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  • 1.
    Ericson, Jenny
    et al.
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Centre for Clinical Research Dalarna, Uppsala University, Falun; Department of Pediatrics, Falu Hospital, Falun.
    Ahlsson, Fredrik
    Department of Women's and Children's Health, Uppsala University, Uppsala.
    Wackernagel, Dirk
    Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg, University Mainz, Mainz, Germany; Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm.
    Wilson, Emilija
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm.
    Equally Good Neurological, Growth, and Health Outcomes up to 6 Years of Age in Moderately Preterm Infants Who Received Exclusive vs. Fortified Breast Milk-A Longitudinal Cohort Study2023In: Nutrients, E-ISSN 2072-6643, Vol. 15, no 10, article id 2318Article in journal (Refereed)
    Abstract [en]

    Moderately preterm infants (32-36 weeks of gestational age) have an increased risk of worse health and developmental outcomes compared to infants born at term. Optimal nutrition may alter this risk. The aim of this study was to investigate the neurological, growth, and health outcomes up to six years of age in children born moderately preterm who receive either exclusive or fortified breast milk and/or formula in the neonatal unit. In this longitudinal cohort study, data were collected for 142 children. Data were collected up to six years of age via several questionnaires containing questions about demographics, growth, child health status, health care visits, and the Five to Fifteen Questionnaire. Data on the intake of breast milk, human milk fortification, formula, and growth during hospitalization were collected from the children's medical records. No statistically significant differences in neurological outcomes, growth, or health at six years of age were found between the two groups (exclusive breast milk, n = 43 vs. fortified breast milk and/or formula, n = 99). There is a need for research in larger populations to further assess potential effects on health and developmental outcomes when comparing the use of exclusive versus fortified breast milk for moderately preterm infants during neonatal hospitalization.

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  • 2.
    Ericson, Jenny
    et al.
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Center for Clinical Research Dalarna, Uppsala University, Falun; Department of Pediatrics, Falu Hospital, Falun.
    Anagrius, C.
    Rygaard, A.
    Guntram, L.
    Wendel, S. B.
    Hesselman, S.
    Women’s experiences of receiving information about and consenting or declining to participate in a randomized controlled trial involving episiotomy in vacuum-assisted delivery: a qualitative study2021In: Trials, E-ISSN 1745-6215, Vol. 22, no 1, article id 658Article in journal (Refereed)
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  • 3.
    Ericson, Jenny
    et al.
    Uppsala University; Centre for Clinical Research Dalarna, Falun; Department of Paediatrics, Falu Hospital.
    Eriksson, Mats
    Hellstrom-Westas, Lena
    Hagberg, Lars
    Hoddinott, Pat
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden.
    The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants: study protocol for a randomized controlled trial2013In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 13, article id 73Article in journal (Refereed)
    Abstract [en]

    Background: Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at < 37 gestational weeks), mothers of preterm infants have shorter breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mothers' sense of trust in their own capacity and thereby facilitate breastfeeding.

    Methods/design: A multicentre randomized controlled trial has been designed to evaluate the effectiveness and cost-effectiveness of person-centred proactive telephone support on breastfeeding outcomes for mothers of preterm infants. Participating mothers will be randomized to either an intervention group or control group. In the intervention group person-centred proactive telephone support will be provided, in which the support team phones the mother daily for up to 14 days after hospital discharge. In the control group, mothers are offered a person-centred reactive support where mothers can phone the breastfeeding support team up to day 14 after hospital discharge. The intervention group will also be offered the same reactive telephone support as the control group. A stratified block randomization will be used; group allocation will be by high or low socioeconomic status and by NICU. Recruitment will be performed continuously until 1116 mothers (I: 558 C: 558) have been included. Primary outcome: proportion of mothers exclusively breastfeeding at eight weeks after discharge.

    Secondary outcomes: proportion of breastfeeding (exclusive, partial, none and method of feeding), mothers satisfaction with breastfeeding, attachment, stress and quality of life in mothers/partners at eight weeks after hospital discharge and at six months postnatal age. Data will be collected by researchers blind to group allocation for the primary outcome. A qualitative evaluation of experiences of receiving/providing the intervention will also be undertaken with mothers and staff.

