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Aim To compare experiences of stress in mothers and fathers of preterm infants during the first year of life, assess changes in parental stress and explore potential predictors of parental stress. Methods Between 2013 and 2015, data on parental stress were collected at 8 weeks after discharge and at 6 and 12 months postpartum from 493 mothers and 329 fathers of 547 preterm infants in Sweden. The Swedish Parenting Stress Questionnaire was used as a secondary outcome in a randomised clinical trial of breastfeeding support. Results At the three time points, mothers perceived more role restriction and fathers more social isolation (P < .001). Stress decreased in mothers during the first year (P = .018), whereas stress increased in fathers between 6 and 12 months (P = .048). Mothers of very preterm infants (P = .024), parents of twins (P = .038) and parents with lower perceived general health (P = .003) reported higher levels of stress during the first year after birth. Conclusion This study identified several factors that influenced parental stress. Mothers and fathers showed different patterns of stress levels during the first year after birth. This finding indicates different needs for mothers and fathers regarding the time at which parental support after discharge might be most beneficial.

Background Breastfeeding support is important for breastfeeding mothers; however, it is less clear how mothers of preterm infants (< 37 gestational weeks) experience breastfeeding support during the first year. Thus, the aim of this study was to describe how mothers of preterm infants in Sweden experience breastfeeding support during the first 12 months after birth. Methods This qualitative study used data from 151 mothers from questionnaires with open‐ended questions and telephone interviews. The data were analyzed using an inductive thematic network analysis with a hermeneutical approach. Results The results exposed two organizing themes and one global theme. In the organizing theme “genuine support strengthens,” the mothers described how they were strengthened by being listened to and met with respect, understanding, and knowledge. The support was individually adapted and included both practical and emotional support. In the organizing theme “inadequate support diminishes,” the mothers described how health professionals who were controlling and intrusive diminished them and how the support they needed was not provided or was inappropriate. Thus, the global theme “being thrown into a lottery—dependent on the health professional who provided breastfeeding support” emerged, meaning that the support received was random in terms of knowledge and support style, depending on the individual health professionals who were available. Conclusion Breastfeeding support to mothers of preterm infants was highly variable, either constructive or destructive depending on who provided support. This finding clearly shows major challenges for health care, which should make breastfeeding support more person‐centered, equal, and supportive in accordance with individual needs.

Objective: To evaluate the effects of estimated breastfeeding on infant outcomes in comparison to test weighing and to describe staff members’ experiences of estimated breastfeeding as a method for supporting the transition from tube feeding to breastfeeding. Design: A mixed method evaluation. Setting: Neonatal Intensive Care Unit (NICU) in Sweden. Participants: The study included 365 preterm (25th–36th gestational weeks) infants and 45 nurses or nurse assistants. Methods: A retrospective comparative medical record study was used to assess infant outcomes during a period of test weighing (196 infants) and again after the implementation of estimated breastfeeding (169 infants). A qualitative survey was conducted to explore the staff experiences of estimated breastfeeding. Results: No differences were found between groups regarding duration of tube feeding, length of hospital stay, gestational age, weight at discharge, and rate of any breastfeeding. Infants in the estimated breastfeeding group had a higher risk of not being exclusively breast milk fed than infants in the test-weighing group (OR = 2.76, CI [1.5, 5.1]). Staff perceived estimated breastfeeding as a more facilitative and less stressful method for mothers than test weighing. Some staff had difficulty following guidelines while simultaneously providing person-centered care. Conclusions: Estimated breastfeeding is a nonintrusive and feasible method for assessing and supporting the transition from tube feeding to breastfeeding among preterminfants in a NICU. However, the increased risk for not being exclusively breastfed is of concern. Additional research is needed to assess whether this method is appropriate and feasible in varying contexts and cultures.