Breast Milk for Preterm Infants

Event start date
Event start time

Arvo building, auditorium F115, address: Arvo Ylpön katu 34

Doctoral defence of MNSc Riikka Ikonen

Breast Milk for Preterm Infants: Mothers’ milk expressing experiences, practices, and coping strategies

The field of science of the dissertation is Nursing Science.

The opponent is Adjunct Professor Anna Axelin (University of Turku). Professor Marja Kaunonen acts as the custos.

The language of the dissertation defence is Finnish.

Offering breast milk to preterm infants is important for mothers

Expressing breast milk, or removing milk without the suckling of an infant, and then giving the milk to an infant hospitalized in a neonatal intensive care unit supports the mother’s feelings of motherhood by allowing her to contribute to the care of her infant. Mothers often choose to express milk regardless of the stress of expressing or its other effects on their own well-being.

It is commonly known that breast milk is important for an infant’s health. Breast milk is especially important for preterm infants because it offers protection against life-threating infections. Furthermore, receiving breast milk during the first weeks of life promotes health in childhood and adolescence. Breast milk can be given to a preterm infant through a nasogastric tube until the infant has matured enough to suckle at a breast. Mothers of preterm infants should start milk expression soon after giving birth and should express frequently around the clock to achieve adequate milk supply.

This study was conducted to describe the expression-related experiences of preterm infants’ mothers, their expression practices, and coping strategies. The findings of previous studies, maternal narratives of their expression-related experiences, and survey data were used as study materials.

The results show that milk expressing is a very important, even necessary, task for mothers of preterm infants. Offering breast milk is a way to contribute to the care of an infant and help the infant survive and thrive. The factors that help mothers express milk include sufficient time, adequate equipment, private environments, and feeling that the expressing is going well. On the other hand, mothers’ frustration and exhaustion, challenges in daily life, knowledge that expressing is unnatural, and separation from their infants in hospital wards are among the factors that impede expressing.

In this study, the mothers hospitalized in neonatal intensive care units found expressing moderately stressful but felt they were managing it fairly well. Despite the positive experience associated with expressing milk, only one-third of the mothers initiated expressing soon after giving birth, and only one-third of the mothers expressed with adequate frequency. Contrary to previous study findings, lapses in the mothers’ well-being or the stress of expressing did not explain their inadequate expression frequency. The mothers used widely different coping strategies to manage the stress of expressing.

These findings reveal that mothers of preterm infants experience the expressing and giving of breast milk to their infants as an important part of motherhood. Many such mothers express persistently, and they use a wide range of coping strategies to continue expressing so that they can eventually achieve breastfeeding. Still, expressing is difficult for mothers, and they need support from their families and health care professionals.


The dissertation is published in the publication series of Acta Universitatis Tamperensis; 2349, Tampere University Press, Tampere 2018. The dissertation is also published in the e-series Acta Electronica Universitatis Tamperensis; 1855, Tampere University Press 2018.

Additional information