Winging it: Maternal Perspectives and Experiences of Breastfeeding Newborns with Complex Congenital Surgical Anomalies

OBJECTIVE: To describe the experience of breastfeeding (inclusive of breast milk expression/pumping, provision of breast milk via devices, and at-breast feeding) among mothers of newborns with complex congenital surgical anomalies and the contexts under which pro-breastfeeding behaviors and attitudes are facilitated or compromised. STUDY DESIGN: We used qualitative description to analyze 23 interviews conducted with 15 mothers of newborns undergoing surgery for gastrointestinal, cardiac, or neural tube defects. RESULTS: Breastfeeding experiences were characterized by naivety regarding the importance and rationale for exclusive breast milk feedings and best practices to facilitate milk supply maintenance and transition to at-breast feeds. Maternal breastfeeding views and behaviors were impacted by indeterminate prenatal plans to breastfeed/provide breast milk, limited prior breastfeeding exposure and knowledge, and gaps in postnatal lactation support. CONCLUSION: Future research should investigate methods to improve exclusive breast milk feeding and facilitate transitions to at-breast feeds among mothers of newborns with surgical congenital anomalies, with consideration of identified barriers.