    Discussion: This paper presents the rationale, study design and protocol for a RCT providing person-centred proactive telephone support to mothers of preterm infants. Furthermore, with a health economic evaluation, the cost-effectiveness of the intervention will be assessed. Trial registration: NCT01806480

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  • 4.
    Ericson, Jenny
    et al.
    Uppsala University; Centre for Clinical Research Dalarna, Falun; Department of Paediatrics, Falu Hospital.
    Eriksson, Mats
    Hellström-Westas, Lena
    Hoddinott, Pat
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Proactive telephone support provided to breastfeeding mothers of preterm infants after discharge: a randomised controlled trial2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 5, p. 791-798Article in journal (Refereed)
    Abstract [en]

    AIM: The aim was to evaluate the effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants after discharge from neonatal intensive care units (NICU).

    METHODS: Between March 2013 and December 2015, a randomised controlled trial was conducted at six NICUs across Sweden. At each NICU, a breastfeeding support team recruited, randomised and delivered the support to participating mothers. The intervention group received a daily proactive telephone call up to 14 days after discharge from the support team. The control group could initiate telephone contact themselves. Primary outcome was exclusive breastfeeding eight weeks after discharge. Secondary outcomes were maternal satisfaction with breastfeeding, attachment, quality of life and parental stress.

    RESULTS: In total, 493 mothers were randomised, 231 to intervention group and 262 to control group. There were no differences between the groups for exclusive breastfeeding, odds ratio 0.96, 95% CI 0.66-1.38, nor for maternal satisfaction with breastfeeding, attachment or quality of life. The intervention group reported significantly less parental stress than the controls, t=2.44, 95% CI 0.03-0.23, effect size d=0.26.

    CONCLUSION: In this trial, proactive telephone support was not associated with increased exclusive breastfeeding prevalence eight weeks following discharge. However, intervention group mothers showed significantly lower parental stress. This article is protected by copyright. All rights reserved.

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  • 5.
    Ericson, Jenny
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet, Centre for Clinical Research Dalarna, Falu lasarett.
    Eriksson, Mats
    Hoddinott, Pat
    Hellström-Westas, Lena
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Breastfeeding and risk for ceasing in mothers of preterm infants - long-term follow-up2018In: Maternal and Child Nutrition, ISSN 1740-8695, E-ISSN 1740-8709, Vol. 14, no 4, article id e12618Article in journal (Refereed)
    Abstract [en]

    Breastfeeding is challenging for mothers of preterm infants. The aim of this paper is to describe risk factors for ceasing breastfeeding and methods of feeding until 12 months postnatal age in mothers who breastfed their preterm infants at discharge from neonatal intensive care units (NICUs). The data come from a randomised controlled trial, which evaluated the effectiveness on exclusive breastfeeding at 8 weeks of proactive telephone support compared with reactive support offered to mothers of preterm infants following discharge from NICU. Six NICUs across Sweden randomised a total of 493 mothers. We used regression and survival analyses to assess the risk factors for ceasing breastfeeding and the long-term outcomes of the intervention. The results showed that 305 (64%) of the infants were breastfed at 6 months and 49 (21%) at 12 months. Partial breastfeeding at discharge, low maternal educational level, and longer length of stay in the NICU increased the risk for ceasing breastfeeding during the first 12 months. Furthermore, the Kaplan-Meier analysis showed that the proportion of mothers who ceased breastfeeding did not differ between the intervention (n = 231) and controls (n = 262) during the first 12 months (log-rank test p = .68). No difference was found between groups on method of feeding. More than 85% of the infants were fed directly at the breast. These findings provide important insights for health professionals who are supporting mothers of preterm infants to breastfeed long term.

    Registered in www.clinicaltrials.gov (NCT01806480).

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  • 6.
    Ericson, Jenny
    et al.
    Department of Paediatrics, Falu Hospital.
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Estimated breastfeeding to support breastfeeding in the neonatal intensive care unit2013In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 42, no 1, p. 29-37Article in journal (Refereed)
    Abstract [en]

    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 (25th36th 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 preterm infants 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. JOGNN, 42, 29-37; 2013. DOI: 10.1111/j.1552-6909.2012.01423.x

  • 7.
    Ericson, Jenny
    et al.
    Uppsala University; Centre for Clinical Research Dalarna, Falun; Department of Paediatrics, Falu Hospital.
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hellström-Westas, Lena
    Eriksson, Mats
    Changes in the prevalence of breast feeding in preterm infants discharged from neonatal units: a register study over 10 years2016In: BMJ Open, E-ISSN 2044-6055, Vol. 6, article id e012900Article in journal (Refereed)
    Abstract [en]

    Objective: There are indications that the prevalence of exclusively breastfed preterm infants is decreasing in Sweden. The objective was to investigate trends in exclusive breast feeding at discharge from Swedish neonatal units and associated factors in preterm infants.

