A Quantile Regression Analysis of Factors Associated with First-Time Maternal Fatigue in Korea

The aim of this cross-sectional study was to identify the factors associated with different percentiles of first-time maternal fatigue. A total of 123 first-time healthy mothers aged 18 years or older participated through an online survey. The fatigue was measured by the Korean version of the fatigue severity scale. Main variables were constructed based on the integrated fatigue model, which included mothers’ sleep quality, parenting stress, the amount of free time mothers have, the number of the child’s night wakings, general characteristics including socioeconomic status, and working status. Quantile regression was used to analyze the associated factors according to the fatigue level of first-time mothers with a young child. The mean age of the mothers and children were 32.11 years and 20.81 months, respectively. Mean fatigue score was 6.16 among the 75% quantile with high fatigue score. Lack of adequate free time in mothers, advanced maternal age, being a housewife, having a moderate income, and frequent night wakings of their child significantly increased fatigue among mothers in the third quantile of fatigue. To reduce fatigue, healthcare providers should focus on exploring ways to reduce maternal sleep disturbance and improve maternal sleep quality.

Implementing a three-hourly feeding schedule in stable preterm infants to decrease maternal fatigue

BackgroundA three-hourly feeding schedule has been shown to be as safe as a two-hourly schedule in preterm neonates. It saves nursing time and may be less tiring for the mothers. However, tradition and apprehensions have prevented its wider acceptance. We used a quality improvement approach to implement a three-hourly feeding schedule in stable preterm infants >32 weeks postmenstrual age (PMA) in our unit through a series of plan–do–study–act (PDSA) cycles.MethodsAll preterm neonates >32 weeks PMA, who were on full enteral feeds and without any respiratory support were eligible. The key quantitative outcome was maternal fatigue score. Safety was assessed in terms of episodes of hypoglycaemia and feed intolerance. Qualitative experiences from nursing staff were captured. The volume of expressed breastmilk and requirement of formula feeds were also recorded. After recording baseline data on a two-hourly feeding schedule, four PDSA cycles were sequentially completed over 21 weeks. The results of each PDSA cycle informed the change strategy for the next cycle.ResultsIn the baseline phase, five neonates on a two-hourly schedule were studied. In PDSA cycles I, II, III and IV, a cumulative of 122 neonates were studied on a three-hourly schedule. There was a significant decrease in median maternal fatigue score (13 (IQR 8–23) to 3 (IQR 1–6); p=0.01)). Only one neonate had feed intolerance, while two had mild asymptomatic transient hypoglycaemia. Six (5%) neonates were shifted to two-hourly feeds temporarily due to transient reasons. Nursing staff felt mothers could devote more time to Kangaroo mother care. The volume of expressed breastmilk and requirement of formula feeds were not different from the three-hourly schedule.ConclusionsIt was possible to change the traditional two-hourly feeding schedule to three-hourly in stable preterm infants using a quality improvement approach, while objectively documenting its safety and benefits.

Faktor- Faktor yang Menyebabkan Kejadian Postpartum Blues

About 70-80% of postpartum mothers experience mood or feeling disorders. In general, this condition is still considered normal, felt from 2-3 days after delivery and normally disappears after 2 weeks post partum. The purpose of this study was to determine the factors that cause the symptoms of postpartum blues to appear. This research method used qualitative through a phenomenological approach by taking the population by means of purposive sampling. The results showed that age and parity did not always trigger the symptoms of postpartum blues, the causes of postpartum blues were worrying about the baby, maternal fatigue, comments from people around the mother, husband's support and presence, adaptation to the baby's presence.

Pilot Study of Breastfeeding Support on the Night Shift

Exclusive breastfeeding during the first 6 months of life facilitates optimal health for mothers and their infants and is a hospital discharge perinatal core measure. The purpose of this study was to identify nurses’ experiences, perceptions, and practices of breastfeeding support on the night shift; recognize barriers; and offer recommendations to maintain exclusive initial breastfeeding. Data were collected using an anonymous 14-item online questionnaire, developed from the literature. The results identified baby’s behavior and maternal fatigue as the biggest challenges to breastfeeding support on the night shift. Our recommendations include education of families regarding normal nighttime behaviors and encouragement of mothers to nap when their newborn is napping. More research is needed with a larger, national, and more geographically representative sample to validate these findings.