QUALITATIVE ANALYSIS OF BARRIERS TO BREASTFEEDING IN VERY-LOW-BIRTHWEIGHT INFANTS IN THE HOSPITAL AND POSTDISCHARGE
Bibliographic record
Abstract
PURPOSE: To determine barriers to the successful establishment and maintenance of breastfeeding in very-low-birthweight (VLBW) infants, both in the hospital and after discharge, and changes in barriers over time. SUBJECTS: Sixty-four mothers of infants <1500 g birth weight who planned to breastfeed and were in the supplementary structured breastfeeding counseling intervention group. DESIGN: This qualitative, longitudinal study is a secondary analysis of a previously reported randomized controlled trial of a breastfeeding support intervention that examined infants weighing <1500 g at birth. METHODS: A qualitative technique, content analysis, was used to review, analyze, interpret, and categorize data for the current study. Data were extracted from the research records of the research lactation consultant that addressed all aspects of mothers' reported breastfeeding experiences. The principal investigator identified the main issues of the conversations, entered these into a summary chart, and then assigned appropriate categories. All categories are a reflection of maternal perception. Categorical data were analyzed descriptively using the crosstabs function. MAIN OUTCOME MEASURES: Barriers to the successful establishment and maintenance of breastfeeding during discharge from the neonatal intensive care unit (NICU), at discharge home, and at 1, 3, 6, and 12 months corrected age, or until weaning from breastfeeding. Changes in breastfeeding barriers across the 6 time periods were also determined. PRINCIPAL RESULTS: At NICU discharge, low milk volume was the greatest breastfeeding barrier. During the period from discharge home and at 1 month and 3 months, the infants' compromised physical status was the largest barrier to breastfeeding. Data from the 6- and 12-month time periods indicated that the provision of complementary feeding was the greatest barrier to breastfeeding; it was most prevalent in the period following NICU discharge and before discharge home. Across all time periods, nipple and breast problems were most prevalent at NICU discharge, whereas poor technique was a barrier at 1 month. Mothers' compromised emotional status was greatest at discharge from the NICU and diminished thereafter. CONCLUSIONS: Results from this study indicate the need to address time-period-specific barriers encountered during the breastfeeding experience of mothers of VLBW infants.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.038 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.005 | 0.005 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".