    Design, setting and participants: This is a register study with data from the Swedish Neonatal Quality Register. Data from 29 445 preterm infants (gestational age (GA) <37 weeks) who were born during the period 2004–2013 were retrieved. Data included maternal, perinatal and neonatal characteristics. Data were analysed for the whole population as well as for 3 GA groups.

    Results: From 2004 to 2013, the prevalence of exclusive breast feeding decreased, in extremely preterm (GA 22–27 weeks) from 55% to 16%, in very preterm (GA 28–31 weeks) from 41% to 34% and in moderately preterm infants (GA 32–36 weeks) from 64% to 49%. The decline was statistically significant (p<0.001) in all 3 GA groups. This decline remained significant when adjustments were made for factors negatively associated with exclusive breast feeding and which became more prevalent during the study period, that is, small for GA (all groups) and maternal mental illness (very preterm and moderately preterm infants).

    Conclusions: In the past 10 years, Sweden has experienced a lower rate of exclusive breast feeding in preterm infants, especially in extremely preterm infants. The factors analysed in this study explain only a small proportion of this decline. The decline in exclusive breast feeding at discharge from neonatal units raises concern and present challenges to the units to support and promote breast feeding.

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  • 8.
    Ericson, Jenny
    et al.
    Uppsala University; Centre for Clinical Research Dalarna, Falun; Department of Paediatrics, Falu Hospital.
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Mothers' experiences of a telephone-based breastfeeding support intervention after discharge from neonatal intensive care units - a mixed-method study2017In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 12, no 1, article id 50Article in journal (Refereed)
    Abstract [en]

    Background: After discharge from a neonatal intensive care unit (NICU), many mothers of preterm infants (gestational age<37 weeks) experience a lack of support for breastfeeding. An intervention study was designed to evaluate the effects of proactive (a daily telephone call initiated by a member of a breastfeeding support team) and/or reactive (mothers could call the breastfeeding support team) telephone based breastfeeding support for mothers after discharge from the NICU. The mothers in the intervention group had access to both proactive and reactive support; the mothers in the control group only had access to reactive support. The aim of this study was to explore the mothers' experiences of the proactive and reactive telephone support.

    Methods: This study was a qualitatively driven, mixed-method evaluation using three data sources: questionnaires with qualitative open-ended questions, visual analogue scales and telephone interviews. In total, 365 mothers contributed data for this study. The qualitative data were analysed with an inductive thematic network analysis, while the quantitative data were analysed with Student's t-test and the chi-square test.

    Results: Proactive support contributed to greater satisfaction and involvement in breastfeeding support. The mothers who received proactive support reported that they felt strengthened, supported and secure, as a result of the continuous care provided by staff who were knowledgeable and experienced (i.e., in breastfeeding and preterm infants), which resulted in the global theme 'Empowered by proactive support'. The mothers who received reactive support experienced contradictory feelings; some felt secure because they had the opportunity to call for support, whereas others found it difficult to decide when and if they should use the service, which resulted in the global theme; 'Duality of reactive support'.

    Conclusion: There were positive aspects of both proactive (i.e., greater satisfaction and feelings of empowerment) and reactive support (i.e., the opportunity to call for support); however, the provision of reactive support alone may be inadequate for those with the greatest need for support as they are the least likely to access it.

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  • 9.
    Ericson, Jenny
    et al.
    Department of Pediatrics, Falu Hospital, Falun; Center for Clinical Research Dalarna, Uppsala University, Falun.
    Lampa, E.
    Flacking, Renée
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Breastfeeding satisfaction post hospital discharge and associated factors - a longitudinal cohort study of mothers of preterm infants2021In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 16, no 1, article id 28Article in journal (Refereed)
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  • 10.
    Ericson, Jenny
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University; Falu Hospital.
    Palmér, Lina
    University of Borås.
    Cessation of breastfeeding in mothers of preterm infants: A mixed method study2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 5, article id e0233181Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Many women cease breastfeeding earlier than desired. This study examined the cessation of breastfeeding among mothers of preterm infants. Thus, the aim was to describe the cessation of breastfeeding in mothers of preterm infants up to 12 months after birth.

