Breastfeeding Preterm Infants at a Neonatal Care Unit in Rural Tanzania

Objective: To describe the breastfeeding experiences of mothers with preterm and low-birth-weight infants in a neonatal unit in Tanzania. Design: A qualitative research design. Setting: A neonatal unit at a referral hospital in rural Tanzania. Participants: Convenience sample of 10 new mothers with preterm infants. Additionally, to triangulate the data, five nurses affiliated with the neonatal unit were interviewed. Methods: A semistructured interview guide was used for data collection. All interviews were audiotaped and transcribed verbatim. Data were analyzed with inductive qualitative content analysis. Results: One main category, The mother has to adapt to the new situation to make breastfeeding natural, and three generic categories, The challenges of breastfeeding a premature infant, Enhancing the feeding situation, and The need for support, were used to describe breastfeeding challenges. Challenges consisted of the perception that the infant was different than healthy infants and the infant's and mother's health problems and needs. To improve the feeding situation, mothers learned how to feed their infants using timing strategies. Confidence and security were achieved with support from family and friends, the other mothers, and the health care staff. Conclusion: Mothers perceived breastfeeding as natural but needed support to overcome the challenges of breastfeeding preterm infants. Through support and education they were empowered, adapted to their new situations, and felt confident with breastfeeding.