dit sluit in swak moederlike geestesgesondheid; swak moeder-baba binding en gehegtheid; en potensiële suboptimale ontwikkelingsuitkomstes vir die kind. Navorsingsdoelstellings: Die oorkoepelende doelstelling was om te verken en beskryf hoe Afrikaanssprekende moeders wat in lae sosio-ekonomiese omstandighede in die Wes-Kaap lewe, dit ervaar het om vir hulle premature baba in die eerste maande van lewe te sorg. Die bevindings kan bydra tot ‘n beter begrip van die behoeftes van arm moeders van babas met moontlike risiko faktore vanuit kultureel en linguisties diverse populasies, aangaande die vroeë kommunikasie- en voeding intervensie. Metode: Die studie het gebruik gemaak van ‘n dwarssnit, kwalitatiewe ontwerp wat verkennend en beskrywend van aard is. Elf deelnemers is deur ‘n doelgerigte steekproefnemingmetode geselekteer, en het aan individuele en in-diepte onderhoude deelgeneem deur middel van ‘n semi-gestruktureerde besprekingsskedule. Nege van die onderhoude is tematies ontleed. Die deelnemers is Afrikaanssprekende moeders met lae sosio-ekonomiese status, wat hulle premature baba na ‘n opvolgafspraak by ‘n Hoë-risiko Kliniek by ‘n openbare tersiêre hospitaal in Kaapstad gebring het. Die deelnemers is ‘n kwesbare groep oor wie beperkte navorsingsliteratuur beskikbaar is. Bevindinge: Om ‘n premature baba tydens die hospitaliseringstydperk te voed, is ‘n prominente evaring vir die deelnemers. Voeding is ervaar as ‘n progessiewe taak wat doelgedrewe is en voortdurend ‘n nuwe voedingsmetode, hoër volumes melk en verhoogde gewigstoename by die baba vereis om die uiteindelike doel van ontslag uit die hospitaal te bereik. Die taak is as stresvol ervaar weens verskeie faktore waarvan onvoldoende borsmelkvoorsiening ‘n beduidende bydraer is. Verder is die hospitaalopset ervaar as iets wat bydra tot hul angs aangaande voeding, maar terselfdetyd die potensiaal gehad het om hul angs te verminder. Die moeders het gevoel dat hulle self en die baba met verloop van tyd en toenemende ervaring geleidelik meer gemaklik en geskool geraak het in die taak van voeding. Wanneer die moeder-baba tweetal in staat was tot suksesvolle borsvoeding, is dit beskryf as ‘n wonderlike ervaring en een wat die deelnemers uiteindelik soos moeders laat voel het. Slotsom: Die deelnemers het voeding ervaar as een van die mees beduidende stressors wat met die sorggewing van hul baba verband hou, veral in die eerste lewensmaande terwyl die baba gehospitaliseer is. Verskeie faktore is geïdentifiseer wat ‘n positiewe en/of negatiewe invloed op die ervaring gehad het. Die navorsingsresultate het implikasies vir toekomstige navorsing, asook die opleiding en kliniese praktykvoering van alle persone in gesondheidsberoepe wat diens lewer aan moeders met premature babas uit kultureel en linguisties diverse populasies wat in armoede lewe.
Description
Thesis (MSL&HT)--Stellenbosch University, 2021.
Keywords
Premature infants -- Nutrition -- Western Cape (South Africa), Mother and infant -- Health aspects -- Western Cape (South Africa), Mother and infant -- Economic aspects -- Western Cape (South Africa), Afrikaners -- Western Cape (South Africa), UCTD
Citation