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Emotional journey of Asian mothers of premature infants who received pasteurised donor human milk: a qualitative study
  1. Hui Fang Loh1,
  2. Jiayu Rachel Lee2,
  3. Andrea Ruwen Tan3,
  4. Xin Lei Goh4,
  5. Yi Fen Low4,
  6. Yvonne Peng Mei Ng3,5,
  7. Shefaly Shorey6
  1. 1 Department of Nursing, National University Hospital, Singapore
  2. 2 Department of Obstetrics and Gynaecology, National University Hospital, Singapore
  3. 3 Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, Singapore
  4. 4 Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  5. 5 Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  6. 6 Alice Lee Center for Nursing Studies, National University of Singapore, Singapore
  1. Correspondence to Dr Yvonne Peng Mei Ng, Neonatology, National University Hospital,1E Kent Ridge Road, NUHS Tower Block Level 12, Singapore 119228, Singapore; paeynpm{at}nus.edu.sg

Abstract

Objective To explore the effect of donor human milk usage on the emotional experience of mothers with premature infants in a multiracial Asian population.

Design A qualitative descriptive study. Semistructured individual interviews were audio-recorded, transcribed and analysed using Braun and Clarke’s process of thematic analysis.

Setting and patients Seventeen mothers whose premature infants received donor human milk in a level III neonatal intensive care unit.

Main outcome measures Perceptions of mothers whose premature infants received donor human milk.

Results Mothers described their experience as a journey of acceptance with three sequential themes. ‘Resistance to receiving somebody else’s milk’ was a process of overcoming initial hesitation and concerns. ‘Recognising maternal limitations and baby’s needs’ depicted the mothers’ struggles in reconciling their infant’s milk demand and their low milk supply. ‘Embracing benefits of donor human milk and acceptance with gratitude’ illustrated the mothers’ joy and gratitude to milk donors as they embraced benefits of donor human milk usage. Although participants had agreed to use of donor human milk after counselling, many still struggled with negative emotions of anxiety and guilt. Mothers of Muslim faith had additional concerns about milk kinship and religious permissibility of donor human milk.

Conclusion Mothers undergo a spectrum of complex emotions from initial hesitation to acceptance with gratitude, when their premature infants receive donor human milk. Some continue to struggle with negative emotions and require more support. By recognising their emotional responses, healthcare providers can support mothers in their breastfeeding journey with targeted counselling.

  • Neonatology
  • Paediatrics
  • Paediatric Emergency Medicine

Data availability statement

Data are available upon reasonable request. Deidentified interview transcripts can be obtained from the corresponding author upon reasonable request.

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Data availability statement

Data are available upon reasonable request. Deidentified interview transcripts can be obtained from the corresponding author upon reasonable request.

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Footnotes

  • Contributors HFL, ART, XLG and YFL contributed to data acquisition and formal analysis, and drafted the manuscript. HFL, ART, JRL, XLG, YFL, YPMN and SS contributed to research conceptualisation and formal analysis of the work. YPMN is guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.