    METHOD: This mixed methods study used a convergent design with both qualitative data, consisting of written comments, and quantitative data, on breastfeeding status and breastfeeding satisfaction. The data were collected from questionnaires sent to the mothers at three points during the first year after birth. In total, 270 mothers of preterm infants who breastfed at the time of discharge from the neonatal unit provided data for the study. The quantitative and qualitative data were analysed separately with statistical tests and hermeneutical analysis, respectively and then together according to the convergent mixed methods design.

    RESULTS: Four themes of the meanings of the cessation of breastfeeding were identified in the qualitative analysis: "Desire to regain the mother's and the infant's well-being", "The mothers interpretation that the infants actively ceased breastfeeding", "The mother's body and/or the infants' signals showing the way" and "The mother's own will and perceived external obstacles". Mothers who did not breastfeed as long as they wanted were more likely to report less satisfaction with breastfeeding, a shorter breastfeeding period, and less activity when ceasing breastfeeding. In comparison, mothers who breastfed as long as they wanted were more satisfied with breastfeeding, breastfed for a longer period of time and were more active in decision making in breastfeeding cessation.

    CONCLUSION: Maternal passivity or activity influenced the cessation of breastfeeding in mothers of preterm infants who breastfed at the time of discharge from the neonatal unit. Passive behaviour related to breastfeeding may result in early cessation of breastfeeding, and low breastfeeding satisfaction while active behaviour may increase breastfeeding length and satisfaction.

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  • 11.
    Ericson, Jenny
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Palmér, Lina
    Experiences of breastfeeding support in mothers of preterm infants2018Conference paper (Refereed)
  • 12.
    Ericson, Jenny
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Center for Clinical Research Dalarna, Uppsala University, Falun; Department of Pediatrics, Falu Hospital, Falun.
    Palmér, Lina
    Faculty of Caring Science, Work Life and Social Welfare, University of Borås.
    Mothers of preterm infants' experiences of breastfeeding support in the first 12 months after birth: a qualitative study2019In: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 46, no 1, p. 129-136Article in journal (Refereed)
    Abstract [en]

    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.

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  • 13.
    Jess, Kari
    et al.
    Dalarna University, School of Health and Welfare, Social Work.
    von Ahlefeld Nisser, Désirée
    Dalarna University, School of Teacher Education, Education.
    Ericson, Jenny
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Olsson, Maria
    Dalarna University, School of Teacher Education, Education.
    Randell, Eva
    Dalarna University, School of Health and Welfare, Social Work.
    Tillsammans för varje barn i Falu kommun: Ett pilotprojekt 2018-20212022Report (Other academic)
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  • 14. Jonsson, Anna
    et al.
    Jakobsson, Magdalena
    Ericson, Jenny
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Centre for Clinical Research Dalarna, Falun; Department of Paediatrics, Falu Hospital, Falun.
    A qualitative study of recorded telephone support calls with mothers of preterm infants: Expressing both positive and negative feelings.2021In: Nursing Open, E-ISSN 2054-1058, Vol. 8, no 6, p. 3065-3072Article in journal (Refereed)
    Abstract [en]

    AIM: To describe the structure and content of telephone support calls between mothers of preterm infants and support team members after hospital discharge.

    DESIGN: This is a qualitative study.

    METHODS: Data consisted of 19 recordings of telephone calls that occurred between March 2013 and December 2015. The calls were made by support team members to mothers within two weeks of discharge from the neonatal unit. Analyses were performed using content analysis.

    RESULTS: One category referred to what the support team members said that facilitated or did not facilitate the conversation. It was found that the support team members managed to have conversations that were tailored to the mother's current needs and conversations where the focus was on what the support team members thought was important. A second category referred to the topics the mothers talked about and that the mothers expressed both negative and positive feelings.

