Factors influencing direct breastfeeding of preterm infants in neonatal wards and the provision of breastfeeding support: a qualitative systematic review protocol
Bibliographic record
Abstract
OBJECTIVE: The objective of this review is to synthesize the qualitative evidence on factors that influence direct breastfeeding of preterm infants in neonatal wards and the provision of breastfeeding support. INTRODUCTION: Breastmilk is critical for the health of preterm neonates, and infants who directly feed at the breast are more likely to receive breastmilk exclusively for longer periods. Direct breastfeeding is associated with improved maternal coping and development of maternal identity. Preterm infants are significantly less likely to breastfeed than their term counterparts. An understanding of barriers and facilitators of direct breastfeeding and breastfeeding support in neonatal wards is lacking. INCLUSION CRITERIA: The proposed qualitative systematic review will include studies using qualitative methods and mixed methods, exploring the perceptions of breastfeeding parents, neonatal health care staff, and/or support people about the barriers and facilitators to direct breastfeeding (ie, suckling breastmilk directly from the parent's breast) among preterm infants (infants born at less than 37 weeks' gestation) admitted to a neonatal ward. Articles written in English or French will be considered. METHODS: MEDLINE (Ovid), CINAHL (EBSCOhost), Embase (Ovid), PsycINFO (Ovid), Scopus, and the Cochrane Library will be searched, with no time restrictions applied. Two independent reviewers will screen and extract data using a tool developed for this purpose. The findings will be coded and pooled using the meta-aggregation approach. The findings will be mapped to specific domains of the Theoretical Domains Framework using an iteratively developed coding manual. Studies will be appraised using the JBI critical appraisal tool for qualitative research, and confidence in the overall findings will be assessed using the ConQual approach. REVIEW REGISTRATION: PROSPERO CRD42024557250.
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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 | 0.110 | 0.081 |
| Meta-epidemiology (narrow) | 0.003 | 0.004 |
| Meta-epidemiology (broad) | 0.010 | 0.008 |
| Bibliometrics | 0.016 | 0.012 |
| Science and technology studies | 0.005 | 0.005 |
| Scholarly communication | 0.005 | 0.008 |
| Open science | 0.005 | 0.007 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.036 | 0.003 |
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".