Title Zastupljenost i razlozi primjene adaptiranog mliječnog pripravka u rodilištu u zdrave donesene novorođenčadi
Title (english) Prevalence and reasons for use of commercial milk formula in the maternity hospital among healthy, term newborn infants
Author Ana Vidović Roguljić https://orcid.org/0000-0003-4720-8178
Mentor Irena Zakarija-Grković (mentor)
Committee member Joško Markić (predsjednik povjerenstva)
Committee member Anet Papazovska Cherepnalkovski (član povjerenstva)
Committee member Jelena Marušić (član povjerenstva)
Granter University of Split School of Medicine Split
Defense date and country 2024-07-30, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pediatrics
Universal decimal classification (UDC ) 61 - Medical sciences
Abstract Uvod: Praksa hranjenja novorođenčadi u rodilištu značajno utječe na kasnije ishode dojenja; poznavanje prediktora i razloga zbog kojih majke traže primjenu adaptiranog mliječnog pripravka u svoje zdrave novorođenčadi može pomoći u poboljšanju stopa dojenja. Metode: Na Klinici za ženske bolesti i porode u Kliničkom bolničkom centru Split, od 1. lipnja do 21. listopada 2020. provedena je presječna studija među ženama koje su rodile zdravu novorođenčad gestacijske dobi ≥ 37 tjedana i porođajne mase ≥ 2500 g. Majke su ispunile upitnik o praksi hranjenja novorođenčadi u rodilištu i ljestvicu samoučinkovitosti dojenja. Multinominalnom logističkom regresijom analizirana je povezanost perinatalnih čimbenika s primjenom adaptiranog mliječnog pripravka. Između svibnja i lipnja 2021. organizirane su četiri fokus-skupine s ukupno 25 žena koje su u presječnoj studiji tražile primjenu adaptiranog mliječnog pripravka za svoje novorođenče. Za vođenje razgovora s majkama korišten je polustrukturirani vodič s 15 otvorenih pitanja. Primijenjena je refleksivna tematska analiza. Rezultati: U presječnoj studiji pristupile su 392 majke, od kojih je 355 (90,6 %) uključeno: 286 (80,6 %) je reklo da je njihovo novorođenče primilo adaptirani mliječni pripravak u rodilištu, te su one to tražile u 173/286 (60,5 %) slučajeva. Najjači prediktori koji utječu na primjenu adaptiranog mliječnog pripravka su nedostatak prethodnog iskustva s dojenjem (OR 9,42, 95 % CI 3,51 – 25,28), poteškoće s dojenjem u rodilištu (OR 9,12, 95 % CI 3,46 – 24,09) i starija djeca koja su primila adaptirani mliječni pripravak u rodilištu (OR 11,51, 95 % CI 4,4 – 30,1). U kvalitativnoj studiji generirane su tri teme. Prva tema „strah od gladi“ odnosila se na strahove majki koji proizlaze iz poteškoća u tumačenju ponašanja novorođenčadi i pronalaska utjehe u primjeni adaptiranog mliječnog pripravka. Druga tema „nedostatna – prekasna“ podrška odražavala je neostvarena očekivanja majki za zdravstvene djelatnice. Treća tema „obeshrabrujuća komunikacija“ odnosila se na potrebu majki za empatijom tijekom boravka u rodilištu. Zaključak: Neprihvatljivo visok udio zdrave novorođenčadi je primio adaptirani mliječni pripravak u rodilištu. Iako su majke željele dojiti, često su se osjećale nedovoljno podržane za vrijeme boravka u rodilištu. Kao načine smanjenja potrebe za primjenom adaptiranog mliječnog pripravka za svoju zdravu novorođenčad majke su predložile prenatalno obrazovanje trudnica i osposobljavanje osoblja rodilišta za savjetovanje o dojenju, sa snažnim naglaskom na komunikacijske vještine, kao i zapošljavanje međunarodno certificiranih savjetnica za dojenje i/ili dobrovoljnih savjetnica za dojenje.
Abstract (english) Background: In-hospital feeding practices significantly affect later breastfeeding outcomes; knowledge of predictors and reasons why mothers request in- hospital formula supplementation may help improve breastfeeding rates. Methods: At the University Hospital of Split's Department of Gynecology and Obstetrics, cross-sectional research was carried out from June 1 to October 21, 2020, among women who gave birth to healthy newborn infants weighing at least 2,500 grams at delivery and gestational age of 37 weeks or more. A breastfeeding self-efficacy and hospital infant feeding habits evaluation was given to mothers to complete. We looked the relationships between perinatal variables and formula supplementation using multinomial logistic regression. We had four focus groups with 25 mothers who had taken part in the cross-sectional survey and had looked for formula for their infants between May and June of 2021. Fifteen open-ended questions made up the semi-structured interview program. Thematic analysis that was reflexive was used. Results: We recruited 392 moms for the cross-sectional study, and 355 (90.6%) of them were included. Of those, 286 (80.6%) reported that their newborn got formula in the hospital, and in 173/286 (60.5%) of the cases, it was done at their request. The strongest predictors for formula supplementation were: having older children who were given formula in the birth hospital (OR 11.51, 95% CI 4.4–30.1), breastfeeding difficulties in the hospital (OR 9.12, 95% CI 3.46–24.09), and no prior experience breastfeeding (OR 9.42, 95% CI 3.51–25.28). Three topics emerged from the qualitative analysis. 'Fear of Hunger' was the first topic. This was a reference to the worries that mothers had when they could not figure out how their newborns behaved and turned to commercial milk formula for comfort. The subsequent topic, "too little support–too late," represented the participants' unfulfilled expectations of medical personnel. The need for empathy among moms throughout their hospital stay after giving birth is portrayed in the fourth topic, "non-supportive communication." Conclusion: In summary, an excessively high percentage of healthy newborns were given formula in hospitals. Although they want to breastfeed, Croatian mothers feel unsupported in the hospital setting where they give birth. Participants saw employment of International Board Certified Lactation Consultants and/or volunteer breastfeeding counsellors, as well as prenatal education of women and training of hospital maternity staff in breastfeeding counseling, as a means of preventing mothers' dependence on formula for their healthy, newborn infants.
Keywords
adaptirani mliječni pripravak
novorođenčad
majke
rodilišta
Keywords (english)
Infant Formula
Newborn Infant
Mothers
Maternity Hospitals
Language croatian
URN:NBN urn:nbn:hr:171:201701
Study programme Title: Translational Research in Biomedicine - TRIBE Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, interdisciplinarna područja znanosti (doktor/doktorica znanosti, interdisciplinarna područja znanosti)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2024-10-31 09:30:09