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  • 15. Olsson, Emma
    et al.
    Carlsen Misic, Martina
    Dovland Andersen, Randi
    Ericson, Jenny
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Center for Clinical Research Dalarna, Uppsala University, Falun; Department of Pediatrics, Falun Hospital, Falun.
    Eriksson, Mats
    Thernström Blomqvist, Ylva
    Ullsten, Alexandra
    Study protocol: parents as pain management in Swedish neonatal care - SWEpap, a multi-center randomized controlled trial.2020In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 20, no 1, article id 474Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: During the first period of life, critically ill as well as healthy newborn infants experience recurrent painful procedures. Parents are a valuable but often overlooked resource in procedural pain management in newborns. Interventions to improve parents' knowledge and involvement in infants' pain management are essential to implement in the care of the newborn infant. Neonatal pain research has studied a range of non-pharmacological pain alleviating strategies during painful procedures, yet, regarding combined multisensorial parent-driven non-pharmacological pain management, research is still lacking.

    METHODS/DESIGN: A multi-center randomized controlled trial (RCT) with three parallel groups with the allocation ratio 1:1:1 is planned. The RCT "Parents as pain management in Swedish neonatal care - SWEpap", will investigate the efficacy of combined pain management with skin-to-skin contact, breastfeeding and live parental lullaby singing compared with standard pain care initiated by health care professionals, during routine metabolic screening of newborn infants (PKU-test).

    DISCUSSION: Parental involvement in neonatal pain management enables a range of comforting parental interventions such as skin-to-skin contact, breastfeeding, rocking and soothing vocalizations. To date, few studies have been published examining the efficacy of combined multisensorial parent-driven interventions. So far, research shows that the use of combined parent-driven pain management such as skin-to-skin contact and breastfeeding, is more effective in reducing behavioral responses to pain in infants, than using the pain-relieving interventions alone. Combined parental soothing behaviors that provide rhythmic (holding/rocking/vocalizing) or orogustatory/orotactile (feeding/pacifying) stimulation that keep the parent close to the infant, are more effective in a painful context. In the SWEpap study we also include parental live lullaby singing, which is an unexplored but promising biopsychosocial, multimodal and multisensory pain alleviating adjuvant, especially in combination with skin-to-skin contact and breastfeeding.

    TRIAL REGISTRATION: ClinicalTrials.gov ( NCT04341194 ) 10 April 2020.

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  • 16.
    Olsson, Maria
    et al.
    Dalarna University, School of Teacher Education, Education.
    Ericson, Jenny
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Randell, Eva
    Dalarna University, School of Health and Welfare, Social Work.
    von Ahlefeld Nisser, Désirée
    Dalarna University, School of Teacher Education, Education.
    Between an educational task and an idea for treatment: multiprofessional collaboration for supporting children “at risk” – a coordinator role in pedagogical practice2023In: Scandinavian Journal of Educational Research, ISSN 0031-3831, E-ISSN 1470-1170Article in journal (Refereed)
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  • 17. Palmér, Lina
    et al.
    Ericson, Jenny
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Center for Clinical Research Dalarna; Falu hospital.
    A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth2019In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 14, article id 35Article in journal (Refereed)
    Abstract [en]

    Background: Being a mother of a preterm infant (< 37 gestational weeks) puts the mother in a vulnerable and fragile situation wherein breastfeeding is an important part of becoming a mother and bonding with the infant. Nevertheless, the breastfeeding experience of mothers during the first year after a preterm birth has not been well studied. To develop professional caring and supporting relationships, it is important to address this knowledge gap. The aim of this study was to describe the breastfeeding experience of mothers of preterm infants from birth up until 12 months after birth.

    Methods: The data in this qualitative study are derived from a multicentre randomized controlled trial where 270 mothers of preterm infants provided 496 written comments through questionnaires containing open-ended questions. The questionnaires were sent to the mother three times during the first 12 months after birth. A thematic network analysis based on hermeneutical philosophy was used to analyse and interpret the resulting data to describe the mothers' experiences of breastfeeding.

    Results: Three organizing themes, namely, "navigating smoothly," "navigating with a struggle" and "navigating in ambiguity" were revealed in the mothers' narratives regarding their breastfeeding experiences during the first 12 months after birth. These organizing themes were further interpreted as one global theme that was deemed "A journey to finding one's unique way in breastfeeding."

