Date of Award

11-30-2020

Degree Type

Thesis

Degree Name

MSc in Nursing

First Advisor

Ms. Arusa Lakhani

Second Advisor

Dr. Naghma Rizvi

Third Advisor

Dr. Sohail Salat

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background:Oral feeding competency among preterm neonates is a key criterion for hospital discharge. It is often delayed for preterm neonates until 34 weeks of gestation, as it is considered that their feeding readiness is established thereafter. However, researchers have signified that there are differences in the competencies of neonates to engage in breastfeeding. Therefore, it is important to assess the readiness of neonates for initiating breast feeding. According to the researcher’s knowledge, no such study has been carried out in the Pakistani context, to evaluate breast feeding readiness in preterm neonates and its associated factors, which may guide practice of initiation of breastfeeding after safe assessment, before infant’s 34 weeks of gestation age.
/="/">Purpose The study aimed to assess breastfeeding readiness in preterm neonates (30-34 weeks) and to identify the association of infant and maternal factors with neonates’ breastfeeding readiness, at a tertiary care hospital in Karachi, Pakistan.
/="/">Methods: A quantitative cross-sectional analytical study was conducted. A total of 58 preterm neonates, born between 30 to 34 weeks of gestation, were recruited through the consecutive sampling approach, to identify the proportion of breastfeeding readiness, through the Preterm Oral Feeding Readiness Assessment Scale (POFRAS). The infant and maternal factors associated with breastfeeding readiness were assessed through a structured questionnaire, by assessing their demographic and clinical characteristics. Neonates who were found ready on POFRAS assessment were also assessed for non-nutritive sucking at their mother’s breast.
/="/">Results :Out of 58 preterm neonates, 74.1% presented oral feeding readiness. The mean POFRAS score was 30.8 ± 2.0, ranging from a minimum score of 26 to a maximum score of 36. Along with this, the median age for breastfeeding readiness among preterm neonates was 33 weeks. The gestational age of newborns was found to be statistically significant in affecting breastfeeding readiness. It was found that with each increased week in the gestational age of a preterm neonate, the probability of breastfeeding readiness increases (AOR: 2.32, 95% CI 1.063-5.103, P=0.035). In addition, neonates, who presented feeding readiness, also exhibited non-nutritive sucking when placed on their mother’s breast.
/="/">Conclusion: The study concludes that more than half of the study participants were ready for oral feeding before 34 weeks of gestation. It also presents that preterm neonates exhibit feeding reflexes and cues that can be used to assess their readiness for safe transition, along with the gestation age, as a significant factor associated with breastfeeding readiness. It is recommended that early and safe assessment of preterm neonates’ feeding readiness should be performed for safe and early transition.

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1

Last Page

90

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