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Breastfeeding the Late Preterm Infant: A Grounded Theory Study

Demirci, Jill Radtke (2012) Breastfeeding the Late Preterm Infant: A Grounded Theory Study. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Late preterm infants (LPIs), born between 34 0/7 and 36 6/7 weeks gestation, are reported to experience suboptimal breastfeeding rates and significant morbidity related to inadequate breast milk intake. Although unrecognized physiological immaturities are often implicated in these issues, breastfeeding is a complex phenomenon impacted by multiple and interrelated social, medical, and system-level factors. This dissertation addresses the available evidence on breastfeeding outcomes and patterns within the LPI population and also includes a population-level analysis of LPI breastfeeding initiation. The main study, however, utilized grounded theory techniques to examine the maternal experience of breastfeeding a late preterm infant. Ten late preterm mother-infant dyads participated in the study, which incorporated serial interviews and several other data collection methods, over a 6-8 week period after delivery. Breastfeeding in the LPI population was found to be a fluctuating, cascade-like progression of trial and error, influenced by a multitude of contextual factors and events and culminating in breastfeeding continuation (with or without future caveats regarding breastfeeding duration or exclusivity) or cessation. The trajectory was explained by the basic psychosocial process Weighing Worth against Uncertain Work, which encompassed the tension between breastfeeding motivation, the intensity of breastfeeding work, and ambiguity surrounding infant behavior and feeding cues. Several sub-processes were also identified: Playing the Game; Letting Him be the Judge vs. Accommodating Both of Us; and Questioning Worth vs. Holding out Hope. Our theoretical model indicates that mothers of LPIs require early, extended, and intensive breastfeeding support that emphasizes management strategies and the connection between infant prematurity and observed behaviors.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Demirci, Jill Radtkejvr5@pitt.eduJVR5
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCohen, Susan M.cohensu@pitt.eduCOHENSU
Committee CoChairHapp, Mary Bethmhapp@pitt.eduMHAPP
Committee MemberBogen, Debra
Committee MemberAlbrecht, Susan A.saa01@pitt.eduSAA01
Date: 6 June 2012
Date Type: Publication
Defense Date: 23 May 2012
Approval Date: 6 June 2012
Submission Date: 31 May 2012
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 234
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: breast feeding; lactation; infant, preterm; late preterm; grounded theory; theoretical model
Date Deposited: 06 Jun 2012 18:51
Last Modified: 15 Nov 2016 13:58


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