Biomedical subjects

K H Nyqvist

Publications and source records attributed to K H Nyqvist.

10 recordsLinked to original sources

PubMed2001

Early oral behaviour in preterm infants during breastfeeding: an electromyographic study.

UNLABELLED: The objectives were to increase the understanding of the characteristics of oral behaviour during breastfeeding in preterm infants and to validate direct observations of infant sucking. Twenty-six infants were investigated once by simultaneous observation and surface electromyography (EMG) at 32.1-37.1 postmenstrual weeks. The orbicularis oris muscle was used for data analysis, as it provided the most distinct registrations. High correlation coefficients were observed with respect to classifications of EMG data by two raters on the number of sucks per burst (r = 0.97) and duration of sucking bursts (r = 0.99). The agreement between direct observations of sucking and EMG data was high. The median for mean number of sucks per burst was 8 (range 2-33) and for longest burst 28 (5-96) sucks. Sucks with low and very high intensity constituted a median of 14 (1-94)% and 25 (0-87)% of all sucks. The range in mean sucking frequency was 1.0-1.8 sucks s(-1). Suck duration ranged from 0.6 to 1.1 s. There was a considerable variation between infants in the extent of mouthing. No association with maturational level appeared for any of the components in oral behaviour. CONCLUSION: EMG data provided evidence of early sucking competence in preterm infants during breastfeeding, with wide individual variations. Surface EMG and direct observation are recommended as valid methods in the evaluation of breastfeeding behaviour in preterm infants.

Breast Feeding↗

PubMed2000

The role of the Swedish Child Health Services in breastfeeding promotion.

Sweden has one of the highest breastfeeding incidence and duration rates among industrialized countries. Although the Child Health Services offer breastfeeding support to all mothers, there are geographical differences in breastfeeding frequency at different ages. The aims of this study were to describe the present activities in the Child Health Services regarding breastfeeding promotion and to find research evidence regarding interventions. Thirty-three out of 42 healthcare districts replied to a questionnaire. Differences were found in the transfer of responsibility for newborn infants from hospital to Child Health Centres, criteria for and timing of home visits and recommendations regarding introduction of supplementary food and breastfeeding education for parents and professionals. There were also regional differences in breastfeeding statistics and follow-up periods. The following recommendations were made on the basis of the survey and relevant literature: transfer of responsibility for newborn infants must guarantee follow-up of all mother-infant pairs; uniform breastfeeding assessment and documentation must be established; all mother-infant pairs must be offered early home visits, continued on a regular basis by health visitors; drop-in consultations must be established; a telephone hotline must be set up; for preventive purposes, growth charts must be used based on breastfed infants; evidence-based guidelines for the introduction of other foods must be followed; information must be provided in parent groups; breastfeeding statistics must use WHO definitions; polyclinics must be available for service to mothers/infants after early discharge and as resources for Child Health Centres; Child and Maternal Health Centres must collaborate; quality assurance programs must be established; breastfeeding courses must be offered in the under- and postgraduate training of professionals; compulsory in-service education must be offered; lactation consultant training must be offered at the university level; and lactation consultant positions must be established.

Breast Feeding↗

PubMed1999

The development of preterm infants' breastfeeding behavior.

Extensive scientific data are available on the development of sucking in term infants, but corresponding knowledge about preterm infants has been lacking. The aim was to describe the development of preterm infants' behavior at the breast, according to postmenstrual and postnatal age. Mothers co-operated as data collectors using the Preterm Infant Breastfeeding Behavior Scale for observations. Seventy-one singletons (born after 26.7-35.9 gestational weeks) were studied prospectively. Mothers received regular advice about breastfeeding and guidance about interaction and appropriate stimulation. Breastfeeding was initiated at a postmenstrual age (PMA) of 27.9-35.9 weeks. Mothers provided 4321 records of infants' behavior, 70% of the total breastfeeding sessions during the infants' hospital stay. Irrespective of PMA, the infants responded by rooting and sucking on the first contact with the breast. Efficient rooting, areolar grasp and latching on were observed at 28 weeks, and repeated bursts of > or = 10 sucks and maximum bursts of > or = 30 sucks at 32 weeks. Nutritive sucking appeared from 30.6 weeks. Sixty-seven infants were breastfed at discharge. Fifty-seven of them established full breastfeeding at a mean PMA of 36.0 weeks (33.4-40.0 weeks). Their early sucking behavior is interpreted as the result of learning, enhanced by contingent stimuli. We therefore suggest that guidelines for initiation of breastfeeding in preterm infants should be based on cardiorespiratory stability, irrespective of current maturity, age or weight.

Adolescent↗

PubMed1997

Successful breast feeding in spite of early mother-baby separation for neonatal care.

OBJECTIVE: To study the effects on breast feeding duration of mother-baby separation after birth, owing to full-term babies' care in a neonatal unit for a maximum of six days. DESIGN: Retrospective review of medical records and telephone interviews with mothers. SETTING: A level II and III NICU in a University Hospital. PARTICIPANTS: 148 mother-baby pairs in a separated group and 3516 in a comparison group. MAIN OUTCOME MEASURES: Breast feeding success is defined as the duration of exclusive and partial breast feeding. FINDINGS: There were no differences in breast feeding duration between babies in the separated group and the comparison group. More than 70% of the babies in both groups were breast fed exclusively after two months and more than 50% for more than four months. In the separated group delays in physical contact, first suckling and regular breast feeding, and duration of separation were not associated with shorter duration of breast feeding. Mixed feeding, both breast and bottle at the time of discharge from hospital, and baby diagnosis of hypoglycaemia had a negative impact. Maternal level of education was also associated with the breast feeding outcome. CONCLUSIONS: Although every possible effort should be made to avoid mother-baby separation, women can be reassured that separation, because of their or the baby's medical condition during the first days after birth, need not be considered an obstacle to successful breast feeding.

