How to support fathers of preterm infants in early parenthood - An integrative review.

PROBLEM: Preterm birth is a stressful event. Paternal experiences of having a preterm infant indicate a need for tailored support. However, it is unclear which interventions work best. This review presents the evidence on existing healthcare interventions to support fathers of preterm infants in early parenthood, how effective they are and paternal experiences with the interventions. ELIGIBILITY CRITERIA: The integrative review process of Whittemore and Knafl was used to guide the study. A structured and comprehensive literature search was conducted in PubMed (MEDLINE), Embase, CINAHL, PsycInfo, Cochrane, Scopus, Web of Science, SweMed+, and Proquest Dissertation & Thesis Global. SAMPLE: A total of 18 qualitative and quantitative studies were included in the review. The Mixed Methods Appraisal Tool was used to assess quality. RESULTS: Three overall themes were identified in the analysis: 1) Skin-to-skin contact supported interaction between infant and father, 2) information impacted paternal experiences of stress, anxiety, and development of fatherhood, 3) fathers' relationships with the nurses oscillated between conflict and assistance. CONCLUSIONS: Our findings show that targeted interventions could support father-infant interaction and reduce stress among fathers of preterm infants. IMPLICATIONS: Fathers of preterm infants rely on nurses to support their engagement in early parenthood, while nurses facilitate the interventions that engage the fathers. It is also essential to develop a culture within the neonatal intensive care unit that encourages the presence of fathers and enhances educational nursing strategies for supporting fathers of preterm infants during early parenthood.

Early breastfeeding problems: A mixed method study of mothers' experiences.

OBJECTIVES: Breastfeeding problems are common and associated with early cessation. Still length of postpartum hospital stay has been reduced. This leaves new mothers to establish breastfeeding at home with less support from health care professionals. The objective was to explore mothers' perspectives on when breastfeeding problems were the most challenging and prominent early postnatal. The aim was also to identify possible factors associated with the breastfeeding problems. METHODS: In a cross-sectional study, a mixed method approach was used to analyse postal survey data from 1437 mothers with full term singleton infants. Content analysis was used to analyse mothers' open text descriptions of their most challenging breastfeeding problem. Multiple logistic regression was used to calculate odds ratios for early breastfeeding problems according to sociodemographic- and psychosocial factors. RESULTS: Up to 40% of the mothers had experienced early breastfeeding problems. The problems were associated with the mother, the infant and to lack of support from health care professionals. Most prominent problems were infant's inability to latch on (40%) and mothers having sore, wounded and cracked nipples (38%). Pain often occurred when experiencing breastfeeding problems. Factors associated with the problems were primiparity, lower self-efficacy and lower self-perceived knowledge of breastfeeding. Mothers with no or short education reported less frequently breastfeeding problems. CONCLUSIONS: Breastfeeding problems occurred frequently in the early postnatal period and often caused breastfeeding to be painful. Health care professionals should prepare mothers to deal with possible breastfeeding problems. New support options should be reviewed in an early postnatal discharge setting.

"Dad - a practical guy in the shadow": Fathers' experiences of their paternal role as a father during early discharge after birth and readmission of their newborns.

OBJECTIVES: The aim is to explore how new fathers experience early discharge after birth and readmission of their newborn in relation to their role and involvement as a father. Fathers of today are active participants during pregnancy, birth and in the care of the newborn. Still studies demonstrate that health care professionals are unsuccessful at involving fathers in ante- and postnatal care. How fathers experience their paternal role in the early postnatal period may affect the well-being of the new family. STUDY DESIGN: A qualitative study inspired by the hermeneutic approach. Data was collected through telephone interviews. The study was conducted in the Region of Southern Denmark in a University Hospital setting. Convenience sampling was applied. Eight fathers were included from November 2015 till February 2016 and six were interviewed. RESULTS: The data analysis revealed three categories: Early discharge - ups and downs, Readmission -waiting but being in good hands, and Practical guy in the shadow. CONCLUSIONS: Our study points at fathers being comfortable with being discharged early, but experienced insecurity when at home. The fathers experienced to be categorized by health care professionals as the practical guy, who had to assist the mother. Yet fathers saw themselves as equal to the mothers. Fathers also saw themselves in the shadow of the mother and showed greater considerations for the mother's feelings than their own. Fathers can be insecure in their paternal role when being met as just the practical guy.