{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:45:42Z","timestamp":1792057542994,"version":"4.4.0"},"reference-count":74,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp;amp; Child Nutrition"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    In Ireland, while most women express milk for their preterm very low birthweight (VLBW) infants, only a few are discharged home exclusively receiving mothers' own milk, and even fewer are engaged in direct feeding at breast (DFAB). This is in the context of Ireland having one of the lowest breastfeeding initiation and sustenance rates in the world. This qualitative descriptive study aimed to explore parents' experiences and perspectives on sustaining breastmilk expression and DFAB for VLBW infants. Semi\u2010structured interviews were conducted with nine mothers and three partners, and the data were analysed using Braun and Clarkes' (2022) framework for reflexive thematic analysis. The themes developed were: (1) Sustaining breastmilk expression for preterm infants; (2) Navigating the transition to DFAB; and (3) The emotional Journey of feeding a VLBW infant. Supportive conditions for sustained milk expression included access to equipment, skin\u2010to\u2010skin contact, and both practical and emotional support from partners and healthcare professionals. Key influences on the transition to DFAB encompassed infant\u2010related challenges, health system factors and the role of partner involvement. Scheduled support from lactation consultants, midwives and nurses in both hospital and community settings, who have undertaken specialised training on supporting women to breastfeed a VLBW infant is recommended to facilitate the transition to DFAB. Participants identified strategies that could be integrated into a \u2018\n                    <jats:italic>DFAB care pathway\u2019<\/jats:italic>\n                    to provide a structured and consistent evidence\u2010based approach to support women, their premature infants and families.\n                  <\/jats:p>","DOI":"10.1111\/mcn.70193","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:08:51Z","timestamp":1779887331000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sustaining Breastmilk Expression and Direct Feeding at Breast for Very Low Birth Infants: A Qualitative Exploration of Parental Perspectives"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2313-9964","authenticated-orcid":false,"given":"Maria","family":"Noonan","sequence":"first","affiliation":[{"name":"School of Nursing and Midwifery University of Limerick Limerick Ireland"},{"name":"Health Research Institute (HRI) University of Limerick Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivienne","family":"Fitzgibbon","sequence":"additional","affiliation":[{"name":"University Maternity Hospital Limerick (UMHL) Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Keyes","sequence":"additional","affiliation":[{"name":"University Maternity Hospital Limerick (UMHL) Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"McCarthy","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery University of Limerick Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmel","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery University of Limerick Limerick Ireland"},{"name":"Health Research Institute (HRI) University of Limerick Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia Murphy","family":"Tighe","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery University of Limerick Limerick Ireland"},{"name":"Health Research Institute (HRI) University of Limerick Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Atkinson","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery University of Limerick Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre O.","family":"Connell","sequence":"additional","affiliation":[{"name":"University Maternity Hospital Limerick (UMHL) Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Byrt","sequence":"additional","affiliation":[{"name":"University Maternity Hospital Limerick (UMHL) Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Shanahan","sequence":"additional","affiliation":[{"name":"Public Health Nursing Service, HSE Mid\u2010West Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Desmond","sequence":"additional","affiliation":[{"name":"University Maternity Hospital Limerick (UMHL) Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1729-6330","authenticated-orcid":false,"given":"Barbara","family":"Lloyd","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery University of Limerick Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Healy","sequence":"additional","affiliation":[{"name":"University Maternity Hospital Limerick (UMHL) Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy K.","family":"Philips","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Division of Neonatology University Maternity Hospital Limerick (UMHL) Limerick Ireland"},{"name":"University of Limerick School of Medicine Limerick Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2019.04.001"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2017.12.018"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005252.pub5"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-304029"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2016.98"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.179564"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006973"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/2333393617742282"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1704846"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-69909-7_3470-2"},{"key":"e_1_2_10_12_1","volume-title":"Optimising Maternal Breast Milk for Preterm Infants: Part 2 \u2013 To Discharge and Beyond. A Quality Improvement Toolkit","author":"British Association of Perinatal Medicine","year":"2022"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3945\/an.115.010694"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334419851482"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12586"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12618"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.681341"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-021-00435-8"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334417741304"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15534"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2017.0192"},{"key":"e_1_2_10_22_1","volume-title":"National Standards for Infant Feeding in Maternity Services","author":"Health Service Executive (HSE)","year":"2022"},{"key":"e_1_2_10_23_1","unstructured":"Health Service Executive (HSE).2025. Patient and Public Involvement in Research (PPI). Accessed December 2 2025.https:\/\/hseresearch.ie\/patient-and-public-involvement-in-research\/."},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.14551"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334421993467"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13139"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13133"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13470"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334413485640"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2015.141"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e3181d026da"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.07.012"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1361824"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(90)93304-8"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.16230"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0108208"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11071048"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-6037-x"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2021.10.005"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06910-4"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2016.11.005"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2022-009693"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12536"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15254"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13399"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0325592"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.11.015"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40748-019-0101-0"},{"issue":"2","key":"e_1_2_10_50_1","first-page":"7","article-title":"Infant Feeding and Obesity Risk in the Child","volume":"20","author":"Oddy W. H.","year":"2012","journal-title":"Breastfeeding Review: Professional Publication of the Nursing Mothers' Association of Australia"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.0810"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2018.0104"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01932-8"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3330W"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-018-1857-3"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13424"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu9111202"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12457"},{"key":"e_1_2_10_59_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.20362"},{"key":"e_1_2_10_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2010.00446.x"},{"key":"e_1_2_10_61_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06339-9"},{"key":"e_1_2_10_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.10.080"},{"key":"e_1_2_10_63_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANC.0000000000000105"},{"key":"e_1_2_10_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.10.040"},{"key":"e_1_2_10_65_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANC.0000000000000913"},{"key":"e_1_2_10_66_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_10_67_1","doi-asserted-by":"publisher","DOI":"10.1002\/ped4.12339"},{"key":"e_1_2_10_68_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12010044"},{"key":"e_1_2_10_69_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13020486"},{"key":"e_1_2_10_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01024-7"},{"key":"e_1_2_10_71_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12485"},{"key":"e_1_2_10_72_1","volume-title":"WHO Recommendations for Care of the Preterm or Low\u2010birth\u2010weight Infant","author":"World Health Organization","year":"2022"},{"key":"e_1_2_10_73_1","volume-title":"Global Strategy for Infant and Young Child Feeding","author":"World Health Organization, & United Nations Children's Fund","year":"2003"},{"key":"e_1_2_10_74_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_2_10_75_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-2372"}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70193","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.70193","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:56:11Z","timestamp":1792054571000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.70193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,27]]},"references-count":74,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/mcn.70193"],"URL":"https:\/\/doi.org\/10.1111\/mcn.70193","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,27]]},"assertion":[{"value":"2025-08-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70193"}}