    Conclusion: Mothers of preterm infants are in an exposed and vulnerable situation when initiating breastfeeding during the first year. This situation leads to a unique journey wherein each mother navigates through breastfeeding depending on her individual situation. An awareness of the diversity of breastfeeding experiences may contribute to the provision of professional caring and supportive relationships.

    Trial registration: www.clinicaltrial.gov NCT01806480 registered 7 March 2013.

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  • 18.
    Pellas, Ulrika
    et al.
    Region Dalarna.
    Borgström, Malin
    Region Dalarna.
    Svedbo Engström, Maria
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Ericson, Jenny
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Omvårdnadsrådets utlåtande gällande kuratorverktyg vid inkontinens hos barn2023Other (Other academic)
  • 19.
    Persson, Christine
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing. Uppsala University, Uppsala.
    Ericson, Jenny
    Uppsala University, Uppsala.
    Salari, Raziye
    Uppsala University, Uppsala.
    Eriksson, Mats H.
    Örebro University, Örebro.
    Flacking, Renée
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    NICU parents' mental health: A comparative study with parents of term and healthy infants2023In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 112, no 5, p. 954-966Article in journal (Refereed)
    Abstract [en]

    AIM: To compare mental health in parents of preterm/ill infants and parents of term and healthy infants before birth and 1 month after hospital discharge.

    METHODS: A comparative cohort design was used. In total 439 parents from six neonatal intensive care units (NICUs) and 484 parents from four maternity units (MUs) in Sweden answered a survey 1 month after discharge.

    RESULTS: Parents in neonatal units experienced significantly more psychologically traumatic births and rated their health and the health of their infants less favourably the first week after delivery than parents in MUs. In the neonatal units, both parents had better possibilities to stay together with the infant during hospital stay. There was no difference between the NICU and MU groups in postpartum depressive symptoms 1 month after discharge. Experiencing a traumatic birth was not related to an increased risk of perinatal depressive symptoms (Edinburgh Postnatal Depression Scale ≥13) for mothers in NICUs. In contrast, the risk of depression increased for mothers in MUs.

    CONCLUSION: Family togetherness, parent-infant closeness and emotional support at NICUs may contribute to the positive outcome. Further studies are needed to assess the long-term effects of how family togetherness and closeness influence families long-term.

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  • 20.
    Randell, Eva
    et al.
    Department of Social Work, Uppsala University, Uppsala, Sweden.
    Olsson, Maria
    Dalarna University, School of Teacher Education, Education.
    von Ahlefeld Nisser, Désirée
    Dalarna University, School of Teacher Education, Education.
    Ericson, Jenny
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Centre for Clinical Research Dalarna, Falun, Uppsala University.
    A Qualitative Study of Professionals’ Experiences and Challenges in the Early Identification of Psychosocial Concerns in Children2023In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 2023, article id 9645306Article in journal (Refereed)
    Abstract [en]

    Aim. Early intervention and detecting early signs are often cited as a goal by professionals working with children, butdetecting and describing early signs is not well explored. Thus, the study’s aim was to explore professionals’ experiences and challenges in the early identifcation of psychosocial concerns in children aged 0–16. Materials and Methods. Data were collected from semistructured interviews with 26 professionals (e.g., nurses, psychologists, social workers, teachers, principals, and managers) working with children. The participants engaged in a pilot cooperation model between preschools, schools, social services, and healthcare to reach out early to children in need of support. The interviews were analyzed using thematic network analysis. Results. Four organizing themes were created as follows: “The idea of promoting and preventing is the key to success,” “Identifying the children who need support and intervention,” “Identifying observable early signs,” and “Occupied with children needing immediate support.” The organizing themes were interpreted into one global theme as follows: “All want an early intervention but putting it into practice is challenging.” Conclusion. The study shows that it is difcult to identify children in need of psychosocial support at an early stage because the early signs are difficult to detect. Thus, our results suggest that both preventive interventions targeting all children and specifc interventions for those in need of support are needed to promote health and wellbeing.