Adolescent↗

PubMed1997

A philosophy of care for a neonatal intensive care unit. Operationalization of a nursing model.

Crisis reactions, a stressful environment, infant care practices, and nurse behavior may cause difficulties in entering the natural parental role for parents of infants who are admitted to a neonatal intensive care unit (NICU). In connection with discussions in the Uppsala NICU on what constitutes good care, a philosophy of care, based on Callista Roy's adaptation model, was formulated for the purpose of providing developmentally supportive, family-centered care, and for defining good care and the professional nurse role. The philosophy describes the infant's needs and environment. Caring activities focus on support of the infant's and his parent's roles and self-concept in their progress towards independence from professional assistance. The philosophy is an essential component in the introductory program which integrates newly recruited personnel from different disciplines into the unit. It is presented as a suggestion of how a model-based philosophy of care can be formulated by operationalization of the theoretical concepts of a nursing model.

Adaptation, Physiological↗

PubMed1996

Development of the Preterm Infant Breastfeeding Behavior Scale (PIBBS): a study of nurse-mother agreement.

Research on the development of preterm infant feeding behavior has focused mainly on bottlefeeding, using invasive methods or observations by professionals. In this study, a clinical method for observing breastfeeding was developed in collaboration between observers and mothers for the purpose of enabling neonatal personnel and mothers to describe developmental stages in preterm infant breastfeeding behavior. Tests of interobserver reliability resulted in acceptable agreement between observers, but a somewhat lower level of agreement between observers and mothers. The scale showed a good capacity to discriminate between infant gestational ages and can be used for helping mothers to identify their infants' emerging competence.

Breast Feeding↗

PubMed1996

Supporting a preterm infant's behaviour during breastfeeding: a case report.

Preterm infants present a special challenge to lactation consultants because of their high reactivity to stimuli from their physical and social environment, low muscle tone, and limited extent of awake, alert behavior. In a descriptive case report, a girl at an age corresponding to a gestational age of 29 weeks was observed during a breastfeeding session according to the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Recommendations, based on her behavioral responses, were given to her mother. In an observation two days later, she showed more wakefulness and more efficient sucking. General recommendations are offered for support of preterm infants' behavior during breastfeeding. The NIDCAP structure is advocated as a mental checklist for breastfeeding assessment and advice.

Breast Feeding↗

PubMed1994

Mothers' advice about facilitating breastfeeding in a neonatal intensive care unit.

Admission of newborn infants to neonatal intensive care units (NICU) has been considered an obstacle to breastfeeding because of mother-infant separation and hospital feeding routines. In order to obtain advice on facilitating breastfeeding, we interviewed by telephone 178 mothers of fullterm NICU patients three months after the infants' discharge from hospital. Mothers' advice, in order of prominence, concerned the disturbing impact of the NICU environment, lack of systematic breastfeeding advice, distance between infants' and mothers' units in the hospital, conflicts about parents' roles, perceived lack of organization of work, dissatisfaction with nurse behavior towards parents, and importance of skin-to-skin contact during the mother's first visit. Adaptation of the NICU environment, nurses' awareness of mothers' perspectives, and nurse attitudes and behavior change appear to be as important for facilitating breastfeeding as are routines for breastfeeding advice.

Attitude to Health↗

PubMed1993

Advice concerning breastfeeding from mothers of infants admitted to a neonatal intensive care unit: the Roy adaptation model as a conceptual structure.

Data were collected by telephone interviews with 178 mothers of full-term patients in a NICU (neonatal intensive care unit) concerning advice on facilitation of the initiation of breastfeeding. The main advice to the first author as a nurse in the NICU concerned the environment, advice on breastfeeding, distance between units, work organization and nurse behaviour. The advice to other mothers of patients centred on persistence, physical contact with the infant, and not to let nurses take over maternal role functions. The data were structured into themes and categories, classified by one author and two research assistants according to Roy's adaptation theory, and analysed for degree of interrater agreement. The overall agreement of classification was high, reaching 92.5%. It was easily applied by nurses after a brief introduction and proved useful for structuring interview data. It also contributed to clarification of nurse behaviour and division of roles between nurses and mothers. As the four adaptation modes showed considerable overlap, this kind of classification seems inadvisable for application to the assessment of patient/parent situations in the nursing process. For use in a clinical setting, the theory needs the addition of the interactive aspect of nurse and patient/family role functions, and may then be used as a framework for the development of assessment tools.

Adaptation, Psychological↗

PubMedDate not supplied

Co-bedding twins: a developmentally supportive care strategy.

Twins may have a special capacity for supporting each other (co-regulation) because of their common intrauterine experiences. Co-regulatory activities observed in preterm twins during co-bedding include moving closer, touching, holding, hugging, rooting, sucking on each other, smiling, being awake at the same time, and decreased need for ambient temperature support. This simple clinical strategy of co-bedding twins may be a significant innovation for supporting preterm and full-term twins during their transition to extrauterine life.

Adult↗