Abstract
BACKGROUND: Human milk feeding is crucial for the survival and development of preterm infants, yet their human milk feeding rates at Neonatal Intensive Care Units (NICUs) discharge remain lower than those of healthy newborns. Effective support is essential for improving breast milk feeding outcomes, but remains challenging for NICU nurses. Therefore, this study aimed to examine factors that influence NICU nurses in providing human milk feeding support, including the challenges they face and their needs. METHODS: This study employed a qualitative descriptive design. Using maximum variation and purposive sampling, 19 nurses in the NICU were recruited. Between August and September 2024, semi-structured interviews were conducted in the NICUs of two tertiary public hospitals in Jiaozuo, China. The interviews were transcribed verbatim and analyzed using a thematic analysis approach. RESULTS: This study highlighted the broader context of human milk feeding support in NICUs, influenced by institutional policies that limit parental involvement and the cultural practice of postpartum confinement, which keeps mothers at home after delivery. It underscored the key challenges NICU nurses faced in providing human milk feeding support in China. Against this backdrop, three main themes were identified, representing factors that influence human milk feeding support at the levels of preterm infants and their families, healthcare professionals, and institutions. CONCLUSIONS: This qualitative study identified multiple modifiable factors influencing human milk feeding support for mothers of preterm infants in NICUs, especially offering new insights into the significant role of NICU management policy and postpartum culture. Future interventions should prioritize creating a family-friendly NICU environment and adopting culturally sensitive education and support strategies to address the unique challenges posed by institutional and cultural barriers.