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  • 21.
    Saade, Sandra
    et al.
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Flacking, Renée
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Ericson, Jenny
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden; Department of Paediatrics, Falu Hospital, Falun, Sweden.
    Parental experiences and breastfeeding outcomes of early support to new parents from family health care centres: a mixed method study2022In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 22, no 1, article id 150Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Early parenthood is a sensitive period for parents. Parents may feel uncertain about their new roles and unsure about where to find trusted information and support. The aim of this study was to explore the association between breastfeeding and early home visits and a proactive telephone support intervention and to describe parental experiences.

    METHOD: This study was conducted as a mixed method study with a convergent design using qualitative data from the written comments of parents, and the quantitative data consisted of demographics, breastfeeding, and Likert questions about parents' satisfaction with the early home visit and telephone support. Historic control (2017-2018) and intervention (2019-2020) data were collected from one family health care centre, and control (2019-2020) data were collected from another family health care centre.

    RESULTS: In total, 838 infants, 42 mothers and 38 fathers contributed to the data in the study. The intervention group had a statistically significantly earlier home visit than the control groups. Early home visits and proactive telephone support to parents with newborn infants were not associated with breastfeeding outcomes up to six months after birth, but we could not exclude the possibility that this was a consequence of our observational study design. However, the early home visit was appreciated by the parents where they received both practical and emotional support.

    CONCLUSIONS: Although the intervention was not associated with breastfeeding, the parents appreciated the service. This shows the importance of continuing to investigate how and which support parents of newborn infants need and the effects of such support, including interventions to provide optimal support to facilitate continued breastfeeding.

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  • 22.
    Schmöker, Annika
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Uppsala University.
    Ericson, Jenny
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Center for Clinical Research Dalarna, Uppsala University; Department of Paediatrics, County of Dalarna, Falun.
    Flacking, Renée
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Udo, Camilla
    Dalarna University, School of Health and Welfare, Social Work. Center for Clinical Research Dalarna, Uppsala University; Palliative Research Centre, Ersta Sköndal University College, Stockholm.
    Needs and Perceptions Relative to Emotional Support in Parents With Preterm Infants.2021In: Journal of Perinatal & Neonatal Nursing, ISSN 0893-2190, E-ISSN 1550-5073Article in journal (Refereed)
    Abstract [en]

    Objectives of this study were to explore parents' needs for emotional support and how such support could be best delivered during admittance to a neonatal unit. This study took place at 6 neonatal units in Sweden. Forty-two semistructured interviews were analyzed using qualitative content analysis: 26 individual telephone interviews with mothers of preterm infants 6 to 10 months after discharge and 16 face-to-face interviews with parents of preterm infants admitted to neonatal units. The main category to emerge was needs and preferences for emotional support, which consisted of 2 generic categories: emotional needs and preferences for potential support interventions. Emotional needs define the importance of comprehending the new situation, finding meaning, and managing the situation through resources. Preferences for potential support interventions identify possible ways to deliver emotional support in the form of parental PhD group, diary writing, professional counseling, and Internet support. The results highlight the importance of supporting parents' sense of coherence in their situation and parenthood by offering different interventions according to parent preferences. Parental groups could serve as a keystone for emotional support with the possibility to combine with other support mechanisms.

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  • 23.
    Schmöker, Annika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala University.
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work. Center for Clinical Research Dalarna, Falun; The Department of Health Care Sciences, Ersta Sköndal University College, Stockholm.
    Ericson, Jenny
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Center for Clinical Research Dalarna, Falun; Department of Paediatrics, County of Dalarna, Falun.
    Experienced parental stress and potential predictors up until the preterm infant’s age of 12 months2019Conference paper (Refereed)
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  • 24.
    Schmöker, Annika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala University.
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work. Center for Clinical Research Dalarna, Falun, Sweden / Ersta Sköndal University College.
    Eriksson, Mats
    Hellström-Westas, Lena
    Ericson, Jenny
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Center for Clinical Research Dalarna, Falun, Sweden / Department of Paediatrics, County of Dalarna, Falun, Sweden.
    Longitudinal cohort study reveals different patterns of stress in parents of preterm infants during the first year after birth.2020In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, p. 1778-1786Article in journal (Refereed)
    Abstract [en]

    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<0.001). Stress decreased in mothers during the first year (p=0.018), whereas stress increased in fathers between 6 and 12 months (p=0.048). Mothers of very preterm infants (p=0.024), parents of twins (p=0.038) and parents with lower perceived general health (p=0.003) 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.

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